‘Breastfeeding myths and why they can cause difficulties’ guest piece by Donna Walls with intro by Jess Fedenia

Our blog’s namesake is steeped in mythology.

While researching classical breastfeeding images for their Icons of Breastfeeding presentation, Cindy Turner-Maffei and Karin Cadwell came across art like Tintoretto’s The Origin of the Milky Way and Rubens’s Birth of the Milky Way.

“We were thrilled to find that the milk of a Goddess was thought by ancient peoples to be the source of our Galaxy,” Turner-Maffei shares. “This concurs with our view that breastfeeding is a core experience of human life.”

She and Cadwell retold the classic Milky Way story in their book Case Studies in Breastfeeding: Problem-Solving Skills & Strategies:

​[Jacopo Tintoretto’s beautiful painting, The Origin of the Milky Way, depicts] “the Greek God Zeus (Roman name Jupiter) bringing baby Herakles (Hercules) to suckle at the breast of the sleeping Goddess Hera (Juno), Zeus’s wife. Zeus wants Herakles to receive the milk of a goddess, because it bestows immortal life, and will make Herakles into a god. Zeus anticipates that Hera will not willingly provide her milk to his love child [born to mortal woman Alcmena]. Therefore, he tries to sneak up on her while she is sleeping. However, foreshadowing his adult strength, the baby Herakles attaches forceably to Hera’s breast, awakening her. Hera reacts by pushing the baby off her breast. Her milk spurts forth into the heavens, and creates the stars of what becomes our galaxy, the Milky Way.” (Cadwell & Turner-Maffei, 2004, p. xi)

In a recent piece, we shared an excerpt from Radical Mom Union’s Natasha VC’s Let us Admire the Lactating Fountains of Italy: The most powerful representation of nature in art is a lactating woman. 

“The Fontana della Spinacorona is a marble representation of the mythological founder of Naples, the winged siren Parthenope. Legend has it that the siren shot her breast milk onto the flames of the volcano Vesuvius to extinguish the fire. The work bears the Latin inscription Dum Vesevi Syrena Incendia Mulcet: ‘while the siren of Vesuvius calms the flames’…I must point out how absolutely METAL that is!!??? BREASTMILK TO EXTINGUISH THE VOLCANIC FLAMES OF VESUVIUS!!!!…”

She goes on, urging, “Think about that for a minute. We typically think of a postpartum woman as weak, drained, struggling. Here, the nursing mother with fountains of milk shooting from her ample breasts, puts her on par with the gods of the sky and sea. PURE, RAW POWER, que bella!” 

Mythology offers powerful and inspiring pieces of lore, but myths as we have come to know them in modern times, can be powerfully harmful. 

The visionary Linda Smith covered breastfeeding myths on Our Milky Way over a decade ago. Many persist in our culture today.

Praeclarus Press recently released Breastfeeding Myths: Busting the Misinformation Harming You, Your Baby, and Society by Lucy Ruddle. Unicef offers a page to dispel breastfeeding myths.  Lactation care providers and maternal child health advocates address breastfeeding myths ad nauseam, and sometimes, we’re tasked with unlearning of our own. 

This week, Donna Walls RN, BSN, ANLC takes the opportunity to dispel some myths she often encounters in her guest piece titled Breastfeeding Myths and Why They Can Cause Difficulties. 

Donna is a frequent contributor to Our Milky Way. You can read her other pieces here. 

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Some breastfeeding myths seem to continue unchecked for decades. It seems no matter how much we teach, preach, beg, educate, cajole and insist, they persist. So, I guess I’m going to take one more swing at setting the record straight and hope we can dispel some of the more common ones. 

Myth #1

Some women are just too stressed or ‘high-strung’ to breastfeed. Successful breastfeeding requires relaxation. 

Nothing could be further from the truth. We know women have been successfully nursing their babies in highly stressful situations for eons. During times of war, weather disasters, personal crises, physical illness, financial distress, and so on and so on,  they continue to make the quantity and quality of milk needed for their babies to thrive.

It would be very difficult for our species to survive if a stressful, anxious situation was all it took for our milk supply to shut down. This applies to widespread situations such as wars as well as individuals’ situations. When a new baby is brought into the family, whether it’s the first or fourth, it’s an adjustment. Changes in lifestyle, activities of daily living , sleep patterns and emotional adjustments…no one escapes without some moments of anxiety.  It’s a good thing our bodies are designed to do everything it can to nourish and nurture the next generation.

