32 Real Breastfeeding Questions On Pregnancy, Antibiotics, & More, Answered By An Expert
Breastfeeding can be a hard, isolating, and emotional journey, which is why it's so important to have support. That's why Romper launched a Facebook breastfeeding community, Breastfeeding TBH — to help make feeding another human being with your own body a little easier. Every day readers ask questions because, let's face it, breastfeeding is complicated, and each week in Rack Facts, Romper speaks with a lactation consultant to answer as many of those questions as possible. After all, everyone can use a little expert help, especially when it comes to feeding your kid.
Breastfeeding is totally natural — until you're hooked up to a pumping machine feeling like a dairy cow and wondering what in the world is happening to your life. OK, so it's still natural even then, but it doesn't always feel that way.
And calling it natural? Sometimes that lulls moms into a sense of insecurity. If it's so natural, why does it seem so damn hard? If it's so natural, why are you struggling so much? If it's so natural, why do you want to quit and give up because it's literally turning your life upside down?
Just because something is natural doesn't mean it's easy. Just like parenthood, breastfeeding takes some learning and a lot of patience. I took several reader questions to Tipper Gallagher, International Board Certified Lactation Consultant, to get the answers you need to help regain your confidence and security in breastfeeding. Gallagher runs The Boob Geek, a website with Twitter and Facebook pages, to help share evidence-based support for breastfeeding families. If you're in the Twin Cities area, you can contact her for private consultations and support.
1. Feeding A Baby Cereal In A Bottle
I'm having difficulty feeding my daughter with a bottle. She is exclusively breastfed, but I am trying to give her cereal. Plus my mom needs to bottle feed her with a bottle when she watches her. What should I do?
"Depending upon your baby’s age, you may be able to skip the bottle entirely," Gallagher says. "Babies as young as four months old can sometimes handle soft-spouted sippy cups. Some babies also will reverse cycle, which is when they sleep more during the day and eat more at night." Gallagher says you can try a couple of tricks, like using different bottle nipples, adjusting milk temperatures, trying a different way of holding your baby and the bottle, and utilizing the paced bottle feeding method. If you were hoping to use cereal in a bottle, Gallagher advises against it. "Cereal in bottles is generally not recommended anymore, so you may want to discuss this with your pediatrician."
2. Introducing Milk While Weaning
My little one just turned a year old and I would like to start weaning her. I have no idea what I'm doing. I have given her some whole milk, but she only takes little sips and then she's done. I just need some help on what to do.
"If you’re trying to make the switch to cow’s milk, offering small amounts with a snack or meal is a good place to start," Gallagher says. But she notes that cow's milk isn't necessary if you're continuing to breastfeed and offering a well-rounded diet. "Cow’s milk is a convenient package of protein, fat, calcium, vitamin D, and other vitamins and minerals, but your breast milk will continue to offer some of this, and so will the other foods your little one is eating," Gallagher says. "Some weaning strategies to try include offering a snack, reserving a special time or place for nursing, or nursing while singing a special song." However, she notes that it's totally normal for babies to breastfeed past their first year and that your nursing relationship will probably change a lot on its own.
3. Breasts Not Leaking During Pregnancy
I'm about 8 months pregnant. Last month, my breasts were huge and leaking. Now, they are not as big and not leaking. Did I dry up? Why did this happen?
Don't worry, your breasts are still producing colostrum. "If you try some hand expression, you can see for yourself (and get practice in hand expression before your baby is born). It’s most likely that your breasts have created more milk ducts and the skin has stretched, accommodating the volume," Gallagher says.
4. Lanolin Staining Clothes
Do other moms use lanolin cream? I've gotten some on my tops and I can't seem to get it out.
"Lanolin is fat, which isn’t very clothing friendly," Gallagher says. "Good old fashioned dish soap cuts through grease. Rub this into the stains and try the laundry machine again. It may take more than one attempt to remove the stain."
5. 12 Week Old Upset With Nursing
Is it normal for a 12 week old to suddenly start breast rejection? I just went back to work four days ago, and we only nurse morning and bedtime. I only pump once at work (they won't let me do more). Tonight, she suddenly started popping on and off the breast, getting mad, crying, thrashing violently, and acting as though breastfeeding was the worst thing she's ever experienced. She kind of did this last night too and frankly, she isn't even eating anything. I just had to send my husband back upstairs with a bottle of expressed milk because I was too upset to go back in there. Do I keep trying or just let it go?
