Monday 18 June 2018

Banishing the myths around breastfeeding

Nursing mums are bombarded with information, and often it's wrong. Chrissie Russell sorts the facts from the fiction

Young mother holding her newborn child. Mom nursing baby. Woman and new born boy relax in a white bedroom with rocking chair and blue crib. Nursery interior. Mother breast feeding baby. Family at home
Young mother holding her newborn child. Mom nursing baby. Woman and new born boy relax in a white bedroom with rocking chair and blue crib. Nursery interior. Mother breast feeding baby. Family at home
Sharon Hickey Beehan and her baby daughter Kathleen Photo: Michelle Ghee

In association with the Health Service Executive

When it comes to breastfeeding, there are so many myths and misperceptions out there, it's enough to baffle any new mum. From wondering if it's okay to have that glass of wine to second-guessing milk supply, we asked the experts to separate fact from fiction on the topic of lactation.

1. You might have a 'hungry baby' and can't produce enough milk to satisfy them

"The number-one misperception that many mums have is that they don't have enough milk to feed their baby," reveals IBCLC lactation consultant Nicola Dalton on the HSE's support resource breastfeeding.ie. "Not true at all. Nearly all mums have the ability to make enough milk. Only around 5pc of mums genuinely have some trouble producing milk and, even in those cases, there might be things that can be done to help."

Nicola reckons the belief in the necessity of the formula top-up is a cultural one. "We're a couple of generations removed from when breast-feeding was a cultural norm," Nicola says. "I think a lot of mums expect there to be two or three hours between feeds and don't expect the frequency of feeds that come in the early days of breastfeeding.

"Getting to a breastfeeding support group before baby comes along is a great way to get an idea of what to expect." (Breastfeeding.ie has a great infographic for mums to know if baby is getting enough milk (breastfeeding.ie/First-few-weeks/Guidelines-for-mothers).

2. You can't have a drink if you're breastfeeding

Booze was mostly on the banned list when you were pregnant, so surely it follows that there's no alcohol if baby's guzzling your milk, right?

Siobhan Hourigan, national breastfeeding co-ordinator for the HSE's Health and Wellbeing Division, advises mothers that the safest option when breastfeeding is to avoid alcohol in the first month when feeds are frequent. "In the first month you and baby are getting used to breastfeeding: your baby will be feeding frequently and it may be difficult to predict when they'll need their next feed."

After this, she says, if breastfeeding mothers wish to drink alcohol, it should be in moderation. "This means one to two drinks, and allow two to three hours for alcohol to leave the system before the next breastfeed."

A higher alcohol intake is never encouraged as it will have a negative effect on Mum's ability to care for baby (regardless of how she's feeding).

3. You can't breastfeed if your breasts are too small/ too big/you have the wrong-shaped nipples

"In general, your breast size doesn't matter," says Siobhan. "Women with smaller or bigger breasts generally have sufficient glandular tissue or functional breast tissue to breastfeed. Problems are rare but if you have a medical history like thyroid problems or insufficient breast tissue, lactation support is very helpful. A small number of women have inverted nipples, which can make it more challenging to start breastfeeding, but help from your midwife or lactation consultant will help you to get off to a good start."

4. Dads don't have the same opportunity to bond with baby if Mum's breastfeeding

"There are lots of ways that dads can bond with their babies and this bonding is really special," says Siobhan. "Playing with your baby, looking and smiling at your baby, talking to your baby, touching your baby's hands and feet, changing nappies, bathing, dressing…" (Check out breastfeeding.ie/Ask-our-expert/Questions/Can-Dads-help.html if you need any more convincing.)

5. You can't breastfeed if you're heading back to work

"Lots of people think they have to wean if they're going back to work and contact us in a panic because they can't wean quickly enough, but there are often ways around it: it doesn't have to be all or nothing," reveals Nicola. If Mum is returning to work before the baby is six months, she is entitled to one hour of breastfeeding breaks (which can be taken as the hour or broken down, say, into three sessions of 20 minutes). "In this time she can either go to baby, have baby brought to her or express milk," explains Nicola. "After six months, we recommend discussing it with your manager to see if time can still be facilitated, but there are loads of different options. It might mean dropping a feed during the day, then resuming breastfeeding when you're home. If you're ready to wean, we can help with that too - but mums shouldn't feel it's something they have to do."

6. There's no point breast-feeding past six months

"Not so!" says Nicola. "The benefits of breastfeeding never stop. The evidence is stronger than ever that the longer you breastfeed, the better - there's no cut-off point where the milk is not useful anymore."

Where people get confused is that the guidelines suggest exclusively breastfeeding until six months, at which point solids are introduced. But this doesn't mean stop breastfeeding at six months.