Truly, prolactin is a wonderful hormone! We know it is responsible for milk production, but it is also actually involved in moderating stress responses in males, females, lactating and non-lactating mammals. In simple terms, it has a stress-reducing, calming effect. Even more amazing is our ability to actually increase our prolactin production in times of acute stress. In one NIH study, the levels of prolactin were significantly increased in women who reported long-term stress and resulting depression. So busting this myth should be easy; not only does stress not reduce milk supply, it can actually increase our levels of milk-producing prolactin and help to calm frayed nerves in the process.

Myth #2

Your milk will “come in” about day 3 or 4 postpartum.

This one could be one of the most harmful, because it’s an all-too-common phrase repeated continuously, everywhere. Unfortunately, new mothers, already worried about not having enough milk, are told this as a routine part of breastfeeding education and can result in mothers becoming discouraged in the first hours and days of breastfeeding. We commonly hear them express their fear of “starving” their newborn. Mothers have milk for the first feeds. We call it colostrum, but it’s milk! They have heard about  breasts being so full it hurts, but they don’t see or feel that yet. The perpetuated message is clear but untrue: ‘You  really don’t have milk now, but in 3-4 days, your milk will “come in” so don’t worry!’ This confirms moms’  number one concern about not having enough milk.

Truth is, colostrum is produced beginning about halfway through the pregnancy and is present, and designed for, the first feedings. Could it be that because we label it colostrum it is not perceived as milk?

It would be great if we could completely ditch the term “milk coming in”, reassure prenatal and new moms that they DO have milk (albeit called colostrum) available for the first feedings. Could we change our terminology from “milk coming in” to milk changing over to mature milk? Could we change the name of colostrum to “newborn milk” which sends the message that this is indeed milk?

Myth #3

You will need to give up the foods you like while breastfeeding.

While false, the lists of no-no foods can be quite extensive. No spicy foods are usually at the top of the list. It makes you wonder about all those babies in cultures that have curry, garlic, and chili peppers as a staple of their diets. Babies in Italy or Mexico aren’t fussier babies than in America or Sweden. Many years of work by Julie Mennella clearly demonstrates that newborns accommodate to the smells and tastes of their culture through exposure to those smells and tastes in the amniotic fluid. Infants learn to like the foods that are normal in their mother’s diet before they are born!

While we are on the subject of foods,  another persistent and incorrect myth is that of the need for the “perfect diet” with extra calories to be able to breastfeed. It doesn’t take a lot of research to look at nursing mothers around the world and realize that successful breastfeeding and healthy infants are not reliant on the perfect diet. Women have breastfed in the most dire of circumstances without negative consequences to their babies. The misinformation stating that lactation requires a significant addition of calories, sometimes as many as 1,500/day, to successfully nourish her infant still persists. This can be discouraging to a new mother, anxious to lose pregnancy weight. I think we have all heard concerns expressed that maybe breastfeeding is not the right choice for those wanting or needing to lose postpartum weight. Again, not true. In reality the current CDC recommendation for calories during lactation are an additional 330-400 calories for maternal health, not for milk production. And remember, it’s not just calories but what foods are recommended. Eating a bag of processed chips gives you calories but does not contribute to better maternal health!

Myth #4  

Your breasts are too big…too small. Your nipples are flat…too big…too small.

Oh how we love to judge nipples and of course, make sure the mother understands she does not have breasts or nipples that are perfect for breastfeeding. Then we wonder why women struggle in this culture to breastfeed. Maybe because we work so hard to destroy their confidence even before the newborn goes to breast for the very first time. 

Care providers take one look and diagnose flat nipples, rarely considering how they actually function. Anatomy 101 reminder! Nipples are erectile, they stretch when stimulated. So when the baby touches the nipple either with their hands or mouth the nipple erects, some a little, some a lot. Sadly, many women compare their nipples to an artificial teat and worry that theirs is not the same, not quite right. Let’s set the record straight, we have the gold standard nipples, the rubber ones are a pathetic imitation! 

And consider human infant feeding compared to other mammals. Many other mammals have long, exaggerated teats designed for the offspring to slurp it in and suckle the teat. Human infants breast feed- not nipple feed. Our offspring open their mouths wide and attach to the breast, not just the nipple. Correct latch involves the baby taking in lots of breast tissue. If they are sucking on just the nipple it will cause discomfort and result in inadequate milk transfer. It  makes you wonder why we get so “judgy” about nipples! Let me take a moment to reassure you that babies don’t have a pre-set idea of measurements they want in a nipple. No, they want the one attached to their mother.

