Busting The Booby Traps Part 2: Letting More Lactation Myths Go

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Many common myths and misunderstandings about lactation sabotage breastfeeding parents. Busting these booby traps is one of my favorite hobbies.

Be sure to check out the first installment of the Booby Traps series. Today I will address a few more common misconceptions.

Lactation Myth #6: You need a freezer stash of milk.

Busting The Booby Trap: Understandably, parents worry about having enough milk. They hear about building a freezer stash of extra milk, just in case. This sounds like a great idea – why not go for it?

Well, as it turns out, a small percentage of parents build a stash without much difficulty. But many cannot produce much extra milk, no matter what they try. Pumping more may just cause more nipple discomfort and stress without getting the extra milk they hoped for.

Many other parents develop a condition called hyperlactation in their quest for excess milk production. It’s easy to feel jealous of this problem when you’re dealing with a low milk supply yourself. But caring for many patients with hyperlactation has shown me it isn’t something to envy. Hyperlactation often comes with a great deal of misery and difficulty: breast pain, plugged ducts, mastitis, anxiety, and even the early end of lactation.

If you are in a situation where milk supply is worrying you, then please reach out to a lactation professional like myself for help. We can help create manageable solutions to improve your milk production concerns without causing more problems along the way.

Lactation Myth #7: Babies need more and more milk as they get older.

Busting the Booby Trap: This is true in the first few weeks of life – newborns go from drinking 5 ml to 90 ml (3 oz) per feed over the first few weeks of life. But by 40-6 weeks old, babies are taking the maximum volume they will ever need in a single feeding session!

Most babies will take between 3-4 ounces of milk per feeding. They don’t need more than this as they get older. In fact, once they start taking in a lot of solid foods, they actually decrease their milk intake over time.

Mistakenly thinking babies need more and more milk for their feeds as they get older commonly sabotages breastfeeding. This leads caregivers to ask for more milk whenever the baby cries. Then moms mistakenly believe they can’t make enough milk. Luckily there are simple steps to combat this issue – one of my favorites is paced feeding.

Lactation Myth #8: Bottle feeding is a passive process. Just tilt the bottle and let the baby go to town!

Busting the Booby Trap: Many of us learned how to feed a baby with a bottle the same way: lay baby back in your arms, tilt the bottle 45 degrees or more and let baby chug the milk.

It turns out this isn’t exactly the most comfortable way to drink a bottle. Most people don’t do beer bongs outside of college parties for a reason – it may get the adrenaline going, but it isn’t exactly comfortable.

Instead, I recommend paced bottle feeding. This technique allows the baby to mimic the way milk flows from the breast during nursing. The milk flow is controlled by the baby, not the caregiver.

Pro tip: Sometimes, well-meaning helpers may not understand the importance of feeding a bottle slowly like this to support breastfeeding. I often advise parents to focus on the benefits of helping the baby safely coordinate their sucking, swallowing, and breathing. You’re being honest – this is how we often teach babies with difficulty taking bottles to drink more safely.

Lactation Myth #9: Lactation Myth: Yeast is often the cause of nipple pain and redness.

Busting The Booby Trap: Parents with nipple pain, sharp shooting breast pain, or reddened skin around the nipple are often told yeast (thrush) is causing their problems. Often the baby had some white coating on their tongue but no confirmed yeast infection (thrush) in the mouth. As a pediatrician, I know just how often white coating on the tongue is NOT actually due to yeast. But mom and baby end up treated with yeast medications. Things may improve a bit but then often worsen again.

I can’t give individual medical advice on the internet, just general information. And yes, yeast occasionally causes nipple pain and rash during lactation. But it is MUCH more common for nipple pain and redness to be caused by other problems instead of yeast and thrush.

Often parents are told they need complicated regimens to treat the yeast, including longer courses of anti-yeast medication, over-the-counter solutions to kill yeast which, if used improperly, can cause significant irritation to the baby’s mouth, washing breasts and bras frequently to prevent reinfection, sterilizing bottle and pump parts with each use, holistic regimens to combat yeast growth, and changing the parent’s diet. Yet the same problems frequently keep occurring. It turns out that usually, this is because something else is the problem. So please, if you’ve been told that you just need more and more treatment for yeast causing your pain or nipple irritation, seek the opinion of a physician specializing in lactation care to get another opinion. So often, the actual problem can be solved once we stop focusing on the yeast living on your skin (as it is supposed to).

Lactation Myth #10: Doctors don’t know anything about breastfeeding

Busting the Booby Trap: To be fair, there is a good reason that many people believe this one. And all too often, physicians still don’t know enough to help breastfeeding parents and babies.

For many decades, lactation wasn’t included in medical training curricula. As a pediatrician, I received minimal practical education on breastfeeding. It wasn’t until I experienced my own lactastrophe with my first child that I realized how much I didn’t know.

In the last ten years, I have seen the efforts of my mentors lead to so much progress. These breastfeeding medicine physicians paved the way for those like me to follow. I am still one of only a couple breastfeeding medicine physicians working at a specialist level in the state of Indiana. But I know several others who have become lactation consultants or are currently pursuing further education in this field. The interest among physicians is increasing!

We have a long way to go, but things are changing. I look forward to seeing how much progress is made in the next decade. In the meantime, if you don’t get a satisfactory answer that explains your breastfeeding problems, please seek a higher level of care. Just like primary care physicians refer to a cardiologist for complicated heart problems, it is the logical next step to see a breastfeeding medicine physician for lactation issues that are complex or not improving.

I hope some of this information prevents or stops readers from unnecessary breastfeeding issues. My passion is helping parents predict, prevent, and fix lactation problems and avoid worry, anxiety, and suffering whenever possible. Stay tuned for future installments in this Busting The Booby Traps series.

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Lindsay Moore-Ostby
I am a primary care physician, lactation consultant, and co-owner of Indy Direct Docs, an Indianapolis direct primary care clinic. I love that my job lets me care for people of all ages. I especially love supporting my patients in the postpartum period, often with in-home visits that allow me to really personalize support. I work hard, but coming home to my family is the best. I live in Indianapolis with my husband and two young children. We love legos, building toys of all kinds, walks in nature, and playing pretend. Our favorite dinner is either breakfast-for-dinner or any night my husband makes homemade pizza. And nothing beats a good family snuggle on the couch.