Ending the Rumors: The Truth About Breastfeeding, Coffee, and Weight Loss

About 92% of women giving birth in Israel begin breastfeeding already in the hospital, but despite the high initiation rate, exclusive breastfeeding drops rapidly already during the first weeks and months after birth.

This is according to an Israeli study published in the Israel Journal of Health Policy Research, which found that although most mothers begin breastfeeding, only about 58% continue exclusive breastfeeding at two months of age, and only about 20% at six months of age — far below the recommendations of the Ministry of Health and the World Health Organization. The researchers note that one of the main factors for early cessation is the difficulty in coping with the challenges of breastfeeding and the lack of sufficient professional support.

On the occasion of the International Breastfeeding Week, Racheli Haviv, a Tipat Halav nurse and lactation consultant at Maccabi Healthcare Services, clarifies the common myths that accompany almost every new mother and explains what is actually true, and what has long been debunked by research.

"Certain foods during breastfeeding can cause gas in the baby" - not true

Babies suffer from a phenomenon called "colic" which usually begins in the first weeks of their lives and may last until 3-4 months of age. The phenomenon occurs in babies all over the world regardless of whether they are fed by breastfeeding or formula and without any connection to the mother's diet. The abdominal pain characteristic of colic usually appears at certain hours of the day. The hypothesis is that "colic" is caused by the immaturity of the large intestine which causes a reaction of involuntary contractions that cause pain.

Note that babies of mothers in other regions of the world whose diet is completely different from ours and does not include foods or components considered in Israel to cause "gas" also suffer from this phenomenon. Swallowing air also does not cause colic. Breastfed babies do not swallow air during nursing and yet suffer from the phenomenon. Breastfeeding in many cases reduces the colic phenomenon because breastfeeding causes muscle relaxation including relaxation of the intestinal muscles and the breastfeeding position helps in gentle local warming of the abdominal area, which also contributes to muscle relaxation and pain reduction.

"After a year of age, breast milk has no value" - not true

The World Health Organization and other organizations recommend breastfeeding up to two years and more depending on the family's decision. Breast milk adapts its composition to the baby's age and needs. For example, breast milk produced by a mother of a premature baby is different in composition from milk produced by a mother of a baby born on time. The type of protein in breast milk changes according to the baby's needs and even the type of fat present in the milk changes according to the mother's diet. Even after a year of age, breast milk is produced in accordance with the toddler's nutritional needs.

It is important to remember that breastfeeding is not just 'food', but also fulfills other needs of the baby/toddler such as warmth, security, a tool for calming and more. As long as breastfeeding is suitable for the mother, the baby and the family, it is recommended to continue breastfeeding the baby/toddler. Of course, it is recommended at this age to also combine varied complementary foods in order to meet the toddler's needs.

Transferring antibodies through breast milk that are produced according to the mother's and baby's or toddler's exposure to various pathogens helps even beyond a year of age to cope with various infections. Prolonged breastfeeding also contributes to the mother's health - reduction in the risk of breast cancer, reduction in the risk of diabetes and more.

"Breastfed babies do not sleep through the night" - not true

Babies need to eat and receive energy at all hours of the day including at night as their energy needs are high and occur at all hours of the day. Babies fed by bottle also mostly wake up to eat at night and sometimes parents who give formula are tempted to add cereals to try to prevent waking up at night, something that has not been proven to help.

The baby's eating pattern depends on the child's temperament. There are children who eat small amounts frequently and there are children who eat larger amounts less frequently. Both situations are normal. There are babies who nurse more frequently in the evening hours ("cluster feeding") and then manage to maintain a longer interval between meals during the night hours and there are babies who do not eat in this way. All the baby's eating patterns are normal. Sometimes it is recommended by various parties to stop breastfeeding at night, claiming that the child does not need it. It is possible to check at the age of over a year/18 months whether breastfeeding does not meet a nutritional need and adapt it to the needs of the baby and the family. Remember that breastfeeding at night has additional advantages such as: reducing the risk of SIDS, providing warmth and security to the baby and more.

It is possible to help the mother rest by bringing the baby to the mother, helping with diaper changes, helping with additional household chores or helping to care for other children in the family and more. It is worth asking the mother what assistance will suit her.

"It is important to continue breastfeeding even if the woman is sick" - true

Breast milk contains antibodies that are suitable for the mother's and baby's exposure to bacteria and viruses. When the mother is sick, it is important to help the baby cope with an illness or reduce the risk of infection by actively transferring antibodies through breast milk from the mother to the baby. Direct breastfeeding is important as opposed to giving pumped milk because through pumped milk, the baby will receive only antibodies to bacteria and viruses to which the mother was exposed, whereas in direct breastfeeding, the mother's body produces antibodies (by transferring saliva from the baby's mouth to the mother's breast) also to viruses and bacteria to which the baby was exposed. Alongside this, in the case of the mother's illness, one must be careful to use a mask and means for disinfecting hands frequently to reduce the risk of infection.

