Breastfeeding: Test Your Knowledge-- True or False?

The important human function of breastfeeding is the subject of many myths and misunderstandings. A fascinating meld of biological and behavioral events, it’s worth the attention of everyone interested in early development, even those who will not be participating at the adult end. Test your knowledge of breastfeeding by reading these “true or false?” questions.

1. Breastfeeding helps the baby resist infectious diseases. True or false?

Very true! Although babies are born with a supply of antibodies they got from their mothers’ immune systems, those antibodies can only protect against diseases the mother had already been exposed to, not exposure to new diseases after the birth. In addition, those antibodies will have diminished by the time the baby is about 8 months old, a point at which infants do not yet do a good job of making their own antibodies. The nursing mother acts as an “auxiliary immune system” to her infant. She supplies more of the antibodies she already had, and if the nursing pair are exposed to a new disease, the mother’s efficient immune system goes to work to produce antibodies and pass them on to the baby in her milk. What if the baby is exposed to something, and the mother not exposed to it? Don’t worry, she will be exposed quickly, because the physical intimacy of nursing (and other infant care) means she will come into contact with the baby’s mucus, urine, and feces.

Do note that the baby can still use this kind of help toward the end of the first year. Babies who live in clean conditions, with modern food supplies and access to modern medicine, are less affected by a lack of breastfeeding, but those living in primitive conditions may die of infections that could have been prevented by breastfeeding.


2.Nursing mothers need to eat a lot more than usual. True or false?
It depends on the conditions. If the mother was well nourished during the pregnancy, she has laid down extra fat and extra calcium in her bones, and these will be used to support lactation, so she needs little if any extra food. If the mother is living at a subsistence level, she will need extra calories to compensate for those consumed by the baby. An ounce of human milk has about 20 calories on the average, so you can do the math, considering the amount of milk consumed by babies of different sizes and ages.

The nursing mother does need to drink a lot more fluid than when she is not breastfeeding. Every ounce of fluid the baby takes needs to be replaced. Many nursing mothers automatically go to drink a glass of water before they pick up the baby to nurse, or have a cup of tea while breastfeeding. Traditionally, nursing mothers drank dark beers like porter, which supplied extra fluid and a hefty dose of B vitamins, and gave everyone a nice nap too-- nowadays we tend to frown on this, and certainly this practice would have its dangers if it occurred more than once in a while .

3. You can’t breastfeed a baby once he or she gets teeth. True or false?

False. Babies can easily be taught not to bite the nipple, if the mother is vigilant (and believe me, after one bite she WILL be vigilant). Biting and sucking take different jaw movements, and an attentive mother can see when a sucking baby re-adjusts its jaw position in preparation for a chomp. The mother then gently inserts her finger between the baby’s jaws, toward the back of the mouth. This breaks the suction, so the baby cannot get any milk, and if he or she bites down, there’s not much satisfaction, because those itchy teething gums are in the front. Within 24 hours, the baby will have learned that although you can bite lots of things, you can’t bite that nipple-- it just doesn’t work.

Nursing mothers really have to teach biting babies not to bite, or their nipples can actually be damaged, and the baby will have to be weaned from the breast.

4. Nursing babies don’t like the milk that’s flavored by strong-tasting foods their mothers have eaten. True or false?

This is mainly false, with some possible individual exceptions. The taste researchers Menella and Beauchamp fed a group of nursing mothers an all-garlic-flavored lunch, waited a couple of hours, and then timed how long the babies nursed. When they compared this to nursing time after a bland lunch, they found that the babies actually nursed longer when the milk had a garlic flavor.

There may be some individual differences, with particular babies possibly disliking certain flavors. One important point is that when a nursing mother has had a mild breast infection, the milk on that side seems to be a little saltier than usual, and babies may not care for it-- to the mother’s frustration, as frequent thorough nursing is a help in clearing up these problems.

A Quiet Lunch: Baby-feeding May Not Go Well at Parties

A friend was recently telling me about her new grandbaby, a plump but hungry little girl born by Caesarean section not long ago. The grandmother described how the young mother was worried about breastfeeding and fretting that the baby was not getting enough milk. She also told me of the scene at the new baby’s house when both grandmothers, friends, and various other visitors were all there, and the mother tried-- without much success-- to nurse the baby while socializing with the company.

Naturally, the difficulty she had with this nursing was disturbing to the mother. Like most mothers inexperienced with breastfeeding, she was afraid she wasn’t making enough milk and that the baby was starving. And the tenser she was, the more difficult it was for her to nurse the baby. Breastfeeding requires not only the “manufacture” of milk in the breasts, but a reflexive response to the baby’s sucking, the let-down or ejection reflex, that actually squirts milk out of the nipples. (This water-pistol effect is definitely part of the humorous side of breastfeeding!) Babies don’t just draw milk out of the breast as you’d suck lemonade through a straw, and if milk is not ejected, the baby will get only a few drops at a time rather than a mouthful. First-time mothers, especially, may find their milk does not “let down” easily when there is a lot of commotion or tension to deal with. Whether you’re particularly modest or not, you may find it awkward to nurse the baby when a lot is going on around you. From that point of view, it’s not surprising that my friend’s daughter-in-law had trouble breastfeeding while visitors were there.

But there’s another important point about this situation. The other half of the breastfeeding team, the baby, can also have trouble with exciting surroundings. This is so much the case that bottle-fed babies, too, may have trouble feeding when there are visitors-- and the bottle does not share the mother’s problems with letting down milk, of course.

Some years ago I was at a large party where a young mother had brought her toddler son and 6-week-old baby girl. The mother was longing to talk to all the people, many of them her cousins and friends she hadn’t seen for some time. She was trying to give the baby a bottle while she conversed, but guess what, the baby wasn’t having any; she would suck for a minute or so and then let go of the nipple, fretting. I guessed that everything was too exciting for this baby and offered to have a try. We went to a quiet room, sat down and snuggled and talked for a few minutes, then I offered the bottle and the baby slurped up every drop.

What was this all about? Did I have some kind of experienced-mother magic that I applied to this baby? No, but I was aware that even at the advanced age of six weeks, babies may have trouble organizing their feeding if there is something to distract them. In order to suck from breast or bottle, a baby needs to time properly her sucking, which brings milk into the mouth, and her swallowing. This seems simple to adults-- we even have the ability to swallow voluntarily, as in taking pills, or to take food into the mouth and hold it there without swallowing. But for the young baby sucking and swallowing are still primarily reflexive, and they have to occur at the right times and in the right order. Otherwise, the baby will choke on an excessive amount of milk, or the milk will run out of the sides of the mouth rather than going down.

So, what is the connection? Why should hearing people talk interfere with the baby’s coordination of sucking and swallowing? The problem is that a baby’s movements, breathing, sucking, and so on, are easily “entrained” to events in the environment. Entrainment means that the rhythm of actions begins to follow the rhythm of other things that are going on. It’s like adults dancing to music-- the movements of our feet follow the rhythms of the music. As adults, we can decide not to dance, or we can even dance to a different rhythm than the music that’s playing (though it’s hard to do that). Babies don’t seem to have any choice about entrainment. The rhythms of speech and movements around them can take over the rhythms of sucking and swallowing and make it difficult or impossible to do these things in the necessary pattern.

Young mothers may feel very out of things when they need to go away and be alone with the baby in order to nurse. But this may be exactly what’s needed for both parties. The mother may feel hassled and tense in a group of people, even though she wants to be there. The young baby is quite likely to be disorganized when talk, laughter, and movement take over her rhythms. A quiet place gives mother and child their best situation for feeding by breast or by bottle.