Pregnancy – First to Ninth Month

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pregnancy ninth month

1st Trimester Activities

You can prepare for labour, even in your first trimester!

Keep on moving
In the first trimester, it is normal for women to be clouded by fatigue. So exercise may not be the first thing on your mind. But according to personal trainer, Sam Etches, keeping active in your first trimester can keep you fit throughout the whole pregnancy, as it gives you stamina and increases your chances of having a natural birth. “What you do will depend on your pre-pregnancy fitness levels,” says Sam. “If you haven’t been very active before, now’s not the time to start a vigorous training schedule. Swimming, brisk walking or a pregnancy-based course, such as pilates are excellent ways to keep fit.”

However, if you were active pre-pregnancy, you must remember to tone down the intensity and frequency of your training schedule. “Basically, just avoiding anything that leaves you breathless and red-faced. Remember you have inbuilt cooling down mechanisms, but your baby doesn’t,” reminds Sam.

Meditate
Meditation is one of the best ways to unwind from the stresses of pregnancy. If you practice this early on in pregnancy, not only can you enjoy quiet moments with your baby, but it can also teach you techniques to get you through labour. A 30-minute meditation session is ideal, but even if you can’t squeeze this in, a few sessions here and there will do the trick as well. And better still, you needn’t go to classes for this either, any good bookshops will have a selection of books on practicing these quiet moments.

Get friendly with your doctor
According to research, getting to know your doctor may lead to a more positive labour. Although there’s no guarantee that the doctor that you’ve been assigned to will be present at your birth, it doesn’t hurt to cultivate the friendship during your antenatal visits. When you have a good relationship with your doctor, it often leaves you more relaxed, and such, you’ll be a in a more positive frame of mind when labour comes.

Prep Your Body for Baby

Get fit in your 2nd Trimester

Sumo squats
Pregnant women can definitely benefit from those deep squats that sumo wrestlers love doing. “Squatting is a fantastic thing to start practicing in the second trimester, as it strengthens your lower back, thighs and bum and is a particularly useful labour position,” enthuses Sam. However, caution is needed, as with any form of exercise during pregnancy. “If you have symphysis publis dysfunction (a pregnancy condition that causes pelvic pain), certain squatting positions will not be possible,” warns Sam. You may need to check with your doctor to see if they can recommend you other positions instead.

Mummy Massage
A mum-to-be massage may take the aches from your back and your feet, and it’ll help you unwind in the process. You can also get your partner involve, if you’d prefer to get a massage in the comfort of your own home. Apart from creating intimacy, it is also a good way to teach him a few techniques that may come in handy during labour. Mother & Baby nurse, Michelle Lyne, says that a perineum massage is also recommended after 28 weeks, to help it become more flexible for birth and to reduce tearing. Here’s how to do it: wash your hands, run a little unscented oil into them, insert two fingers into your vagina then pull gently down and outwards. You should feel a slight tingling, but not pain.

The Final Countdown

Here’s what to expect in the last weeks of pregnancy

The last weeks of pregnancy is normally filled with anxiety and excitement. Your body’s gotten so big that you’re finding it hard to be comfortable. Don’t spend the last weeks of pregnancy worrying. Soon, you’ll meet your new baby. Here’s our week-by-week guide on how you can make the most of the last 10 weeks of your pregnancy.

10 weeks to go
Healthy diet
Just because you’re getting bigger and you feel the need to stock up on energy for labour, it doesn’t mean that you can go wild eating your favourite ice cream. You don’t actually need to eat for two. It’s more important to keep to a healthy diet that includes nutritious food.

Snack on dried fruits, nuts, cereal bars and lightly-cooked strips of vegetables such as eggplant and carrots.

9 weeks to go
Rest up
With a big belly, it’s hard to get a good night’s sleep. So, try to relax for an hour during lunch time. A good idea is to sleep on your side with a pillow under your belly. Now is also a good time to start shopping for baby. Check out the best deals for baby essentials, such as a crib and stroller.

