Booby Traps™ Series: Don’t judge a breastfeeding book by its cover

This is the ninth in a series of posts on Booby Traps™ in pregnancy, made possible by the generous support of Motherlove Herbal Company.

A few weeks ago I told Best for Babes founders Bettina and Danielle that I wanted to write something for this series about the Booby Trap™ of bad breastfeeding advice in books.  After all, many of us are told that we should read a breastfeeding book during pregnancy, and many of us keep a breastfeeding book at our bedsides for reference (usually at 4:00 am) after our babies come.

I’ve read and reviewed nearly all the breastfeeding books there are, so I thought I knew what’s out there.  But I figured that I should head to the bookstore in case there was something I’d missed.

So last weekend I sat in the aisle of a chain bookstore and read through the breastfeeding sections of a number of current, popular books.  And after a while I found it hard to suppress the urge to pull aside the women browsing the pregnancy section and say “I don’t know you, but please don’t buy this book.”

Here’s a sampling of the misinformation I found in popular, mainstream books:

“You also should not breastfeed if you have a serious infection…In these cases, go to formula.” (You: Having a Baby, Roizen and Oz, 2009–yup, that’s Oprah’s Dr. Oz)

“It’s often hard to get a proper let down if you’re stressed, distracted, or breastfeeding on the go.  And without a proper letdown, your baby will not get enough to eat and will be hungry again in no time.”  (You: Having a Baby, Roizen and Oz, 2009)

A sidebar on the composition of breastmilk over the course of a feeding:  “Quencher: first 5 to 15 minutes; Foremilk: starts 5 to 8 minutes into the feed; Hindmilk: starts 15 to 18 minutes in to the feed.”  (Secrets of the Baby Whisperer, Hogg, 2001)

“Most experts agree that six months of breastfeeding confers most of the medical benefits…” (Dr. Spock’s Baby and Child Care, 8th ed., Spock and Needham, 2004)

“Between nine and twelve months the nutritional value of breastmilk drops…”  (On Becoming Babywise, Ezzo, 2006)

There were many things lacking in these books as well.  Each covered some common issues but left other significant ones out.  Some didn’t even mention the importance of seeking help from breastfeeding support people like lactation consultants, La Leche League leaders, or breastfeeding peer counselors.  None of them were inspiring.  These books may or may not contain good information on other topics, but when it came to breastfeeding some of their information ranged from inadequate to truly bizarre.

This exercise helped me think through my criteria for choosing a good breastfeeding book.  I think that a good breastfeeding book should be:

1)  Evidence-based. The statements above have no basis in research, and several contradict the policies of health organizations that have reviewed the research.  You want a book based on what we actually know about breastfeeding, not personal opinion.  For this reason, I suggest looking for authors with some credentials in breastfeeding support, like an IBCLC, a La Leche League leader, or a member of the Academy of Breastfeeding Medicine.

2)  Comprehensive. It’s no accident that I found the worst breastfeeding advice in general books on pregnancy and newborn care.  It’s just not possible to get all of the important breastfeeding information into one chapter.  To get a book that will take you from “why should I breastfeed?” all the way through weaning, I suggest getting a book solely about breastfeeding.

3)  Current. You’d think that not much would change in breastfeeding, but new discoveries, new best practices, and new resources are always emerging.  You want a book that reflects the latest and best ideas on how to make breastfeeding work, so look for one that was recently written or recently updated.

4)  Easy to navigate. This is a big one for me.  You want a book written by people who know that you’ll be searching, with bleary eyes, for “milk blister” at 4:00 am.  If the authors make it hard for you to find information, it doesn’t belong on your nightstand.  You want a well organized book with a comprehensive index. I give bonus points for books with good illustrations or photos for important things, like how to get a good latch.