In general, Gallagher says babies don't self-wean before they are 18 months old, but there are many reasons why a baby might suddenly refuse to nurse before they're ready. "If your baby is used to a fast bottle flow, she may get frustrated at the breast and paced bottle feeding may help with this," Gallagher says. "There is also a strong possibility that your milk supply is low due to infrequent milk removal, which leads to slower milk flow. Breastfeeding or expressing milk at least every three hours is recommended for maintaining milk supply and you can try things like breastfeeding in a dark, quiet room or nursing in the bathtub as well." She suggests visiting an International Board Certified Lactation Consultant or La Leche League leader to help with more strategies for your specific situation.
6. One Breast Producing Less Than The Other
How can I boost milk production on only one breast? My left side is hardly making anything while my right is almost over producing.
"It’s very normal to produce different volumes of milk on different breasts, but sometimes we accidentally contribute to this," Gallagher says. "The key is that removing milk creates more milk so pay attention to which breast you use to start nursing. Since babies are more vigorous when first eating, they’re likely to get more milk at that time, which increases milk supply." She also suggests checking to see if your pump flanges are sized correctly as some people need a larger size on one breast than the other.
7. Thawed Milk Smells & Tastes Like Plastic
I recently have been thawing my milk for use with oatmeal cereal. But after it is thawed, it smells like plastic and has that taste, too. Is there something I'm doing wrong? Is the milk still good?
Gallagher notes that there are a few possibilities. "The milk could be old — if you’re storing milk in a refrigerator freezer, it will stay fresh for six weeks to three months, depending upon where in the freezer it’s stashed and it will stay fresh for up to a year in a deep freezer," Gallagher says. But she notes that the containers could be contributing to the taste as well and that you may want to try a different milk freezer bag or store the milk in glass containers. "A less-likely possibility is high lipase. Lipase is an enzyme in milk that breaks down fat. Some people produce milk with higher lipase, which is perfectly healthful and fine to eat, but can develop a strange taste (often described as soapy). The fix for this is to scald your milk before storing it." Gallagher says that in any of these cases, the milk is most likely safe to use, but you could use it in non-edible ways if you're still unsure, like adding it to your baby's bath water.
8. Thawed Breast Milk That Baby Doesn't Finish
What are the guidelines for how long pumped milk is good after your baby drank from the bottle? For instance, if I thaw milk and the baby drinks from the bottle but doesn't finish it, how long does it stay good? Should it go back in the fridge in the meantime?
"The rule of thumb is that a bottle of breast milk that has been partly eaten from can be reused for the next feeding, within two or three hours," Gallagher says. "After that, any milk should be thrown away." She says it's ideal to keep a half-eaten bottle in the refrigerator, especially if it is thawed milk. "Fresh milk may be more resilient, as the freezing process can disable some of the immune properties of breast milk," Gallagher says. "But in contrast, formula that is not finished within an hour needs to be thrown away, which is one reason why it’s a good idea to avoid mixing breast milk and formula in the same container."
9. Baby Wants To Be Nursed To Sleep
I have been breastfeeding my infant daughter for a month today. During the day, I've had other people feed her formula from a bottle to get her used to when I go back to work. She tolerates it well so far, but the problem is at night. My husband has tried feeding her so that I can get some sleep, but she will not go to sleep on her own without being nursed, even if she has a full belly. We have tried everything. I'm not sure I want to continue breastfeeding, and now I feel like I don't have the option to quit because I don't want to lose more sleep than I already am.
"Babies sometimes want to breastfeed for connection — it’s the best way they have to be close to you," Gallagher says. "You may find that even once you transition entirely to bottle feeding, your baby will still feel the most comforted and relaxed when close to you." She notes that if sleep is the biggest issue, you can explore explore alternative ways of getting more sleep, such as nursing in a side-lying position (if you’re uncomfortable with co-sleeping, your husband can supervise while baby is nursing) or taking "shifts" at night where you or your husband are responsible for all of the feeding and baby care while the other sleeps a solid chunk. "Babies are not known for being great sleepers, so it’s also possible that no matter what you do, your baby will have other ideas," Gallagher says. "The nice (and not-so-nice, at times) thing about this is that their preferences change often, so take heart that this isn’t forever, even if you can’t fix it."
