First Baby Born From Uterus Transplanted from Deceased Donor

By Maria Cheng for the Associated Press
Read more from Cheng


Baby born from transplanted uterus, from deceased donor

Brazilian doctors are reporting the world’s first baby born to a woman with a uterus transplanted from a deceased donor.

Eleven previous births have used a transplanted uterus, but from a living donor, usually a relative or friend. Experts said using a uterus from women who have died could make more transplants possible.

Ten previous attempts using deceased donors in the Czech Republic, Turkey, and the United States have failed.

This baby girl was delivered last December by a woman born without a uterus because of a rare syndrome. The woman — a 32-year-old psychologist — was initially apprehensive about the transplant, said Dr. Dani Ejzenberg, the transplant team’s lead doctor at the University of Sao Paulo School of Medicine. "This was the most important thing in her life," he said. "Now she comes in to show us the baby and she is so happy!"

The woman became pregnant through in vitro fertilization seven months after the transplant. The donor was a 45-year-old woman who had three children and died of a stroke.

The recipient, who was not identified, gave birth by cesarean section. Doctors also removed the uterus, partly so the woman would no longer need to take anti-rejection medications. Nearly a year later, mother and baby are both healthy.

Two more transplants are planned as part of the Brazilian study. Details of the first case were published Tuesday in the medical journal Lancet.

Uterus transplantation was pioneered by Swedish doctor, Mats Brannstrom, who has delivered eight children from women who each received a donor uterus from family members or friends. Two babies have been born at Baylor University Medical Center in Texas, and one in Serbia, also from transplants from living donors.

In 2016, doctors at the Cleveland Clinic transplanted a uterus from a deceased donor, but it failed after an infection developed.

"The Brazilian group has proven that using deceased donors is a viable option," said the clinic’s Dr. Tommaso Falcone, who was involved in the Ohio case. "It may give us a bigger supply of organs than we thought were possible."

The Cleveland program is continuing to use deceased donors. Falcone said the fact that the transplant was successful after the uterus was preserved in ice for nearly eight hours demonstrated how resilient the uterus is. Doctors try to keep the time an organ is without blood flow to a minimum.

Other experts said the knowledge gained from such procedures might also solve some lingering mysteries about pregnancies. "There are still lots of things we don’t understand about pregnancies, like how embryos implant," said Dr. Cesar Diaz, who co-authored an accompanying commentary in the journal. "These transplants will help us understand implantation and every stage of pregnancy."

Transplant team with baby

Related Reading:

The Lancet: Uterus transplantation from a deceased donor. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)32106-8/fulltext#articleInformation

Science Daily: https://www.sciencedaily.com/releases/2018/12/181204183703.htm

CNN: https://www.cnn.com/2018/12/04/health/uterus-transplant-deceased-donor-study/index.html

Hire an Expert for the Type of Birth YOU Want


If there is one thing you can do RIGHT NOW to ensure your best birth experience, it is this: choose a care provider who is an EXPERT in the type of birth you are planning.

If you are planning a safe, skilled cesarean birth, you should hire someone who is an expert at cesarean sections. You wouldn’t hire a doctor to perform that procedure who said, "Well, actually, I’m not really comfortable with that type of birth, but I’ll let you do it if you want, I suppose..."

If you’re planning a safe, natural, unmedicated birth, you should hire someone who is an EXPERT at supporting natural birth. A doctor with a 30% c-section rate is not a natural birth expert. Neither is a doctor who does routine episiotomies, or doesn’t understand how to catch a baby unless mom is [lying] on her back. A doctor who says, "Well, most of my patients do end up getting an epidural, but if you want to go natural you can do that, I suppose..." is NOT an expert in unmedicated birth.

When you find the right care provider, they will understand your birth plan before you even show it to them -- because it is what they already do every day!

—Lauralyn Curtis

Read related content at Midwifery Today: The Heart and Science of Birth

Birthing Group: FB.com/groups/Birthing (holistic)
Pregnancy Moms Due [this year]: FB.com/groups/DueDateGroup (mainstream)
Peaceful Parenting Community: FB.com/groups/ExplorePeacefulParenting (gentle parenting group)

How to tell if a toy is for girls or boys...


When shopping this season, use this handy chart to determine if a toy is for girls or boys...

Hint: toys made for children are for all children, regardless of sex!


The Lasting Impact of Trauma and How We Can Help Survivors

By Ryan B.


The impact of severe trauma is possible to last a lifetime, and it can come and go.

The symptoms vary in each person. Sometimes trauma symptoms are not as apparent -- they can present though a down mood, or even physical symptoms. A person can often find themselves in a bad mood, or feeling physically sick, without a conscious understanding that there was a trigger or associated experience (time of year, smell, or anything that is associated with the trauma).

People can end up blaming themselves for the way they feel or call themselves 'selfish' and many other negative things, when in reality they are only experiencing the results of trauma. This can become a form of self abuse, or even a means to control the abuse that is coming. Again, the coping with past trauma is not always a conscious process.

What helps? What can a person who has been through trauma do? What can their loved ones do?

When a person who has been through trauma can talk about how they feel it helps. When the person is in a safe environment that doesn't tell them to 'get over it' directly or indirectly with statements like 'Why are you in such a bad mood?' it helps. When your loved ones understand this it helps.

Friends and family can even help an individual see what is happening before this person makes the connection that it is that time of year, or the physical symptoms, are trauma related. Loved ones can be attentive and aware.

Be Patient.

Telling someone who has survived trauma (even when that trauma was in infancy) that it is okay to speak and share as they feel like doing; that it is safe to talk any time, or share the negative emotion they are feeling, tends to allow the processing of trauma to go more quickly.

It is when someone holds things in, or tries to fight through the memories, associations, or emotions, that the impact of trauma is prolonged and continues to present itself time and time again through various means: anxiety, mood fluctuations, physical symptoms.

We are sending our love and support to trauma survivors. Reach out when you need to.

*******

Also by Ryan B.

A Father's Regret: http://www.SavingSons.org/2018/01/a-fathers-regret.html

Happy Travels: Best Kids' Tablet for Less Stress Travel with Children

By Danelle Day


Pre-kids I believed I would never allow my children to watch screens until they were at least 5 years old or more... and then for a very limited amount of time. My own mother limited our screens to no more than 30 minutes/day as children, and while I hated it at the time, I grew to appreciate that this forced us into other activities. So my intentions were good. They were rooted in what I wanted for my kids -- the best!

Then life happened. 

And mothering happened.

And my husband was deployed for many months at a time, and to see him (or any family) I often had to travel cross-country with children and a baby by myself. To do so (long car rides or on flights) I had to keep the kids HAPPY. And to do so, screens -- Baby Einstein, Baby Signing Time, Wonder Pets, Thomas the Train, Paw Patrol, Blues Clues, and everything in between -- came into our lives. I learned that having a happy, calm toddler is more important than rigidly attending to my no-screens desire. The 'lesser evil' is Baby Einstein if the alternative is a crying, stressed, unhappy, cortisol-spiked traveling tyke (and mom)! I wish that someone had put this little compilation together for me years ago (though technology is far different now from when I had to balance a portable DVD player and hope I could keep discs from scratching while traveling...)

