Tuesday, 13 October 2015

My Thoughts on Breastfeeding

I was determined to breastfeed when I was pregnant with my #1 even though I do not have much knowledge of it. However, I was very confident it is the best choice for my baby because I know it's God's gift to us. It can never be wrong.  Also,  it seems natural to me to breastfeed because people around me are doing it, my sisters in Christ and people close to me like my sis-in-law, who is a teacher like me. She continued to express breastmilk even when she resumed her teaching duties, at the comfort of her own workstation. Her example encouraged me and made me believe that I will also be able to do the same for my baby. Being a lazy mum, I did not research much into breastfeeding even though I had some materials on hand, thinking that it is better to learn on the job instead.My dream is to be able to latch my baby on the go anywhere, anytime, and that vision is always on my mind.

My #1 was breastfed for 1 year and I am currently still latching my almost 33 months toddler. Of course I have my fair share of woes, sore nipples, nipple confusion, worries over my supply, stress to build up supply, newborn latching after every half an hour, so engorged that my breasts became as hard as stones, figuring out the demand and supply theory, losing my sleep etc...many.....but I guess the rewards are even greater. The satisfaction and assurance that you get because you know that you are giving your baby the best and nothing else. When my then 18 months #2 could only utter a few words, he would say "换边” (which means to change side in English) after he was done with latching each side. And recently, when #2 was done with his night feed, he said "妈咪的neh neh最甜的。” (Mummy's milk is the sweetest.) with a satisfied smile on his face.

I thank God for blessing me with all the wonderful people around me who helped to make my breastfeeding journey a successful one. For breast feeding mums, it is indeed very important to have a supportive environment. Two of the most important people in my life , my Mummy and husband support breastfeeding fully. I also have a great PD and gynaecologist now who are on the same line as me. I did not have a good experience with the PD at TMC though.

In 2013, my #2 was born at week 35 with a mere weight of 2kg, but miraculously was not admitted into NICU. He was wheeled out for observation shortly after he was born and as the PD's main concern was to increase my baby's weight, she ordered for him to be fed with formula. I respected her as I believed that she made this decision based on her professional judgement and for the good of my baby. However, I did not feel comfortable talking to her as she spoke in a demeaning tone, doubting my ability to produce sufficient milk for my baby.  My gynaecologist on the other hand told me that we have underestimated my baby and he is much stronger than we think. (And I agree with her absolutely!You should have watched him suckle so powerfully even though he was just a 2kg newborn). My gynae Dr Yeap has 3 children and strongly supports breastfeeding, she said "In my house, we only offer breastmilk and nothing else." Love my gynae. 

Thank God we managed to find another PD, Dr Lau for our boys. 

1st Pd at TMC: What's the use of expressing milk if you only managed to express so little? 
Dr Lau (when baby only managed to latch for 5 min): 5 min is better than nothing!

Once when my #2 was down with a diarrhea, I was shocked to learn that breastmilk was actually causing it to be worse. Reason being that all mammal's milk contains lactose and during the infection, lactose was not broken down properly resulting in abnormally watery stool. Even then, Dr Lau did not advise me to stop breastfeeding. He said if the diarrhea did not get any worse and I could manage the watery stool, I can continue to breastfeed. Awesome!

And did I mention about my wonderful colleague who helped me to put up this curtain so that I could express milk at the convenience of my own work desk. Well, actually it was because my school did not have a proper place for mummies to express milk and no way was I going to express at the toilet. Tough to express at work as teaching life is pretty hectic and I was always tense when expressing and hence my supply continued to drop after I went back to work. To make things worse, my #1 gave up on latching as he started to take a preference for bottles. Nevertheless, I still managed to pass the one year mark for my #1.

I grew more in awe and continued to be amazed with God's Creation as I learnt more about the benefits of breastfeeding and breastmilk.

Breastfeeding is the best for baby. In the first few days of life, the baby receives colostrum from its mother. Colostrum CANNOT be manufactured synthetically. It is specially designed for the baby and is similar in many of its content to the nourishment which the baby has received in the womb, thus lessening for him the shock and strangeness of birth. Colostrum contains exactly the nourishment the baby needs during the first few days, as well as antibodies from the mother, to protect him against any disease which the mother has had or has been immunized against.