Yoga relaxation can work wonders at this stage. Get your body properly supported while lying on your side in a quite, dimly-lit room, close your eyes and focus on your breathing. Relax each part of your body and take time to stretch out and sit up slowly.

8 weeks to go
Pack your bag

If you have other children, get them used to the idea of a new baby. You’ll need to start packing your hospital bag too, as labour may start at anytime. Use your time at your antenatal classes to discuss any worries you have and iron out your labour plans.

Pack a couple of treats in your hospital bag – some really nice body cream, your favourite CDs or a new lip gloss.

7 weeks to go
Plan properly
Braxton-Hicks (practice contractions) may be happening around this time. This means that your body is getting ready for the real thing. You should start thinking about how your like your labour to be – who should be there, what you would like for pain relief, and so on.

For tiredness, rest with your feet above the level of your heart, as this helps your circulation and protect you against varicose veins that may likely be appearing now (and most likely disappear once your baby’s born).

6 weeks to go
Calm down

You can do a few gentle exercises to help prepare your body for labour. But don’t try to do anything that causes extra strain on you mentally or physically.

To avoid tearing during childbirth, now’s a good time to do a daily massage (once or twice a day) in your perineum (the area between your vagina and anus). Use a little bit of olive oil, and place your thumbs about 3-4cm inside your vagina. Gently massage and stretch your perineum for three to four minutes.

 

Massage benefits for moms and baby

Massage is beneficial during pregnancy & after childbirth. It helps relieve aches that you may experience.  Therapists will also be able to help in treating and healing.  Massage & spa therapies will also help in relaxation & to re-energise  – much needed in your job as a mother!

During my pregnancy with Timmy, I had both chiropractic alignment as well as regular massages with a recommended Malay massage lady whom I also used for postnatal massage after birth.  Chiropractic treatment is useful as proper alignment of the pelvic bones also means an easier birth. The traditional Malay massage was done using aromatherapy oils during pregnancy.  I liked the massage using a little force in the strokes, so it was really relaxing for my tired pregnant body and aches.  After birth, the massage lady used some herbs on the abdomen to get rid of wind, to warm up the area.  It included binding with a loooong cloth the traditional way.  This was done for 5 days.

Traditional Malay/Indonesian Massage Pre & Post-Natal :
Mdm Jamilah  Tel: 91862917
Mdm Naini.  Mobile 94562817, Tel 62190062.
Mdm Fauziah. Tel: 91993324
Mariam Rawi, Aesthetician & Physiotherapist (Indah Faidah Traditional Salon), HP : 9067 2482
Mdm Dolly Lim, 
(at customer’s house), Contact HP: 97386081

Ms Vivan Seah, Lightweaver Therapeutic Massage & Bodywork
Vivian Seah is a Certified Massage Therapist providing pre-natal massage therapy through all stages of pregnancy. She is specially certified in pre-natal massage therapy in the USA and is experienced in treating back problems to do with muscular pain or tension as a result of the changes during pregnancy.

Address: Camden Medical Centre, #07-06

Phone: 9669 2609  E-mail: [email protected]

Lightstreams Chiropractic Care Pte Ltd (Dr Nancy Schrauth) Tel: 6-7380605304 Orchard Road #05-54B Lucky Plaza
Email :  [email protected]  Website: 
 http://www.lightstreamschiropractic.com/
Dr Schrauth has experience in helping women during pregnancy and postnatally who are experiencing back problems. Nancy Schrauth, the chiropractor, uses gentle techniques to help women adjust to the changes that pregnancy brings and relieves aches and pains in the spine and the pelvis while maintaining flexibility of the spine and joints. The treatment uses gentle pressure to do the adjustments and is not painful .  Do read more in Dr Schrauth’s Article “Chiropractic Care for the Childbearing Years”.

Osteopathic Pain Relief Centre Tel: 6327 8545 .  www.osteopath.com.sg
China Square Central. No. 3 Pickering St #01-10 Nankin Row (Opposite Great Eastern Bldg Starbucks Cafe)
  Email :  [email protected]
Osteopathy helps pain relief by correcting imbalances in body structures (muscles, bones, ligaments, organs & fascia).  This improves the harmonious working of the nervous and muscoloskeletal systems.  Healthy functioning is thus promoted.   Adjustments are done by finger and hand manipulations.