For those who need an affordable option for videos on long trips, this combo is perfect for little kids. It is a combo not easily broken, lasts forever, and you can stock the micro SD card with kid-friendly, brain-stirring shows (for babies under 30 months I do most recommend the various Baby Einstein and Baby Signing Time videos):

Amazon Fire: https://amzn.to/2TPABdk $49

Foam Kids Case: https://amzn.to/2PXEEGu $19 -- our kids have dropped, thrown, spilled on, etc. this and it keeps things secure -- they are better than the Amazon Fire kids' edition because they have a holder that doubles as a stand, and the foam casing is thicker.

Screen protector: https://amzn.to/2r3sFrW (3 for $6) -- these are so great that it has even held together a broken Amazon Fire screen for over a year for us without allowing it to crack or break further! It was broken before we found the foam cases above... 

Micro SD card of any type/size (depending on how much you want to hold): https://amzn.to/2ztmMJg (price varied)

Baby Einstein DVDs (can be transferred to digital files or purchased online in some locations as digital files; best videos for babies under 36 months): https://amzn.to/2BAfJ1F

Baby Signing Time DVDs (also able to be transferred from DVD to digital, or downloaded in some locations as digital files; best videos for babies under 36 months): https://amzn.to/2SevaUf


Happy Travels!



Please, Respect Your Wives as Mothers


My wife is a best friend kind of woman. She has hour upon hours of long conversations with her friends ALL the time, and occasionally I get to hear little pieces.

Recently she was talking to a friend and they were talking about this thing called "cosleeping" and I heard the other person ask, "Doesn't your husband hate that? My husband would never let me do that..."

This blew my mind, and has bothered me for days. So I just decided to come out as a man and set a few things straight.

I do NOT hate any part of what makes my wife the mother that she is.

I would NEVER degrade or disregard anything that she feels like doing for my children.

Do I have to squeeze into a small corner of the bed sometimes? Yeah? But, my God, how beautiful does she look holding my children? Making them feel loved and safe?

The thing is that our wives only experience these little seasons in motherhood for a short time. They carry our babies, they birth them, they nurture them, and maybe while they are little they let them crawl into our beds and snuggle; but eventually our babies get bigger, they grow up, they get "too cool" for snuggles, so why would we as men want to steal a single second of this time from them?

Being mothers is part of their identity and what's a year or three out of decades of life spent together?

I just want to say that I am proud of the decisions my wife makes as a mom and I support every single one of them. I would never want to rob her of this time she has or these seasons that are, in reality, too short to not enjoy.

Please respect your wives as mothers.

-David Brinkley

*******

Related Reading on CoSleeping and Healthy Baby Sleep:
http://www.DrMomma.org/2009/06/truth-about-co-sleeping-how-stats.html

CoSleeping Community: FB.com/groups/CoSleeping

This piece originally appeared publicly on Facebook.

Midwifery Care Leads to Better Birth Outcome


Yet another study has demonstrated that birth with an experienced midwife reduces the likelihood of problems during pregnancy and birth. With this study the focus is on women of lower socioeconomic status (more often positively correlated with pregnancy and birth complications). Researchers looked for three problems in particular: small size of baby (SGA = small for gestational age), having a pre-term birth (PTB) and having a baby with a low birth weight (LBW). 

Researchers compared the outcomes of 4705 women cared for by midwives in British Columbia, Canada, with 45,114 cared for by general practitioners (GPs), and 8053 cared for by obstetricians. 

Women who received midwifery care had the best outcomes of all groups. With a midwife attending to pregnancy and birth, women were less likely to have a small or low birth weight baby, and they were less likely to have a baby born preterm.

Reduced prevalence of small-for-gestational-age and preterm birth for women of low socioeconomic position: a population-based cohort study comparing antenatal midwifery and physician models of care. BMJ Open. 2018 Oct 3;8(10):e022220.

Abstract

OBJECTIVE: Our aim was to investigate if antenatal midwifery care was associated with lower odds of small-for-gestational-age (SGA) birth, preterm birth (PTB) or low birth weight (LBW) compared with general practitioner (GP) or obstetrician (OB) models of care for women of low socioeconomic position.

SETTING: This population-level, retrospective cohort study used province-wide maternity, medical billing and demographic data from British Columbia, Canada.

PARTICIPANTS: Our study included 57 872 pregnant women, with low socioeconomic position, who: were residents of British Columbia, Canada, carried a singleton fetus, had low to moderate medical/obstetric risk, delivered between 2005 and 2012 and received medical insurance premium assistance.

PRIMARY AND SECONDARY OUTCOME MEASURES: We report rates, adjusted ORs (aOR), and 95% CIs for the primary outcome, SGA birth (<the 10th percentile), and secondary outcomes, PTB (<37 weeks' completed gestation) and LBW (<2500 g).

RESULTS: Our sample included 4705 midwifery patients, 45 114 GP patients and 8053 OB patients. Odds of SGA birth were reduced for patients receiving antenatal midwifery versus GP (aOR 0.71, 95% CI 0.62 to 0.82) or OB care (aOR 0.59, 95% CI 0.50 to 0.69). Odds of PTB were lower for antenatal midwifery versus GP (aOR 0.74, 95% CI 0.63 to 0.86) or OB patients (aOR 0.53, 95% CI 0.45 to 0.62). Odds of LBW were reduced for midwifery versus GP (aOR 0.66, 95% CI 0.53 to 0.82) or OB patients (aOR 0.43, 95% CI 0.34 to 0.54).

CONCLUSION: Antenatal midwifery care in British Columbia, Canada, was associated with lower odds of SGA birth, PTB and LBW, for women of low socioeconomic position, compared with physician models of care. Results support the development of policy to ensure antenatal midwifery care is available and accessible for women of low socioeconomic position. Future research is needed to determine the underlying mechanisms linking midwifery care to better birth outcomes for women of low socioeconomic position.

*******


Mama, You Are Home To Me




Dear Mama,

Could you wake up for a minute? I know it's hard for you to open your eyes - we haven't slept a lot yet tonight. But Mama, I kinda need you right now. You see, the thing is, I feel a bit lonely at the moment. I'm laying here and I'm somewhat cold.

I didn't mean to cry so I'm sorry I did. I've been trying to get your attention by making some noises for a while now but you were in such a deep sleep, you couldn't hear me. I don't know how else to get your attention. During the day, I see and hear you all make noises and I see you respond well to each other. You talk to me like that too. And I try very hard but I don't know how to do that yet. So I cry so you'd listen to me.

Mama, I'm sorry for crying. Like I said, I feel a bit lonely. I just spent nine months inside your belly where I've always felt safe. It's a bit scary to me to be in such a big bed all by myself. I miss your heartbeat, the rushing of your blood, the warmth and the food. I miss your breathing and your hands you put over me to protect me when I still was inside your belly.

So Mama, would you please listen to me? I'm calling for you in the only way I'm able to. I feel really alone. I need your warmth and your peace for a moment. I need to know for sure you're still here. So can I lay with you for a little while to feel your warmth?

Some cuddles first. Mama, this feels so nice. When I feel you holding me while you gently rock me and when I can smell and feel you, I feel so safe. I can feel your hand on my back and my ear is placed just right on your heart. Mom, this is home to me. Do you remember back when we were always together? I always felt like this back then. Sometimes I miss that time. It was so nice to be close to you.

I hear you softly whisper into my ear, "Everything is okay little one, everything is fine." Your voice is so soft and familiar. You smell good mom. A bit like me and a bit like you.

Mama, will you hold me just a little longer? I'm really tired and I feel so relaxed in your arms. It almost feels like before. I'm going to close my eyes for a little while, okay? Can I please stay with you here a little longer to enjoy your love and your presence?