Colostrum has a slight laxative effect which prepares the baby's digestive system and clears out the bowels. It thus helps to get rid of the meconium, the sticky black substance which is the baby's first stool, and in the process this reduces the concentration of the jaundice-producing bilirubin in baby's body. Therefore, even if you cannot breastfeed for long, your baby will benefit greatly from receiving your milk, which contains colostrum, for the first ten days of life.

Breastmilk is almost always completely free of germs. It is virtually impossible to make a bottle feed so pure, and this is particularly important in our tropical climate where germs multiply rapidly.

What are the advantages for the baby?

a) Breastmilk is uniquely adapted for human babies, just as cow's milk is the best milk for calves.

b) The composition of Breastmilk is ideally suited to baby. The composition of human milk changes to meet the changing needs of baby as he matures. Even when baby is able to take solids, human milk is the primary source of nutrition during the first year. It becomes a supplement to solids during the second year. In addition, it takes between two and six years for a child's immune system to fully mature. Human milk continues to complement and boost the immune system for as long as it is offered.

c) Doctors agree that breastfed babies are less prone to gastro-intestinal infections, constipation and allergies.

d) Breastfed babies benefit from increased immunity against disease - if the mother is exposed to an illness, especially one transmitted through the mouth, the antibodies made in response to it will soon be excreted in her milk to provide protection to her baby. What a smart system!

e) Breastmilk is always available when the baby needs it, at the right temperature and from germ-free containers.

f) Breastfeeding promotes a close bond between mother and child because it enables skin and eye-to-eye contact to take place.

g) If the baby does fall sick, breastmilk is the best food for him as it is so easy to digest. Once, my #2 was down with a high fever while we were in Malaysia. He lost his appetite and ate and drank very little but fortunately he finds comfort in latching. Just as well as I know that breastmilk is the best for him then. He recovered very quickly although his crankiness remained for the rest of the trip. I was so thankful that I chose to breastfeed. 

h) Premature babies also do better if they are fed on breastmilk because it appears that this milk is ideally suited to the very rapid weight gain and growth in brain tissues of the premature infant. I thank God that although my #2 was premature, he managed to latch on successfully in the hospital. (I was not discouraged even though the nurses told me not to pin too much hope on him latching successfully as he was a premature baby)

What are the advantages for the mother?

a) The baby's suckling in the early weeks causes the uterus to contract, which speeds up its return to pre-pregnancy size and lessens the chances of severe bleeding.

b) The fat stored around the hips and thighs during pre-pregnancy is used up during lactation, provided the mother exercises restraint and has a sensible diet. Maybe this is my secret to resuming my pre-pregnancy weight in a month's time while eating 5 meals a day.

c) A great deal of time is saved by the mother not having to prepare and sterilize bottles, teats, etc. This is the greatest motivation factor for me, the lazy me hates the washing, sterilizing and expressing part. And it also lightens my baby bag a lot and I appreciate it even more when I go overseas. You get the best for doing less, how good is that? I'm killing two birds with one stone!

d) Statistics show that women who breastfeed their babies run a lesser risk of developing breast and ovarian cancers.

e) Breastmilk is the most economical means of feeding your baby. One does not have the expense of buying bottles, teats, equipment, etc. However, a breastfeeding mother needs to ensure she has an adequate caloric intake with the emphasis on high protein food and so she may have to spend more on food than usual. Special nursing bras, nursing pads and clothes that allow for quick, easy and discreet access to the breast may also need to be bought initially.

f) Many years of medical research into the question of breastfeeding have indicated that most women who breastfeed their babies enjoy more physical and emotional benefits. 

The above stated are just some of the advantages of breastfeeding and I am sure there are more to add on to the list.

One important thing that breastfeeding mums need to remember is that they must have confidence in themselves and believe that they have milk and they have sufficient milk. Due to the false belief that there is no milk present in the breast during the first days after delivery, a mother do not try to breastfeed their babies at this time and the absence of stimulation tends to delay the milk supply. They start to offer formula milk for fear that their babies are not drinking enough and this marks the beginning of a vicious cycle. The amount of milk that is expressed is also not reflective of how much milk the mother has. The magic word is "latch" and latching on demand will ensure that your supply keeps up with your baby's appetite. Except for medical conditions, all women are able to produce sufficient milk for their babies and almost all problems can be overcome with information and encouragement.

