Of course! Depending on the surgical technique used, it is possible that your milk supply could be affected, but there is no way to really predict this, and this does not mean you cannot, or should not breastfeed. Your Lactation Consultant may suggest that during the early weeks you use a hospital-grade breast pump in addition to feeding your baby to optimise milk production. If your milk supply should be impaired, you can supplement your baby at the breast with a Lactation Aid. Remember also that there is much more to breastfeeding than milk!

Absolutely! The baby feeds at the breast, not on the nipple. In many women who seem to have flat/inverted nipples, the situation seems to correct itself during the last trimester of pregnancy or when breastfeeding is initiated. Truly inverted nipples are rare. There are many types and shapes of nipples and breasts, all perfectly « normal ». A perceived "anomaly" and the expectation of a problem are what seem to create an obstacle to breastfeeding. However, for mothers with flatter nipples, it is possible that early feedings may require closer attention, but this is by no means a contra-indication. In this situation, it is even more important to avoid artificial nipples, since the difference in stimulation from the artificial nipple compared to that of the mother's is even more marked. That being said, don't forget that no woman's nipple resembles an artificial nipple!

No. Although a breastfeeding baby has a certain degree of « work » to do to extract milk from the breast, breastfeeding is easier because the baby controls the flow of milk, whereas at the bottle, the baby has little or nothing to do to obtain milk, and no real control. A baby at the breast is more stable (oxygen saturation, breathing, temperature) than at the bottle. It is easier (especially for a preemie) to learn to coordinate sucking, breathing and swallowing at the breast.

Absolutely not, although that's what the formula companies would like you to believe. Breastmilk is specifically designed for human babies, and is a living substance that changes with the baby's age, the climate, the time of day, within a feeding, the environment, etc. It contains more than 200 identified components and each plays a role not only in the baby's nutrition, but also in general development and growth as well as the development of the immune and nervous systems. It is 99% assimilated by the baby. Formula, on the other hand, is an inert product that never changes or adapts, that has a poor shelf life and is very vulnerable to contamination. Moreover, many components essential to your baby's growth and development aren't even present in artificial baby milks. A relatively low percentage of formula is assimilated by the baby. The artificial baby milk industry is not regulated in any way: it has been called the largest "in vivo" experimentation in the history of humanity. Formula is often recalled because of contamination, spoilage, etc.

It is only natural for a mother and her baby not to be separated during the first months of life. At birth, human beings are among the most vulnerable of mammals. Breastfeeding is the natural progression of pregnancy and childbirth. The first 9 to 12 months are a period of "external gestation" crucial to the baby's development. Breastfeeding allows the mother to travel with her baby without having to worry about sterile bottles, milk spoilage, etc. Once breastfeeding is well established, around 4 to 6 weeks, if the mother wants to go away for a few hours without her baby, she can express her milk and provide it in a cup, spoon, dropper, etc., economically and without jeopardising the breastfeeding relationship.

No! Having a baby is demanding and can be tiring, no matter how the baby is fed. It is easy to blame fatigue on breastfeeding when our expectations about life with a new baby aren't met. Breastfeeding mothers who keep their baby close by at night sleep more and have better sleep quality than those who are separated from their baby and/or don't breastfeed. Many mothers don't even wake up as they breastfeed at night! Night breastfeeding is less disruptive to one's sleep than getting up and preparing a bottle while your baby is crying. Mothers whose spouse gets up at night to feed the baby often say that they wake up anyway…

Yes. A Woman can easily and economically continue breastfeeding after returning to work. Breastfeeding protects your baby against illnesses that could require that you miss work. Employers and co-workers are easily sensitised to the importance of breastfeeding for working mothers. They can and must accommodate you with the necessary time and space to express your milk. Transition and separation are easier to adjust to for both mother and baby when the breastfeeding relationship is maintained. When the mother is home, she can breastfeed, whereas the mother who chooses to wean no longer has this option. There are several ways other than bottles to give breastmilk to the baby in the mother's absence.

See also Working and breastfeeding and Dr. Jack Newman's article What to feed the baby when the mother is working outside the home

Babies have many needs other than feeding. Fathers bond with their babies through other activities, such as massage, bathing, and rocking, where they can interact with their child much more than by bottle feeding. This fear is the result of artificial baby milk marketing that glorifies the act of giving a baby a bottle, as if the acts of breastfeeding and giving bottle were equivalent. Breastfeeding is a dynamic process between a mother and her baby, and this cannot be duplicated with a bottle. This is why some advantages of breastfeeding have nothing to do with breastmilk itself. Breastfeeding is an essentially maternal role. Mothers and fathers are not substitutes for each other, but rather complement each other perfectly!

Yes. After an unmedicated labour and delivery, healthy, term babies left on their mother's abdomen have the innate ability to crawl up and latch onto the breast, unassisted. This reflex can be disrupted and even inhibited when the mother is medicated or when mother and baby have been separated. Most pain medications used during labour have an effect on the baby (sleepiness, irritability, etc.) and possibly on early breastfeeding and mother-baby attachment, and this varies according to dosage and time lapsed between administration and delivery. Certain effects may last long after birth. Breastfeeding difficulties that may stem from these effects can, in certain cases, be difficult of impossible to surmount, if they are poorly managed. Expectant mothers must be well informed about these possible consequences as well as available alternatives so that they can make informed choices when it comes to pain management.