Traditional Chinese Tui Na Massage (suitable for infants and children):
Yu Guo Chinese Physician Acupuncture & Physiotherapy Pte Ltd
398, Changi Road #01-08/10/11 Castle Court S(419845) Tel : 64474761
Mon – Fri: (except Wed)  9:00 am – 12:30 pm, 2:00 pm – 5:00 pm,  6:30 pm – 8:30 pm
Sat:  9:00 am – 12:30 pm, 2:00 pm – 5:00 pm
Sun: 9:00 am – 12:30 pm  (Closed on Wed & Public Holiday)

 

Kang Jia Chinese Medicine & Physiotherapy

9 YIO CHU KANG ROAD #02-11

KOVAN CENTRE, SINGAPORE 545523

TEL : 62870379 HP : 96870175
(Able to make home calls if necessary – do call to make appointments or to enquire)

 

MA GUANG Medical Group ( Ms SUN JUN YAN): Do call to enquire:
Mondays @ Blk 306 Woodlands St. 31 #01-53 S(730306): Tel: 6362 0560
Tuesdays @ Blk 451 Ang Mo Kio Ave 10 #01-1755 S(560451): Tel: 6556 1460
Weds @ Toa Payoh: Tel: 6556 1460

Children & Tooth Decay

Our 2 older children have perfect teeth, the eldest is 7yrs. But our youngest – now 2years has one chipped front tooth that does look like it was caused by decay.  We have been putting off any treatment as we have no experience in this area of teeth & children.  And the friends that I know with similar problems just do not do anything b/c they feel that it is only “milk teeth”.

Anyway, it was puzzling to me as I wondered why our 3rd child had this problem.  I did some reading to have information so I can decide what to do.  If you are interested, here are some very useful links on articles & many parents’ experiences:

Eventually, we did bring Timmy to the dentist.  Firstly because I wanted to hear professional opinion, secondly because I was afraid of further tooth decay, and thirdly because the chipped off part of the tooth was sharp and scrapped against me when he nursed!

This treatment cost us all of S$25 and only 10minutes of work. We had it done at a nearby dentist.  I decided not to use any of the nearby clinics  as they all looked a little old & dinghy.  And we tried not to go to a pediatric dentist because of the cost (remember, we have 3 children!).

The dentist said it was definitely decay.  Said that it was best to have it filled up as Yes, it could spread, and as I suspected, there is some risk to the front tooth next to it.  And it was better to fill up for those reasons as Timmy being only 2 years’ old would need to have at least another 4 years’ use of the tooth!

He said it was nothing to do with poor enamel, nor genetics. Apparently tooth enamel can be affected by medication during pregnancy – but I was on little if any medication with Timmy’s pregnancy.  The dentist said these  conditions were very common these days – waaah… is it our water then?  This dentist just seemed happy to get the job done.  He did not blame the decay on anything.  Did not say anything about bottle syndrome nor anything about breastfeeding even though I mentioned it (hey, I could not resist testing the ground!).

Timmy was a real good boy.  I sat on the dentist chair with Timmy reclined in my arms and used my other hand to keep Timmy’s
mouth open.  It was very similar to how I would put my finger in to take my nipple out after nursing.   I reminded him not to bite Mommy’s hand, so he was very gracious about it.

The dentist scrapped the decayed tooth, then filled it up with white filling.  I had brought Timmy there earlier in the day to make the
appointment, so Timmy had seen that there was a playground there.  On the way there, I also kept telling him how he had to be a big boy and sit on the dentist chair and let the dentist uncle clean his teeth and patch it up for him – and that if he was a good boy, Mommy & Daddy would buy a car for him.  After it was over,  Timmy went out of the room and said “Let’s go and buy car!!!”.  whoa!

Well, I must say that I was really glad at how it turned out.  Timmy was not scared to go into the dental clinic, nor has he been scared off by the visit & the treatment, apparently.  I asked him tonight if he liked going to the dentist and he said “yes”!  And the dentist had not even given him toys or treats or whatever.

