Nancy E. Wight MD, FAAP, IBCLC

As in many facets of medicine and life, we operate with imperfect information most of the time. Although research into all aspects of breastfeeding and human lactation has expanded exponentially over the last 10 years, we still know very little of the basic physiology, pathology, cultural and social overlays of human lactation. In the not too distant past, breastfeeding knowledge was passed from mother to daughter. The scientific method has proven many "old wives' tales" true, and a few false. Below is a collection of myths about breastfeeding generated by the medical establishment, and the research facts to counter them. We hope you find them useful.

MYTH 1. There is not enough milk for the first 3 to 4 days after birth.
FACT: Infants are well hydrated via the placenta at birth. Small colostrum feedings (5-15 ml) are physiologic:

• appropriate for the size of the infant's stomach¹
• sufficient to prevent hypoglycemia²
• easy to manage as infant learns to coordinate suck, swallow, breathing³

1. Scammon & Doyle. AJDC 1920; 20:516-538
2. Williams A. Hypoglycemia of the Newborn: Review of the Literature, Geneva, Bulletin for the WHO, 1997
3. Howard CR et al. Pediatrics 1999: 104:1204

MYTH 2. There is no immunologic benefit to breastfeeding after the first 3 (6, 9, 12) months.
FACT: Although the greatest protection from infection appears to be in the first few months of life, breastmilk continues to contain direct anti-infective factors and immunomodulators as long as it is produced. ⁴ As an individual's immune system is not thought to be fully mature for at least 2-4 years, breastmilk changes over time to meet the needs of the developing infant and child. ⁵
4. Goldman, Goldblum & Garza. Acta Paediatr Scand 1983;72:461-2
5. Goldman AS. Pediatr Inf Dis J 1993;12:664-7

MYTH 3. Breastfeeding past 2 (3, 4, 5, 6) yrs of age is abnormal and causes over dependence on the mother.
FACT: Because age at weaning is culturally determined, not physiologically, the best estimate of the biologically "natural" age of weaning is 2.5-7 years. This is based on anthropologic studies of non-human primates, traditional societies, and historical data.⁶
There is no evidence in the child psychology or developmental literature to suggest that a longer duration of breastfeeding engenders abnormal dependence on either mother or child. In fact, the research that does exist suggests children who breastfed longer are more independent than their peers.⁷
6. Dettwyler KA. Chap. 2, Breastfeeding: Biocultural Perspectives, Aldine de Gruyter, NY, 1995
7. Ainsworth MA: The development of mother-infant attachment. In Caldwell BM, Ricciuti HN (eds): Review of Child Development Research. Chicago. Univ. of Chicago Press, 1973

MYTH 4. Early feedings should be timed to prevent maternal sore nipples.
FACT: Infant feeding patterns vary widely as does maternal skin sensitivity. Sore nipples are usually caused by poor latch-on and poor positioning, further aggravated by unnecessary washing, lotions and creams. Timed breastfeeding does not prevent sore nipples, but does decrease duration of breastfeeding.⁸
8. Slaven & Harvey. Lancet 1981; Feb 14:392-3

MYTH 5. Now that DHA has been added, modern formulas are almost the same as breastmilk.
FACT: Artificial milks (formulas) contain nutrition. Breastmilk contains species -specific nutrition, enzymes needed to digest and absorb the nutrition, direct anti-infective factors, immunomodulators, anti-inflammatory factors, growth and developmental hormones and many other factors yet to be identified. ⁹ Because the factors in breastmilk are multi-functional and interactive, adding an additional factor to formula does not guarantee that it will act the way it does in human milk! Feeding formula in a bottle also discounts the emotional, social and developmental benefits of breastfeeding itself. ¹⁰
9. Lawrence RA & Lawrence RM. Breastfeeding: A Guide for the Medical Profession. 5th Ed, Mosby, St. Louis, 1999; Chap 4-5
10. Lawrence RA & Lawrence RM. Breastfeeding: A Guide for the Medical Profession. 5th Ed, Mosby, St. Louis, 1999; Chap 6

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