Tuesday, September 29, 2009

Common breastfeeding mistakes

Not long ago, I had to face my first ever "are-you-still-breastfeeding" comment, followed by spooky stories about four-year-olds who refuse to wean and are causing daily embarrassment to their mothers. I understand that the longer I breastfeed, the more "haven't-you-weaned-yet" remarks I'm going to hear; and in honor of this event, I'm going to summarize (and add my comments to) a great article I've read (here's the link to the original, in Hebrew) which lists 15 common mistakes that might hamper breastfeeding.

1. Starting by saying "it's great if it works out, it's alright if it doesn't" – breastfeeding is far too important and can encounter far too many obstacles to start out with such an attitude. More often than not, it takes a great deal of commitment, patience and perseverance to succeed.

2. Getting advice from women who didn't breastfeed or had a bad breastfeeding experience. Whether to breastfeed or not is each woman's personal choice, but it really annoyed me when I was told by a certain mother, "you might not be able to breastfeed, I couldn't do it past three months, I didn't have milk" – and when questioned a bit, it turned out that this mother actually started heavily supplementing when her baby was only a month and a half old, because she couldn't find the time to breastfeed as often as the baby needed. I'm very sorry to hear of such a regretful breastfeeding experience of someone who obviously had no supportive environment, but why provide misleading information to another mother?

3. Thinking that if you hear something about breastfeeding from a doctor or a nurse, it's necessarily true. It isn't. Many medical professionals haven't got a clue about breastfeeding, and this subject certainly isn't covered extensively enough in medical schools. I've encountered this numerous times, and already wrote about it here and here.

4. "Let's give a bottle after breastfeeding and see if the baby is still hungry" and "let's pump and see if there is enough milk"; babies are born with a strong urge to suck, even when they are not hungry. Milk pumps can be awfully ineffective; I, personally, can never have letdown with a breast pump; if I need to pump, I can only do it effectively if my baby is nursing on the other breast. Breasts are not bottles and trying to measure them like bottles can be very misleading.

5. "Pain is a normal part of breastfeeding" – it is not! Pain indicates something is badly wrong, such as an incorrect latch, which can also cause lowered milk production. If you are in pain, get help.

6. "It isn't that important to nurse shortly after delivery". Nursing right after the baby is born, while the baby is usually alert and active, is far more important than some of the routine proceedings hospital staff insists to do right after the delivery.

7. Giving bottles (even with pumped milk) and pacifiers while the baby is very young. This can lead to the baby learning and strengthening feeding techniques which are alright with bottle-feeding, but are ineffective and/or painful when the baby is transitioned to the breast. For example, when the baby is bottle-fed, there is no need to open the mouth as wide as during breastfeeding, and there's no waiting until the letdown. The flow of milk is generally faster. Yes, sometimes there is no choice but to use bottles extensively, such as when the baby cannot nurse for a period of time and the mother is exclusively pumping, but when there's a choice, it's so much better to avoid artificial nipples.

I'll stop for now because this is getting a bit long. Coming soon: part 2 of Common Breastfeeding Mistakes.


fairmaiden said...

Though it has been 14 yrs. since I had my last baby I still remember the younger years of breastfeeding well. I loved that season, even with all the trials. I had no support system. My mom was one whom believed the Doctor's when they told her she did not have enough milk to breastfeed and so she didn't even try. When my first born was born he could not latch on. A lactation consultant helped me for three months...the problem was that my nipples we're inverted(I never knew) and it took 2 months of pumping my milk till he latched on. I was so glad I persevered. I never gave him formula...he had to drink my milk from a bottle till my nipples came out enough for him to latch on. Once he did I was able to nurse for his first 11 mos. when I became pregnant again. I nursed all my babies from pregnancy to pregnancy and my last, my fourth child I was able to nurse till he was 2 yrs. old. I got more critism than praise, but I knew what I was doing was the best thing for my children. One day I can help my daughter's with breastfeeding and be the support system that I never had. The longer you nurse the better it is for your child's health.

Coffee Catholic said...

The pain thing is a big issue for me ~ because it's so ignored and not addressed!

