Written by Jack Newman, MD, FRCPC. © 20051. A breastfeeding mother has to be obsessive about what she eats. 哺乳媽媽必須嚴格注意飲食
Not true! A breastfeeding mother should try to eat a balanced diet, but neither needs to eat any special foods nor avoid certain foods. A breastfeeding mother does not need to drink milk in order to make milk. A breastfeeding mother does not need to avoid spicy foods, garlic, cabbage or alcohol. A breastfeeding mother should eat a normal healthful diet. Although there are situations when something the mother eats may affect the baby, this is unusual. Most commonly, "colic", "gassiness" and crying can be improved by changing breastfeeding techniques, rather than changing the mother's diet. (Handout #2 Colic in the breastfed baby).2. A breastfeeding mother has to eat more in order to make enough milk. 爲了多產奶，哺乳媽媽必須多吃
Not true! Women on even very low calorie diets usually make enough milk, at least until the mother's calorie intake becomes critically low for a prolonged period of time. Generally, the baby will get what he needs. Some women worry that if they eat poorly for a few days this also will affect their milk. There is no need for concern. Such variations will not affect milk supply or quality. It is commonly said that women need to eat 500 extra calories a day in order to breastfeed. This is not true. Some women do eat more when they breastfeed, but others do not, and some even eat less, without any harm done to the mother or baby or the milk supply. The mother should eat a balanced diet dictated by her appetite. Rules about eating just make breastfeeding unnecessarily complicated.3. A breastfeeding mother has to drink lots of fluids. 哺乳媽媽必須喝大量液體
Not true! The mother should drink according to her thirst. Some mothers feel they are thirsty all the time, but many others do not drink more than usual. The mother's body knows if she needs more fluids, and tells her by making her feel thirsty. Do not believe that you have to drink at least a certain number of glasses a day. Rules about drinking just make breastfeeding unnecessarily complicated.4. A mother who smokes is better not to breastfeed. 吸菸的媽媽最好不餵奶
Not true! A mother who cannot stop smoking should breastfeed. Breastfeeding has been shown to decrease the negative effects of cigarette smoke on the baby's lungs, for example. Breastfeeding confers great health benefits on both mother and baby. It would be better if the mother not smoke, but if she cannot stop or cut down, then it is better she smoke and breastfeed than smoke and formula feed.5. A mother should not drink alcohol while breastfeeding.哺乳期間媽媽不應喝酒
Not true! Reasonable alcohol intake should not be discouraged at all. As is the case with most drugs, very little alcohol comes out in the milk. The mother can take some alcohol and continue breastfeeding as she normally does. Prohibiting alcohol is another way we make life unnecessarily restrictive for nursing mothers.6. A mother who bleeds from her nipples should not breastfeed. 乳頭出血的媽媽不應餵奶
Not true! Though blood makes the baby spit up more, and the blood may even show up in his bowel movements, this is not a reason to stop breastfeeding the baby. Nipples that are painful and bleeding are not worse than nipples that are painful and not bleeding. It is the pain the mother is having that is the problem. This nipple pain can often be helped considerably. Get help. (Handout #3 Sore Nipples and #3b Treatments for Sore Nipples and Sore Breasts). Sometimes mothers have bleeding from the nipples that is obviously coming from inside the breast and is not usually associated with pain. This often occurs in the first few days after birth and settles within a few days. The mother should not stop breastfeeding for this. If bleeding does not stop soon, the source of the problem needs to be investigated, but the mother should keep breastfeeding.7. A woman who has had breast augmentation surgery cannot breastfeed. 接受乳腺增生手術的媽媽不能餵奶
Not true! Most do very well. There is no evidence that breastfeeding with silicone implants is harmful to the baby. Occasionally this operation is done through the areola. These women do have often have problems with milk supply, as does any woman who has an incision around the areolar line.8. A woman who has had breast reduction surgery cannot breastfeed. 曾經接受過縮乳手術的婦女不能餵奶
Not true! Breast reduction surgery does decrease the mother's capacity to produce milk, but since many mothers produce more than enough milk, some mothers who have had breast reduction surgery sometimes can breastfeed exclusively. In such a situation, the establishment of breastfeeding should be done with special care to the principles mentioned in the handout #1 Breastfeeding―Starting Out Right. However, if the mother seems not to produce enough, she can still breastfeed, supplementing with a lactation aid (so that artificial nipples do not interfere with breastfeeding).9. Premature babies need to learn to take bottles before they can start breastfeeding. 早產嬰兒需要在母乳餵養之前學習接受奶瓶