And can I drink some more? Mama, since we're laying like this anyway... I'd like to ask you something. I know, it sounds pretty sad because I can't talk like you can yet so I'm sorry for crying again. But mama, can I please drink some more? My throat is dry and my tummy is empty and since we're here anyway... maybe I can have a few more sips? Your milk tastes delicious and is so warm and familiar.

Thanks Mom, that's exactly what I needed. I was really really thirsty. Your finger on my cheek feels great by the way. And you're smiling at me. Nothing makes me happier than seeing your smile and feeling your presence. I'll close my eyes again, okay? Please don't put me away straight away, I really enjoy falling asleep here. This feels really good. Can I stay with you?

My tummy hurts. What is that?! Mama! Can you feel this? Mom? My tummy hurts so bad. What is happening? Please help me mama, I don't know what's happening. I've never felt anything like this.

Thank you for rubbing my belly mom. It's late and everyone is asleep. I'm so happy you're here for me. I don't know what I'd do without you mama. My tummy already hurts less and when you hold me like that... I feel pretty tired. Maybe I'll close my eyes again. Please hold me a little longer?

Can I have more cuddles? You won't believe this mama! I'm a bit scared. I just woke up and I didn't know where I was for a second. It was all dark and a little cold again. I know you're tired mama. But I really missed you, can I please be with you again for a while?

Mama, I can see that you're tired. There are tears in your eyes, and every now and then a tear rolls down your cheek. I'm sorry Mama, but I feel really strange in this new world. I miss home. I miss always being close to you.


Sometimes I feel a tear fall on my head while you gently rock me. You're singing me a song so that I can go back to sleep. You softly dry the tears that fell on my head with your hand. That feels nice Mom, do that again?

I fall asleep on your chest. You feel so soft, so familiar. There's nowhere I sleep better than here. My legs are pulled up, just like they were back when I still lived with you. I can hear your heartbeat again and I move along with your breathing.

Mama, you're the best place to be. I'm so glad I get to come to you over and over again. I don't like being unable to just ask either but I'm really happy you listen to me when I call for you.

Soon, I'll be able to be there for you. Or for my brothers or sisters. Or for my friends in school. You're teaching me how to take care of someone. You're teaching me that you listen, even when I can't ask. You're teaching me I'm safe, even when sometimes it feels like I'm not. You're teaching me that you love me, even when you're very tired. Thank you.

And Mama, I love you.

{author unknown}




The Last Time




The Last Time

From the moment you hold your baby in your arms,
You will never be the same.

You might long for the person you were before,
When you had freedom and time,
And nothing in particular to worry about.

You will know tiredness like you never knew it before,
And days will run into days that are exactly the same,
Full of feeding and burping,
Whining and fighting,
Naps, or lack of naps.

It might seem like a never-ending cycle.

But don't forget...

There is a last time for everything.

There will come a time when you will feed your baby for the very last time.

They will fall asleep on you after a long day
And it will be the last time you ever hold your sleeping child.

One day you will carry them on your hip, then set them down,
And never pick them up that way again.

You will scrub their hair in the bath one night 
And from that day on they will want to bathe alone.

They will hold your hand to cross the road,
Then never reach for it again.

They will creep into your room at midnight for cuddles,
And it will be the last night you ever wake for this.

One afternoon you will sing 'the wheels on the bus' and do all the actions,
Then you'll never sing that song again.

They will kiss you goodbye at the school gate,
The next day they will ask to walk to the gate alone.

You will read a final bedtime story, and wipe your last dirty face.

They will one day run to you with arms raised, for the very last time.

The thing is, you won't even know it's the last time until there are no more times,
And even then, it will take you a while to realize.

So while you are living in these times,
Remember there are only so many of them,
And when they are gone,
You will yearn for just one more day of them -
For one last time.

Author Unknown


Your Baby's Signs of Hunger




This poster, created by the Women's and Newborn Services of Royal Brisbane and Women's Hospital, highlights a human baby's hunger cues - her way of communicating to parents that she needs to eat.

As highlighted in the 2010 article, 7 Breastfeeding Fact You Should Know, parents are reminded that stirring, mouth opening, turning a head (to seek a nipple) and rooting are signs that your baby is hungry. Stretching, becoming agitated, and sucking on her fist, fingers or thumb is your baby's way of telling you that she is really hungry. By the time fussing and crying start, your baby is experiencing hunger that is physically painful. It is the type of hunger you experience after your belly has been empty for 14-16 hours. Your baby's belly is very small - this is the reason she gets full so quickly, and then hungry again so soon. Her tiny stomach cannot handle more than this, and does not have any place to 'store' some for later. She is entirely dependent upon you to provide that fill-up according to her cues that she is hungry.

Too often new parents believe they should schedule feedings or wait until their baby cries to nurse. But crying is a late indicator of extreme hunger. Always eating when you are so famished, when your belly hurts and stress hormones from being anxious to eat are at an ultimate high, leads to things like reflux, gas, stomach aches, 'colic,' and general agitation and general withdrawal from the world around - especially if you are brand new and helpless in this world.

Don't wait until your baby is in pain to nurse. Instead, feed at the first cue of hunger, and everyone will be much healthier and happier all around.

For related reading, see the Breastfeeding Resource Page.


A little tiny tummy wisdom from Baby Wisdom (UK):

Size of a baby's stomach.
Day One - the size of a cherry
Day Three - the size of a radish
Week Two - the size of a large egg
Month Two - the size of an apricot

For this reason, babies need to eat small amounts very often throughout the day and night time hours. Watch your little one and his/her cues. Nursing on cue, around the clock, leads to a baseline level of health, development, and happiness for babies, and their parents.


*******

The 10 Most Important Things I've Learned Since Losing My Son

By Richard Pringle
Originally on Facebook
Also at The Mirror and Newsner



1. You can never, ever kiss and love too much.

2. You always have time. Stop what you’re doing and play, even if it’s just for a minute. Nothing is that important that it can’t wait.


3. Take as many photos and record as many videos as humanly possible. One day that might be all you have.

4. Don’t spend money, spend time. You think what you spend matters? It doesn’t. What you do matters. Jump in puddles, go for walks. Swim in the sea, build a camp, and have fun. That’s all they want. I can’t remember what we bought Hughie, I can only remember what we did.


5. Sing. Sing songs together. My happiest memories are of Hughie sitting on my shoulders or sitting next to me in the car singing our favorite songs. Memories are created in music.

6. Cherish the simplest of things. Night times, bedtimes, reading stories. Dinners together. Lazy Sundays. Cherish the simplest of times. They are what I miss the most. Don’t let those special times pass you by unnoticed.


7. Always kiss those you love goodbye, and if you forget, go back and kiss them. You never know if it’s the last time you’ll get the chance.

8. Make boring things fun. Shopping trips, car journeys, walking to the shops. Be silly, tell jokes, laugh, smile, and enjoy yourselves. They’re only chores if you treat them like that. Life is too short not to have fun.


9. Keep a journal. Write down everything your little ones do that lights up your world. The funny things they say, the cute things they do. We only started doing this after we lost Hughie. We wanted to remember everything. Now we do it for Hettie, and we will for Hennie too. You’ll have these memories written down forever, and when you're older you can look back and cherish every moment. 

10. If you have your children with you: To kiss goodnight. To have breakfast with. To walk to school. To take to university. To watch get married. You are blessed. Never ever forget that. ❤


End Note: Richard Pringle, of Hastings U.K., went through the most unimaginable pain a parent can know when his son, Hughie, passed away following a brain hemorrhage at age 3. One year after Hughie's death, Richard shared his list of the most important things he learned. It’s a list that everyone should read and take to heart. It is a reminder not to take our loved ones for granted.

