Busting Breastfeeding Myths

Lactation and breastfeeding are a unique experience for every parent and infant. Your feeding journey may have different phases: beautiful, challenging, satisfying, remarkable, and complicated—sometimes, all at once. It can leave parents searching for fast fixes or relying on decades-old information.

Amelia Henning, CNM, MSN, IBCLC, director of the Mass General Breastfeeding & Lactation Clinic, and Annie Brewer, RN, IBCLC, bust myths and share new evidenced-based information to help parents succeed with breastfeeding and pumping.

Myth: Massage and heat help mastitis and clogged ducts

Mastitis is a spectrum of inflammation that can happen in breast tissue when a person is breastfeeding. It starts with simple inflammation but may progress to an infection that needs antibiotics or other medical interventions.

It was previously thought that breast massages and heat are the best remedies for mastitis and clogged ducts. People were told to avoid ice because it was thought to decrease milk flow and production. Heat and massage can worsen the problem by increasing blood flow and inflammation in the breast and putting more pressure on the ducts which makes it harder for the milk to drain. Deep massage can also damage the tissue, and small blood and lymphatic vessels in the breast.

New evidence shows that treating the inflammation will resolve most clogged ducts and mastitis. If you develop a red, swollen or tender spot on your breast, treat the inflammation similarly to how you’d treat a sprained ankle. You can remember the steps using the acronym, GRACE:

• Gentle touch: Use a gentle sweeping motion as you rotate around the breast, sweeping up towards your collar bone. This graphic demonstrates this technique for lymphatic drainage which can reduce inflammation by gently moving extra fluid from the breast tissue into your lymph system. Don’t use any deep pressure or hard tools to massage the area
• Rest: Feed your baby when hungry or pump only as often as your baby needs to eat. Give your body time to rest otherwise. Extra pumping or feeding can make your symptoms worse
• Anti-inflammatory: Apply cold compresses and take 600 mg of ibuprofen (such as Motrin, Advil) and/or 1,000 mg of an acetaminophen (such as Tylenol) every six hours to decrease the swelling
• Comfortable bra: Keep the breast well supported in a well-fitting, comfortable bra. It may help to avoid underwire or very tight bras
• Encouragement: You are doing a great job, and if you need additional support there are lactation resources available. OB/GYN offices or your baby’s pediatrician’s office can help connect you with a lactation consultant in your community

If you do not feel better in 24-48 hours, please call your health care provider for an evaluation.

Myth: I need to power pump to build up a freezer stash of breastmilk

Creating a ‘freezer stash’ of milk may seem like an attractive option, but practices like power pumping—where you pump on and off for 60 minutes—can lead to an overproduction of milk and mastitis. It generally isn’t recommended. While it can mimic a baby cluster feeding (when a baby wants to nurse more frequently), power pumping should only be used occasionally under the direction of an experienced lactation care provider.

Myth: Saltwater soaks, milk collectors, and vibrating massage tools are necessary.

These practices and items recently rose in popularity, but they certainly are not necessary.

• Milk collectors: There is a difference between a milk collector, which catches drops of milk that leak, and a silicone hand pump, which applies pressure on the breast. Milk collectors are appropriate in some cases, such as if one breast is leaking while the other is feeding. Speak with a lactation specialist if you are considering using a collecting device
• Saltwater soaks: Saltwater soaks shouldn’t be used at all in lactation care because they cause the skin to breakdown. It will not help with milk production or inflammation and may harm your nipples
• Vibrating massage tools: These tools, even hairbrushes and toothbrushes, should never be used to massage your breasts for any reason. If you’re concerned about mastitis or a plugged duct, refer to the GRACE steps above, specifically gentle touch methods

Myth: Cabbage leaves help engorgement

While previously there was some evidence that cabbage leaves can help with early postpartum engorgement (increased breast swelling as your milk first comes in), recent evidence shows no difference between the use of cabbage leaves and ice packs.

If you’re breasts are feeling engorged or if you are experiencing inflammation due to mastitis, you can try soft ice packs (layer a towel or other thin cloth between the ice pack and your breast) and gentle touch to encourage lymphatic drainage (use a gentle sweeping motion as you rotate around the breast, sweeping up towards your collar bone). This is a method of gently moving extra fluid into the lymph system to be properly drained.

Myth: If I want to give my baby the best start with breastfeeding, I must collect colostrum prenatally

Collecting prenatal colostrum can be a great tool and is especially beneficial for those who may have a more difficult time producing milk after their baby is born, but it is certainly not a ‘must do.’

If you are prenatally producing and expressing colostrum—which is the first milk produced by the breasts during pregnancy and in the early days after childbirth—and choose to collect it, expect very small amounts. In fact, drops are normal. Most pregnant people can begin this practice after 36-37 weeks of pregnancy, but as always, check with your prenatal care provider first.

The greatest benefit of prenatal colostrum collection is learning the skill of hand expression.

Learn more about hand expression »

Myth: If my baby has thrush, I need to treat my nipples for yeast

This was a very common approach for many years. However, new research shows there’s no significant evidence that yeast grows on nipples. The vast majority of “nipple yeast” is due to skin irritation (dermatitis) or trauma from improper pump use or latching.

Please reach out to your pediatric provider and your midwife, OB, or lactation care provider if you are experiencing symptoms that you think might be yeast or if your baby is experiencing thrush (a common fungal infection that can affect the mouth and throat).

Myth: Breastfeeding is going to be hard and it’ll hurt, but I must power through

While breastfeeding can have ups and downs, especially as both you and your baby are learning this new skill, it should not hurt long-term. If it does or if you’re feeling overwhelmed, there is support.

• Join a virtual support group
• Take a breastfeeding class. The Department of OB/GYN offers one that you can take prenatally
• OB/GYN departments across Mass General Brigham provide a variety of general breastfeeding and outpatient lactation services:
  • Brigham and Women’s Hospital Center for Women and Newborns provides lactation support services
  • Newton-Wellesley Hospital provides breastfeeding/lactation services including a support group and outpatient clinic
  • Salem Hospital provides breastfeeding services including classes, a support group, and telephone counseling
• The Mass General Breastfeeding & Lactation Clinic can help manage medically complex issues and support patients in meeting their goals for feeding their infant. A breastfeeding and lactation medicine specialist can diagnose, treat, and help patients plan for complicated breastfeeding and lactation problems