"The HSE would say the same as the WHO, which is to breastfeed for two years and beyond, as long as you're happy." Not only do the antibodies in your breast milk help protect baby against infections but evidence shows the longer you breastfeed, the greater your protection against breast and ovarian cancers.

7. On no account should you feel sore when breastfeeding

Not entirely true. Breastfeeding is a new skill to be learned and it may take a while before it feels entirely comfortable. "In the early days, sometimes up to two weeks, some mums feel soreness or discomfort at the start of a feed; this fades as the feed continues," says Siobhan. "Some mums will count to 10 and then the feeling of soreness is gone and she can comfortably feed her baby." However, if the feeling of discomfort persists, it's important to seek help because it might be the positioning of the baby needs adjustment, that baby has tongue tie or some other (usually easily resolved) issue. See breastfeeding.ie for tips on positioning and attachment.

8. You have to eat a special diet if you're breastfeeding

"Not true!" says La Leche League spokesperson Jenny Powell. She suggests reading 'More Breastfeeding Myths,' written by Dr Jack Newman (a member of the LLL International Health Advisory Council). "A breastfeeding mother should try to eat a balanced diet but she doesn't need to eat any special foods or avoid certain foods. You don't need to drink milk to make milk, nor do you need to avoid spicy foods, garlic or cabbage. Although there are situations when something the mother eats may affect the baby, this is unusual. Most commonly 'colic', 'gassiness' and crying can be improved by changing breastfeeding technique rather than the mother's diet."

9. Formula is practically the same as breast milk - sure, don't the ads say so?

"We cannot replicate the wonder of breast milk, and the number of nutrients, vitamins, antibodies and protective factors," says Siobhan. "A mother's milk gives all the nutrients her baby needs, and for the first six months of life it is baby's complete nutrition." The one supplement the HSE recommends all parents use (regardless of whether baby is breastfed or formula-fed) is vitamin D drops for the first 12 months, because of our lack of exposure to sunlight.

10. Certain establishments can ask you to stop breastfeeding in public -there's a time and a place

No, they can't. If someone is offended by the sight of you feeding your baby, that is their issue. "You are legally entitled to breastfeed anywhere. If you're allowed to be there, then you're allowed to breastfeed there," says Nicola. No one has the right to tell a nursing mother to cover up or take her baby elsewhere. "There are laws protecting mothers, and we have a section on breastfeeding.ie on this so every mum should feel reassured."

“As time goes on, it gets easier”

Primary school teacher Sharon Hickey Beehan (36) from Mullingar is breastfeeding her 11-week-old daughter, Kathleen. She also nursed her three other children. She says:

"I find that, with having three others to run around after, breastfeeding is a nice way for me to have time with the baby. It really makes me sit down and spend the time with her.

"I feel lucky that breastfeeding was normal for me in my family. My mother breastfed all nine of us and she was also an LLL [La Leche League] leader. I know it's not the cultural norm, so I can see where it's difficult for other people who don't have that support.

Kathleen Beehan_Cropped.jpg
Sharon Hickey Beehan and her baby daughter Kathleen Photo: Michelle Ghee

"As a new mum, you're so vulnerable: you're just looking for help and advice, and the first place most women look is their own mam. With the best will in the world, most people advise from experience.

"The early weeks are hard - there's no two ways about it! You feel like you've been dropped on your head; there's no night or day, no weekends anymore... Motherhood is hard, regardless of what way you feed your baby. I think sometimes breasts get blamed if a baby is fussier or isn't sleeping, when really it's just babies being babies.

"At the start, breastfeeding is a real commitment - because it's only you who can do it - but as time goes on, it becomes easier. You can bring the baby anywhere and you don't have to be worrying about equipment: that's what I find really liberating.

"I practised breastfeeding in front of a mirror, which helped build my confidence about feeding in public, because it helped show me how little there really is to see - just the back of baby's head! But I've never had any negative reaction. Generally, the only people who notice are other breastfeeding mums!

"Even on my fourth, it's been like going back to the beginning. It took a bit of time to get the attachment right and I had a little bit of soreness. I've a friend who had a baby around the same time and it was good to be able to ask her, 'Are you going through this?' You just want to know what you're experiencing is normal. You need support; you need mammy friends.

"I joined LLL before I had my first boy, who is now nine, and those mums are still my friends today. That's one of the most important things I've learned - you need to surround yourself with a support system. Oh, and watch the baby, not the clock, and just trust yourself."

 

Useful links...

HSE breastfeeding support resource: breastfeeding.ie

If you want to order breastfeeding or other printed health information, visit healthpromotion.ie

Irish Independent

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