There's something wrong with my breasts. They are always in pain and the slightest touch (even when not pregnant) is agony. I tried and tried to get a doctor or nurse to investigate this issue *before* I had children but no one cared! Then, while pregnant, I was simply told: "Breastfeed anyway. Sometimes it's painful for women."

My instincts told me "No way!!" How can something so natural be so painful? So I can't breastfeed. End of story. Problem is, could I breastfeed if someone would bother to investigate my breast pain and possibly treat it??

Coffee Catholic said...

Anna ~ I've been reading in the news about Iran launching nuclear missiles... on your holiest of days no less! Meanwhile Pres. Obama is kissing the backsides of Muslims and Muslim leaders. (And bowing and kissing the hand of the King of Saudia Arabia!!) Things are getting scary.

If you ever need somewhere safe to go, you and your family are welcome to come here to us. You have my contact info. Even if you have to show up unnanounced that's fine.

Anonymous said...

I agree with most of these (as a mom who breastfed all 5 kids, some till age one or two).
However, I must say breastfeeding ALWAYS caused me a great deal of pain in the first two weeks. Maybe I was doing something wrong?? But it was pure torture. The nipples need to toughen up I think (tmi?) and it can really hurt in the beginnning. Although I must say, the various creams out there really help.
Also, those first couple of weeks, each time a woman breastfeeds, her womb contracts. Some of these contractions are very painful, although of course necessary to get back to form. These contractions actually hurt more if you have already had a child or more.
So breastfeeding can hurt, terribly, in the beginning. It should pass by week 2. I always stuck it through because I knew how important it was, but I'm sure the pain deters many.

Anonymous said...

I would just comment that you don't have to be perfect - I made at least two of these common mistakes (with surgery I was unable to nurse immediately, or even for a few hours, and I did let my guy have a pacifier - it gave him something to focus on when he was gassy, other than just his discomfort) and yet we had a great experience, he nursed like a champ, and I had plenty of milk. Everyone is different, and while guidelines might be helpful, you have to find out what works best with your body, your mind, and your baby.

Persuaded said...

Sounds like a great article... wish I could read Hebrew;)

And speaking as someone who nursed her babes well past the "traditional" age of weaning, I can honestly say that I have no regrets whatsoever about our extended breastfeeding. In fact the only regret I do have is allowing myself to be pressured into weaning one of my children at the age of 1yo. I actually did have one of my children nurse until the age of 4, and it was never a problem of any kind. Of course an older nursling doesn't nurse as frequently as a younger babe. They can understand such concepts as privacy and have the self control to respect limits set by mama (such as only nursing at home, during the daytime, or after a younger sibling.) In my experience children that are allowed to self-wean blossom into beautifully secure and independent little people... it's difficult to understand why some folks insist on taking issue with that.

Stepping off my soapbox now;)

Joanna said...

I very much appreciate this article, Anna. I am not yet a mother but my husband and I hope to soon be blessed in that way & I enjoy all the advice that I can get, particularly from someone who I trust in this area. It's a shame that more doctors aren't supportive of doing things the way that God intended.

Kacie said...

I can't believe you're already getting the "is she still nursing?" questions! Unless they're simply curious, which is fine -- but if they're judging you for it, that's just ridiculous. Shira is still a baby! She's a long ways from four years old.

The World Health Org suggests nursing until age 2. At least.

And so what if you're still nursing when she's four? Can't the busybodies find something else to worry about?

Smoochagator said...

I found this post very interesting and informative, and I'm looking forward to part 2. I'm not yet a mother, but when I do have children, I want very much to breastfeed and I anticipate some bad advice coming my way. It's wonderful to hear insight from a mom who is committed to her child's health and who has made breastfeeding work. Thank you!

Anonymous said...

Preach Sister, PREACH!

I have encountered all of this. And as for weaning. Each child is different and each situation is different. My four year old didn't totally wean until she was three and a half....because I encouraged the breast feeding to get her through two very serious illnesses. And, IT DID!

My second is two and weaned several months ago. Lost interest.

I leave it in God's hands and everytime someone has "advice" for me I have found that they either never even tried breast feeding or gave up in a week.

