I often find myself in the position of helping first time moms with questions about breastfeeding. As I have done this over the past few years I have seen many different situations, some good and some heartbreaking. As I have gained more experience and begun developing some of my own materials for teaching at the hospital, I have started keeping a list of things that I have seen jeopardize breastfeeding. This allows me to encourage moms and help prepare them before their baby is born. It is my opinion that information empowers parents to make decisions that are based on facts instead of doubts and fears. Decisions that are based on informed consent are probably not regretted as much as decisions based on incomplete or wrong information.

Things (often well-meaning) people say that damage a mother's confidence in breastfeeding that are not supportable by current lactation research:

1. "Oh your baby is so big. You will not be able to provide enough for him. You should just go ahead and supplement with formula from the beginning."
   Fact: Breastmilk production is related solely on the demand/supply concept. As the breast is stimulated, prolactin is released, which drives the amount of milk the body produces. The size of the breast does not determine how much milk a mom can make or store. The physical body structure of a mom does not determine how much milk a mom can make or store. I have seen plenty of small, petite women provide more than enough milk for their 10/11 pound babies to grow and thrive. God designed our bodies well, and we can trust His design.
2. "Your baby is crying because he is so hungry. The colostrum just won't fill him up and a little bottle of formula won't hurt anything."
   Fact: After birth, babies have everything they need in the colostrum that God perfectly designed the body to make for the first few days after birth. It has a high concentration of protein, especially immune proteins, and a lower concentration of fat and lactose. Colostrum protects the gut by coating and lining it and helps establish gut flora by affecting the pH of the gut. It also aides in gut closure (the gut is more permeable at birth). The passage of meconium is facilitated by colostrum, and the fact that it is thick and is released in small amounts makes learning to nurse easier.
3. "You are so tired from giving birth. Just let the nurses keep your baby overnight and give him a bottle."
   Fact: The body's natural prolactin levels are highest at night and that is an important time for you to be with your baby when he is hungry. Nursing during the night does not take that much time and if you are careful to rest when your baby is resting, it is more beneficial to maintain breastfeeding even during the night. In the event of an unusual situation with special needs for the mom or the baby, nurses can and should help you pump even during the night (every 3 hours) so your body can be getting the right signals to provide enough milk for your baby.
4. "Giving your baby a bottle or a pacifier will not damage breastfeeding. Babies can learn the difference in sucking patterns."
   Fact: There is no research that conclusively supports the danger of early pacifier or bottle use. There is, however much anecdotal information to suggest that babies who do not use artificial nipples for the first 4 to 6 weeks stand a better chance of getting nursing established. After the first 4 to 6 weeks there is plenty of time to introduce and use a bottle if that is what you prefer. In the rare event that your baby refuses a bottle (after trying different nipples), there are other ways to supplement and feed your baby without the use of bottles (cup feeding, for instance is very easy once it is demonstrated, and is the method of choice in baby-friendly hospitals for supplementing even babies with special health needs).
5. "Babies with jaundice should be weaned until the jaundice is cleared up."
   Fact: The American Academy of Pediatrics recommends continued breastfeeding even when a baby is jaundiced. Colostrum is especially important in preventing jaundice because it facilitates bowel movements (bilirubin is released through bowel movements). Even in rare circumstances where the bilirubin count is high enough to suggest a need for formula supplementation, the formula can be put into a supplementer so the baby can obtain it by nursing at the breast, thus decreasing the risk of breastfeeding problems. More often than not, increasing the frequency of feedings is all that is needed to resolve physiologic jaundice (in addition to sunlight or phototherapy depending on bilirubin levels).That said, there is a rare type of jaundice called breastmilk jaundice that does require a temporary cessation of breastfeeding until bilirubin levels fall, BUT it does not appear until 10 to 14 days after birth--long after typical physiologic jaundice is usually diagnosed (in other words, if someone tells you that your baby must have breastmilk jaundice and your baby is only 2-5 days old--when most conditions of jaundice are diagnosed--it is unlikely that you are receiving accurate information).