No. Pain is not part of the normal evolution of breastfeeding. During the first few days, many women feel discomfort when the baby initially latches on and stretches the nipple in his mouth. However, any discomfort that worsens, especially if the nipples are damaged/cracked, is not normal and should be a red flag that there is an underlying problem requiring assistance by a skilled helper. Some of the most common causes of nipple pain/damage are incorrect latch and bacterial/fungal infections.

See also Sore nipples and Dr. Jack Newman's article Sore nipples

Yes. At birth, your baby's stomach can only contain 5-7 ml of colostrum at one time (the size of a marble), and this matches quite closely the quantity produced by the mother (about 30 to 100 ml per 24 hours). Therefore, it would not be physiologically normal nor desirable to give larger quantities of milk to your baby, as is often done when we give them a bottle. Breastmilk is very easily and rapidly digested by your baby. Breastfeeding in the early days is characterised by very frequent feedings (every 1 to 2 hours). As days go by and milk production increases, your baby's stomach capacity also increases, so that on day 6, and until 6 months, it can contain 50-60 ml of milk at one time (the size of a golf ball). At this stage, your production will correspond, accordingly, to about 500-750 ml per 24 hours.

Supplements can delay the « coming in » of milk and interfere with milk production, thus initiating a vicious cycle difficult to break. There are very few medical indications for supplementing a baby. First, we must always deal with the cause of the problem before supplementing. If there is a medical reason for supplementation, formula is the last choice: mother's own milk is the first choice, then donated human milk, and last, formula. Moreover, the bottle is also the last choice of methods for giving supplements to a breastfed baby. Milk can be given by Lactation Aid or spoon, among other options.

See Dr. Jack Newman's articles Using a Lactation Aid and Finger feeding

By observing your baby (and not with absolute measurements), you can know without a doubt that your baby is getting enough milk:
-baby suckles well and swallows in a rhythmic fashion (no pain for mother)
-as of day 4, baby stools at least 2-3 times per 24 hours (liquid, yellowish stools)
-baby's urine is clear and with no strong odour
-baby has regained birth weight by 2 weeks (3 weeks maximum) and is gaining an average of about 15-30 gr (½-1 on.) per day until the age of 4 months.

See Dr. Jack Newman's article Is my baby getting enough?

Whoever gives you an absolute number is misleading you and is giving you a false reference point. Each baby, and each feeding, is unique. The duration of feedings varies with the baby's age, time of day, quality of latch, and state of baby (sleepy/alert). The baby can be at the breast without actually feeding, so it's important to learn to tell the difference. You are certainly not ahead of the game if your baby spends hours at the breast without really suckling and feeding! A baby who feeds well on one breast can very well turn down the other. This is perfectly normal. It is actually preferable for the baby to stay on one side until he is full than to switch sides after "X" minutes. The latter could mean that the baby is not getting the fatty hindmilk, and may be unsatisfied and/or "colicky", or even have slow or poor weight gain. The baby will tell you when the feeding ahs ended, either by falling asleep or letting go of the breast.

No. Breastmilk is 85-90% water and it fully satisfies your baby's fluid requirements. Formula, on the other hand, can cause thirst because they have a high solute load. Beware! Water has no nutritional value, but can fill up your baby's stomach, thus he will drink less milk and get less nutrition, and if the baby drinks less, the mother will produce less… On hot days, we all tend to drink more, because our fluid requirements increase. It is perfectly normal for your baby to do the same and feed more frequently.

Breastmilk of healthy mothers contains adequate amounts of Vitamin D. Babies are born with stores of Vitamin D that last about 2 months. Thereafter, one to two hours per week (only a few minutes at a time) of exposure to sunlight enables the baby to synthesize all the Vitamin D he needs. Certain risk factors, such as dark skin pigmentation, Vitamin D deficiency in the mother or a baby that is not regularly exposed to sunlight, may justify administrating a Vitamin D supplement, but not all breastfed babies require supplementation.

Only one bottle of formula alters your baby's gut flora for 2 weeks, which can make him more vulnerable to certain pathogens, such as E-coli. Formula reduces some of the anti-infectious properties of breastmilk. The earlier the baby is exposed to formula, the higher the risk of developing certain diseases (such as Diabetes).

See also Risks and costs of formula feeding

Nipple preference is a real problem, even though it may not affect all babies. It results from a process called "imprinting" and from the fact that suction mechanisms at the breast and at the bottle are completely different. When you compare the average woman's nipple to an artificial nipple, it is plain to see why artificial nipples cause a super-stimulus that can be quite confusing for the baby, and why so many women, without reason, believe that their nipples are "flat"…

You should eat a balanced diet, like any other healthy person. Except in extreme cases, your diet does not affect the quality of your milk. However, if you eat poorly, you may find yourself lacking certain nutrients, which can lead to fatigue or weak immune system.