Breast feeding is a marathon, not a sprint. The child needs to train and develop endurance. They cannot be expected to nurse like a nine month old...as a newborn. And a nine month old cannot possibly be expected to need the same amount of milk. Obviously they need more milk because they are BIGGER :)

Anna, you may like this. A woman told me...with certainty, that all breast milk turns to water on the child's first birthday.

She said it was a medical fact. I tried not to laugh hysterically (I used to be a medical writer and read studies on breast milk for fun) but I was SHOCKED someone could be so unimformed and uneducated AND be so into telling everyone this misinformation and insisting against all reason that it was true. Goodness, how many new Mama's has she discouraged?

I basically don't listen to anyone unless they have successfully breast fed a child over a year old. And anyone who feels it is too much work, well, we know where they are coming from....

Many Blessings :)

Alycia said...

I'm stunned that you are already getting comments about the fact that you are "still" breastfeeding Shira! I nursed my son until he was 34 months old (right through my second pregnancy and several months beyond), and I am currently nursing my 15 month old daughter while 8 weeks pregnant with my next child.

It's funny - while I was totally confident that I was doing the right thing by nursing my son for at least two years, I still started feeling sheepish about it as he passed the one-year mark. This time, my daughter still seems like such a baby to me that I would probably look at someone in shock if she asked me if I was "still" breastfeeding her. Of course I am!

Good for you for continuing to nurse your little one in the face of negative comments.

Anonymous said...

Very good advice. I breastfed one of my kids for 2 yrs-wish it was longer. She's very well adjusted. La Leche league was very helpful to us when she had "latching on" problems at the beginning. They are in many countries. Rita

Anonymous said...

"Coffee Catholic" is so sweet in her offer. I firmly believe that there is no place on earth as safe as Israel. I love the verse, "He who watches Israel will neither slumber nor sleep." Anna, do you have room for all of us over there? :-) I wish! We just continue to trust and believe that the Lord is in control.
Mrs. L.

Jennifer said...

Hello Anna.
I, too, have nursed all 5 of my babies, although my milk dried up at 6 weeks when my eldest was little. But that was due to medication I was taking and so I had plenty of milk with the other ones. So I have been on both sides: the breastfeeding only camp and the formula camp. I love breastfeeding, but I'm also sensitive to those who don't because I have been there.

Number 5 child was the only one whom I weaned. The other ones weaned themselves once I became pregnant. I suppose it's because my milk changed flavor with all the hormones running through my body. The earliest one to wean was 9 months old. I wasn't ready for that one! But the other 2 were close to 12 months and to be honest, I'm ready to stop by that time. Not that I think there is anything wrong with going longer that 12 months or so, but it just hasn't been something I've desired to do. I'm usually expecting by then anyway and I'm ready to stop.

I have given pacifiers to all my babies and I have never had a problem with "nipple confusion", as some say you will/might. In fact, I tried to not give a pacifier to one of my children,(I thin it was #4) but they began to use me as a pacifier and I quickly put an end to that one! If you have a conviction not to use one, by all means, don't use it. But if you do use a pacifier, don't let others tell you it's wrong.

Number 6 is due in about 16 days (actually, my due date is in 4 days, but I average 8 days over with my babies. So I'm telling people to expect on in about 2 weeks or so)! I am so ready to meet this little one! And to be able to nurse again, too. We are having our first home birth with a midwife for this one and I am really looking forward to it.

Jennifer D

Loving All Mothers said...

Thanks so much for this article! Congratulations on your little one! It's wonderful that you're breastfeeding and for so long. :)

I am perplexed about something though. My intention is not to be confrontational, but I am legitimately curious about the to breastfeed or to not breastfeed "mommy war". Can someone explain why breastfeeding is so so important? Some mothers become very angry if they find out another mother is not breastfeeding... they criticize the doctors, saying mothers are ignorant because they don't know the in's and out's of breastfeeding, they're not bonding with their baby, etc, etc, etc.

I was a formula baby and I'm healthy(I didn't grow a 3rd eye. LOL!) and my mother never said she didn't bond with me because she made the choice not to breastfeed. My husband was a formula baby as well.