"Breastfeeding can help with weight loss" - partially true

Breastfeeding adds 500-800 kcal per day to the daily caloric expenditure. This additional expenditure allows some breastfeeding mothers to lose weight faster. However, if you ask mothers if breastfeeding actually helped them lose weight, we will often get a negative answer. Breastfeeding women are sometimes hungrier and eat more during the day both because of hormonal changes and because they are at home more. Sometimes due to lack of time, women eat more foods that are not recommended and are high in fats and sugars (snacks). Eating is sometimes also used as a means to prevent falling asleep at night. Hormonal changes that occur after birth impair the ability to lose weight. If you want to lose weight, maintain a sensible diet and physical activity and consult a certified nutritionist. Remember, many breastfeeding women report weight loss only a year after birth and this situation is normal.

"Breastfeeding reduces the chance of postpartum depression" - partially true

Postpartum depression is a condition influenced by hormone levels after birth and worsened by fatigue. Breastfeeding releases a hormone called oxytocin, which improves mood and allows for better coping with the birth of the baby.

At the same time, postpartum depression also exists in breastfeeding women and is sometimes worsened by the fatigue and lack of sleep that exist after birth and especially in the first weeks after birth. Rarely, breastfeeding may cause an unpleasant feeling and sadness (a condition called DMER) and one can consult a lactation consultant about the phenomenon. Try to rest as much as possible, try to use various support factors as much as possible and if you feel changes in mood, it is recommended to consult the treating physicians, Tipat Halav nurses and various support and treatment factors. Remember! Postpartum depression can appear up to a year after birth and it is a condition that can be treated.

"Breastfeeding causes pain in the first period" - not true

Many women suffering from wounds and pains in the first breastfeeding period hear from their surroundings that "breastfeeding is painful in the first period and the pain will pass when the child grows up". Breastfeeding pains are caused by incorrect position and attachment or by the baby's mouth structure. Breastfeeding is not supposed to be painful but in the first weeks one can feel a pulling sensation of the nipple which is sometimes unpleasant. If you suffer from breastfeeding pains, it is recommended to contact a lactation consultant as soon as possible who will help to refine the baby's attachment and if necessary will refer to medical factors for further treatment.

"Stress and anxiety affect the amount of milk" - true

Breastfeeding depends on the mother and the new baby, it depends a lot on the frequency and duration of feeding, on good attachment and full emptying of the breast. Studies have found a link between the mother's anxiety after birth and a decrease in confidence in breastfeeding and breastfeeding performance. In addition, stress and anxiety after birth are linked to lower self-efficacy of the mother and because of this to her lack of adherence to exclusive breastfeeding. From the combination of these data we can understand that there is a clear link between stress and anxiety and the amount of milk the mother produces.

Many mothers are subject to environmental pressure around breastfeeding. Various statements such as "he is not eating enough", "your milk is not nutritious enough", "if you give a bottle he will sleep at night / will gain more weight / you will have more time for yourself" and more, often reduce the mother's confidence in breastfeeding and they are myths that are not true. Find support factors you trust. You can also participate in breastfeeding support groups in your area, with professionals, other breastfeeding mothers and supporting family members. If necessary, contact lactation consultants who will be able to help adapt breastfeeding to your needs and the baby's needs based on facts.

"It is forbidden to drink coffee during the breastfeeding period" - not true

Similar to the pregnancy period, it is recommended for the breastfeeding mother to reduce the amount of caffeine she consumes to an amount of up to 3-4 servings per day. Caffeine in large amounts is found in coffee, tea, energy drinks including cola drinks and in chocolate. Caffeine passes into breast milk, accumulates in the baby's body and causes (similar to its effect in large amounts in adults), restlessness in the baby and over-arousal.

"It is forbidden to give a baby a pacifier until a month of age" - not accurate

The sucking reflex exists in babies and it is intended to provide them with appropriate nutrition, calming and security. The most appropriate means for fulfilling the baby's need for sucking is breastfeeding which fulfills all the baby's basic needs.

The Ministry of Health recommends putting babies to sleep with a pacifier to reduce the risk of SIDS after breastfeeding is established, however in a breastfed baby, breastfeeding fulfills this role. Giving a pacifier at an early stage of the baby's life can affect the sucking pattern because the baby learns that he must close his mouth instead of opening his mouth wide for effective sucking. In case a pacifier is given, one must be careful about optimal attachment and latching with an open mouth. Another risk stems from giving a pacifier when the baby is crying after a meal with the thought that the crying stems from stomach pains, fatigue etc. while the baby is still hungry and will be happy to receive additional food (unfortunately this phenomenon occurs mainly in babies fed by bottle). To help you adapt the giving of the pacifier to the baby's needs, it is recommended in the first month to give the baby a pacifier in the following situations - when changing the baby's diaper and he is crying, crying during undressing the baby for a shower, during a car ride and when the mother needs to be in the bathroom. The rest of the time it is recommended to use breastfeeding to fulfill the baby's needs.

"If you are not breastfeeding fully, there is no point in breastfeeding partially" - not true

Breastfeeding is indeed the optimal nutrition for the baby. However, sometimes mothers do not want, cannot or do not prefer to breastfeed their baby fully. Remember that any amount of breast milk and any breastfeeding, whether the baby receives only colostrum (the initial milk) and whether you breastfeed partially or fully, breastfeeding and breast milk contribute to your health and the baby's health.