Sad to say … the filling came out again later. Opinions differed.  One dentist that I consulted said it was no point filling as it would most likely come out again.  Reason being that the child would not be able to open his mouth and be still long enough to have the teeth surface dried well so that the filling would be able to adhere properly.  If the filling is mixed with saliva, most likely, it would not last.  The problem though, was that with the filling out, the edges of the decayed tooth was very sharp, and with that “sharp tooth”, it was like breastfeeding a T-Rex!  Hence, I started my search for a dentist that would appreciate my problem and be able to help us work through it.   Thankfully, I remembered that one of our breastfeeding mothers’ husband was a dentist.  I had met him before a few times.

Brought Timmy to see Dr Ben Lim.  My intuition was right.  He explained the procedures and what to expect.  He also knew that our goal was to get a filling in and have it stay.  He used a fast drying filling and a light-ray to do the filling.  No drilling as Timmy was afraid of it.  Dr Lim did manage to polish off the sharp edge of Timmy’s tooth though, so that helped even more for a “smooth” breastfeeding time!  Timmy was not as cooperative this time around though.  Had Dr Lim running off to find toys to entertain Timmy. Buses & dinosaurs… well, we got the job done and the filling has remained for a good number of months already.  whew!

If you need consultation, do check them out.  Dr Lim’s quite good with children, although he’s not a pedodontist.  Timmy was not too amused, I must say, but 5yo Daniel’s attention was certainly captured by the dentist’s “elevator-style” chair!

Dr. Ben Lim
Hosanna! Dental Clinic
Blk 123 #01-515
Toa Payoh Lor 1
Singapore 310123
Tel: 6258 8456

Tips for Discreet Breastfeeding

On hearing that I had breastfed my son for more than 2 years, a mother I had just met exclaimed “Aiyoh!  Does that mean you never went out of the house?  How did you manage to do that for so long!”.

Well, I certainly have not confined myself to the house.  One of the greatest advantages of breastfeeding is it’s convenience, isn’t it?  A breastfeeding mother does not need to worry about carting around a big bag and making sure that there are enough bottles, milk powder and warm water.  Mommy’s milk is available fresh and at the right temperature all the time.

No one has to convince us that breastfeeding is good for our children, and that breastfeeding is beautiful.  But in public?  It does sound a little daunting, especially for mothers breastfeeding for the first time.    Even the most liberal among us might feel uncomfortable about “baring” our breasts in public, even though this act of breastfeeding should be the most natural thing to do.

A new mother thus faces this dilemma:  wanting to breastfeed, and wanting to continue a previously active life out of the house, but how to do both without leaving baby at home?  I have personally breastfed my children everywhere in Singapore and on trips overseas.  You can do it too.  With some planning and practice, you will be able to breastfeed easily and comfortably wherever you are.

To help you breastfeed in public, here are some ideas and tips:

NURSING BRAS

Wearing a nursing bra is a “MUST”.   Get the style of nursing bra that can be easily fastened and unfastened with one hand.   You need to hold the baby in the other hand, afterall!

DRESS APPROPRIATELY

Wear clothes that allow easy access for nursing.  With the right clothes, you can nurse without feeling like you are disrobing in public.  You can buy nursing clothes which are specially designed for breastfeeding mothers.  Wearing separates work well too.

WEAR BABY IN A SLING

You could also use a sling to nurse baby.  Slings make it easy to position a baby to nurse discretely. Once you have baby latched on, you could continue walking and shopping around.  And if you have an older child to care for, this allows you to keep up with him while still nursing the baby.  I have done this while playing with my older son at Tumble Tots sessions too!

TIMING

Pay attention to your baby’s signals. Find a spot to nurse at the first hint of her discomfort, so fussing does not turn into screaming.  Loud, crying babies attract far more attention than a baby who is quietly nursing away.  For some babies, it might be better to take frequent breastfeeding breaks.  Plan your time such that you breastfeed BEFORE going into the supermarket or into the bank.  I have found this step to be an essential for a peaceful car journey with my newborn.  Observe & learn your baby’s rhythms. This will help you plan your outings so that you are in a convenient place when he is hungry.

