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I have spent probably hundreds (if not thousands) of hours in breastfeeding support groups online. Breastfeeding isn’t easy, and in the throes of new motherhood, moms come to places like these for advice.
Don’t get me wrong: It is awesome to have a support network of people who have gone through–or are going through–what you’re experiencing. As a new mom, I learned a ton of really helpful information from these groups.
And I also got some really bad advice.
Now that I have more experience and actual lactation training, it’s much easier to spot bad breastfeeding advice. But how are new moms supposed to know what to watch out for?
I’ll tell you:
“To maintain supply, you have to drink tons of water.”
False. Research has actually shown that extra fluids in excess of natural thirst have no effect on milk volume (source)! If you are going to be out in the heat, or if you find that you struggle to remember to drink water (mom brain, we get busy, it happens), then yes–drink more fluids. But don’t feel like you need to drink some arbitrary number recommended by some other mom.
The takeaway: Drink to thirst. If you’re never really thirsty, try–as a rule of thumb–having a drink of water every time baby nurses.
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“To have a good supply, you have to eat lactation foods/drinks.”
Cookies. Oatmeal. Fenugreek. Mother’s Milk Tea. Brewers yeast. Body Armor. Blue Gatorade. Coconut water. The list goes on and on. I’ve even seen moms suggest carrots…?
Here’s the deal. There is virtually NO solid research supporting the efficacy and use of galactagogues (<– the “official” name for milk supply boosting supplements) such as these (source, source, source).
In fact, fenugreek, an herb commonly recommended for its milk boosting powers, isn’t even recommended anymore in the latest (2018) edition of the Core Curriculum for Interdisciplinary Lactation Care. Fenugreek can make baby gassy and fussy, and can cause upset stomach and gas in mom. Additionally, fenugreek is actually contraindicated in moms who are pregnant, diabetic, hypoglycemic, on medications to slow blood-clotting, allergic to peanuts or chickpeas, or who have an over- or underactive thyroid (source).
But I digress.
Galactagogues–particularly non-herbal ones, like oatmeal–aren’t usually going to be harmful, so it probably doesn’t hurt to try them. Anecdotally, many moms swear by them.
But the fact of the matter is, even a river of blue Gatorade or a mountain of oatmeal will not be enough to increase low supply (if mom even has it) without also effectively removing milk from the breast an appropriate number of times a day.
The truth is, milk production is about milk removal and nipple stimulation (source). If you don’t have a good latch, or if you aren’t pumping effectively, your supply will be affected.
So yes, most special lactation foods or drinks probably won’t hurt. The problem is, they are also unlikely to solve the underlying issue. And they tend to distract moms from what will really help increase supply: more frequent nursing and/or pumping.
When these galactagogues do “work,” it may be that mom needed a little calorie boost (which she could have gotten from any calorically dense food), but it is unlikely that a short-term, small calorie deficit would significantly affect milk volume (source).
So what is likely? Experts suggest a placebo effect. Or, it may also be that an accompanying increase in pumping/nursing is really what does the trick.
The takeaway: Ensure that baby has a good latch, or that you have a pump that effectively removes milk. Then, remove milk by feeding baby on demand day and night or pumping as often as baby would otherwise nurse.
“Feed baby on a schedule, because it makes life easier and is good for them!”
A feeding schedule is a formula feeding norm. And it isn’t necessary. In fact, it can even be harmful to milk supply (source). And ultimately, worrying about low supply down the road isn’t going to make your life easier.
Babies fed from the breast should be fed on demand in order to maintain milk supply (source). This is a fundamental truth that advocates of “parent-led schedules” miss every time. Breastfed babies do not need to have the time between feeds stretched as they age (this is also a formula feeding norm), and you should question any “experts” who tell you otherwise.
Over time, your baby will fall into a routine. He or she will naturally nap at certain times an eat at certain times. It’s okay to follow baby’s natural routine. But following a parent-led feeding schedule is not likely to help your breastfeeding relationship long-term. In fact, moms who follow parent-led feeding schedules are more likely to stop breastfeeding sooner compared to moms who don’t (source, source).
The takeaway: Feed on demand. Routine is fine. Schedule is not.
“Cracked, painful nipples? Just push through it!”
Breastfeeding at first will be uncomfortable. I won’t lie.
But discomfort is different from straight up pain. If your nipples are cracking, bleeding, causing you to gasp or hold your breath or curl your toes–this is not normal. If the discomfort lasts more than a week or two–this is not normal.
The takeaway: The answer to the problem of nipple pain is not to push through it. It is to get help! Preferably in person with an IBCLC!
An IBCLC is an international board certified lactation consultant. Not everyone who calls themselves a “lactation counselor” or “lactation consultant” or “lactation nurse” is an IBCLC. Some providers without this credential are still qualified to assist with latch and painful nipples. But if your problem is not getting better or if you feel the advice you’re getting seems off, do not be afraid to get a second opinion from a different lactation professional! Pediatricians usually do not have lactation training and are therefore usually not the best source of lactation advice.
