By Dr. Maya Bunik, UCHealth
For new moms, smart phones are lifelines. They use apps to track their babies’ feedings, diaper changes, naps and growth. We all love hopping online whether we want reviews, an idea for dinner or to learn a new skill. Want to know how to knit or get the kinks out of bent window blinds? Someone on YouTube can teach you.
While we have more sources than ever to gain knowledge, I’m finding that the mothers who come see me are drowning in misinformation. It’s no surprise since many are exhausted, overwhelmed, isolated and vulnerable.
They need help and babies are hard to read.
A recent Google search for the words “breastfeeding problems” yielded 33 million results in less than a second. Sadly, my most trusted, go-to sources don’t rise to the top and some require subscriptions. Based on my experiences seeing patients, writing books on breastfeeding and conducting research, I tell mothers that 50 percent of breastfeeding recommendations are evidence-based and well-studied, while 50 percent are not.
What gets lost in all of our searching is an intuitive approach. Instead of talking with trusted friends, family members, spouses and partners, or seeing a qualified lactation expert, mothers are reaching for their phones. Yes, they’ll get some information and solace. They’ll know they are not alone in this breastfeeding journey.
But in the first three to four weeks after a baby’s birth, it’s critical for mothers to get a good start. And that means they need accurate information, not misleading myths like the following:
Myth No. 1: My milk supply is low. Fact: infants need very little milk and most mothers produce plenty of milk. Many mothers pump their milk to try to boost milk supply because they believe their infant has lost too much weight in the first few days. If mothers are not pumping exactly one ounce per hour, they panic and start supplementing. This can lead to a vicious cycle. Milk volumes have been well studied and healthy infants take as little as one to one-and-a-half ounces per feeding. At a year, most infants take in a maximum of four ounces at a time. Why are there eight-ounce bottles on the market? (Most adults would be satisfied with four ounces of whole milk; eight ounces would be too much.) We also know that mothers make the most milk in the wee hours of the morning when prolactin levels are highest and much less in the late afternoon. Variation in milk production is normal. I tell mothers that good milk supply in the morning is a great sign.
Myth No. 2: So-called “power pumping” boosts milk supply. Fact: Putting your baby to the breast and pumping every few hours is far more beneficial. Some bloggers promote the idea of pumping 10 minutes on and 10 minutes off over a two-hour period. There’s no evidence to support this idea. It’s crazy and exhausting. Spend time with your baby instead, singing, cuddling or putting your baby to the breast if he or she seems hungry. Or if your baby sleeps, you could take a “power nap.”
Myth No. 3: Herbs boost milk production. Fact: Breastfeeding and pumping build milk supply. All moms are concerned that they’re not producing enough milk. And many believe that herbs like fenugreek, anise, thistle, alfalfa and even lactogenic oatmeal cookies will boost milk production. One study found that mothers felt their breasts were more full after drinking a lactation tea, but there was no change in milk supply. Breastfeeding mothers need to stay hydrated. They also need plenty of food and rest. If mothers focus too much on herbs, I worry they won’t be using proven strategies to boost their supply. Research shows us that frequent breastfeeding and pumping at least six times every 24 hours boost milk supply. Working with a trained doctor or a certified lactation consultant to asses pre- and post-feeding weights can also give mothers confidence that their babies are getting enough milk and doing fine.
Myth No. 4: Fussy babies aren’t getting enough to eat. Fact: sometimes fussiness isn’t tied to hunger. It takes time for new parents to learn to read their babies’ cues. Sometimes fussiness isn’t related to hunger. Some babies can be fed too much. This can lead to spitting up, which can cause discomfort and more tears.
Myth No. 5: Swaddling harms a baby’s motor development. Fact: Swaddling comforts many babies and there’s no evidence of harm for motor skills. Wrapping new babies tightly in blankets can duplicate the feelings of warmth and safety in the womb. Swaddling can reduce fussiness and help babies sleep better.
Myth No. 6: Many infants need surgeries or laser treatments to fix tongue or lip ties. About one third of the patients in my clinic have already had their infants’ tongues or lips clipped. Photos of both conditions abound online. A prominent pediatric dentist near our hospital even advertises this service on his phone tree: “Press one for lip or tongue procedure.” Mothers who are struggling to breastfeed often pay out of pocket for unnecessary procedures. Lip- and tongue-tie repairs may be unnecessary. Getting them can delay mothers from seeking evidence-based evaluations and help.
Myth No. 7: Prematurity doesn’t affect breastfeeding. Fact: the earlier babies arrive before their due dates, the more they may struggle. Babies born between 36 and 39 weeks gestation can struggle to breastfeed. Sometimes they don’t latch well, are sleepy at the breast and have had bilirubin problems and have lost weight. With time and help, many mothers of preemies can help their babies breastfeed.
The truth is that babies sometimes need a little time to get good at breastfeeding. Especially if they are sleepy or have tight oral musculature or are small mouthed, babies need time to get up to speed and their mothers need support. Pumping in the early weeks can be key, but it can also be exhausting.
I tell moms to do something fun when pumping rather than watching for drops of milk. They can listen to a podcast or an audio book. Or they can binge on a show.
I just hope they won’t be searching for online advice.
Maya Bunik, M.D., M.P.H., F.A.B.M. and F.A.A.P., practices at Children’s Hospital Colorado and at UCHealth’s University of Colorado Hospital. She’s the author of Breastfeeding Telephone Protocols and Advice and oversees the Breastfeeding Management Clinic at Children’s Hospital Colorado.