Not true! Premature babies are less stressed by breastfeeding than by bottle feeding. A baby as small as 1200 grams and even smaller can start at the breast as soon as he is stable, though he may not latch on for several weeks. Still, he is learning and he is being held which is important for his wellbeing and his mother's. Actually, weight or gestational age do not matter as much as the baby's readiness to suck, as determined by his making sucking movements. There is no more reason to give bottles to premature babies than to full term babies. When supplementation is truly required there are ways to supplement without using artificial nipples.10. Babies with cleft lip and/or palate cannot breastfeed. 脣裂和（或）顎裂的嬰兒不能母乳餵養
Not true! Some do very well. Babies with a cleft lip only usually manage fine. But many babies with cleft palate do indeed find it impossible to latch on. There is no doubt, however, that if breastfeeding is not even tried, for sure the baby won’t breastfeed. The baby's ability to breastfeed does not always seem to depend on the severity of the cleft. Breastfeeding should be started, as much as possible, using the principles of proper establishment of breastfeeding. (Handout #1 Breastfeeding―Starting Out Right). If bottles are given, they will undermine the baby's ability to breastfeed. If the baby needs to be fed, but is not latching on, a cup can and should be used in preference to a bottle. Finger feeding occasionally is successful in babies with cleft lip/palate, but not usually.11. Women with small breasts produce less milk than those with large breasts. 乳房小的婦女比乳房大的婦女產奶少
Nonsense!胡說八道12. Breastfeeding does not provide any protection against becoming pregnant. 母乳餵養對於懷孕不能提供任何保護
Not true! It is not a foolproof method, but no method is. In fact, breastfeeding is not a bad method of child spacing, and gives reliable protection especially during the first six months after birth. It almost as good as the pill if the baby is under six months of age, if breastfeeding is exclusive, and if the mother has not yet had a normal menstrual period after giving birth. After the first six months, the protection is less, but still present, and on average, women breastfeeding into the second year of life will have a baby every two to three years even without any artificial method of contraception.13. Breastfeeding women cannot take the birth control pill. 母乳餵養的婦女不能吃避孕藥
Not true! The question is not exposure to female hormones, to which the baby is exposed anyway through breastfeeding. The baby gets only a tiny bit more from the pill. However, some women who take the pill, even the progestin only pill, find that their milk supply decreases. Estrogen containing pills are more likely to decrease the milk supply. Because so many women produce more than enough, this often does not matter, but sometimes it does even in the presence of an abundant supply, and the baby becomes fussy and is not satisfied by nursing. Babies respond to rate of flow of milk, not what's "in the breast", so that even a very good milk supply may seem to cause the baby who is used to faster flow to be fussy. Stopping the pill often brings things back to normal. If possible, women who are breastfeeding should avoid the pill, or at least wait until the baby is taking other foods (usually around 6 months of age). Even if the baby is older, the milk supply may decrease significantly. If the pill must be used, it is preferable to use the progestin only pill (without estrogen). 14. Breastfeeding babies need other types of milk after 6 months. 母乳餵養的嬰兒在6個月後需要其它奶
Not true! Breastmilk gives the baby everything there is in other milks and more. Babies older than six months should be started on solids mainly so that they learn how to eat and so that they begin to get another source of iron, which by 7-9 months, is not supplied in sufficient quantities from breastmilk alone. Thus cow's milk or formula will not be necessary as long as the baby is breastfeeding. However, if the mother wishes to give milk after 6 months, there is no reason that the baby cannot get cow's milk, as long as the baby is still breastfeeding a few times a day, and is also getting a wide variety of solid foods in more than minimal amounts. Most babies older than six months who have never had formula will not accept it because of the taste.