LOCATION

Find a place where you will be comfortable – a bench in a shopping centre, at a restaurant table, a quiet corner in your favourite bookstore or even in the MRT.   If you are driving, you could also nurse baby in the car before setting off on your shopping spree or run your errands.  If you need more privacy,  you could also look for a Mother/Baby/Nursing room in some shopping centres.

BODY LANGUAGE

Relax! The feeding will go easier if you do.  Looking around nervously will just draw attention to yourself.  If you do not act self-conscious while breastfeeding, people will probably not notice.  In all likelihood, they might think you are just cuddling a sleeping baby!  Babies are cute, so often draw smiles from curious passers-by.   Smile back, or create your own privacy by reading a magazine or engaging in conversation with a friend.

Practice nursing discreetly at home before your first big outing with baby.  Nurse in front of a mirror until you are confident that nothing shows.  You could also meet with friends and nurse in front of  them first to help you become comfortable enough to breastfeed in public.  If you have no breastfeeding friends, look up groups like our local Support Group and go for their meetings and workshops.  Internet newsgroups & mailing lists are also a good source of breastfeeding information and support.

Rest assured that breastfeeding in public comes easier with practice. It is a learnt skill. You will eventually become an expert at this!

How to Handle Breastfeeding at Night

The easiest way to handle breastfeeding in the night is to have your baby sleep next to you in your bed.  If you are working full-time during the day, you will find this to be an essential survival tool !

If you haven’t tried breastfeeding your baby while in the lying down position, do so!  Experiment with different methods, positions, & pillows. I had little problems nursing lying down with our 1st baby Sarah.  However, for some reason, I did find it difficult getting comfortable with our 2nd baby Daniel.  Eventually,  I found it easier to nurse get into position by slowly sliding down from my sitting position, and slowly slowly moving him with me in my arms. After a while, I got the hang of it, and of course, Daniel also “demanded” being nursed lying down, especially when he was very tired & sleepy!  For our youngest,  we did find that using a sleep positioner helped a lot in positioning a young newborn on the bed when co-sleeping and also to latch on at night for nursing.  Once you can get comfortable while lying down to nurse, you’d be sooooooo relieved because you can then handle night nursing much more easily.
After sleeping with your baby for a while, your sleeping patterns will be such good “co-ordination”  and in tune with your baby’s sleep patterns, that you can sense when he needs to nurse.  You can then let him latch on in a semi-conscious state.  For me,  I mostly don’t wake enough to even remember “how many times” the baby nursed at night!  And the baby doesn’t even need to cry.  I would be nursing him even before he did!   Because of this, his Daddy doesn’t get woken up much by the baby at nights.  More often than not, if the Daddy gets woken up, it’d be by the older kids!

Our 3rd Baby has slept with us in our bed from the time he came back from the hospital.  We did not even use the baby cot for him.   And as I found that Timmy could be calmed by having him sleep tummy-to-tummy on my chest, we got a Soft Bed Rail to put by the side of our bed.  This helped allay my fears of Timmy failing off the bed without me noticing in my sleep.  By his 3rd month, he matured to be a “big enough” boy and could turn over and latch on himself during the night.  Too easy, I must say!   This way, I’m rested for my “mommy duties & responsibilities” the next day.

 

Management of Sore Nipples

Nursing should not hurt. Sore, cracked, bleeding, or blistered nipples can be prevented by proper positioning and latch-on. Even in the early days of nursing,  the initial soreness at the start of a nursing session will become comfortable with milk letdown if latch & positioning is proper.  If you are unsure or if the soreness is perpetual, and if you suddenly develop sore nipples after a period of pain-free nursing, please do consult a professional certified Lactation Consultant for guidance.

However, if you are already experiencing damaged nipples, it would be necessary to relieve the pain and maintain a good breastfeeding relationship. Healing skin on the breast is also necessary to prevent infection like mastitis for instance as cracked nipples can be an easy entry point for bacteria. You would not want to ruin your nursing experience by such suffering.