This comment from ACE threw me for a loop:
"I basically don't listen to anyone unless they have successfully breast fed a child over a year old. And anyone who feels it is too much work, well, we know where they are coming from...."

Where are they coming from? Because she felt it's too much work, she's casted aside? Is a mother not worthy to listen to because she didn't breastfeed a child for over a year? I look at this comment as being too proud and looking at someone as if they're beneath you.

Since when are mothers not supportive of each other? Since when is it honorable to judge a person if they choose to raise their family differently they we do? If a mother chooses to use formula, why can't we just be supportive of her?

We mothers need to stick together, be understanding, and not to pass judgement. Think about the fear, anxiety ,and stress a mother must feel when someone puts her down for not breastfeeding or telling her she's not doing something right in your opinion. It's a difficult world and the more support we get from each other, the more harmonious and joyful life can be.

Here are a few quotes from an article that hits the nail on the head: "We live in a society that wouldn't dare pass judgment on even deviant sexual practices, but we can't let women make their own decisions on how to diaper their children."

"Parenting is one of the most important vocations we can be given. Yes, the obligations of childrearing are difficult, but when the duties are fulfilled with the knowledge that we are doing the will of God, our reward is great. God has placed me as the mother of my children. So long as I'm not sinning, I am free to serve my children as I see fit."

"Sure, we all have a role to play in upholding community standards and making sure our neighbors' children have their needs met, but we should also be careful not to intrude on others' vocations. Just as we wouldn't rearrange colleagues' offices or tinker with their computers, neither should we presume to know best how they should manage their families.

So if you're an overwhelmed mother, wave the white flag of surrender in the Mommy Wars and enjoy your vocation and the freedom it provides."

White Flag in the Mommy Wars
The theology that many parents are missing.

Anonymous said...

Something I have heard as fact from the doctor is that if you wean you cannot begin nursing again until you have another pregnancy...I stopped nursing my first at 6 months because my brother-in-law was having a fit..He had to ask if I was still nursing so it wasn't an immodesty issue..and I was so shocked I stopped that day. A week later I regretted the whole thing and put her back on the breast for a few weeks and the milk came back in! My sister had to travel for work and left her 18 month old behind, when she arrived back after 2 weeks she began nursing again and continued another year. This can't be that uncommon if it happened to both of us ? Lots of wonderful things to find out.

Bethany Hudson said...

Ah, yes, those comments are fun :) Most of the time, people ask out of genuine curiosity, but when they ask just to gawk...*sigh*

I appreciated your thoughts here, and I agree with every single one. It astonishes me that such inaccuracies are not being debunked by the medical professionals. Thank goodness for lactation consultants, midwives, and breastfeeding mamas!

Coffee Catholic- I'm so sorry to hear about that! Certainly, I would think that something would be wrong. Have you spoken with a midwife or lactation consultant? I have found that they seem to know MUCH more about these things than your average OBGyn. Prayers! That is really rough.

Inca said...

This may not be popular here...but there is one more item that should be added to this list:

If you have made as much effort as you feel capable of, and the nursing is still not working out, DO NOT FEEL GUILTY OR INADEQUATE. It is okay and your child will be okay too.

Anonymous said...

Everything seemed to conspire against my nursing my 2nd daughter - from a hospital staff pediatrician who wittheld breast milk because of newborn jaundice (it was severe enough for her to go to intensive care for a couple days) to a sitter who kept telling me my milk wasn't strong enough because #2 was skinny (we found a new sitter as soon as we could). My husband also was not that supportive with sticking to the regimen and working through difficulties, even though he supported my decision to breastfeed. #2 never had a good latch on and I believe that's part of the reason for her skinniness. Maybe I should have consulted an expert.

We found a good pediatrician who fully advocated nursing until the child gives it up. I finally told her, "no more" when she was a little over 4 years old. Neglectful mom that I am, I was tired of nursing after 4 years! I wasn't convinced I was serving as anything more than a human pacifier by that point, anyway, though she insisted she got milk. (I wasn't able to express any, so I wasn't convinced) Of course, by then, it was only part of the bedtime routine. She fussed a bit for a couple nights, but accepted the rocking & cuddles and the same lullaby repertoire and did fine.

