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5 Things You Thought You Knew About Breastfeeding

An exploration of five breastfeeding myths.

In addition to breastfeeding her own daughter for longer than a year, actress Salma Hayek breastfed a malnourished infant during her UNICEF trip to Sierra Leone to promote breastfeeding.

Hayek's action was met with shock and skepticism from our culture. Could this be a result of common misconceptions Americans have concerning breastfeeding? The following list addresses prevalent myths about breastfeeding.

Myth 1: Breastfeeding is easy and instinctual.

Even though mothers and babies both have reflexes that enable breastfeeding,1,2 breastfeeding is not automatic and requires learning through observation and instruction. 1

Feeding within the first hour of birth is extremely important for longterm breastfeeding success, and mothers and healthcare professionals alike should strive to achieve this.

Birth medications and interventions or latching problems may make breastfeeding more difficult,4,5 but these difficulties can usually be overcome with the help and support of a lactation consultant.

Myth 2: Some women can't produce enough milk to breastfeed.

It is very rare that a woman is not able to produce enough milk to breastfeed, even though that concern is often raised.6-8 Breastfeeding on demand, even at night, right after the child is born guarantees that mothers will not run out of milk.8

Over time, a breastfeeding woman's body adapts to more efficiently release milk (breasts become softer, leak less, etc.), which women could misinterpret as insufficient milk supply.9 In fact, mothers' breast milk actually adapts in both quantity and quality to the changing nutritional needs of the child.10

Myth 3: When babies eat frequently, it means they are not satisfied by breastmilk alone.

Just like growing children, babies go through growth spurts, causing them to eat more or less depending on their nutritional needs.11 Mothers' milk adapts to these changing needs.10

If the baby is eating more frequently, it doesn't necessarily mean that mom's milk isn't satisfying the baby, perhaps just that the baby is hungrier and experiencing a growth spurt.11

Myth 4: Breast milk alone for the first six months is not enough for babies.

Both the American Academy of Pediatrics (AAP) and the World Health Organization (WHO) recommend that mothers breastfeed exclusively for the first six months after birth.12,13 Breastmilk provides all of the necessary nutrition and hydration that babies require for the first six months.14

Though recent research has shown that breastfed babies15 sometimes don't get enough vitamin D, it means the mother is not getting enough vitamin D (from sunlight or supplements). The amount of vitamin D in breast milk is directly related to maternal vitamin D intake and so can be improved when needed.16 Breast milk supplies all other vitamins and minerals that babies need.

Myth 5: Breastfeeding a child for longer than a year is abnormal and bad for the child.

It is completely normal and natural to breastfeed for longer than one year. Our evolutionary ancestors breastfed for 4 years on average,17 and according to primate models, mammals similar to humans breastfeed until the child's first adult molar, that's six years for humans.18,19

The World Health Organization recommends breastfeeding for at least two years. 13 Even though the American Academy of Pediatrics recommends that moms breastfeed for at least one year, only one in five women in the U.S. are breastfeeding at all when their child is one year old.12 The health benefits the child gains through extended breastfeeding last a lifetime.20

Regarding Hayek breastfeeding another's child, our ancestors raised their children together ("cooperative breeding"17). In that light, what Hayek did was not so unusual.

Note: Co-authored with Elizabeth Ledden and Stephanie Sieswerda.

Also, see my previous post: The Tremendous Benefits of Breastfeeding.


Small, M. (1998). Our babies, ourselves: How biology and culture shape the way we parent. New York: Random House.

Colson, S., Meek, J., & Hawdon, J. (2007). Optimal positions for the release of primitive neonatal reflexes stimulating breastfeeding. Early Human Development, 84, 441-9.

Edmond, K., Zandoh, C., Quigley, M., Amenga-Etego, S., Owusu-Agyei, S., & Kirkwood, B. (2006). Delayed breastfeeding initiation increases risk of neonatal mortality. Pediatrics, 117(3), e380-e386.

Rowe-Murray, H. & Fisher, J. (2002). Baby friendly hospital practices: Cesarean section is a persistent barrier to early initiation of breastfeeding. Birth, 29(2), 124-31.

Baumgarder, D., Muehl, P., Fischer, M., & Pribbenow, B. (2003). Effect of labor epidural anesthesia on breast-feeding of healthy full-term newborns delivered vaginally. JABFP, 16(1), 7-13.

Ahluwalia, I., Morrow, B., & Hsia, J. (2005). Why do women stop breastfeeding? Findings from the Pregnancy Risk Assessment and Monitoring System. Pediatrics, 116, 1408-12.

Ruowei, L., Fein, S., Chen, J., & Grummer-Strawn, L. (2008). Why mothers stop breastfeeding: Mothers' self-reported reasons for stopping during the first year. Pediatrics, 112, S69-S76.

Moore ER, Anderson GC, Bergman N. Early skin-to-skin contact for mothers and their healthy newborn infants. Cochrane Database Syst Rev. 2007;(3):CD003519.

Amir, L. (2006). Breastfeeding: Managing "supply" difficulties. Australian Family Physician, 35(9), 686.

Stuebe, A. (2009). The Risks of Not Breastfeeding for Mothers and Infants. Reviews in Obstetrics & Gynecology, 2(4), 222-231.

Akre, J. (ed.) (1990). Infant feeding: The physiological basis. Bulletin of the World Health Organization, 67(Suppl.).

Gartner, L.M., Morton, J., Lawrence, R.A., Naylor, A.J., O'Hare, D., Schanler, & R.J., Eldelman, A.I.; American Academy of Pediatrics Section on Breastfeeding. (2005). Breastfeeding and the use of human milk. Pediatrics, 115(2), 496-506.

Fifty-Fifth World Health Assembly. Infant and Young Child Nutrition: Global Strategy on Infant and Young Child Feeding. Geneva, Switzerland: World Health Organization; 2002.

Goldberg, N.M. & Adams, E. (1983). Supplementary water for breast-fed babies in a hot and dry climate-not really a necessity. Arch Dis Child, 56(1), 73-4.

Lips, P. (2006). Vitamin D physiology. Prog Biophys Mol Biol, 92(1), 4-8.

Rothberg, A.D., Pettifor, J.M., Cohen, D.F., Sonnendecker, E.W., & Ross, F.P. (1982). Maternal-infant vitamin D relationships during breast-feeding. J Pediatr, 101(4), 500-3.

Hrdy, S. (2009). Mothers and others: The evolutionary origins of mutual understanding. Cambridge, MA: Belknap Press.

Smith BH. (1991). Age of weaning approximates age of emergence of the first permanent molar in nonhuman primates, abstracted. Phys Anthropol Suppl., 12, 163-4.

Borgin B & Smith H. (1996). Evolution of the human life cycle. American Journal of Human Biology, 8, 703-16.

Horta BL, Bahl R, Martinés JC, et al. Evidence on the long-term effects of breastfeeding: systematic review and meta-analyses. Geneva: World Health Organization; 2007