Thursday, November 24, 2011

Breastfeeding FAQ

These are all that I've learnt about breastfeeding and I want to share with every mother!

1. Help, I don't have enough milk for my new born! I only managed to pump out a little bit of yellow liquid :(

Don't worry! When I was in the hospital I only managed to pump out a little amount of yellow, sticky liquid called colostrum. This early milk is high in antibodies and very important for your baby. Allow your baby to latch on as often as possible to get as much of these colostrum as possible. In a few day's time, your milk supply will come and the milk will change from yellow colostrum to more whitish transition milk and then to white colored milk. Don't worry if there seems to be very little for your baby. Baby has reserve in his body for 3 days so even if you do not have milk yet, it is ok for baby! Just keep latching baby on to stimulate your breast to produce milk.

The below is a picture of the colostrum I pumped out while at hospital.

This is a picture of the full milk I pumped out when we went home. This totally white colored milk only comes in a week after discharge.


2. I use the electric pump to pump out my milk and only get 30ml! That's not enough for my baby, right?

Using a pump to measure the amount of milk your baby is drinking during breastfeeding is a very inaccurate measure! Your baby is much better at extracting milk than any good breast pump in the world, so baby can actually suck more than the amount you pump. Also, when you feed baby, the feelings of closeness encourage let down of milk and its different when you pump, so the milk production will be much more when you are latching baby directly.

People with fast milk flow can fill up the bottle quickly. People with slow milk flow may take some time to fill up the bottle. But that still does not mean you do not have enough milk for your baby. Baby is having enough output, wetting diaper 6-8 times a day, looks satisfied after a feed, and is gaining weight means you are feeding your baby well. Just persevere on and you'll be glad that back then, you never give up!

3. Should I just express out my milk and feed baby with bottle? Direct latching is so difficult and feeding takes so long.

Don't do that yet. Don't choose to feed expressed breast milk (EBM) in bottles just because breastfeeding is difficult. Personally, I think babies should be introduced bottles only when mothers need to be away and cannot breastfeed her directly, like going to work, or going off somewhere for longer hours. Latching my baby isn't easy. He was a sleepy baby due to jaundice so we had to keep waking him up to feed and had to keep him awake during feeding. He's also very fussy partly due to my fast milk flow and his fussiness caused me to have sore nipples, blisters, and bleeding. During the first month, I really felt like giving up. Whenever I thought of the feeding session, I cringed as I am reminded of the pain on my nipples. However, I told myself that I have to persevere and be positive. With the encouragement of friends and my hubby, I have persevered with direct latching.

The most important reason one should do direct latching as much as possible is because this is the best way to stimulate milk production. Pumping cannot stimulate breasts to produce milk as much as babies' suckling. Most mothers I know have their milk dry up because they start exclusive pumping very early on, and there's almost no latching.

Another reason is that latching on provides the best bonding between mother and child. I feel happy seeing my child cuddle up close at my breast suckling, feeling safe and secure. I can cradle him and feel his warmth against my body, and touch him as he feeds.

4. Breastfed babies do not need to be burped.

Oh well, some say so but from my personal experience, yes, my total breastfed baby do need to be burped. He will swallow air when he cries or when he tries to search for nipple and is unsuccessful, or when he sucks and made clicking or sucking sounds because the latch is not very good. I have fast milk flow so baby is prone to unlatch and cry due to the flow being too fast for him, or make sucking sounds and have to be unlatched and latched again. Other friends who breastfeed their babies also say they need to burp their babies even though they do not have fast milk flow. So I guess the safest way is the burp baby after feeds. But don't over burp babies. Over burping them can cause them to spit out milk. It is not necessary to hear a "burp" sound after burping. Sometimes, there's just no air trapped inside so there's no need for baby to burp it out. (But if you bottle feed baby, you do need to burp baby until he burps because bottle fed babies almost always gulps in air.)

5. My baby drinks a bit and cry and pull off from my nipple! Sometimes, she pushes me away with her arm.

My baby does this most evenings since he's 3 weeks old. At first we thought he's frightened, what Chinese call "Xia Dao" by loud noises, noisy kids, etc so kept crying non stop and refused nipple even though he was apparently hungry and cried for milk. So we gave him Jing Feng San. And we also thought maybe he had gas in his stomach and gave him Ru Yi oil. Oh well, we came up with all kinds of theories and we were so at a lost of what to do. Then a good friend introduced me to this concept of CLUSTER FEEDING and FUSSY EVENINGS, and asked me to read Kelly Mom for more information on these stuff. Then I know! His behavior is not abnormal. Parents all over the world are experiencing this difficult moment.

Cluster feeding is when baby nurse more and for longer duration for a period of time usually in the evenings before he stores the energy for a longer duration without feedings, which is night time. During this time, baby may feed for a few min, then pull off, then feed then pull off.