Medical studies now show that what helps is “moist wound healing”.  The way to make use of this concept is to keep your wound moist and warm, which prevents scab formation and accelerates healing.   Do note as we talk about “moist wound healing” that simply keeping your skin wet is not considered “moist wound healing” as the skin layers are not kept hydrated.  Eg. putting water-soaked cotton pads.  And between soaks, the skin will dry up,  healing will be delayed.  Furthermore, drying skin promotes cracking.

From my experience, to help heal wounded nipples/breast skin, here are some tips:

1.  Hand-express some milk to wet the nipples & breast just before you start nursing.  This will make it more comfortable when baby latches on.  I find that even today, if I am going through a phase of dry skin, expressing some milk onto my breastskin before nursing helps the same way.

2.  Express some hindmilk onto the breastskin AFTER a nursing session and air-dry. Breastmilk has some Vit E and many beneficial healing properties.  And hindmilk is fatty & oily to hydrate the skin.  Do note however that although this method may be soothing to a mother with simple nipple tenderness it may not work well enough for more damaged nipples.

3.  Cool teabags (any plain type of tea, eg. Lipton teabags) applied to the breast after nursing can be soothing.  The tannin in the tea leaves are said to be good to some extent in healing sore skin.  Camomile or calendula tea might help soothe sore skin and with healing as well.

4. Apply 100% USP modified lanolin between nursing sessions.  Lansinoh Cream for Breastfeeding Mothers – because of the aspect of “Moist Wound Healing”. Indeed the cream is great, albeit a little sticky and messy.  To use effectively, dab enough Lansinoh on the affected area to cover it.  Dab the cream on the corresponding area on your breastpad so that the sore part of your nipple/breast is bathed in this cream and is prevented from further abrasion.  Another way to prevent the cream from rubbing off on your bra or breastpad is to use a breastshell after applying the cream.  You may also use a small-sized plastic mesh tea strainer (with handles cut off of course).

This ultra-purified lanolin cream further works by being  absorbed into the upper layers of the epidermis and  maintain the skin’s natural moisture level.  It does not need to be removed before breastfeeding. Cream that has to be removed before the next feeding may disrupt the healing process.

This cream is especially useful to me, having a tendency to dry skin and eczema. It is a great moisturiser. And if like me, you have sensitive nipple skin, you may find it useful to apply it on your nipples/areola area before you take a bath or shower and before you go for a swim in a chlorinated pool.

I found that Lansinoh works great on my lips as well.  If you have dry lips, put Lansinoh on overnight and you will have supple lips the next morning!  It also provides great shine as a lipgloss!  Just a dab will do the trick.  If your children, or even your husband, have cracked lips, applying this overnight would help close the wound too.  So this would certainly be a useful item to have in your first-aid kit on travels!  Especially when visiting places of cooler climates.

5. For cuts, cracks, raw & sore-feeling skin on nipples & breasts, Hydrogel Dressings for Breastfeeding Mothers would be really helpful. Hydrogel dressings started off being used in hospitals as a medically advanced method of healing wounds.  It has in recent years become increasingly popular and easily available for use by the ordinary consumer.   The simplest form that you can find at the supermarket shelves these days has to be the common band-aid that promotes “superior protection for fast natural healing” with a waterproof multi-day use plaster that has “moisture-seal” technology.  But as we are breastfeeding mothers, we can’t possibly use bandages that are multi-day sealing, right?  We need to feed on the breast!  Hence the beauty that comes with the development of hydrogel dressings for breastfeeding mothers.  Mothers who for whatever reason have raw, cracked, damaged skin on your breasts will find quick relief from such hydrogel dressings.

Hydrogel dressings utilize a saline-based hydrophilic polymer that does not need to be rinsed off before nursing. These dressings produce a closed moist healing environment, provide a bacterial barrier and feel soothing, especially if your gel dressings were placed in the fridge before application.