5)  Inspiration. When I sat reading in the pregnancy section reading these books I tried to imagine the feeling I’d have about breastfeeding if I were pregnant and new to the idea.  And the feeling I had was decidedly lukewarm.  That’s not what you want.  While you don’t necessarily need a cheerleader to pop out of the book, a good book will help you understand the reasons why breastfeeding is important, help you put the challenges in perspective, and give you confidence in your ability to make it work.

A few books which meet these criteria, in my personal opinion, are The Womanly Art of Breastfeeding, 8th edition, and Breastfeeding Made Simple, 2nd edition, and The Nursing Mother’s Companion, 6th edition.

I know you have favorites of your own.  Which books have been a source of support for you?  What do you recommend to friends?  Which books do you tell friends to steer clear of?

Editor’s Note 4/28/11:  Click here to see the what our Facebook fans told us were the WORST books for breastfeeding moms!



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22 Responses to Booby Traps™ Series: Don’t judge a breastfeeding book by its cover

  1. Rachel says:

    What is incorrect about this statement: And without a proper letdown, your baby will not get enough to eat and will be hungry again in no time.”  (You: Having a Baby, Roizen and Oz, 2009)

    • Tanya Lieberman says:

      Yes, it’s true that if you don’t have a let down your baby won’t get that milk, but it’s the statement that precedes it which has no basis in research: “It’s often hard to get a proper let down if you’re stressed, distracted, or breastfeeding on the go.”

      If you can’t make milk when you’re distracted (caring for other kids, eating, talking on the phone, etc.), stressed (who isn’t?), or “on the go” (I assume this means out in public) the human race would have died out long ago! :)

      • Tanya Lieberman says:

        To clarify my clarification, yes, stress can sometimes impact milk ejection. But to quote The Breastfeeding Mother’s Guide to Making More Milk (West, Marasco), “Such short-term episodes rarely have a lasting impact on milk production. However, chronic long term inhibition could reduce production over time….”

        What I’m objecting to here is the implication that you always have to be calm, focused, and planted on the couch in order to make milk. This kind of message can deter mothers from breastfeeding.

        • Eric says:

          I understand the book’s statement to be more of an observation of a bigger societal/cultural issue: people in general, and mothers in particular, have overloaded expectations of their own time and involvements. This can interfere with breastfeeding, so being cognizant of one’s own mental/emotional state and adjusting the environment as necessary can make breastfeeding more successful, particularly when mom and baby are first getting in a groove. This philosophy applies not only to breastfeeding but many other areas of life, including mental and physical health, parenting, and childbirth.

  2. Robbin says:

    I like Dr. Jack Newman’s book(s). I have his ultimate breastfeeding Q&A book. It’s great.

  3. Teresa says:

    I loved a book called “so that’s what they’re for.” It had great information, but was also funny and fun to read. It took me from “I’m going to give it a try, but I won’t beat myself up if it doesn’t work out.” to “I’m going to nurse this baby until he’s a toddler.”

    • Miranda says:

      I used “So That’s What They’re For!” extensively. It has great information, presented in a casual and humorous way. It’s strongly pro-breastfeeding without being too millitant. My son’s pediatrician recommended it while I was pregnant and I’ve recommended it to others. But “The Womanly Art of Breastfeeding” was the most helpful for learning to breastfeed my twins.

  4. Rachel says:

    Regarding the quote in my first post above, is it true that with no letdown the baby wouldn’t get as much milk as with one, but if mom has a large storage capacity and there is milk stored in the breasts, even with no letdown the baby would be able to transfer that milk? So maybe baby could get enough to eat in this specific situation?

    • Tanya Lieberman says:

      Hmmmm. That’s an interesting question!

      So, most of the milk the baby gets at a feeding is made at that feeding (you can see this if you pump). I don’t know of any research showing that a baby would get more milk if a mother didn’t have let down than a mother who had a smaller storage capacity. I guess theoretically that’s possible, but it sure would be hard to measure! Of course, I’m not saying that breast size matters overall, or that it’s a good idea to wait a long time in between feedings. :) Hope that answers the question!

