Breast surgeon debunks common breastfeeding myths
Breastfeeding is often surrounded by rules and advice, but according to Dr. Katrina B. Mitchell, a breast surgeon and international board-certified lactation consultant, much of this advice is not supported by current knowledge of breast anatomy and physiology.
Dr. Mitchell is the founder of Physician Guide to Breastfeeding, a widely used evidence-based resource for parents and healthcare professionals. Her new book, Go With the Flow, aims to dispel common breastfeeding myths.
Myth-Busting Breastfeeding Advice
One common myth is that breastfeeding mothers cannot drink alcohol. However, new research shows that even binge drinking is unlikely to result in significant blood levels of alcohol in an infant.
This is because the baby consumes a fraction of the volume of alcohol that the mother does, and then has to metabolize it through their stomach, gut, liver, and bloodstream.
Unless consuming extremely high amounts of caffeine, it is safe for breastfeeding mothers to have a cup of coffee or other caffeinated beverages.
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Dr. Mitchell’s work aims to change the current state of breastfeeding advice by providing evidence-based information and resources to healthcare professionals and parents.
Debunking Common Breastfeeding Myths
Dr. Mitchell explains that milk is stored in milk-making cells, not ducts, and that swelling and redness in the breast are caused by increased blood flow, not a “clog” of milk.
Instead of using heat, Dr. Mitchell recommends using ice to reduce swelling and pain, similar to how one would treat a sprained ankle or post-surgery pain. This approach can help to alleviate discomfort and promote healing.
Additionally, the use of APNO (all-purpose nipple ointment) is not necessary, as the nipple is not a common site for fungal or bacterial infections. Steroids in APNO can also be dangerous if used for extended periods.
Separating Fact from Fiction
Wearing a bra does not cause mastitis, and poor posture, wearing a seatbelt, or sleeping on one’s side do not increase the risk of developing mastitis. These factors have been incorrectly linked to mastitis in the past.
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Massaging the lactating breast is also not recommended, as it can lead to complications such as mastitis and abscesses. Instead, Dr. Mitchell suggests treating the breasts gently and using ice to reduce swelling and pain.
The idea that breastmilk forms a “cesspool” of infection if the breasts are not regularly “emptied” is also a myth. The body is designed to accommodate variability in feeding patterns, and breastmilk production is regulated by the body’s natural responses to feeding stimuli.
Understanding Nipple Pain and Infections
Nipple pain, itching, redness, or rash are often misattributed to a “yeast infection.” However, yeast infections are rare in the breast or nipple, and such symptoms are more likely caused by nerve pain or dermatitis (eczema).
Nerve pain can be treated with medication, while dermatitis can be resolved by stopping exposure to allergens and using a short-term prescription steroid cream.
