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Breastfeeding Fact or Fiction?
By Marianne Neifert, M.D.,
Author of Great Expectations: The Essential Guide to Breastfeeding

Now that a large majority of new mothers in the U.S. begin nursing their newborns, breastfeeding is a familiar topic among expectant and new parents. But there may be some facts you still don't know or "things you know that just aren't so" about the natural art of breastfeeding. Test your breastfeeding IQ by answering whether the following breastfeeding statements represent Fact or Fiction.

1. Breastfeeding makes your breasts sag.

2. Breastfeeding is a natural contraceptive.

3. A nursing mother needs to eat an ideally balanced diet in order to make the most nutritious milk for her baby.

4. Once your baby gets teeth, breastfeeding will be uncomfortable, if not impossible.

5. There's no breast pump that works as comfortably or effectively as your own baby.

6. Continuing to breastfeed a 2- or 3-year old will delay their development of independence.

Answers: 1. Fiction; 2. Fact; 3. Fiction; 4. Fiction; 5. Fiction; 6. Fiction

1. Breastfeeding makes your breasts sag.

It is a common belief that lactation causes a woman's breasts to lose shape and sag. However, a recent study by plastic surgeons has found that breastfeeding is not related to losing breast shape after pregnancy. Rather, the degree of breast sagging was found to be related to other factors, including a woman's body mass index (BMI), how many times she has been pregnant, having a larger pre-pregnancy bra size, smoking, and age. Probably the greatest influence on how much a woman's breasts will sag over time is the type of breast-supporting tissues she inherits.

2. Breastfeeding is a natural contraceptive.

Under specific conditions, breastfeeding can provide effective contraception for up to 6 months postpartum. Breastfeeding, compared to feeding formula, causes a delay in ovulation and the return of menstrual periods after giving birth, a phenomenon known as "lactation amenorrhea." Using lactation amenorrhea as contraception after childbirth is called the Lactation Amenorrhea Method (LAM). LAM is a highly effective temporary family planning method for breastfeeding women in the early months after giving birth. Women who continue to fully breastfeed their babies, and who have no vaginal bleeding after 56 days postpartum (i.e. their menstrual periods have not yet returned) have less than a 2% risk of pregnancy during the first 6 months postpartum. It is critical that you meet all three criteria for LAM before using it as protection against pregnancy: (1) You must be less than 6 months postpartum; (2) Your periods must not have returned yet; and (3) You must be fully breastfeeding. Your chances of pregnancy increase if you supplement with formula more often than once every 10 feedings or go longer than 4 hours between feedings during the day, or longer than 6 hours at night. If any one of the above 3 conditions changes, you need to begin using an additional family planning method to protect against pregnancy. (You also should use another family planning method if you are unwilling to accept even a remote risk of pregnancy).

3. A nursing mom needs to eat an ideally balanced diet in order to make the most nutritious milk for her baby.

Concerns about the adequacy of their diet cause many women to doubt the quality of their breastmilk. But a mother's diet doesn't have to be perfect in order for her to make adequate milk and to nourish her baby well. Certainly a healthy diet enhances your sense of well-being and long-term health, improves your energy level, increases your resistance to illness, and helps ensure an ample breastmilk supply. However, skipping a meal, drinking soda, occasionally eating junk food, or disliking vegetables won't adversely affect the quality of your milk. Women all over the world produce milk of amazingly uniform composition, while eating diets that vary widely. The different nutritional components in milk are taken or made from substances in your bloodstream. Whether the protein you eat at a meal comes from fish, eggs, beans and rice, peanut butter, or the most expensive steak, the milk your body makes contains the right amount of human milk protein. If your diet is temporarily deficient in a certain nutrient, such as calcium or folic acid, you will continue to make nutritious breastmilk by depleting your own body stores, if necessary. However, if you have an eating disorder or eat a chronically poor diet, the amount and quality of milk you produce may be reduced. Most expectant moms make an effort to eat a nutritious diet during their pregnancy. Simply continue those healthy eating patterns while you breastfeed. As a precaution, it's a good idea to continue taking your prenatal vitamins during lactation.