Fussy evenings is when baby just simply fusses. Nobody knows exactly why baby fusses more in the evenings or why baby does it. There is something causing discomfort in baby but he can't tell us and we can't diagnose it. So what hubby and I do is we try everything! We rocked baby in cradle hold but he didn't seem to like it so we bounced him while supporting his neck and buttocks and he loved it. So we bounced him for hours. I bounced and sang to him for few minutes, then switch to hubby to bounce, then he started crying regardless of the bouncing and we knew he wanted milk so I nursed him and he pulled off and cried and nursed few minutes and then pulled off and cried again. These went on and on. Until about 12midnight or 1am... Sometimes hubby and I KOed and we had to hand baby over to my mother in law (who was doing confinement for me then) to hold baby while we rest. Usually when we hand baby to mother in law, he wasn't crying so much already.

There's one saying that during fussy evenings, even though what we do may not soothe baby effectively, it doesn't matter because what's more important is baby knows and feels someone is there with him when he's feeling distressed and uncomfortable. Someone cares. Someone loves him. Someone wants all the best for him. Someone is trying their best to make him happy and comfortable. Using this theory, I tell myself to keep calm and positive for baby. There was once I scolded him when he made me so exhausted and I couldn't forgive myself after that. It's absolutely silly of me. Baby doesn't know why he does the thing he does. He just wants cuddles, comfort and attention. So I tell myself never to do that again. When I am tired, I enlist the help of other family members when they are around and I take a nap or rest and do what I like to do. Then I go back with renewed energy and care for baby again. I tell myself that I must give all my heart and love for baby, no matter whether he fusses or he keeps crying or makes my nipple painful and sore, I still tell him he's the most adorable most important person to me, and I love him 100%.

Now, baby is 6 weeks old and everything is much better. Yes, the fussy evenings do get better although its not over yet. The fussiness actually peaked at 6 weeks and then stopped altogether when baby is 3-4 months old. The first month was the most trying. We just don't know how to deal with this little person who just popped into our lives! Baby destroyed whatever misconceptions I have about taking care of babies. I thought its just diaper changing, feeding, carrying... anyway, babies sleep most of the time, don't they? Alamak its not so simple and not so easy! If there's anyone who needs to teach their horny teenager a thing or two about safe sex, just come baby-sit my baby during one of his super fussy evenings! Those movies which glorified single parenthood? "Glorified" is an understatement! It's blatant distortion of reality! I can't imagine taking care of baby if I do not have hubby and parents or parents in law. I'll get really shagged and crazy.

6. I've a very sleepy newborn who refused to wake up for feeds, and when he does, he falls asleep quickly after nursing for a while!

I had the same problem because my baby had jaundice and jaundice babies are very sleepy. Those were my darkest moments. I became very depressed and cried almost everyday at about 5pm. Post-natal depression. I was also very possessive of baby, feeling unhappy whenever people, other than my hubby, hold him, and wanted to keep baby at my side at all times. I cried at every and any thing, including stories I read online, TV shows, News etc... even those stories that weren't even touching or sad and people won't usually cry at.

You just have to keep waking baby up! It wasn't easy. I had to tickle his ears, tickle his feet, touch him, talk to him, and my hubby read the news aloud to him so as to keep him awake, and yet most of the time, to no avail... yes, that's how frustrating it is. But we just keep doing it. The elders say, aiyoh, see he slept so well, let him sleep, no need to wake him up! But I refused to listen. I am one very headstrong mummy! I kept to the 2 hr feed schedule, sometimes changing to 3 hr feed if he seems to drink more during the previous session. I wake baby up every 2 hr, using whatever method we could think of or read about. Tickling, changing diaper, rubbing his chest, press cold towel on his face and chest... really whatever method. And I kept feeding him. We were delighted that during his 3rd week assessment, even when he still had jaundice, his weight has gained to more than the birth weight! Babies' weight should go back to birth weight by 1 month, and he's already much much better :) This gave me confidence and I continued feeding him with renewed vigor.

A certain pediatrician in Mount Alvernia told us to feed baby infant formula at night and to feed baby water because he has jaundice. Needless to say, I've stopped visiting this pediatrician and changed to a more breastfeeding friendly one. That one even told me to not be a hero, and that she had gone through this and she knows. Pui! I'm glad I never followed through any of her "advices" and persisted in total breastfeeding.