*******

Mother Loses Baby to SIDS and Cautions Parents to Protect Their Own from Circumcision


The following is a letter to Saving Our Sons, the intact education branch of Peaceful Parenting:


I want to thank you for all you do in educating people about the cruel and unnecessary act of male genital mutilation. You work to open so many minds on this archaic process built on lies.

I recently lost my second son to SIDS at 24 days old. He was a beautiful healthy baby boy who tragically passed away in his sleep. The medical examiner found absolutely nothing wrong with him. He had an extensive autopsy, and all reports showed nothing wrong.

The hospital I birthed him at kept asking me over and over again if I was going to have him circumcised. Everytime my answer was a clear NO! A day later as I nursed my sweet, perfect baby boy, a nurse came into my room and said, "I am here to take him for his procedure."

I asked, "What procedure?"

She answered, "His circumcision."

I said, "He is NOT being circumcised."

She replied, "Well, he is on the board out in the nurse's station to be circumcised."

I said, "Absolutely not! I don't know who put him on that board but I have clearly stated over and over he is not to be circumcised."

She turned red in the face and apologized. She said someone must have made a mistake.

My point is that a parent has to be diligent in making sure that even though they say NO to genital cutting, that is not done 'by mistake.'

After losing my baby boy I realized that I had to speak up and say something. I am having a difficult time as it is, and if he had suffered that unimaginable pain in his short life I would never be able to live with myself. I just want to warn other mothers and fathers. Some parents send their babies to the nursery to get some rest, and if they take them to circumcise, then the parents would not know until it is too late.

One thing I take solace in is knowing my son never had to experience any suffering, including circumcision. If I had not questioned that nurse he would have been wheeled away to face mutilation that no baby boy deserves.

❤ Audrea


Awareness raising stickers and cards at Etsy

Mr. Rogers' Neighborhood & The Tree of Life Congregation


💔 Let's love each other along life's journey.

The Tree of Life congregation is located in Mr. Fred Rogers’ neighborhood. Mr. Rogers once told the world, "When I was a boy and I would see scary things in the news, my mother would say to me, 'Look for the HELPERS. You will always find people who are helping.'"

Artist of the piece above, Sasha Phillips, adds, "This is one of those times that looking is not enough - you have to BE one of those HELPERS, in every way you can - by stopping hateful speech in its tracks, by voting, by being heard, by reaching out to support those who are being persecuted. You have to do this with light and love in your heart. Because 'the only thing evil can’t stand is forgiveness.' Wish we paid more attention to Mr. Rogers."



Related Reading 

• Mister Rogers' Neighborhood homepage: https://www.misterrogers.org

• Healing power of art inspires Pittsburgh lawyer's Mister Rogers drawing: http://www.post-gazette.com/local/neighborhood/2018/10/30/Mister-Rogers-Pittsburgh-lawyer-art-synagogue-shootings-Tree-Life/stories/201810300132

• After Pittsburgh shooting in Mr. Rogers' real-life neighborhood, Squirrel Hill neighbors follow his lead: https://abcnews.go.com/US/pittsburgh-shooting-mr-rogers-real-life-neighborhood-squirrel/story?id=58849272

• Mister Rogers' Neighborhood on PBS: https://pbskids.org/video/mister-rogers/1421146807

• Won't You Be My Neighbor (2018 Documentary, Amazon): https://amzn.to/2s6Yofv

• A Beautiful Day in the Neighborhood (2019 film): https://www.abeautifulday.movie

• Artwork by Sasha Phillips: https://www.facebook.com/photo.php?fbid=10218143154789258&set=a.10201884967024725

Be Kind to Yourself
Be Kind to Animals
Be Kind to Others

Bob Ross
Steve Irwin
Fred Rogers



Breastfeeding Myths

By Jack Newman, MD, FRCPC, IBCLC
Revised by Edith Kernerman, IBCLC
Photographs by Peaceful Parenting readers. Have a myth-debunking photo to share? Email with your name to DrMomma.org@gmail.com
Read more from Dr. Newman at Breastfeeding Inc. and the International Breastfeeding Centre site, as well as in his published texts.


There are so very many 'booby traps' for nursing mothers today. Myths and misconception are rampant across many of our sub-cultures, and misunderstanding when it comes to lactation and mother/baby-nutrition is so ubiquitous that even medical professionals commonly dish out poor advice to new moms. Here, Dr. Newman responds to many of the myths alive and present in our world today - those that commonly hinder a mother's breastfeeding relationship with her baby.

1. Many women do not produce enough milk. Not true! The vast majority of women produce more than enough milk. Indeed, an overabundance of milk is common. Most babies that gain too slowly, or lose weight, do so not because the mother does not have enough milk, but because the baby does not get the milk that the mother has. The usual reason that the baby does not get the milk that is available is that he is poorly latched onto the breast. This is why it is so important that the mother be shown, on the first day, how to latch a baby on properly, by someone who knows what they are doing.

2. It is normal for breastfeeding to hurt. Not true! Though some tenderness during the first few days is relatively common, this should be a temporary situation that lasts only a few days and should never be so bad that the mother dreads breastfeeding. Any pain that is more than mild is abnormal and is almost always due to the baby latching on poorly. Any nipple pain that is not getting better by day three or four or lasts beyond five or six days should not be ignored. A new onset of pain when things have been going well for a while may be due to a yeast infection of the nipples. Limiting feeding time does not prevent soreness. Taking the baby off the breast for the nipples to heal should be a last resort only. (See Information Sheet Sore Nipples).


3. There is no (not enough) milk during the first three or four days after birth. Not true! It often seems like that because the baby is not latched on properly and therefore is unable to get the milk that is available. When there is not a lot of milk (as there is not, normally, in the first few days), the baby must be well latched on in order to get the milk. This accounts for "but he's been on the breast for 2 hours and is still hungry when I take him off". By not latching on well, the baby is unable to get the mother's first milk, called colostrum. Anyone who suggests you pump your milk to know how much colostrum there is, does not understand breastfeeding, and should be politely ignored. Once the mother's milk is abundant, a baby can latch on poorly and still may get plenty of milk, though good latching from the beginning, even in if the milk is abundant, prevents problems later on.

4. A baby should be on the breast 20 (10, 15, 7.6) minutes on each side. Not true! However, a distinction needs to be made between "being on the breast" and "breastfeeding". If a baby is actually drinking for most of 15-20 minutes on the first side, he may not want to take the second side at all. If he drinks only a minute on the first side, and then nibbles or sleeps, and does the same on the other, no amount of time will be enough. The baby will breastfeed better and longer if he is latched on properly. He can also be helped to breastfeed better and longer if the mother compresses the breast to keep the flow of milk going, once he no longer drinks on his own (Information Sheet Breast Compression). Thus it is obvious that the rule of thumb that "the baby gets 90% of the milk in the breast in the first 10 minutes" is equally hopelessly wrong. To see how to know a baby is getting milk see the videos at nbci.ca.


