New study finds common maternity ward practices around formula, pacifiers and pumps aren’t backed by evidence.
A review of 78 international studies finds that common maternity ward practices — early formula supplementation, pacifier restrictions and routine breast pump use — may be undermining, not helping, breastfeeding success in the first days after birth. ()
New research is challenging some of the most persistent beliefs held by clinicians and new parents alike about what happens in the earliest hours after childbirth.
Published in the Journal of Maternal-Fetal & Neonatal Medicine to coincide with World Breastfeeding Week, the review — led by researchers at Sapienza University of Rome — found that three widely accepted maternity ward practices are not backed by current scientific evidence, and may in some cases actively work against breastfeeding success.
The study arrives at a critical moment. The World Health Organization recommends exclusive breastfeeding for the first six months of a baby’s life, yet fewer than half of infants worldwide meet that target, with rates falling even lower in many high-income countries.
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What Are the Three Breastfeeding Myths the Study Identifies?
Lead author Dr Maria Di Chiara, a neonatologist at Sapienza University of Rome, and co-author Professor Gianluca Terrin examined 78 published sources spanning countries including the US, Italy, Germany, Australia, India and Mexico. Their review focused specifically on the critical 48 to 72 hours after birth, and identified three commonly held misconceptions:
1. That early milk production (colostrum) is insufficient for newborns.
2. That pacifier use interferes with breastfeeding.
3. That electric breast pumps should be introduced early to boost milk supply.
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Is Colostrum Really Not Enough for a Newborn?
The most widespread misconception, according to the review, is that colostrum — the concentrated first milk produced after birth — cannot adequately nourish a baby. This belief is often cited as the reason formula is introduced in the first days of life.
But the evidence tells a different story. In healthy, full-term infants, colostrum production is physiologically matched to a newborn’s stomach capacity and nutritional needs.
Dr Di Chiara notes that perceived insufficient milk supply remains the most commonly reported reason for early formula introduction and premature breastfeeding cessation worldwide — but in most cases, these concerns reflect unrealistic expectations rather than an actual problem with supply.
The researchers stress that formula supplementation can be appropriate when there is genuine medical need. However, they warn that unnecessary supplementation may reduce breast stimulation, lower milk production over time, and reinforce a mother’s fears about inadequate supply — creating a cycle that can undermine breastfeeding before it’s properly established.
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Do Pacifiers Actually Interfere with Breastfeeding?
Many maternity wards continue to restrict pacifier (dummy) use out of concern that it will disrupt breastfeeding. According to the review, randomized controlled trials show this concern is unfounded: pacifier use in healthy, full-term babies does not reduce breastfeeding duration or exclusivity.
While older international guidance advised against artificial teats altogether, more recent evidence supports informed parental choice rather than blanket bans. Professor Terrin says routine pacifier restrictions in maternity settings aren’t supported by current evidence and should be reconsidered.
Should New Mothers Use Electric Breast Pumps in the First Days After Birth?
Electric breast pumps are commonly recommended on maternity wards to stimulate supply or track milk production. However, the review found little evidence to support introducing them routinely in the first days after birth. In some cases, early pump use may actually worsen outcomes by reinforcing a mother’s fear that she isn’t producing enough milk.
When expression is genuinely needed — for instance, due to a poor latch or temporary separation from the baby — the researchers say hand expression is generally the preferred first-line method. Pumps, they note, still have an important role in specific clinical circumstances, just not as a default tool in the earliest days.
Five Steps to Better Breastfeeding Support
Based on their findings, the authors outline five evidence-based priorities for supporting breastfeeding in the first 72 hours after birth:
- Give parents realistic prenatal information about colostrum volumes, newborn stomach capacity and normal early weight loss.
- Use hand expression as the first-line method when milk expression is needed.
- Apply structured protocols for formula supplementation only when medically necessary.
- Replace blanket pacifier restrictions with balanced, evidence-based counselling.
- Ensure early access to lactation support from a trained professional within the first 48 hours.
Study Urges Hospitals to Update Postnatal Practices
No. The researchers are clear that their findings do not challenge the WHO’s recommendation of exclusive breastfeeding for six months. Instead, they say the goal is to close the gap between routine hospital practice and the best available evidence — particularly in high-income healthcare settings, where these misconceptions appear most persistent.
“What struck me most was how often well-meaning, routine advice runs ahead of the evidence,” Dr Di Chiara said. “Small changes in those first three days could make a real difference for families.”
She added that she hopes the review gives clinicians “the confidence to reassure mothers, rather than reach for formula, a pacifier ban or a pump by default,” so that postnatal care is shaped by evidence and by listening to parents.
References:
- Colostrum is enough, the pacifier is not the enemy, and the pump can wait: a narrative review of common misconceptions affecting early breastfeeding in healthy term neonates – (https://www.tandfonline.com/doi/full/10.1080/14767058.2026.2671562)
Source-Medindia