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Continued from page 1 MYTH 6. If a mother has an infection she should stop breastfeeding. FACT: Acute infectious diseases in the mother are NOT a contraindication to breastfeeding if such diseases can be readily controlled and treated. By the time the mother is diagnosed, the infant has already been exposed. Breastfeeding should continue in order for the infant to receive mother's antibodies and other host resistance factors in breastmilk.11 11. AAP, 1997 Red Book: Report of Committee on Infectious Diseases
MYTH 7. Jaundiced babies should not continue breastfeeding.
FACT: Early onset (days 3-5) jaundice is due to decreased breastmilk intake. It is the infant form of adult "starvation jaundice". 12 The more frequently an infant feeds in the first few days of life, the lower his bilirubin will be. 13 If mother's full milk supply is not established, or the infant is not feeding well enough to transfer the milk, supplementation with mother's expressed breastmilk or an elemental formula could be used to lower the bilirubin in addition to breastfeeding. 12 Late onset (days 10-14) jaundice is physiologic due to a common factor in mature milk, yet to be identified, which increases enterohepatic reabsorption of bilirubin. There is no need to temporarily discontinue breastfeeding (for 12-48 hrs) unless the bilirubin exceeds 20 (rarely). 14 12. Gartner LM, Herschel M. Jaundice and Breastfeeding. Ped Clin NA, April 2001; 48(2):389-399
13. Yamauchi & Yamanouchi. Pediatrics 1990; 86(2):174
14. AAP. Practice Parameter: Management of hyperbilirubinemia in the healthy term newborn. Pediatrics 1994; 94:558-565
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MYTH 8. Women with small breasts make less milk.
FACT: Milk volume regulation in lactating women is regulated by infant demand. The amount of milk made per feeding and per 24 hours depends on the frequency and completeness of emptying of the breasts, not the size of the breasts. The more frequently and more completely the breasts are emptied, the more milk is made. The size of the breast determines only the storage capacity. Infants of mothers with small breasts may need to eat more frequently to take in the same amount of milk per 24 hrs as infants of mothers with larger breasts. 15 15. Daly SE, Hartmann P. JHL 1995; 11(1): Part 1-pg 21-26; Part 2-pg 27-37
MYTH 9. There is no way to know how much breastmilk the baby is getting.
FACT: Although there is no easy way to measure the amount of breastmilk an infant is getting, you can know if a baby is getting enough. Weight gain and stool volume/characteristics are the best monitors of infant intake. 16 An optimally breastfed infant will lose approximately 6% of birth weight by day 3 17, begin to gain weight days 4-5 (milk "coming in"), and regain birth weight by days 10-14. Thereafter the infant should gain approximately 20-30 gms/day. Stool should change from meconium to yellow, seedy, curdy by day 5. An infant with weight loss > 8% of birth weight or green stools after day 5 requires further evaluation. 16 16. Black L. Ped Clin NA April 2001; 48(2):299-319
17. Marchini & Stock. J Pediatr 1997; 130(5):736-739
MYTH 10. A breastfeeding woman cannot get pregnant.
FACT: Although any breastfeeding does not guarantee against pregnancy, a woman who is exclusively breastfeeding, less than 6 months postpartum and whose periods have not returned (Lactational Amenorrhea Method- LAM) has the same chance of pregnancy as if she were taking hormonal contraception (1-2%).18 18. Labbok M. Ped Clin NA. Feb 2001; 48(1):143-158
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