10. Oversupply Symptoms
I have a 5 week old that is very colicky after every feed and often well past nursing. He is burpy, reflux-y, and has a ton of gas. A lot of the time, he still has a belly ache two to three hours after a feed. He takes a very shallow latch, which doesn't hurt me, and "clicks" while feeding, but he is growing just fine. I'm wondering if maybe I have an oversupply. He can't nurse for comfort and gas drops and gripe water don't seem to do much.
Gallagher says the behaviors you’re describing could be related to many different things, and oversupply is one of them. "This is a circumstance when an in-person assessment by an International Board Certified Lactation Consultant would be a good idea. IBCLCs are able to watch you feed your baby, weigh your baby before and after feedings to see how much he’s taking in, observe your baby’s behaviors, and offer specific suggestions." You can use a directory to find an IBCLC near you or ask your doctor or child's pediatrician for suggestions. "In the meantime, using laid-back breastfeeding could help your baby handle the milk flow a little better," Gallagher says.
11. Skipping Pumping To Nurse
My baby is 6 months old. During a work day, I typically pump at 8:00, nurse at 11:30, and pump at 2:00. I'll be away for two full days of training and am only taking a hand pump because I may only get quick breaks. My baby is coming along with my partner and I plan to nurse at 8:00, 12:30, and 4:30. Do you think I can get away without pumping since this isn't too far off from normal, or should I plan to do a quick hand pump around 10:00 and 2:00 just to relieve pressure? We are taking 24 ounces of frozen milk, so he will have plenty to eat, even if I don't pump.
"Since you’re able to feed your baby at those times, you may find you’re able to drain your breasts better than pumping two of them," Gallagher says. "Babies who nurse well are more efficient than pumps." She says it's a good idea to take your manual pump, just in case you get uncomfortable. Remember, breast milk is good at room temperature for up to eight hours, so you don't have to take ice or get access to a refrigerator.
12. Bottles To Avoid Nipple Confusion
My baby is 6 weeks old and she is breastfed only. I had trouble latching her onto my breast when she was born because she has a very small mouth and I have large breasts. I want to introduce a bottle to give her my milk, but the bottles are too wide and she can't latch. What kind of bottle should I use to avoid nipple confusion?
"Most babies do very well with the long-nippled, narrow-based (think classic bottle shape) nipples," Gallagher says. She says that the ones marketed as being "more like the breast" are usually harder for babies to use. "At 6 weeks old, you probably don't need to worry about nipple confusion. But to help avoid preference for the flow of the bottle, which can be faster and/or easier than a breast's flow, try paced bottle feeding."
13. Baby Gulping Air While Breastfeeding
I have a 3-week-old baby who seems to be gulping a lot of air while breastfeeding. It hurts to see her cry so much after because it hurts her stomach. Am I doing something wrong?
Breastfeeding is instinctual and natural, but it's still something you have to learn to do, Gallagher notes. It's not always easy and it's not because you're doing anything wrong. "Visiting your local La Leche League is a great place to start to learn what might work to improve your baby’s latch and other strategies to help breastfeeding go more smoothly. In the meantime, using laid-back breastfeeding can help a baby latch better to the breast — a deeper latch often leads to less air being taken in while breastfeeding," Gallagher says.
14. Nipples Bruised After Pumping
I am having a hard time pumping as my nipples turn purple and feel bruised for days after I pump once. My mom is bringing my baby to me every few hours at work to feed her, but with the winter months coming, I don't want her to have to come out into the cold. What can I do?
Definitely take a look at the fit of your pump flanges, which is the part that fits onto your nipple and areola. "A flange that is too small or too large can damage your nipple," Gallagher says. "Second, experiment with the suction level of your pump. You will want the suction to be up as high as you can tolerate without any pain. Just like breastfeeding, pumping should be comfortable."
15. Alternative For Medela SoftFit Shields
When my son was a baby, I used the Medela SoftFit shields which worked great. They don't make them anymore, but you can get them for $85 a pair on Amazon. Is there a soft and flexible alternative that will fit my Medela pump that doesn't cost $85?