Total breastfed baby has jaundice that last longer but they will go alway. Mine only goes away slightly after his 1st month. Now, he no longer feeds on schedule because he can wake up for feeds already. He cries for feeds or sometimes, I see that he is awake and shows rooting behavior and feed him before he cries. My dad kept saying, let him be hungry for awhile and let him cry very hard before feeding him, then he'll drink more. But I do not see the necessity. Anyway, my baby feeds very well even though I don't let him cry hard for milk. I don't like to purposely allow my baby to cry. Excessive crying isn't good for babies' throats and babies with needs consistently ignored will grow up to become very insecure.

7. My baby keeps hiccuping. Can I give him some hot water?
There's no need to give water to babies when they hiccup. Its natural for them to hiccup and it goes away by itself after a while. Older generations have been advising me to give warm water to baby when he hiccup. Oh well. Some comments is 聽聽就好,笑一笑就忘了. But when it comes to my mother in law, who is doing confinement for me and thus caring for baby too, I am very firm about NO WATER for baby because I am doing total breastfeeding. Giving them water when they hiccup may choke them. See number 8 on why total breastfed babies do not need water at all. Remember to give very firm and definite rules to your confinement ladies and whoever helps care for him or her. Don't let them rule over you.

8. Does total breastfed babies need water?
The answer is NO! Many people like to suggest giving water to babies because they have been used to feeding babies infant formula. Total breastfed babies get the hydration and fat requirement from mothers' breast milk and that's all that they need. Feeding water to total breastfed babies can make them feel artificially full and they won't request for milk, won't suck more milk during feeding and thus may interfere with their growth. I've been breastfeeding my baby all the while and never giving him a drop of water. He's not dehydrated and he's growing very well.

9. What is total breastfeeding and partial breastfeeding?
Some mothers choose to give babies breast milk at times and infant formula or soy milk infant formula at other times. Usually they give infant formula at night so that baby feels "fuller" and will sleep for longer hours. Then mothers and confinement lady or whoever is the caregiver can get more sleep. This is partial breastfeeding. Total breastfeeding is feeding baby breast milk exclusively, with no water, no glucose, no infant formula as supplement.

10. Is partial breastfeeding better? I can get more sleep at night then!
Personally, I do not agree with this practice. Firstly, if you mix breast milk with infant formula, your milk supply may gradually dry up. This will lead to earlier weaning from breastfeeding. Breastfeeding works on a supply-demand basis. If there's less demand from baby, baby latches on lesser and sucks less, of course, your milk production will decrease because your body will send signal to your brain to stop producing more milk as there's no high demand for it.

Secondly, to feed baby infant formula makes him have a "fuller" feeling but that's not because infant formula is better! Quite on the contrary, its because infant formula is harder to digest. That's why when breastfed babies need to be fed every 2-3 hourly, infant formula fed babies only need to be fed 3-4hourly. Yes, caregivers or mothers get more time to do chores, and they get more sleep but is that good for baby? I'm not saying that infant formula is bad for babies but it definitely is inferior to my breast milk. I'm giving the best to my precious baby! Also, I do not think I should sacrifice baby's health just for my convenience. Not to worry, baby do learn to sleep longer hours at night as they grow older. That day WILL come. Anyway, some infant formula fed babies still wake up a lot over the night for night feeds so there isn't much difference in terms of the rest you get.

11. But if I breastfeed baby, its so difficult to bring her out!
No, its not! I've brought baby to shopping malls at Orchard Road and to baby showers and housewarming parties, and he's only 6 weeks old. Its generally difficult to bring such young babies out. Their needs are numerous and when they need something, they want it immediate. My baby cried so loudly in the MRT that we were terribly embarrassed.

Its NOT MORE DIFFICULT to bring breastfed babies out. All you need is a sling to sling your baby and a breastfeeding cover to cover him up as you feed him. Shopping will take a longer time though as you may need to find a nursing room or if there's none, you may need to find a quiet corner to sit down and feed baby. My friend has tried walking around shopping and breast-feeding baby discreetly in sling and breastfeeding cover so its not impossible! But I haven't tried that. My baby is so heavy and big... my shoulders will ache like crazy haha. But sometimes he like me to walk around as I feed him. If you don't have a sling, you can also just carry him and feed him under a cover. Some clothes are breastfeeding friendly and you can just pop baby under the cover of the blouse and feed.

Here's a picture of me wearing the sling on an MRT:

And here's a picture of me and my baby feeding under the breastfeeding cover:


You do need to have a change in wardrobe though. I have to give up many of my dresses and blouses and exchange them for blouses that have front open buttons to facilitate feeding.

There are a lot of nursing rooms in shopping malls in singapore. There's a list in this forum thread that you check before you go shopping. Some malls even offer free baby stroller loans.