5. A breastfeeding baby needs extra water in hot weather. Not true! Breastmilk contains all the water a baby needs.

6. Breastfeeding babies need extra vitamin D. Not true! Everyone needs vitamin D. Formula has it added at the factory. But the baby is born with a liver full of vitamin D, and breastmilk does have some vitamin D. Outside exposure allows the baby to get the rest of his vitamin D requirements from ultraviolet light even in winter. The baby does not need a lot of outside exposure and does not need outside exposure every day. Vitamin D is a fat soluble vitamin and is stored in the body. In some circumstances (for example, if the mother herself was vitamin D deficient during the pregnancy) it may be prudent to supplement the baby with vitamin D. Exposing the baby to sunlight through a closed window does not work to get the baby more vitamin D.

7. A mother should wash her nipples each time before feeding the baby. Not true! Formula feeding requires careful attention to cleanliness because formula not only does not protect the baby against infection, but also is actually a good breeding ground for bacteria and can also be easily contaminated. On the other hand, breastmilk protects the baby against infection. Washing nipples before each feeding makes breastfeeding unnecessarily complicated and washes away protective oils from the nipple.

8. Pumping is a good way of knowing how much milk the mother has. Not true! How much milk can be pumped depends on many factors, including the mother's stress level. The baby who breastfeeds well can get much more milk than his mother can pump. Pumping only tells you have much you can pump.

9. Breastmilk does not contain enough iron for the baby's needs. Not true! Breastmilk contains just enough iron for the baby's needs. If the baby is full term he will get enough iron from breastmilk to last him at least the first six months. Formulas contain too much iron, but this quantity may be necessary to ensure the baby absorbs enough to prevent iron deficiency. The iron in formula is poorly absorbed, and the baby poops out most of it. Generally, there is no need to add other foods to breastmilk before about 6 months of age.

10. It is easier to bottle feed than to breastfeed. Not true! Or, this should not be true. However, breastfeeding is made difficult because women often do not receive the help they should to get started properly. A poor start can indeed make breastfeeding difficult. But a poor start can also be overcome. Breastfeeding is often more difficult at first, due to a poor start, but usually becomes easier later.


11. Breastfeeding ties the mother down. Not true! But it depends how you look at it. A baby can be breastfed anywhere, anytime, and thus breastfeeding is liberating for the mother. No need to drag around bottles or formula. No need to worry about where to warm up the milk. No need to worry about sterility. No need to worry about how your baby is, because he is with you.

12. There is no way to know how much breastmilk the baby is getting. Not true! There is no easy way to measure how much the baby is getting, but this does not mean that you cannot know if the baby is getting enough. The best way to know is that the baby actually drinks at the breast for several minutes at each feeding (open mouth wide—pause—close mouth type of suck). Other ways also help show that the baby is getting plenty (Information Sheet Is my Baby Getting Enough Milk?). Also see the videos at nbci.ca.

13. Modern formulas are almost the same as breastmilk. Not true! The same claim was made in 1900 and before. Modern formulas are only superficially similar to breastmilk. Every correction of a deficiency in formulas is advertised as an advance. Fundamentally, formulas are inexact copies based on outdated and incomplete knowledge of what breastmilk is. Formulas contain no antibodies, no living cells, no enzymes, no hormones. They contain much more aluminum, manganese, cadmium, lead and iron than breastmilk. They contain significantly more protein than breastmilk. The proteins and fats are fundamentally different from those in breastmilk. Formulas do not vary from the beginning of the feed to the end of the feed, or from day 1 to day 7 to day 30, or from woman to woman, or from baby to baby. Your breastmilk is made as required to suit your baby. Formulas are made to suit every baby, and thus no baby. Formulas succeed only at making babies grow well, usually, but there is more to breastfeeding than nutrients.

14. If the mother has an infection she should stop breastfeeding. Not true! With very, very few exceptions, the mother’s continuing to breastfeed will actually protect the baby. By the time the mother has fever (or cough, vomiting, diarrhea, rash, etc) she has already given the baby the infection, since she has been infectious for several days before she even knew she was sick. The baby's best protection against getting the infection is for the mother to continue breastfeeding. If the baby does get sick, he will be less sick if the mother continues breastfeeding. Besides, maybe it was the baby who gave the infection to the mother, but the baby did not show signs of illness because he was breastfeeding. Also, breast infections, including breast abscess, though painful, are not reasons to stop breastfeeding. Indeed, the infection is likely to settle more quickly if the mother continues breastfeeding on the affected side. (Information Sheets Breastfeeding and Medication and Breastfeeding and Illness).


15. If the baby has diarrhea or vomiting, the mother should stop breastfeeding. Not true! The best medicine for a baby's gut infection is breastfeeding. Stop other foods for a short time, but continue breastfeeding. Breastmilk is the only fluid your baby requires when he has diarrhea and/or vomiting, except under exceptional circumstances. The push to use "oral rehydrating solutions" is mainly a push by the formula manufacturers (who also make oral rehydrating solutions) to make even more money. The baby is comforted by the breastfeeding, and the mother is comforted by the baby's breastfeeding. (Information Sheets Breastfeeding and Medication and Breastfeeding and Illness).

16. If the mother is taking medicine she should not breastfeed. Not true! There are very very few medicines that a mother cannot take safely while breastfeeding. A very small amount of most medicines appears in the milk, but usually in such small quantities that there is no concern. If a medicine is truly of concern, there are usually equally effective, alternative medicines that are safe. The risks of artificial feeding for both the mother and the baby must be taken into account when weighing if breastfeeding should be continued (Information Sheets Breastfeeding and Medication and Breastfeeding and Illness).

17. A breastfeeding mother has to be obsessive about what she eats. Not true! A breastfeeding mother should try to eat a balanced diet, but neither needs to eat any special foods nor avoid certain foods. A breastfeeding mother does not need to drink milk in order to make milk. A breastfeeding mother does not need to avoid spicy foods, garlic, cabbage or alcohol. A breastfeeding mother should eat a normal healthful diet. Although there are situations when something the mother eats may affect the baby, this is unusual. Most commonly, "colic", "gassiness" and crying can be improved by changing breastfeeding techniques, rather than changing the mother's diet. (Information Sheet Colic in the Breastfed Baby).

18. A breastfeeding mother has to eat more in order to make enough milk. Not true! Women on even very low calorie diets usually make enough milk, at least until the mother's calorie intake becomes critically low for a prolonged period of time. Generally, the baby will get what he needs. Some women worry that if they eat poorly for a few days this also will affect their milk. There is no need for concern. Such variations will not affect milk supply or quality. It is commonly said that women need to eat 500 extra calories a day in order to breastfeed. This is not true. Some women do eat more when they breastfeed, but others do not, and some even eat less, without any harm done to the mother or baby or the milk supply. The mother should eat a balanced diet dictated by her appetite. Rules about eating just make breastfeeding unnecessarily complicated.

19. A breastfeeding mother has to drink lots of fluids. Not true! The mother should drink according to her thirst. Some mothers feel they are thirsty all the time, but many others do not drink more than usual. The mother's body knows if she needs more fluids, and tells her by making her feel thirsty. Do not believe that you have to drink at least a certain number of glasses a day. Rules about drinking just make breastfeeding unnecessarily complicated.


20. A mother who smokes is better not to breastfeed. Not true! A mother who cannot stop smoking should breastfeed. Breastfeeding has been shown to decrease the negative effects of cigarette smoke on the baby's lungs, for example. Breastfeeding confers great health benefits on both mother and baby. It would be better if the mother not smoke, but if she cannot stop or cut down, then it is better she smoke and breastfeed than smoke and formula feed.

