Developing a thick skin may be what you need to start your breastfeeding journey

By Christina Ching

Shrug off all comments, no matter how well meaning, that your baby isn’t getting enough milk. During her first days, your newborn won’t be drinking milk, but colostrum. This is enough to sustain a normal baby. She’ll not need any supplementary feeds of glucose water or formula milk, which will hinder your milk production.  Never forget the fundamental principle of breastfeeding - that supply equals demand. The more milk your baby takes, the more your body will produce, so you should always have enough to satisfy her. Instead of combining formula feeds with breastfeeding, let your baby nurse frequently.  It’s vital to be aware of what will help get your breastfeeding efforts off to a flying start ? from positioning and how to latch baby on, to what to expect and whom to contact if you run into a roadblock.  “Your baby is getting enough milk if, after the first three days, she is producing six to eight wet diapers a day.”  Make sure to get help if you encounter problems - most setbacks can be sorted out with skilled support. Don’t wait until it’s too late as minor problems can quickly escalate and spell the end of breastfeeding.

It’s impossible to ignore the “breast is best” message when you have a baby. In 2001, the National Breastfeeding Survey, which surveyed more than 2,000 Singaporean mothers, found that more than nine in 10 new mums tried to breastfeed their babies - wow! Sadly, after a month, this figure dropped to seven in 10 mums, and at 2 months, only half kept it up. By the time the babies reached 6 months, a dismal two in 100 infants were still being nursed. 

For mums who breastfed their babies exclusively, the numbers were even more gloomy. The Health Promotion Board study found that most mothers combined supplementary bottle feeds with breastfeeding - only 14 per cent of 2-month-old infants were breastfed exclusively, and by 6 months, the number had plunged to less than 1 per cent! 

Indeed, Singapore’s breastfeeding figures are bleak in spite of the intense messages in the media of the benefits of breastfeeding for both mums and babies. As breastmilk contains just about everything a newborn needs, the World Health Organisation also recommends that babies be exclusively breastfed until they reach 6 months. 

Is it that women simply don’t want to or can’t breastfeed, or is it that the support system is failing new mums? 

BACK ME UP
Breastfeeding doesn’t come naturally for many women, so the early weeks can be especially challenging. “Support and encouragement from family members and healthcare professionals are critical in ensuring breastfeeding success,” notes Cynthia Pang, a senior lactation consultant at KK Women’s and Children’s Hospital. 

It’s easy to become worried and upset if things go wrong, especially if you don’t know whom to turn to for help. It may take just a reassuring phone call, or a chat with a skilled expert to overcome your problem in order for you to continue breastfeeding happily. 

So, is help and support easily available or lacking? 

New mums are shown how to breastfeed in hospital, but breastfeeding hiccups usually don’t arise until day four or five when milk comes in ? when the mothers are already out of the hospital. You can seek help yourself - by phoning a breastfeeding helpline or seeing a lactation consultant - or give up. Many women, exhausted, emotional and in pain, choose the latter. Indeed, it can be hard to get support even when you’re in hospital. 

“The nurse offered to feed my crying baby formula milk, so that I could get a good night’s rest,” says Julie Ang, 33, mum to Mark, 11 months, and Nicole, 6. But the mum-of-two stood firm and asked to see a lactation consultant, who helped her baby latch on properly. Since then, nursing Mark has become second nature. 

Others, like Evangeline Teo, 33, faced family obstacles. “I had difficulty breastfeeding because of my inverted nipples and had to use a nipple shield, so Zach became very impatient when I was preparing myself to nurse him. My mother-in-law kept nagging that Zach was not getting enough milk and urged me to supplement with formula,” she recalls. “Suffering from sore nipples and with Zach crying non-stop, I caved from utter exhaustion.” 

When Evangeline was discharged, she insisted on nursing her son, now 5 months, but had to express her breastmilk when she ended up with bleeding nipples. 

“Whenever he cried, my mother-in-law continued to assert that my baby was not getting enough milk and looked disapprovingly at me, as if I was torturing my baby by insisting on breastfeeding him, instead of offering formula,” she says indignantly. 

Stressed and fatigued, she gave in to pressure as she was also doing the household chores during her confinement, while staying up at night to care for her baby. 

Evangeline’s nursing experience went downhill from that point ? as she did not have enough milk, Zachariah got impatient at the breast, and after three painful months, she stopped nursing her baby. 

RULES OF ENGAGEMENT
To ensure that you’re off to a good start, you’ll need to understand the basic principles of breastfeeding. As you and your baby are new to the game, it’s a skill you’ll both need to learn together. In the early days, focus on learning to position your baby properly and helping her latch on correctly. 

Shrug off all comments, no matter how well meaning, that your baby isn’t getting enough milk. During her first days, your newborn won’t be drinking milk, but colostrum - a creamy liquid that’s packed with protein, water, sugar, vitamins, minerals, as well as antibodies, to boost her immune system. “This is enough to sustain a normal baby,” stresses Wong Boh Boi, a senior lactation consultant at Thomson Medical Centre. “She’ll not need any supplementary feeds of glucose water or formula milk, which will hinder your milk production.” 

Never forget the fundamental principle of breastfeeding - that supply equals demand. The more milk your baby takes, the more your body will produce, Wong explains, so you should always have enough to satisfy her. 

Instead of combining formula feeds with breastfeeding, let your baby nurse frequently, especially in the early days before your supply is established and when you think your baby isn’t getting enough milk. Studies show that breastfeeding problems, like a poor milk supply or if the baby is not sucking well, are usually caused by supplementary bottle feeds. Nurse frequently and consistently to overcome such setbacks, advises Pang, who’s the honorary secretary at the Association for Breastfeeding Advocacy (Singapore) 

“This will increase your milk production, as well as prevent your baby from being confused, since breastfeeding and bottle-feeding require different sucking actions. What’s more, she may learn to prefer the bottle, consequently rejecting the breast,” she explains.

If you have any comments or practical suggestions, write to us at editor@family.sg 

- Mother & Baby
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