Many people mistakenly think of a mother’s milk supply as being like “flesh-covered bottles” that are completely emptied and then need time to refill before baby nurses again. This is simply not how we understand milk production to function.
First of all, milk is being produced at all times, so the breast is never empty. Research has shown that babies do not take all the milk available from the breast – the amount that baby drinks depends upon his appetite. The amount of milk removed from the breast varies from feed to feed, but averages around 75-80% of the available milk.
! Trying to completely empty a breast is like trying to empty a river — it’s impossible, since more milk will keep flowing in while milk is being removed.
Research also tells us that the emptier the breast, the faster the breast makes milk. So when baby removes a large percentage of milk from the breast, milk production will speed up in response.
! Rather than thinking of nursing or pumping as “pouring milk out of a container” think of it as flipping on the “high speed production” switch!
! Yet another analogy: Imagine you are using a straw to drink from a glass of water. As you drink, a friend is very slowly pouring water into your glass. The emptier the glass, the faster your friend pours the water. Would you be able to drink all the water in your glass?
Waiting a set amount of time to nurse your baby (under the mistaken belief that breasts need time to “refill”) is actually counterproductive. Consistently delaying nursing will lead to decreased milk supply over time because milk production slows when milk accumulates in the breast.

So the question is not whether you have sufficient milk or not but whether are the breasts stimulated frequent enough to enable your body to interpret accurately the appetite of your baby. So again, I would say the magic words are "latch on demand" if possible as babies are the most powerful and efficient pumps.
What should mothers do to prepare themselves for breastfeeding?

I am 100 percent confident in breastfeeding because of my strong belief in God. To me, God's design is, and always will be the best. Hence, I decide to learn on the job instead of reading up more about breastfeeding. However, I will strongly encourage mothers-to-be to read up about breastfeeding to better prepare themselves mentally. With sufficient knowledge on breastfeeding, they can also educate the people around them and bust any myths related to breastfeeding. They will be more confident to defend their stand when faced with pressure to offer formula instead of breastfeed. Talking to mothers who are experienced in breastfeeding also helps a lot as they will be able to share with you on the struggles that they have gone through and you won't feel so lonely on this journey. Joining a Breastfeeding mums Facebook group will also connect you to other breastfeeding mums all over the world. You can pose queries online and many helpful breastfeeding mamas will be more than willing to lend a helping hand.

Looking forward
I am looking forward to the day when Singapore will be more accepting of breastfeeding in public. It should not be viewed as a social taboo. Mothers should be able to breastfeed anywhere and anytime without having any worries of inviting stares, being chided or stomped. Instead, they should be encouraged and given thumbs up for this beautiful act of love. Honestly, I do not think breastfeeding mothers need to cover up if they are wearing proper nursing wear which will prevent them from exposing themselves. Even a teeny weeny bit of flesh exposed is harmless. If you know the mother is breastfeeding, you should look away..unless you're staring so hard then will you be able to notice the flesh. I do not understand how people can accept woman wearing exposing clothes that reveal half the breasts and term it sexy and beautiful, yet view public breastfeeding as an inappropriate act. 

In Taiwan, it is an offence to hinder mothers from breastfeeding in public. It is their choice to go to nursing rooms, if not, nobody has any right to tell them to do so. Love it.

Education is the key. People need to be educated on the true benefits of breastfeeding. Ignorance is not bliss-ignorance is ignorance. Media and social media are important platforms to promote breastfeeding. Campaigns need to be in place to raise public awareness. I believe Government has an important role to play as well. However, I am thankful for the improvements in facilities as well, new shopping malls have bright, spacious and comfortable nursing rooms for mothers to nurse their babies. People should be educated not to abuse these facilities though.
To end, breastfeeding is a choice and no one has the right to judge. The decision that you made at the end of the day does not make you a better or worse mum. We believe that all mothers love their children unconditionally. Mothers certainly should not breastfeed at the expense of their own physical and mental health. The well being of mothers should be the top priority because only with good health can we take better care of our little ones. However, if circumstances permit, I will still strongly encourage mothers to breastfeed.

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