21. A mother should not drink alcohol while breastfeeding. Not true! Reasonable alcohol intake should not be discouraged at all. As is the case with most drugs, very little alcohol comes out in the milk. The mother can take some alcohol and continue breastfeeding as she normally does. Prohibiting alcohol is another way we make life unnecessarily restrictive for breastfeeding mothers.


22. A mother who bleeds from her nipples should not breastfeed. Not true! Though blood makes the baby spit up more, and the blood may even show up in his bowel movements, this is not a reason to stop breastfeeding the baby. Nipples that are painful and bleeding are not worse than nipples that are painful and not bleeding. It is the pain the mother is having that is the problem. This nipple pain can often be helped considerably. Get help. (Information Sheet Sore Nipples and Vasospasm and Raynaud’s Phenomenon). Sometimes mothers have bleeding from the nipples that is obviously coming from inside the breast and is not usually associated with pain. This often occurs in the first few days after birth and settles within a few days. The mother should not stop breastfeeding for this. If bleeding does not stop soon, the source of the problem needs to be investigated, but the mother should keep breastfeeding.

23. A woman who has had breast augmentation surgery cannot breastfeed. Not true! Most do very well. There is no evidence that breastfeeding with silicone implants is harmful to the baby. Occasionally this operation is done through the areola. These women do have often have problems with milk supply, as does any woman who has an incision around the areolar line.

24. A woman who has had breast reduction surgery cannot breastfeed. Not true! Breast reduction surgery does often decrease the mother's capacity to produce milk, but since many mothers produce more than enough milk, some mothers who have had breast reduction surgery sometimes can breastfeed exclusively. In such a situation, the establishment of breastfeeding should be done with special care to the principles mentioned in the Information Sheet Breastfeeding—Starting Out Right. However, if the mother seems not to produce enough, she can still breastfeed, supplementing with a lactation aid (so that artificial nipples do not interfere with breastfeeding). See Information Sheet Lactation Aid.

25. Premature babies need to learn to take bottles before they can start breastfeeding. Not true! Premature babies are less stressed by breastfeeding than by bottle feeding. A baby as small as 1200 grams and even smaller can start at the breast as soon as he is stable, though he may not latch on for several weeks. Still, he is learning and he is being held which is important for his wellbeing and his mother's. Actually, weight or gestational age do not matter as much as the baby's readiness to suck, as determined by his making sucking movements. There is no more reason to give bottles to premature babies than to full term babies. When supplementation is truly required there are ways to supplement without using artificial nipples.

26. Babies with cleft lip and/or palate cannot breastfeed. Not true! Some do very well. Babies with a cleft lip only usually manage fine. But many babies with cleft palate do indeed find it very difficult to latch on. There is no doubt, however, that if breastfeeding is not even tried, for sure the baby won’t breastfeed. The baby's ability to breastfeed does not always seem to depend on the severity of the cleft. Breastfeeding should be started, as much as possible, using the principles of proper establishment of breastfeeding. (Information Sheet Breastfeeding—Starting Out Right). If bottles are given, they will undermine the baby's ability to breastfeed. If the baby needs to be fed, but is not latching on, a cup can and should be used in preference to a bottle. Finger feeding occasionally is successful in babies with cleft lip/palate, but not usually (See Information Sheet Finger and Cup Feeding).

27. Women with small breasts produce less milk than those with large breasts. Nonsense!


28. Breastfeeding women cannot take the birth control pill. Not true! The question is not about exposure to female hormones, to which the baby is exposed anyway through breastfeeding. The baby gets only a tiny bit more from the pill. However, some women who take the pill, even the progestin only pill, find that their milk supply decreases. Estrogen-containing pills are more likely to decrease the milk supply. Because so many women produce more than enough, this sometimes does not matter, but sometimes it does even in the presence of an abundant supply, and the baby becomes fussy and is not satisfied by breastfeeding. Babies respond to the rate of flow of milk, not what's "in the breast", so that even a very good milk supply may seem to cause the baby who is used to faster flow to be fussy. Stopping the pill often brings things back to normal. If possible, women who are breastfeeding should avoid the pill, or at least wait until the baby is taking other foods (usually around 6 months of age). Even if the baby is older, the milk supply may decrease significantly. If the pill must be used, it is preferable to use the progestin only pill (without estrogen).

29. Breastfeeding babies need other types of milk after six months. Not true! Breastmilk gives the baby everything there is in other milks and more. Babies older than six months should be started on solids mainly so that they learn how to eat and so that they begin to get another source of iron, which by 7-9 months, is not supplied in sufficient quantities from breastmilk alone. Thus cow's milk or formula will not be necessary as long as the baby is breastfeeding. However, if the mother wishes to give milk after 6 months, there is no reason that the baby cannot get cow's or goat’s milk, as long as the baby is still breastfeeding a few times a day, and is also getting a wide variety of solid foods in more than minimal amounts. Most babies older than six months who have never had formula will not accept it because of the taste.

30. Women with flat or inverted nipples cannot breastfeed. Not true! Babies do not breastfeed on nipples, they breastfeed on the breast. Though it may be easier for a baby to latch on to a breast with a prominent nipple, it is not necessary for nipples to stick out. A proper start will usually prevent problems and mothers with any shaped nipples can breastfeed perfectly adequately. In the past, a nipple shield was frequently suggested to get the baby to take the breast. This gadget should not be used, especially in the first two weeks! Though it may seem a solution, its use can result in poor feeding and severe weight loss, and makes it even more difficult to get the baby to take the breast. (See Information Sheet Finger and Cup Feeding). If the baby does not take the breast at first, with proper help, he will often take the breast later. Breasts also change in the first few weeks, and as long as the mother maintains a good milk supply, the baby will usually latch on by 8 weeks of age no matter what, but get help and the baby may latch on before. See Information Sheet When a Baby Does not yet Latch.


31. A woman who becomes pregnant must stop breastfeeding. Not true! If the mother and child desire, breastfeeding can continue. Some continue breastfeeding the older child even after delivery of the new baby. Many women do decide to stop breastfeeding when they become pregnant because their nipples are sore, or for other reasons, but there is no rush or medical necessity to do so. In fact, there are often good reasons to continue. The milk supply will likely decrease during pregnancy, but if the baby is taking other foods, this is not a usually a problem. However, some babies will stop breastfeeding if the milk supply is low.

32. A baby with diarrhea should not breastfeed. Not true! The best treatment for a gut infection (gastroenteritis) is breastfeeding. Furthermore, it is very unusual for the baby to require fluids other than breastmilk. If lactose intolerance is a problem, the baby can receive lactase drops, available without prescription, just before or after the feeding, but this is rarely necessary in breastfeeding babies. Get information on its use from the clinic. In any case, lactose intolerance due to gastroenteritis will disappear with time. Lactose free formula is not better than breastfeeding. Breastfeeding is better than any formula.

33. Babies will stay on the breast for two hours because they like to suck. Not true! Babies need and like to suck, but how much do they need? Most babies who stay at the breast for such a long time are probably hungry, even though they may be gaining well. Being on the breast is not the same as drinking at the breast. Latching the baby better onto the breast allows the baby to breastfeed more effectively, and thus spend more time actually drinking. You can also help the baby to drink more by expressing milk into his mouth when he no longer swallows on his own (See Information Sheet Breast Compression). Babies younger than 5-6 weeks often fall asleep at the breast because the flow of milk is slow, not necessarily because they have had enough to eat. See videos at nbci.ca.