"There is one pump brand that comes very highly recommended that uses soft breast flanges, and that is Limerick Inc," Gallagher says. If you don't want to buy a new pump, Gallagher says you should be able to achieve a comfortable fit with standard flanges and having an International Board Certified Lactation Consultant observe you pumping can help ensure a good fit and offer specific suggestions. "Just like breastfeeding, pumping should be comfortable, regardless of the flanges used," she says.
16. Knowing When To Pump
I only want to pump while I'm at work, otherwise I want my daughter at the breast. What are some tips for knowing when to pump?
"The usual recommendation is to empty your breasts by breastfeeding or pumping at least every three hours," Gallagher says. "Most people who work an eight-hour shift seem to pump three times per day. Your individual comfort level, breast storage capacity, and work situation may allow for more, or less, flexibility."
17. Baby Has Lip Tie
My little one is 1 month old and has terrible latch. He has an upper lip tie that isn't severe, but enough to make breastfeeding very uncomfortable for me. Do I work through it or go with some sort of medical intervention? I've heard about snipping the tie and using lasers.
"In my experience as an International Board Certified Lactation Consultant, most situations where an upper lip tie is thought to be the problem need only help with positioning and latch, not surgical intervention," Gallagher says. "Upper lip ties are generally revised by pediatric dentists with lasers. If you have not seen an IBCLC or it has been some time since you have seen one, a visit could help you decide how to proceed."
18. Baby Suddenly Refuses Bottle
While at work, my 7 month old requires my mom to give him a bottle of expressed milk. All of a sudden (he has had bottles since the hospital and I have been back at work since August) he refuses a bottle. We have tried sippy cups, we have tried syringe, and we have tried straw. We even stopped solids to see if he would just get hungry enough to give in, and no luck.
"These situations can be stressful, because we all want our babies to be fed well when we’re away from them," Gallagher says "But if your baby is breastfeeding while you are together, and is able to eat solid food, you can rest assured that even if he refuses expressed milk while you’re apart, he’ll make up for any lost calories when you are together." She suggests watching his weight gain to see if he continues on his growth curve, continue trying to offer a bottle, and see what happens. "He could be temporarily refusing expressed milk because he’s decided he prefers to nurse, or he could be distracted, in pain from teething, or have an ear infection. If you suspect he could be sick, talk to your doctor about strategies for helping him," Gallagher says.
19. Giving 5 Year Old Breast Milk For A Cold
My 5 year old is starting to show signs of a cold, cough, runny nose, etc. Can I give him some breast milk? If so, should it be fresh or should I use my freezer reserve? My 2 month old seems completely unaffected by this cold.
"It certainly won’t hurt, but since he is already showing symptoms of a cold, it may not help, either," Gallagher says. "Your fresh milk would be ideal, since it would be more likely to contain antibodies specific to this particular illness."
20. Nursing Without A Boppy
My daughter is 10 weeks old, and up until now I almost never nurse without my Boppy. We just can't seem to find a position that she can latch well without it. But she's getting kind of big for it now, and with holidays coming up, I really don't want to drag it around with us everywhere. Any advice on nursing holds without a Boppy?
"Laid-back breastfeeding can help, and you don’t need to lay back at an extreme angle to borrow some of the principles of it," Gallagher says. "Leaning back just a little can help keep your baby as close to you as possible, which helps with arm fatigue and in achieving a deep and comfortable latch." Gallagher suggests sitting in a comfortable spot with pillows for back support. "Start out breastfeeding with the nursing pillow, and then move your bottom forward toward the edge of your seat. Lean back as you do this, holding your baby close the whole time. Then move the nursing pillow away with your other hand (or have someone help). You can tuck extra pillows under your arms for more support," Gallagher says.
21. Weaning Baby Off The Shield
I have a 5 week old. While in the hospital, he had a hard time latching. He was two weeks early and when he would latch, I was left with scabs and it was very painful. They mentioned a nipple shield and I took it to help him. Now, he's used to the shield and won't latch onto me without it. How am I able to wean the baby off the shield?
"If you are using a nipple shield for any reason, it is a good idea to meet with an IBCLC to address the reason why you needed a shield," Gallagher says. "It could be that more support is needed to help your baby latch widely. An IBCLC can also help with strategies to help wean your baby from the nipple shield." She notes that one of the first things to try when weaning from the shield is to start the feeding using the shield and removing it after your baby has done some eating, but isn’t full. "Unlatch your little one long enough to move the shield away, and then encourage him to latch again," Gallagher says.