Disclaimer: The above are personal opinions and preferences from my own experience and other mothers may have very different recommendations :)

I'll add to this FAQ as new questions pops up :)
Last edited 27 Nov 2011, 6.30pm

8 comments:

  1. Great post!! Love it!

    I can totally relate to a lot of what you wrote, especially bringing baby out and about. I used to plan outings around possible feeding times as I wasn't confident in feeding outside of home till my baby was around 4 months old!! Months later I got the hang of it and couldn't care less about using a breastfeeding cover because my son kept pulling it off anyway. It is baby's right to feed anywhere and anytime so I fed often in cafes and while carrying him in the Ergo. I didn't like using stinky nursing/change rooms.

    Now I feel a lot more confident with breastfeeding that when my daughter is born I'll feed her anywhere, anytime, and I couldn't care less if people catch a nip-slip from me. If they don't like it they can put a cover over their heads! The more people see babies being breastfed, the more normalised it will become :o)

    ReplyDelete
  2. bearnowasleep, you are so daring! Hmm... my hubby is a bit more conservative and he'll go crazy if I dun use a breastfeeding cover. haha. I guess in Australia, its much more a norm to breastfeed baby and also breastfeed in public? I went to a baby shower and asked to feed baby in one of the rooms. People kept knocking on the door to come in even though they were though I'm feeding baby inside because they don't understand why they couldn't come in, isn't feeding baby using a bottle? In Singapore, we are conditioned to think so :)

    ReplyDelete
  3. Thanks for the sharing... I have a question to ask. Can the mother take the confinement food which cook with liquor eg. Martell cook with chicken and also can breastfeed the baby at the same time? Or should not take any food that contain alcohol?

    Thanks.

    ReplyDelete
  4. I took confinement food cooked with rice wine or some kind of wine my MIL use. If the food is cooked with the alcohol, there should be no more alcoholic content inside, and its ok.

    If you just drink the alcohol without cooking it with food, then you may need to take precaution. Since baby is below 1 mth old, I think to be safe, dun drink alcohol directly. I didn't drink alcohol directly while I was breast feeding. I drink a red date enzyme that my MIL makes in place of the alcohol.

    Kelly mom has an article on breastfeeding and alcohol: http://kellymom.com/health/lifestyle/alcohol.html

    ReplyDelete
  5. Thanks a lot for the useful reply again :) and with the reference.

    I do not drink alcohol directly but mainly is from the food which use wine or alcohol to cook.

    Enjoy your breast feeding and hope your baby will grow stronger and healthier with the nutritious breast milk :)

    ReplyDelete
  6. Hi Suqi, so do pump out the breast milk and feed your baby with bottle and also breastfeed him at the same time? Will he prefer to drink the breast milk from the bottle since he has a choice? Should I start to buy a breast pump before I deliver? Do yo have any preference of which brand with some specific reason?

    For the milk storage is it bottle or the milk bag is a better option?

    Thank you for sharing more.

    ReplyDelete
  7. Hi Swan Tham, for the first month, I avoid giving him bottle until he is 3 weeks old. I want him to learn how to latch on properly first. At first, the latching on is difficult as newborn's mouth is small yet he needs to cover the whole aerola and suck on the aerola instead of the nipple only. If you offer him pacifier or bottle too early, he may get nipple confusion, preferring the nipples of the pacifier and bottle as they are easier to suck, and for bottle, faster flow.

    I got a pump before I deliver. Its gd to have a pump around in case u get engorgement. U need to express until breast is quite soft before feeding baby. Otherwise its difficult for baby to suck milk out from a hard breast and he'll reject it.

    I got Avent. The electric motor spoil at 4th week after birth and it keeps tipping over, and spilling milk. I've never used other brand of pump. My friend uses Medela electric pump. Its noisy and sometimes disturbs her baby's sleep but its gd with the pumping and more durable. Avent is rather noisy too but the manual one is silent. After the electric spoil, I'm using the Avent manual pump and its ok for me. My milk flow is fast for manual is still ok. I dun have to pump for very long to fill the bottle. If your flow is slow, manual pump will tire you out. Look out for baby fairs to get a package of breast pump plus other goodies! If you don't want to invest in one so early, u can rent different pumps from hospitals and breastfeeding support grp to try out first. This organization rents out pumps: http://www.breastfeeding.org.sg/

    As for storage, you can read my post on http://mummysuqi.blogspot.com/2011/12/how-to-store-and-use-expressed-breast.html.
    I never use bag before. I use glass bottles which I got free some a mummy forum fren. You can get them free from Mount Alvernia hospital or other hospitals you deliver at if they give it out free. You can also buy Avent milk storage plastic bottles especially to store milk. The Avent plastic bottles are quite good. Doesn't spill out when I bring them out.

    ReplyDelete
  8. Dear Suqi, thank you for the detail explanation and guidance and it will definitely a great help for me. I will keep a look out at the available choices for breast pump :)

    Many thanks.

    ReplyDelete