  5. You are so right about bad books. I totally agree “On Becoming Babywize” by Gary Ezzo and Robert Bucknam MD is full of incorrect and just plain bad advice. Mothers who come to our Parenting Center who follow that book almost always complain of low milk supply and storp breastfeeding by 6 or 7 months. The advice from the book that you nurse on a schedule and less and less by 4 to 6 months does not encourage a mother’s milk supply to grow and keep up with her growing baby. The mothers come come to me in tears because they are trying to hard to do everything right, except they are listening to a man, instead of to their own babies. Listen to your hearts Ladies and to your babies. Their instincts are right and good and they DO want to breastfeed lots and lots. That is what nature intended so you wil have lots and lots of milk.

  6. Dr. Oz is SUCH an idiot. He also did a show where he talked about the need for circumcision. Although that isn’t directly related, it is another example of him peppering his facts with his opinion and statements he perhaps wishes were true.

    I liked “Pregnancy, Childbirth and the Newborn” for a pregnancy book. A nurse at my doctor’s office recommended it and I’m so glad she did. Seemed to have not too much misinformation although the breastfeeding section was small.

    LOVE the new site design, BTW!

  7. Rachel says:

    I was just questioning the statement “And without a proper letdown, your baby will not get enough to eat and will be hungry again in no time.”, thinking that if a mom had a lot of milk stored in her breasts, that even without a letdown at that particular feeding, the baby could still get enough to eat. Just curious :)

    Thankyou for answering my questions. I’m a CLC, desperately wanting to become an IBCLC, so I love discussing/learning more about the biology of breastfeeding!

  8. Michelle says:

    A lot of people are very quick to judge “On Becoming BabyWise.” I wonder how many of these critics have actually read this book cover to cover. Everyone criticizes the suggested schedule method and blame this book for the loss of milk. The book focuses on a parent directed method. There is no starving your baby. In fact, the book tells you to feed your baby when he/she is hungry but if there are no hunger sighs then you feed every so many hours. We follow babywise in our household and have a baby who sleeps through the night, everyone comments on how happy our baby is, and she has been breast fed for one year and still going. While this book may not be for everyone, it has some solid suggestions that have shaped our baby into a more independent and confident breast feeder. I recommend it to everyone!

    • Dou-la-la says:

      Are you familiar with the site Ezzo.info, which documents many, many firsthand accounts of failure to thrive due to following the horrible advice of the Ezzos, who have absolutely NO education on infant and child development. When you have the AAP itself issuing warnings about a book, it’s something to take very seriously. Here’s just one link among many: http://aapnews.aappublications.org/cgi/content/abstract/14/4/21

      Please, before you recommend this to any more families, read some of the frightening stories on Ezzo.info. And if you have a child that thrived using Babywise, make no mistake: s/he thrived DESPITE Babywise, not because of it. Consider yourself extremely lucky.

      • Helen says:

        Yes, I certainly did read Babywise cover to cover. I am an IBCLC, and have been a lay breastfeeding counselor for over thirty years. I was so appalled by what I read in the book, that I took pages of notes rebutting what it said. I tried to help a mom who I knew was following Babywise, and she just couldn’t understand that her body made milk very well, if she would feed her baby when it was hungry and dump the schedule. Every time she went back to encouraging her baby to nurse, her milk would return in full force. As soon as she began to follow the schedule again, down it went. She was a slave to a schedule for herself, her baby, and separate ones for each of the older children. It just wasn’t practical, and she refused to believe that she couldn’t do the impossible, and that her milk didn’t build up if she waited longer so the baby would get a really good feeding. After all, the book said so. Since she was following the religious version, she also had to believe that if she followed the baby and not the book that she wasn’t being a good Christian mother. I never read the follow-up book, Your Pretoddler, which was to be folowed from age 4 months. So I never found out what the feeding schedule went to after that. It was alread down to four feeds a day.