“Just use a nipple shield.”
A nipple shield is a thin piece of silicone that goes over the nipple. Babies with difficulties latching may be able to latch with the assistance of one of these, and they can sometimes provide some relief for sore nipples. They can be a very useful tool.
However, a nipple shield is not usually the best long-term solution. Ideally, they should only be used under the guidance of an IBCLC with a plan in place to wean from it. Unresolved latch issues or nipple pain can cause supply issues down the road or put you at increased risk for plugged ducts and mastitis (source). So you really want to get down to the root of the latch issue.
The takeaway: A nipple shield is primarily a band-aid and should be treated as sign that in-person help is needed.
“Don’t let the baby use you as a pacifier!”
The baby is not using you as a pacifier. In fact, baby is using a pacifier as a YOU! It is not a coincidence that pacifiers are nipple-shaped.
There is literally no research to suggest that comfort nursing causes attachment, development, or sleep issues. It is very difficult to overfeed a breastfed baby, and in fact the opposite it true: research has shown time and again that bottle feeding is what is associated with later childhood obesity (source, source, source)
And besides–comfort is a valid need! We wouldn’t tell adults to forego a hug or a favorite pillow or a midnight snack on the basis that those things are “just” for comfort. So why do we hold babies to a higher standard?
The takeaway: If comfort from a pacifier–or a security blanket or beloved stuffed toy–is totally legitimate, why isn’t comfort from the breast?
“Your milk might not be fatty enough. Try eating more fat.”
I have a baby who is in the 98th percentile for weight, and my pumped milk has never had a coveted “fat plug” (a thick layer of cream that settles on the top of cooled human breast milk that prevents the milk from being poured out of a bottle).
Research has shown there is nothing mom can eat to change the total amount of fat in her milk (source, source). Moms don’t produce “skim” milk–they produce exactly what baby needs. Milk fat quantity changes depending on the time of day and on how “drained” (the breast is never truly empty) or full the breast is (source).
All milk is important and nutritional. Make sure that baby has a good latch, feeds on demand, and is showing signs of appropriate milk intake (weight gain and appropriate diaper output).
The takeaway: Weight gain issues in babies are almost never a quality issue (i.e. milk isn’t fatty enough) and are almost always a quantity issue (baby isn’t getting enough milk–usually due to a latch or milk transfer issue) or, more rarely, an issue related to feeding pumped milk.
“You should pump after feeds to build a stash. You need a good sized stash.”
Most breastfeeding moms do not need a whole freezer full of milk. Moms who have one are either exclusive pumpers, milk donors, and/or tend to have massive oversupply.
Oversupply seems like a good problem to have, but it can actually be just as problematic as low supply. It puts mom at risk for clogs and mastitis (source), and it puts baby at risk for painful gas, reflux, and frustrating breast rejection (source).
Many moms recommend collecting “leaked” milk with a Haakaa pump, but this can also cause oversupply and its associated issues, since the Haakaa pump does more than just catch what would otherwise leak during a letdown. It draws out additional milk via suction.
But what about going back to work?
In order to maintain your supply while employed outside the home, you will need to pump at work about as often as baby would otherwise nurse. Relying on a large stash to go back to work, and not pumping as often while there, can make milk supply tank quickly.
The takeaway: Typically–unless mom is exclusively pumping, pumping for a missed feed, or needing to supplement pumped milk for medical reasons–there is no need to pump extra to build a large stash. Breastfeeding is designed to maintain supply long-term by itself. Don’t stress out about having a freezer full of milk!
“Try sleep training or a top-off bottle to get baby to sleep.”
I have already devoted an entire post to the myth of “good” infant sleep, but did you know that early sleep training (and sometimes any sleep training) is actually associated with low supply?
Babies who aren’t nursing at night when they naturally would are sometimes also not making up for that nursing during the day. And since frequency of milk removal and nipple stimulation helps maintain mom’s supply (source), it makes sense that a decrease in these things more often than not result in a decrease in milk supply.
And don’t forget the top off trap! The body has no way of knowing if baby is getting milk from a bottle, so unless you pump for every bottle of supplement baby gets, you risk a supply decrease. There is no research to suggest a top-off bottle of formula helps babies sleep better (source)–in fact, it may make them sleep worse since formula is harder on the belly (source).
The takeaway: If you are struggling with supply, baby is younger than 6 months, and you are sleep training, consider nursing on demand at night to help your supply. And fear not: Studies have shown that breastfeeding moms nursing at night often report getting more sleep, not less (source).
Have you ever been given bad breastfeeding advice by a well-meaning stranger? What were you instructed to do? Let me know in the comments!