?多哺育母乳的迷思 More Breastfeeding Myths
1. 哺乳媽媽須要很注意自己的飲食
?正確！哺乳媽媽應設法均衡飲食，?需特別吃?麼食品亦?用避免某些食物。哺乳媽媽?必爲?u造乳汁而喝牛奶，也?須避免辛辣的食物、大蒜、包心菜或酒，哺乳媽媽應該有正常、健康的飲食。雖然有時媽媽吃的食物會影響嬰兒，但這種情況是罕?的。通常“腹絞痛＂、“脹氣＂和哭鬧可經由哺j母乳的技巧改變而改善，而?是透過母親飲食的改變?改善。
2. 爲?分?足夠的奶水，哺j母乳的媽媽必須多吃一點
?正確！即使是攝取相當低熱?飲食的婦?通常也能u造足夠的奶水，除非媽媽攝取的熱?非常?足，且維持很長一段時間，纔會有影響。通常嬰兒都能從母乳中得到所有他所需要的營養，某些婦?擔心如果她們幾天沒吃好，會影響到乳汁，這沒有必要擔心！飲食上的小變化?會影響奶?或品質。一般會?，哺乳婦?每天須額外補充500卡??，這?是正確的，某些婦?在哺乳期間的確吃得較多，有些甚至吃得較少，也?會對母親、嬰孩或奶?有影響。母親應依她的食j均衡飲食，關於飲食的?法只會使哺乳複雜化。
3. 哺j母乳的媽媽必須喝很多水分
?正確！媽媽應該依自己感覺?攝取水分。有些媽媽一直感到口渴，但很多媽媽並?覺得要喝比平常多的水份。如果需要?多水分，母親的身體會經由感覺口渴?告訴自己，?要相信您每天必須補充相當大?水分的?法，關於水分補充的?法只會使哺乳複雜化。
4. 抽菸的媽媽最好?要哺乳
?正確！無法戒菸的媽媽應該要哺乳，哺j母乳證明可減少香菸對寶寶健康的負面影響，?如對肺部的影響，哺j母乳帶給媽媽和寶寶很多有益健康的好處 。如果媽媽?抽菸，對媽媽和嬰孩當然?好；但如果無法戒菸或減少吸菸?，在二手菸的環境下，哺j母乳勝於j食配方奶。
5. 哺乳媽媽?應該喝酒
?正確！合?的酒精攝取根本?應禁止。如同大部分藥物常有的情形，只有非常少?的酒精會分?到母乳中，對嬰兒的影響?大。媽媽可以喝酒並持續哺j母乳。禁止喝酒是另一種對哺乳媽媽沒有必要地限制。
6. 乳頭?血的媽媽?應哺j母乳
?正確！ 雖然血液會使嬰孩較常吐，甚而出現在他的大?中，但這?是停止哺j母乳的原因。乳頭疼痛及?血並?會比是乳頭疼痛但??血還糟，媽媽的乳頭疼痛纔是問題。乳頭疼痛通常都可以改善的，請尋求協助（單張#3 乳頭疼痛及#3b乳頭和乳房疼痛的治?）。有時媽媽乳頭?血明顯源於乳房內部，通常?會?帶i痛，這常發生在生a後頭前幾天，幾天後就會停止，媽媽?應該因此停j母乳。如果?血?能很快停止，應該要?清楚原因，但媽媽仍應繼續哺j母乳。
7. 做過豐胸手術的婦?無法哺j母乳
?正確！ 大部分都可以j得很好。沒有證據顯示以植硅膠的乳房哺乳對寶寶有害。有時這些手術會從乳??開，如果?口是延著乳?外圍作環??開的，通常這些婦?都會有奶??足的問題。
8. 動過減胸手術的婦?無法哺j母乳
?正確！ 減胸手術確實會?低媽媽u造乳汁的能?，但因爲很多媽媽乳汁過?，有些動過減胸手術的媽媽還可以全母奶哺j。在這樣情況下，母乳哺育的建?應依單張#1母乳哺育─正確的開始仔細進?。但如果奶??夠，媽媽可以持續哺乳，並以哺乳輔助器?添加奶水（如此人工奶嘴?會干擾母乳哺j) 。