4. Once your baby gets teeth, breastfeeding will be uncomfortable, if not impossible.

Although nursing a toothless newborn seems innocuous enough, a toddler with a full set of choppers can make breastfeeding look perilous. However, countless women throughout the world continue to nurse their babies well beyond the time that all 20 primary teeth have erupted. While a teething infant may indeed bite his mother's nipple, nearly all breastfed babies quickly learn the unacceptability of biting. A mother's involuntary, alarming response -- and perhaps the abrupt ending of the feeding -- usually prove effective in curbing further biting. Biting tends to occur toward the end of the feeding, when the flow of milk has tapered and your baby is restless and playful. Once your toothy baby's regular sucking has stopped, switch to the other side or end the feeding before he has a chance to bite. If your baby does bite, sternly say "no," remove your breast, and make sure you don't crack a smile at his antics!

5. There's no breast pump that works as comfortably or effectively as your own baby.

This was a common belief before modern electric breast pumps became available. Today, however, some of the newer hospital-grade and daily-use electric breast pumps mimic the sucking action of a vigorous nursing infant and can actually remove more milk than your baby might take at a feeding! Many at-risk newborns -- such as low birth weight babies, those born several weeks early, newborns with moderate to severe jaundice, or infants with a heart condition or other medical illness -- are unable to breastfeed effectively. Mothers of these infants need to use an efficient breast pump to remove the milk remaining after their baby nurses in order to ensure that they establish a generous breastmilk supply. The extra milk a mom expresses can be used to supplement her at-risk infant until her baby is gaining well and is able to drain her breasts effectively. Similarly, many mothers who have a low milk supply use an effective electric breast pump to signal their breasts to increase milk production by removing any milk that remains after their baby has nursed.

6. Continuing to breastfeed a 2- or 3-year old will delay their development of independence.

In fact, the natural course of breastfeeding often extends into a child's 2nd or 3rd year, or beyond. The American Academy of Pediatrics (AAP) recommends that infants be breastfed for at least 12 months, and as long beyond 1 year as mother and baby desire. According to the AAP, "there is no upper limit to the duration of breastfeeding." Natural weaning is a slow, baby-led process that is geared to your baby's unique developmental needs. What starts out as principally a method of feeding a newborn gradually evolves into principally a method of providing comfort and security for an increasingly independent toddler or preschooler. Late nursing and baby-led weaning do not delay a child's development of independence. Rather, by effectively meeting your child's dependency needs early in life, you ultimately promote self-confidence and independence. Unfortunately, in U.S. society, late nursing -- while perfectly natural and normal -- is often hidden from public view. Many mothers who nurse older toddlers, or preschoolers, resort to "closet nursing," to avoid critical comments from ill-informed friends, relatives, and onlookers.

©2009 Marianne Neifert, M.D., author of Great Expectations: The Essential Guide to Breastfeeding

Author Bio
Marianne Neifert, M.D.,
author of Great Expectations: The Essential Guide to Breastfeeding, also known as Dr. Mom®, is a popular pediatrician, nationally recognized expert in breastfeeding management, and celebrated author of child-rearing books and magazine articles. In 1985, Dr. Neifert co-founded the Lactation Program in Denver -- one of the very first community breastfeeding centers in the nation, sponsored by the Colorado Health Foundation. She is also clinical professor of pediatrics at the University of Colorado Denver School of Medicine. A long-time leader in the field of breastfeeding medicine, Dr. Neifert is a co-founder of the Denver Mothers' Milk Bank, founding member of the American Academy of Pediatrics Section on Breastfeeding, the International Lactation Consultant Association, and the Health Advisory Council of La Leche League International. Dr Neifert has addressed audiences in forty-six states and has been a guest on countless radio shows and national television programs, including Today, Good Morning America, The Early Show, 20/20 and CNN. She has written for numerous publications, including Parenting, BabyTalk, American Baby, and ParentLife.

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