34. Babies need to know how to take a bottle. Therefore a bottle should always be introduced before the baby refuses to take one. Not true! Though many mothers decide to introduce a bottle for various reasons, there is no reason a baby must learn how to use one. Indeed, there is no great advantage in a baby's taking a bottle. Since Canadian women are supposed to receive 52 weeks maternity leave, the baby can start eating solids after 6 months, well before the mother goes back to her outside work. The baby can even take fluids or solids that are quite liquid off a spoon. The baby can start learning how to drink from a cup right from birth or older, and though it may take several weeks for the older baby to learn to use it efficiently, he will learn. If the mother is going to introduce a bottle, it is better she wait until the baby has been breastfeeding well for 4-6 weeks, and then give it only occasionally. Sometimes, however, babies who take the bottle well at 6 weeks, refuse it at 3 or 4 months even if they have been getting bottles regularly (smart babies). Do not worry, and proceed as above with solids and spoon. Giving a bottle when breastfeeding is not going well is not a good idea and usually makes the breastfeeding even more difficult. For your sake and the baby's do not try to "starve the baby into submission." Get help.


35. If a mother has surgery, she has to wait a day before restarting breastfeeding. Not true! The mother can breastfeed immediately after surgery, as soon as she is awake and up to it. Neither the medications used during anaesthesia, nor pain medications nor antibiotics used after surgery require the mother to interrupt breastfeeding, except under exceptional circumstances. Enlightened hospitals will accommodate breastfeeding mothers and babies when either the mother or the baby needs to be admitted to the hospital, so that breastfeeding can continue. Many rules that restrict breastfeeding are more for the convenience of staff than for the benefit of mothers and babies.

36. Breastfeeding twins is too difficult to manage. Not true! Breastfeeding twins is easier than bottle feeding twins, if breastfeeding is going well. This is why it is so important that a special effort should be made to get breastfeeding started right when the mother has had twins (See Information Sheets Breastfeeding—Starting Out Right and The Importance of Skin to Skin Contact). Some women have breastfed triplets exclusively. This obviously takes a lot of work and time, but twins and triplets take a lot of work and time no matter how the infants are fed.

37. Women whose breasts do not enlarge or enlarge only a little during pregnancy, will not produce enough milk. Not true! There are a very few women who cannot produce enough milk (though they can continue to breastfeed by supplementing with a lactation aid). Some of these women say that their breasts did not enlarge during pregnancy. However, the vast majority of women whose breasts do not seem to enlarge during pregnancy produce more than enough milk.

38. A mother whose breasts do not seem full has little milk in the breast. Not true! Breasts do not have to feel full to produce plenty of milk. It is normal that a breastfeeding woman's breasts feel less full as her body adjusts to her baby's milk intake. This can happen suddenly and may occur as early as two weeks after birth or even earlier. The breast is never "empty" and also produces milk as the baby breastfeeds. Is the baby getting milk from the breast? That’s what’s important, not how full the breast feels. Look skeptically upon anyone who squeezes your breasts to make a determination of milk sufficiency or insufficiency. See videos at nbci.ca.

39. Breastfeeding in public is not decent. Not true! It is the humiliation and harassment of mothers who are breastfeeding their babies that is not decent. Women who are trying to do the best for their babies should not be forced by other people's hang-ups or lack of understanding to stay home or feed their babies in public washrooms. Those who are offended need only avert their eyes. Children will not be damaged psychologically by seeing a woman breastfeeding. On the contrary, they might learn something important, beautiful and fascinating. They might even learn that breasts are not only for selling beer. Other women who have left their babies at home to be bottle fed when they went out might be encouraged to bring the baby with them the next time.

40. Breastfeeding a child until 3 or 4 years of age is abnormal and bad for the child, causing an over-dependent relationship between mother and child. Not true! Breastfeeding for 2-4 years was the rule in most cultures since the beginning of human time on this planet. Only in the last 100 years or so has breastfeeding been seen as something to be limited. Children breastfeed into the third year are not overly dependent. On the contrary, they tend to be very secure and thus more independent. They themselves will make the step to stop breastfeeding (with gentle encouragement from the mother), and thus will be secure in their accomplishment.

41. If the baby is off the breast for a few days (weeks), the mother should not restart breastfeeding because the milk sours. Not true! The milk is as good as it ever was. Breastmilk in the breast is not milk or formula in a bottle.


42. After exercise a mother should not breastfeed. Not true! There is absolutely no reason why a mother would not be able to breastfeed after exercising. The study that purported to show that babies were fussy feeding after mother exercising was poorly done and contradicts the everyday experience of millions of mothers.

43. A breastfeeding mother cannot get a permanent or dye her hair. Not true! I have no idea where this comes from.

44. Breastfeeding is blamed for everything. True! Family, health professionals, neighbours, friends and taxi drivers will blame breastfeeding if the mother is tired, nervous, weepy, sick, has pain in her knees, has difficulty sleeping, is always sleepy, feels dizzy, is anemic, has a relapse of her arthritis (migraines, or any chronic problem) complains of hair loss, change of vision, ringing in the ears or itchy skin. Breastfeeding will be blamed as the cause of marriage problems and the other children acting up. Breastfeeding is to blame when the mortgage rates go up and the economy is faltering. And whenever there is something that does not fit the "picture book" life, the mother will be advised by everyone that it will be better if she stops breastfeeding.

45. Breastfeeding mothers cannot breastfeed if they have had X-rays. Not true! Regular X-rays such as a chest X-ray or dental X-rays do not affect the milk or the baby and the mother may breastfeed without concern. Mammograms are harder to read when the mother is lactating, but can be done and the mother should not stop breastfeeding just to get this done. Furthermore, there are other ways of investigating a breast lump. Newer imaging methods such as CT scan and MRI scans are of no concern, even if contrast is used. And special X-rays using contrast media? As long as no radioactive isotope is used there is no concern and the mother should not stop even for one feed. Herein are included studies such as intravenous pyelogram, lymphangiogram, venogram, arteriogram, myelogram, etc. What about studies using radioactive nucleotides (bone scans, lung scans, etc.)? The baby will get a little radioactive nucleotide. However, as we often do these very same tests on children, even small babies, and the potential loss of benefits if the mother stops breastfeeding are considerable, the mother should, in my opinion, continue breastfeeding. If you feel you must stop for a period of time, express milk in advance so that the baby can be fed your milk and not formula. After two half lives, 75% of the compound will be out of your body. This is surely waiting long enough (the half life of technetium, which is used in most radioactive scans is only six hours, so that 12 hours after the injection, 75% of it will be out of your body). The exception is the thyroid scan using I131. This test must be avoided in breastfeeding mothers. There are many ways of evaluating the thyroid, and only very occasionally does a thyroid scan truly have to be done. If the scan must be done, doing it with I123 requires the mother to stop breastfeeding for 12 to 24 hours only depending on the dose. Check first before taking the radioactive iodine—the test can wait until you know for sure. In many cases where the scan must be done, it can be put off for several months. Incidentally, lung scans with radioactive contrast no longer is the best test to rule out a lung clot. CT scan is now the preferred test to prove or disprove the diagnosis. [See also Information Sheet Breastfeeding and Medications)

46. Breastfeeding mothers' milk can "dry up" just like that. Not true! Or if this can occur, it must be a rare occurrence. Aside from day-to-day and morning-to-evening variations, milk production does not change suddenly. There are changes which occur which may make it seem as if milk production is suddenly much less:

An increase in the needs of the baby, the so-called growth spurt. If this is the reason for the seemingly insufficient milk, a few days of more frequent breastfeeding will bring things back to normal. Try compressing the breast with your hand to help the baby get milk (Information Sheet Breast Compression). A change in the baby's behaviour. At about five to six weeks of age, more or less, babies who would fall asleep at the breast when the flow of milk slowed down, tend to start pulling at the breast or crying when the milk flow slows. The milk has not dried up, but the baby has changed. Try using breast compression to help the baby get more milk. See the website nbci.ca for videos on how to latch a baby on, how to know the baby is getting milk, how to use compression. The mother's breasts do not seem full or are soft. It is normal after a few weeks for the mother no longer to have engorgement, or even fullness of the breasts. As long as the baby is drinking at the breast, do not be concerned (Information sheet Is My Baby Getting Enough Milk?). The baby breastfeeds less well. This is often due to the baby being given bottles or pacifiers and thus learning an inappropriate way of breastfeeding.