And ... to quote a friend of mine ... you should nurse only until the child is old enough to bring friends home for lunch!

- Sally

Heather said...

Thank for writing this! I am expecting my first baby in about four months, so this is very timely and helpful information. I look forward to part 2! And I hope you and Shira have a long and happy nursing relationship.

Anonymous said...

I remember a story a friend told me. I don't know how old her nursing baby was at the time but old enough that when his older sibling asked him, "What does it taste like?" he replied, "Peanut butter!" Too funny!
Mrs. L.

Lena said...

Its nice to hear about your belief in breastfeeding, you are right, it is a commitment a mother has to make to nurse her little one, it is hard for the first month or so, but then its the best experience ever.

Anonymous said...

Dear Anna,

I would like to respond to Loving All Mothers since she was offended by one of my comments.

Dear LAM, I would like to remind you that my comments were in a context. That context being that Anna was discussing the comments she was getting and debunking myths.

I also was told over and over by my in-laws that there was no way I could nurse my babies because they were not able to (My MIL never tried because she went back to work and SIL gave up after the first two weeks which someone on here already correctly said is some of the most painful weeks because of uterine contractions and the Baby is learning to nurse).

I was also pressured by an ignorant pediatrition who told me I was STARVING my 20 something pound 3 month old (who was only 7 pounds at birth) and insisted I take a case of formula home with me. Needless to say, this same idiot who also told me it is IMPOSSIBLE for a baby to teeth before a year..when mine cut her first tooth threw at 3 months...was not my ped after that horrific appointment.

IN THAT CONTEXT please read my comment again. I stand by it. I don't ask fat people how to lose weight. I don't ask those in horrible debt how to handle money. I don't listen to parents with unruly children on how to parent mine.

I look towards Mothers who are SUCCSESSFUL in the areas I want to be successful in and take their advice because...they are successful. Someone who either never tried to nurse or gave up or had some kind of medical reason will not HELP me with continuing to nurse successfully. I am not judging them, I am just not looking to them for wisdom on nursing. I think this is common sense!

I am not here to celebrate all Mothers, not all Mothers are good.

This was a post on nursing, I think my comment was clear and concise. Those who would have negative comments towards Anna, Me or others who nurse are...in my experience...curious, ignorant or against nursing (there are some bold enough to tell others they are disgusting and abusing their child ).

I understand you want some kind of unity and support for all women. That is very nice of you. However, I have found that there is good and bad, evil and Holy in this world and I am not looking to get along with everyone. And frankly, that has nothing to do with this post.

The post was to enourage other who would or will Nurse. It wasn't to touch on every thing that could possibly go wrong, all the different ways to decide to do it or not to do it and to make sure no one in no way was offended.

Too much time is spent not giving actual information and education in this world and instead running around trying not to hurt anyone's feelings.

I wasn't trying to hurt yours or anyone elses. I was relaying my experience.

Thank you Anna, I apologize for being so long.

Many Blessings :)

MamaOlive said...

Very helpful article, but I do have to take exception to #5. I'd heard that before, and so obviously I was "doing something wrong." But no, experience (I've done 6) has shown that breastfeeding DOES hurt. The first 6 weeks with my first, and slightly shorter times for the others, were excruciating. There's just a toughen up time involved. It gradually eases after that.
I don't believe it is helpful to tell women that there *should be* no pain. If I believed that was the case, I'd assume I wasn't made to breastfeed and just quit. But knowing pain is normal gives me strength to continue.

Lady M said...

Loving All Mothers,
I believe that Ace was meaning that she was not listening to breastfeeding advice from someone who had not breastfed for at least a year. Not that she would not listen to anyone.

Please do not misunderstand me here - there are legitimate medical reasons for not breastfeeding (cannot say that I blame CC - ouch!).