22. Baby Suddenly Pooping Mucus & Puking
My baby is 8 weeks old and all of a sudden, she has a lot of poop diapers, some with mucus in them. She's exclusively breastfed and I'm wondering if she's sick from me eating strawberries for the first time since birth or from the antibiotics I'm taking for a UTI. She also has been sleeping so much, but no fever and she's been nursing the same.
"The most likely culprits are a bug or the antibiotics you’re taking," Gallagher says. "Antibiotics sometimes pass in small amounts into breast milk and one symptom of this is loose stools in a baby. Keep breastfeeding on demand, and contact your baby’s doctor if you have further questions."
23. Weaning A 2 Year Old
My daughter turns 2 years old in February and after that, I want to start the weaning process. As of right now, she nurses anywhere from one to four times a day and still doesn't sleep through the night, even when she co-sleeps with me. I am needing some advice and help on how to start the weaning process and getting her to sleep through the night.
"Sleep is such a complicated issue. Sometimes, no matter what we do, we can’t make a kid sleep through the night before they’re ready," Gallagher says. She suggests trying some tips from Dr. Jay Gordon on weaning while co-sleeping, but notes that you've really already started the weaning process as you've gone from her newborn feeding patterns to one to four times per day.
"Think about strategies such as only breastfeeding in a certain spot or at a certain time, or nursing for the duration of a song you sing. When you’ve already cut down breastfeeding to a few times per day, weaning “cold turkey” is an option depending upon how much milk you produce," Gallagher says. "You’ll want to make sure you remain comfortable to avoid plugged ducts or mastitis, and you’ll want to be prepared to offer plenty of snuggles and other ways to connect with your little one. Making only one big transition at a time — weaning or encouraging longer sleep stretches — helps to ease you both through them as well."
24. Pumping To Meet Baby's Needs
My baby wasn't gaining weight, so I went to a breastfeeding group at my hospital. She only took in 2 ounces total at the feeding. After renting the hospital grade pump and exclusively pumping for her next feeding, I got 4 ounces total, which is what she is supposed to be getting. So is it her or me? I don't want to pump after each feeding if it's going to give me an oversupply, but also want her to gain adequately. She's always had plenty of wet and dirty diapers, too.
"Renting a pump is a good move, since it will be easier to build and maintain your milk supply while using one," Gallagher says. But there are some things to keep in mind.
"IBCLCs look for weight gain of 5 to 8 ounces a week, on average. You might want to do the math to see how much she’s been gaining. It could be that she’s achieving this goal but expectations are off. Babies also take around 25 to 30 ounces of breast milk per day by the time they are a few weeks old, and the volume of their feedings can vary. A baby’s stomach comfortably holds 2.5 to 5 ounces a feeding by the time they’re 10 days old, but not every feeding will be a full feeding," Gallagher says.
She also suggests taking a look at how often your baby is eating and how much time she spends at the breast. "Are you offering her the breast whenever she shows feeding cues? Is she given a pacifier or swaddled, which can lead to missed cues? Is she eating at least every two or three hours? Are you taking her off the breast after a certain amount of time? Sometimes, all we need to adjust is how often a baby is able to eat," Gallagher says. She also notes that both weighing a baby after a feeding and pumping are educated guesses of how much milk is in the breast and how much your baby is able to get, but there are lot of other factors to consider as well. "That said, this is definitely a circumstance when an in-person assessment by an IBCLC would be a good idea."
25. Pumping Only An Ounce
I have started to pump after every feeding to try to obtain a stash, but I am maybe getting an ounce from both breasts. I pump at least five to ten minutes after the last drop of milk. Please tell me this is normal and will still increase my supply.
"If your baby is gaining weight well and has enough wet and dirty diapers, your milk supply is not the problem, but your expectations might be," Gallagher says. "Breasts ideally make enough to feed your baby and not much more — if you’re able to pump several ounces after breastfeeding, it may mean that your baby is not getting as much milk as he should, or you make more milk than you need to." She also notes that a large freezer stash is not essential, and you should be able to collect enough milk for returning to work or the occasional time away by storing those 1 ounce increments, pumping on one breast while breastfeeding on the other, or pumping after the first feeding of the morning when your milk supply tends to be highest and baby is more content.