The birth control pill may decrease your milk supply. Think about stopping the pill or changing to a progesterone only pill. Or use other methods. Other drugs that can decrease milk supply are pseudoephedrine (Sudafed), some antihistamines, and perhaps diuretics.

If the baby truly seems not to be getting enough, get help, but do not introduce a bottle that may only make things worse. If absolutely necessary, the baby can be supplemented, using a lactation aid that will not interfere with breastfeeding, or by cup if the baby will not take the aid. However, lots can be done before giving supplements. Get help. Try compressing the breast with your hand to help the baby get milk (Information Sheet Breast Compression).

47. Physicians know a lot about breastfeeding. Not true! Obviously, there are exceptions. However, very few physicians trained in North America or Western Europe learned anything at all about breastfeeding in medical school. Even fewer learned about the practical aspects of helping mothers start breastfeeding and helping them maintain breastfeeding. After medical school, most of the information physicians get regarding infant feeding comes from formula company representatives or advertisements.

48. Pediatricians, at least, know a lot about breastfeeding. Not true! Obviously, there are exceptions. However, in their post-medical school training (residency), most pediatricians learned nothing formally about breastfeeding, and what they picked up in passing was often wrong. To many trainees in pediatrics, breastfeeding is seen as an "obstacle to the good medical care" of hospitalized babies.


49. Formula company literature and formula samples do not influence how long a mother breastfeeds. Really? So why do the formula companies work so hard to make sure that new mothers are given these samples, their company's samples? Are these samples and the literature given out to encourage breastfeeding? Do formula companies take on the cost of the samples and booklets so that mothers will be encouraged to breastfeed longer? The companies often argue that, if the mother does give formula, they want the mother to use their brand. But in competing with each other, the formula companies also compete with breastfeeding. Did you believe that argument when the cigarette companies used it?

50. Breastmilk given with formula may cause problems for the baby. Not true! Most breastfeeding mothers do not need to use formula and when problems arise that seem to require artificial milk, often the problems can be resolved without resorting to formula. However, when the baby may require formula, there is no reason that breastmilk and formula cannot be given together.

51. Babies who are breastfed on cue are likely to be "colicky." Not true! "Colicky" breastfed babies often gain weight very quickly and sometimes are feeding frequently. However, many are colicky not because they are feeding frequently, but because they do not take the breastmilk as well as they should. Typically, the baby drinks very well for the first few minutes, then nibbles or sleeps. When the baby is offered the other side, he will drink well again for a short while and then nibble or sleep. The baby will fill up with relatively low fat milk and thus feed frequently. The taking in of mostly low fat milk may also result in gas, crying and explosive watery bowel movements. The mother can urge the baby to breastfeed longer on the first side, and thus get more high fat milk, by compressing the breast once the baby sucks but does not drink. (Information Sheets Colic in the Breastfed Baby and Breast Compression). Also see videos at nbci.ca

52. Mothers who receive immunizations (tetanus, rubella, hepatitis B, hepatitis A, etc.) should stop breastfeeding for 24 hours (3 days, 2 weeks). Not true! Why should they? There is no risk for the baby, and he may even benefit. The rare exception is the baby who has an immune deficiency. In that case the mother should not receive an immunization with a weakened live virus (e.g. oral, but not injectable polio, or measles, mumps, rubella) even if the baby is being fed artificially.

53. There is no such thing as nipple confusion. Not true! The baby is not confused, though, the baby knows exactly what he wants. A baby who is getting slow flow from the breast and then gets rapid flow from a bottle will figure that one out pretty quickly. A baby who has had only the breast for three or four months is unlikely to take the bottle. Some babies prefer the right or left breast to the other. Bottle fed babies often prefer one artificial nipple to another. So there is such a thing as preferring one nipple to another. The only question is how quickly it can occur. Given the right set of circumstances, the preference can occur after one or two bottles. The baby having difficulties latching on may never have had an artificial nipple, but the introduction of an artificial nipple rarely improves the situation, and often makes it much worse. Note that many who say there is no such thing as nipple confusion also advise the mother to start a bottle early so that the baby will not refuse it.

Questions? First look at the website nbci.ca or drjacknewman.com. If the information you need is not there, go to Contact Us and give us the information listed there in your email. Information is also available in Dr. Jack Newman’s Guide to Breastfeeding, and/or our DVD, Dr. Jack Newman’s Visual Guide to Breastfeeding (available in French or with subtitles in Spanish, Portuguese and Italian); and/or The Latch Book and Other Keys to Breastfeeding Success; and/or L-eat Latch and Transfer Tool; and/or the GamePlan for Protecting and Supporting Breastfeeding in the First 24 Hours of Life and Beyond.

To make an appointment online with our clinic please visit www.nbci.ca. If you do not have easy access to email or internet, you may phone (416) 498-0002.



The Breastfeeding Group

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Dr. Jack Newman graduated from the University of Toronto medical school in 1970, interning at the Vancouver General Hospital. He did his training in pediatrics in Quebec City and then at the Hospital for Sick Children in Toronto from 1977-1981 to become a Fellow of the Royal College of Physicians of Canada in 1981 as well as Board Certified by the AAP in 1981. He has worked as a physician in Central America, New Zealand and as a pediatrician in South Africa (in the Transkei). He founded the first hospital based breastfeeding clinic in Canada in 1984. He has been a consultant for UNICEF for the Baby Friendly Hospital Initiative, evaluating the first candidate hospitals in Gabon, the Ivory Coast and Canada.

Dr. Newman was a staff pediatrician at the Hospital for Sick Children emergency department from 1983 to 1992, and was, for a period of time, the acting chief of the emergency services. However, once the breastfeeding clinic started functioning, it took more and more of his time and he eventually worked full time helping mothers and babies succeed with breastfeeding. He now works at the Newman Breastfeeding Clinic and Institute based at the Canadian College of Naturopathic Medicine in Toronto.

Dr. Newman has several publications on breastfeeding, and in 2000 published, along with Teresa Pitman, a help guide for professionals and mothers on breastfeeding, called, Dr. Jack Newman's Guide to Breastfeeding, (revised editions: 2003, 2005, 2009), and The Ultimate Breastfeeding Book of Answers, (revised edition: 2006). The book has been translated into French, Indonesian, Japanese, Spanish and Italian. In 2006, Dr. Newman, along with Teresa Pitman, published The Latch and Other Keys to Breastfeeding Success (Hale Publishing) and was translated into French. He has also, along with Edith Kernerman, developed a DVD as a teaching tool for health professionals and mothers. It is available in English and French. As well, it is subtitled in Spanish, Portuguese and Italian.

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