Breastfeeding is so very important because of the health benefits that the child receives. It will, ultimately, stick with them into adulthood. Did you know that breastfeed causes your child's palate to form properly? I often wonder if that is why so very many children need braces these days. The amount of children wearing braces these days is astounding - and I often wonder if it is because they received a bottle instead of a breast - just my own thoughts there, nothing professional by any means. The long term health benefits are amazing and I suspect that because long term breastfeeders are just now becoming more common, it will be a while before a study of some sort is done that might reflect that. I guess I always figured that since ones breasts naturally produce milk after having a baby, there is some serious good in it for the person. Did you know that YOU benefit from nursing your child? There are studies that reflect significant reduction in risks to specific cancers if a woman breastfeeds her children (for more than a few weeks)?

Just some food for thought. A quick search of the internet will reveal so much more than the space allows here. OH - and breastfeeding is also a wise use of the money in the household - no expensive formula, no bottles to wash and a healthier child (thus, fewer dr. visits).
On a side note, my SIL was told that once you were past 6 weeks, there was no more benefit to the child (ARGH!) and because it came from someone who was an LPN (? - not an LC!), she believed her and switched the child to formula. The other SIL put her child to the breast ONCE in the hospital, decided that since she was tired and was overwhelmed due to an emergency C-section that she did not want to mess with breastfeeding....I cannot imagine what it was like when she got home - now, instead of resting in bed, she had to get up and make bottles, etc. - when the baby would have been right there in bed with her. Sigh - and yes, if I had not been on bedrest, I would have been there to help her anyway I could.

Baby G turns 1 tomorrow. Due to my nipples being large and he a couple weeks early, we had some latching issues. I had to pump almost exclusively the first couple of months. I was so glad when he could latch properly. Other than a couple of emergency bottles that first couple of weeks (initially could not keep up with him until my supply was built back up), he has had only breastmilk and is still nursing. My older 2 nursed for 18 mos and 15 mos respectively. I suspect Baby G will be on the 18 mo. end of it. If there is a problem, it can be done, but it takes persistence, diligence and the thought that this is absolutely the best for ones child. I knew I would do just about anything to make sure my child got to breastfeed.

Please understand that those of us who have breastfed are only adamant about breastfeeding because we know how much we and our children enjoyed it!

Anonymous said...

Just some thoughts on what you wrote:

My nursing training was extremely pro-breastfeeding. I also deilvered my baby at a hospital where breastfeeding is very strongly encouraged, and the small amount of formula they do keep on hand must be logged out.

And I also started my daughter on a bottle (of pumped milk) at 3 weeks old, once a day or so to get her used to it.

She is still nursing at 13 months old, usually once a day before bed and I'm happy to say she never had a drop of formula.

Nurse Bee

Sarah said...

another one in the "it hurts" camp here. quite apart fromt he fact the i was on such strong painkillers that i didnt realise baby wasnt latching properly until i wasnt on the painkillers any more...

for the first 3-4 weeks, letdown felt like the milk was made of molten lava. it was all i could do not to scream and rip the baby off. after the first 2-3 sucks, i felt like my entire breast (both actually as it lets down on both side simultaneously) was being boiled from the inside out. but that goes away.

its only when the pain is persistent that theres a real problem that needs to be seen to.

and of course once those teeth come in.. fun times.

Jia said...

Well, I'm not a mother but when I did my pediatric rotation, I don't know of any doctor or nurse that was not pro-breastfeeding. I can say that even as first and second year medical students, we were given more than ample information on the benefits of breastfeeding. Perhaps the doctors you met who did not understand the benefits of breastfeeding came from an older school of thought.

Also, people who speak of negative breastfeeding experiences may not be trying to deliberately mislead you, but offering up what they remembered as a bad experience.

Those that offer you their negative experiences (however incorrect) may no more trying to "mislead" you than you are when trying to incorrectly remember something. People will remember things surprisingly inaccurately.

And I think it's prudent for anyone trying something new to ask for a variety of feedback. Just hearing about how 'great' something is may discourage you when you find the experience anything less than awesome, and it may deter you from seeking guidance if you don't realize others also shared your struggle.

I had a friend who was a "hardcore" breastfeeder until she gave birth to a sick child who was 'allergic' to her milk (actually the child had a enzyme deficiency and could not break down protein...). She ended up not able to breastfeed but the special formula given to him probably saved the child's life. I would hate to think the guilt she felt if/had she felt breastfeeding was the only acceptable option.