9. 早a兒需先學會使用奶瓶，才能開始j母乳。
?正確！早a兒吸乳房比吸奶瓶?容?讓情況穩定。體重只有1200 克或?小的嬰兒只要?況穩定即可開始哺j母乳，雖然他們可能因爲太小有好幾個星期無法整個含住乳?。但是，他開始學習吸吮母奶並且被親密地抱在媽媽懷?，這對母子親情及早a兒的成長都很重要。實際上，體重或懷孕L?並?如寶寶是否準備好吸吮與他是否能做吸吮動作這些因素?得重要。早a兒並?比足月寶寶?有?由要使用奶瓶j食。當需要j食補充品時，有很多?需使用奶嘴的方式可以使用。
10. 兔脣且/或?的嬰孩無法哺j母乳
?正確！有些寶寶吃得很好。只有嘴脣?縫通常可正常哺乳，但許多有?的寶寶，吸奶的確比較困難。然而，毫無疑問地，??嘗試寶寶當然?會吸奶。寶寶吸奶的能?並非完全取決於?縫的程?。應早以建?母乳哺育原則開始哺j母乳。(單張#1 母乳哺育C正確的開始) 。以奶瓶j食會影響寶寶吸吮的能?。?寶寶?能含上乳房又需要j食，杯j比瓶j優先考慮。以手指j食兔脣／?的嬰孩偶爾?得通，但?是經常都可以。
11. 胸部小的婦?比胸部大的婦?分?較少的奶水
胡?！
12. 哺j母乳沒有任何避孕效果
?正確！哺j母乳?是一個萬無一失的避孕方法，但沒有任何一種方式是安全無比的。實際上，哺j母乳是延長孩子間隔的?錯方法，特別是a後頭?個月有蠻好的效果。如果她的寶寶未滿?個月、全母乳哺j，且a後月經尚未恢?，它的避孕?效果和口服避孕藥一樣。頭?個月後，保護作用會逐漸?低，但仍有一些效果，一般第二?繼續哺乳的婦?在未使用人工避孕法的情況下，平均隔二到三?會再有小孩。
13. 哺j母乳的婦??能口服避孕藥
?正確！問題?是接觸到?性激素，因爲經由母乳哺j寶寶都會接觸這些賀爾蒙。寶寶只會吸收到非常少?從避孕藥?的激素。?過，有些服用避孕藥的婦?，發現她們的奶?會減少，甚至是隻有黃體素的避孕藥也如此。因爲許多婦?會u造過?的奶水，因此這通常沒有關S。但有時即使奶?充沛，乳汁減少會使嬰兒變得煩燥且無法經由哺乳得到滿足。寶寶會對奶水?速有要求，而?是乳房中的奶水?，所以即使奶?足夠也會使習慣奶水?速快的寶寶變得煩燥。停止服用避孕藥通常會回?正常?況。如果可能，哺j母乳的婦?應避免口服避孕藥，或至少等到寶寶開始吃副食品（通常6個月大左右）。即使是較大嬰兒，奶?也可能因此明顯的減少。如果必須使用口服避孕藥，最好使用黃體素的避孕藥（?含雌激素），這樣比較?會影響奶?。
14. ?個月大後，母乳寶寶需要添加配方奶
?正確！母乳供應寶寶比其他奶?還多的營養。大於6 個月的寶寶應開始吃固體食物，這樣他們才能學習怎麼吃並且開始從其他食物?源吸收鐵質，寶寶7-9 個月大，單單從母乳無法獲得足夠的鐵質。因此只要寶寶還在吃母乳，就?需要牛奶或配方奶。但如果媽媽希望?個月大後給寶寶喝牛奶，只要嬰孩一天還吃好幾次母乳，且食用足?卻多樣化的固體食物，沒有?由?能喝牛奶。大部份從未吃過配方奶的寶寶，6個月大後?會接受配方奶，因爲他們?喜歡配方奶的味道。