  9. Titania says:

    Hi Tanya,

    Thanks for this great article! Two books that totally frustrated me despite coming highly recommended were “On Becoming Babywise” and “The Contented Little Baby Book.” I literally threw those books across the room in disgust. Could have been the postpartum hormones :) As the social media manager for baby gooroo, as well as a HUGE fan of Best for Babes, I couldn’t resist commenting on this article for you to check out “BREASTFEEDING, A Parent’s Guide” by Amy Spangler, MN, RN, IBCLC. http://www.babygooroo.com/store/ I actually read the book before I began working for baby gooroo and it (as well as Amy) helped me tremendously. Thanks for all that you do to help beat the booby traps!

  10. Deva Millward says:

    I read the Womanly Art of Breastfeeding while pregnant and felt like it was a great book and have read Dr. Jack Newman’s book since habing my son. We had a bad case of interductual thrush and I was able to get the proper care due to what I’d read in his book. On a side note, a friend gave me the Babywise book and she raved about it. I began reading it and just felt that it wasn’t a right fit for my family…I don’t recommend it to others.

  11. Eileen says:

    I really liked The Breastfeeding Book by Dr. Sears. It had good, helpful info as well as good pictures to help me understand proper latch and different holds. It suggests throughout to contact a lactation consultant if you have trouble. I breastfed my oldest until she self weaned at 2 1/2, still nursing my baby.

    • Kathy says:

      Great comment and I couldn’t agree more. I am still nursing my 21 month old son with great success. I was recommended to use the “Babywise” method by a good friend and luckily I was recommended “Attachment parenting” by an even better friend. I really identified with Dr. Sears and all of his books are GREAT! People these days are so affraid of “spoling” their newborns and hell-bent on controlling them… it is really sad.

  12. Chandra says:

    First, thank you for doing this particular article. I had the chance to visit a book store with a pg friend a few weeks back to point out some of the books I found most helpful. I dutifully went to the library when I was about seven months pregnant and checked out every parenting and breastfeeding book I could get my hands on (among them were Babywise, Baby Whisperer, Nursing Mother’s Companion, Womanly Art of Breastfeeding, Baby 411, the AAP Caring for Your Child Birth to Age 5, and Pregnancy, Childbirth, and the Newborn). My favorite book on breastfeeding, and the one I recommend to all of my friends, is the Nursing Mother’s Companion. I thought it was a little easier to navigate and I managed to read it cover to cover before my son arrived (the Womanly Art of Breastfeeding just seemed overwhelmingly large, though might have made a great reference after my son arrived). After reviewing the copies from the library I bought the ones that were most helpful. Interestingly, I was intrigued at first by Babywise…but when I went to order it from Amazon and saw the reviews, I decided against it. Little did I realize I would become such a babywearing, on-demand feeding mama. 11 months in to my motherhood journey I can see how dangerous it is, but at the time as a type-A power career type I was attracted to this “to get outcome A, complete input 1,2,and 3 in precisely this order” nature. Actually the one that irked me the most from the library was Baby Whisperer. She just annoyed me. Not surprised to see there was also bad breastfeeding information in her book!

  13. Debbie Page says:

    Tanya, this is a great post. Most every book I’ve read on general pregnancy, breastfeeding and baby raising are not research based. I suppose people have been selling their “expert” advice for centuries, even as far back as in The Garden. And of course it’s not limited to books any longer; websites are full of erroneous information. Unfortunately I’ve heard IBCLCs give horrendous, non-research based information in classes and at bedside, including DVDs. So what is a poor mother to do? Stick with the books Tanya recommended and be careful of what is being taught in classes. I also like Laura Keegan’s Breastfeeding With Comfort and Joy. Every slide I create for the classes I teach are done so with these books spread open and Dr. Tina Smillie’s lectures notes in full view.

  14. sarah says:

    the complete book of breast feeding by Sally Wendkos olds, Laura marks, and Marvin s eiger was the book that I found the most helpful, I had no problem breastfeeding

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