There are no forbidden foods during breastfeeding. "Colic", which is often blamed on something the mother ate, is caused by the baby's immature digestive system and is not related to the mother's diet. Certain babies may react to high doses of caffeine ingested by the mother (don't forget chocolate also contains caffeine!). Every culture has its forbidden foods and its miracle foods, and some cultures forbid other cultures' miracle foods!

No. Alcohol in moderation is not contraindicated during breastfeeding, but it will not help the baby sleep. On the contrary, common reactions to alcohol ingested by the mother (depending on the quantity and time lapsed between ingestion and breastfeeding) include inhibited letdown reflex, agitation and reduced suckling efficiency, which can actually cause the baby to sleep less than normal.

No. Sleep has nothing to do with diet. A baby's sleep cycle is a matter of neurological development, not nutrition. Most babies continue to wake at night during the better part of the first year of life. Studies have shown that the introduction of solid foods has no impact on babies' sleep habits.

Absolutely! Although it would be ideal to quit smoking (or at least cut down), it is less risky to breastfeed in spite of your habit than to formula feed. Breastfeeding reduces some of the effects of cigarette on your baby.

No matter what, NO ONE should ever smoke in the presence of your baby.

Wrong! Although you may feel that your breasts are "fuller" when the interval between feedings is longer, you are really not producing more milk. In fact, the exact opposite could occur, because milk that accumulates and "stays" in the breasts sends a signal to your breasts to STOP producing milk. The quantity of milk that can be "stored" before this signal is sent varies from one woman to the other. This is why some women can feed at longer intervals without experiencing a drop in milk supply. Also, don't forget that the "fuller" your breasts, the lower the fat concentration in the milk.

No. The average breastfed baby feeds every 1½ to 3 hours. Remember that your baby has to double his birth weight by the age of 5-6 months. Considering that until this age his stomach can only hold about 50-60 ml of milk at one time (the size of a golf ball), and that breastmilk is digested very rapidly, it is easy to understand why your baby needs to feed more frequently than every 4 hours. Infrequent feedings can lead to insufficient milk supply.

Yes, it is the Lactation Amenorrhea Method (LAM). It is 98-99% effective if you meet each of the following criteria: your baby is less than 6 months old; you have not had the return of your menses; you are breastfeeding exclusively (that is, your baby does not receive any food or drink other than breastmilk); AND feedings are frequent (no more than 6 hours apart). LAM is as effective as oral contraceptives, but without the possible negative side effects on milk production. It is completely natural and free. It is one more incentive to practice exclusive breastfeeding and delay introduction of solid foods, as is recommended by the World Health Organisation.

Yes! Breastmilk contains everything your baby needs, and more. It changes constantly, in response to his changing needs. Introduction of solid foods can start after 6 months, but should only be done when your baby is showing signs of readiness, not just because he has reached a certain age. Breastmilk still remains an essential food, even for a baby who is discovering other foods. The WHO recommends breastfeeding until at least 2 years, and for a long as mother and child wish to do so thereafter. According to anthropological studies, natural weaning age in human beings is between 4 and 7 years. The world average breastfeeding duration is 4-5 years.

No. This is a popular belief that has been shown to be unfounded by recent studies. In a normal pregnancy, breastfeeding poses no more risk than sexual relations. Breastfeeding during pregnancy, and subsequent tandem nursing, is quite common in many cultures, and has many benefits for mother, child and baby.

No. The feeling of fullness associated with the milk « coming in » isn't merely a surplus of milk, but rather a combination of edema, lymphatic fluid and milk. Around 4 to 6 weeks (sometimes earlier), and often quite suddenly, the feeling of fullness that some women notice throughout the early weeks tapers off. Although the mother may feel like her breasts are « empty », she is still actually still producing all the milk her baby needs. Persistent engorgement (distension of breast tissue caused by insufficient/inefficient drainage of milk), is not a normal part of breastfeeding, and actually signals the breasts to stop producing milk. The degree of fullness a woman feels is not an indication of the quantity of milk produced, nor is the fact that breasts leak or not. Some women's breasts never leak, while others leak during the entire nursing period.

Yes. In fact, breastfeeding women naturally and effortlessly regain their pre-pregnancy weight more quickly than women who do not breastfeed. There is no contraindication to slow, gradual weight-loss (1-2 lbs per week) that can be achieved with a healthy, balanced diet and physical exercise. On the other hand, restrictive (« crash ») diets are not safe (nor are they effective in the long-term) and should NEVER be attempted (breastfeeding or not). During breastfeeding, these drastic diets can mobilise into milk the toxins that concentrate in fat tissue, and extremely hypo caloric intake (less than 1500 calories per day) can impact the quantity of milk produced.

No. The phenomenon of « bottle carries » is associated with formula and use of bottles, and has never been linked to breastfeeding or breastmilk.

See Dr. Jack Newman's articles Breastfeeding myths