26. Getting Baby Back To Breast
When my baby was born, I had to put him on formula due to low blood sugar. It's been over a week and I want to go back to breastfeeding, but he is so uninterested and only wants the bottle nipple. I do skin-to-skin and try to get him to latch when he is hungry, but he just gets frustrated. Is there any advice on going from bottle to breast?
"Laid-back breastfeeding can help babies stay calmer longer and help tap into a baby’s natural latching instincts," Gallagher says. "Letting your baby latch himself, rather than waiting for a wide gape and pulling your baby toward the breast, can help decrease frustration as well. You can also use nipple shields to help bring a bottle fed baby back to the breast. An IBCLC or La Leche League Leader can help you in person to figure out what might work for you and your baby."
27. Baby Won't Take Bottle
I am having trouble getting my 6-week-old to take a bottle. She never took a pacifier as well. What are some tips or bottles that have worked for other breastfeeding moms?
"Some babies won’t take a bottle if it’s offered by the person who has milk on tap," Gallagher says. "So you may need to enlist someone else’s help and maybe even leave the house entirely." She says there are other tricks to try, too, such as experimenting with different bottle nipples, different milk temperatures, and different ways of holding the baby and bottle. You should also utilize paced bottle feeding to make it even more like breastfeeding.
28. Taking Medicine While Breastfeeding
What can I take for sickness while breastfeeding? I took Robitussin DM, but it's not working.
"There’s some evidence that honey can improve symptoms of a cough at least as well as cough syrup," Gallagher says. "Another popular strategy for breastfeeding parents is a humidifier (or lots of steamy baths). Unfortunately, the only tried-and-true, safe for breastfeeding remedy for a cough or cold is time."
29. Vitamin D For Baby
Should I give my baby the vitamin D drops or do I take vitamin D myself to pass to my baby?
"This is an entirely personal decision," Gallagher says. "Considering that many people in higher latitudes are deficient in vitamin D, you may benefit from supplementation yourself, and supplementing a parent seems to increase the compliance with supplementation for babies." One of the reasons to avoid supplementing your baby directly is to ensure your baby is given only breast milk for the first six months. "Talk to your doctor about the specific type of vitamin D you should take and in what amount," Gallagher says.
30. Mirena & Milk Supply
I just got the Mirena birth control today. I'm eight weeks postpartum and have just mastered breastfeeding, so I'm worried about the Mirena affecting my milk supply.
While there is some anecdotal evidence that the Mirena could affect milk supply, Gallagher notes that there are so many other possibilities. "The top reason for a reduction in milk supply is less-frequent breastfeeding or pumping. Breastfeeding or pumping at least every three hours is recommended to maintain milk supply," she says.
31. Baby Bites While Nursing
I'm currently exclusively breastfeeding my 9 month old, but he now has four teeth and nurses very enthusiastically. Even if I gently tap his cheek with a finger and say no, he still occasionally bites, and I'm struggling with the pain of it. I still want to give him breast milk. Should I transition from exclusively breastfeeding to pumping?
"Switching from breastfeeding to feeding expressed breast milk is not uncommon, but it can be more work overall than breastfeeding," Gallagher says. "It is more difficult to maintain milk supply while exclusively pumping, it's difficult to keep on a 'round-the-clock pumping schedule, and pumps are often not as efficient at milk removal compared with babies." She says it may be worth considering other strategies for dealing with biting while breastfeeding. "When a baby is latched well, they are unable to bite the breast, and a baby who is often biting while breastfeeding is often signaling that he is done nursing, or attempting to get a reaction out of his mother," Gallagher says.
32. Nursing While Pregnant
I just found out I'm pregnant again. My baby is 7 months old and exclusively breastfeeding. I realized I was pregnant because my milk supply suddenly dropped. I'm pretty devastated. I love nursing my little man so much and he loves it, so I don't want to have to stop. Will I be able to increase supply? Does it increase further into the pregnancy?
"It is definitely possible to continue to nurse while pregnant, but there is a possibility you may need to supplement your baby’s milk intake with donor milk or formula," Gallagher says. "Pregnancy, as you noticed, brings about a drop in milk supply. Your milk changes from mature milk to colostrum, and it is often in a lower volume." She notes that it is generally not recommended to try to increase milk supply while pregnant, despite the supplements available that purport to do this safely during pregnancy — there is no good research to back up those claims.