Nipples too big? I have seen small premies open wide and attach to nipples deemed “too big”. Did we forget to tell the infant that their mouth was not the right size to nurse? Asymmetric latch, with the baby starting nose to nipple, coming to the breast chin and bottom lip first, then bringing their head forward in an “up and over” motion can work like magic for little ones.

So before we start judging nipples and breasts, branding them not quite right, let’s first remember our number one job is to build the mother’s confidence and support their breastfeeding journey.

Myth #5

Drinking a lot of water will help you make more milk.

Another persistent one and untrue. I still read it in books and see it on well-meaning how-to websites which state that if you’re concerned about your milk supply the answer is easy: drink more water. Sometimes the amount can be more than a gallon a day with frustrating results. These results are spending more time in the bathroom and less time with your baby. Sadly, this shortcut skips asking pertinent questions like: 

1. How often are you nursing? The answer should be 10-12 times/24 hours.
2. What is the baby’s output? The answer should be at least 4 urinations and 4 stools, with the stools changing color to a golden yellow and the urine a pale yellow, by the fourth postpartum day.
3. What is the baby’s weight gain pattern?  It should be no greater weight loss than 7% in the hospital, no further weight loss by day 5 and regaining to birth weight by 14 days.
4. Have there been changes in the mother’s breasts?  Ideally noticing fuller breasts in late pregnancy and breast becoming rounder, fuller, firmer and heavier as the milk composition changes over to mature milk. 
5. Is the baby latching comfortably? Correct latch facilitates optimum milk transfer. 

Shortcut answers like “just drink more water, eat oatmeal cookies, or drink lactation tea” bypass the need for assessment and can ultimately lead to poor outcomes for the newborn. Rather than setting arbitrary amounts of water, encourage mothers to drink enough to quench her thirst. Some research even shows drinking too much water can actually decrease milk production.

Myth #6  

Breastfeeding is hard and difficult to learn. 

Perhaps the saddest of the myths is that breastfeeding is so hard that your chances of success are really quite low. Breastfeeding is NOT difficult nor is it hard to do. Let me clarify: There can be difficult situations that arise but the vast majority of “problems” are generated by a hospital system or other systemic issues that are not designed to foster successful breastfeeding. Systems that separate mothers and their newborns might be the biggest reason for difficulties. When the newborn is immediately removed for the “experts” to tend to the baby, the message is that we can do a better job of caring for your newborn than you can, not the confidence- building care that supports breastfeeding. When newborns are housed in nurseries and brought out for scheduled feedings, the innate communication between mother and baby is interrupted. This exquisite communication is the foundation of breastfeeding as the newborn signals their needs and the mother’s body responds to provide the nutrition, nurturing and protection all newborns need and deserve. 

Other practices that can reduce the chances of successful breastfeeding are:

-not encouraging skin to skin in the first hours and days after birth

-promoting a strict feeding schedule rather than teaching responsive feeding

-covering the newborn’s hands with mittens, denying them the use of their hand-to-mouth activities

-swaddling tightly and restricting their movements

– nursery housing so the mother “can get her rest” rather than talking with her about how to rest and sleep in the first days and weeks after birth

-allowing a brightly lit, noisy environment in the patient room rather than a calming, quiet environment for rest

-not honoring the magical connection between mother and baby

There are many other myths, of course but hopefully, with time, research and education, we can continue to support breastfeeding families with sound, evidence-based information and early and continued support for all families. 

Sources 

Agata Faron-Górecka. et al. The Involvement of Prolactin in Stress-Related Disorders. Int J Environ Res Public Health. Feb. 2023. doi: 10.3390/ijerph20043257. PMCID: PMC9959798  PMID: 36833950

Cadwell, K. et al. The Pocket Guide to Lactation Management. Jones and Bartlett Publishers,Inc. Fourth Edition. June, 2021. 

CDCAP. CDC.gov. Breastfeeding. Maternal Diet. National Agricultural Library. NAI.USDA.gov

Kent, J. et al. Int. J. Environ. Res. Nipple Pain in Breastfeeding Mothers: Incidence, Causes and TreatmentsPublic Health 2015, 12, 12247-12263; doi:10.3390/ijerph121012247

Mennella,J. Psychophysical Tracking Method to Measure Taste Preferences in Children and Adults. 2019 Apr 2.J Vis Exp. 2016 Jul 16; (113): 10.3791/54163. Published online 2016 Jul 16. doi: 10.3791/54163.PMCID: PMC6445264

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