I myself have tested this product and can attest to its effectiveness.  Those who know me would be familiar with my problems with cuts from my son’s broken teeth.  I had cuts on the sides of both my nipples and had been battling the cure of these cuts for quite a while.  Even when the cuts closed, they would crack again with the next nursing session, much to my chagrin.  I was thus very glad to try out the hydrogel discs when they were introduced to me!  The hydrogel discs were very good as a 2nd skin for surface areas on the nipples and breast that it is able to touch.  Sad to say though, my line cuts were at the base of both nipples, an area that the gel discs could not touch.  On doing further research into this product, I could confirm that it was alright to use creams together with the hydrogel discs as long as it was not excessive.  So I applied Lansinoh at the base of my nipples where the cuts were and used it in conjunction with the gel discs.  This really worked as the gel discs kept my skin from drying out – one reason why skin would crack.  At the same time, the hydrogel discs keep the cream from rubbing off my bra or clothes, which defeats the purpose of using it for moist wound healing.   After I applied Lansinoh & used the hydrogel discs as a “dressing” (eh.. double-protection), the cuts closed in a few hours.  With continued use of  the hydrogel discs, the skin around the cut was kept moist & supple, so the cuts that closed up remained closed even after a number of breastfeeding sessions! *yay!*  In total, I had used the hydrogel discs for 3 days.

6.  Do take extra care to change your nursing pads often.   Wet breastpads are not considered a moist wound environment.  Avoid also nursing pads with plastic linings.  Cloth breastpads & other breathable pads which allow flow of air is essential to healthy nipples.

Having shared my experience with these products and dealing with damaged breast tissue, I would like to remind that to keep healthy skin (and that includes skin on breast and nipples), good nutrition and fluid intake is important.  Again, if the problems do not cease, do seek professional help before it becomes too prolonged!

My Experience with Mastitis

At my dear nursling’s grand ole age of 2yrs 5mths, I came down with *gasp* mastitis!  Like most mothers, I thought this was a “beginning” problem when baby is young.  I have not had any breast problems since the plugged ducts I had when my older son Daniel was 5mths old!  That was 4 years ago!Mastitis is often an indication of stress & a lifestyle that is busy with not enough rest.  This tends to bring down the level of immunity of the mother to an oncoming infection.  Well, for me, I think the other trigering factor could have been Timmy’s little broken front tooth that somehow caused me about 3 cuts on each breast the day before.  Broken skin is an easy route for bacteria to enter.  And well… there are lots of bacteria in a little toddler’s mouth!  Now, to minimise it, I try to get Timmy to drink water before he nurses.  He happily agrees because he wants to nurse!!  *haah*  And to further minimise risks of infection, if I do get any cuts, I would try to heal the cuts as quickly as possible!

What happened was sudden.  The night before – a Saturday night, I felt tired and on Sunday I just could not get up from bed at all.  Not until 6pm in the evening!!!  I was so *zonked* that I was not conscious of much happening around me.  Timmy just dutifully appeared by my side every so often asking to nurse and then ran away to play most of the day.  Realised in the evening that I had 39.5 deg fever and it came to mind that I had been having a sore breast the whole night and day.  And also a sore arm & leg. Flu-like symptoms. The breast just felt like one big bruise, painful to touch but not hard and no clogged ducts.  Thankfully so as Timmy had been nursing frequently from the affected breast.  Amazing too because to me, the milk on the affected breast tasted really off and to me quite salty.

I felt a little bit better after a day of rest & loooong sleep, but was still tired and had the red swollen sore breast for another 5 days. Running my own business also meant responsibilities that could not be put down. Throughout my sickness, I was going to the office everyday despite advice from my Lactation Consultant for bedrest.  I also needed to bring the older 2 children Sarah & Daniel to school as my husband was not in the country. Now you all know why it is much easier to be a salaried employee and just take sick leave.  And it is much easier when the children are not in Primary school yet because then you can simply just not bring them to school !  For me, it made sense to bring Daniel even though he is only in Nursery because his kindergarten is just near Sarah’s Primary school.

To share with all of you, some measures I took to alleviate & heal the mastitis:

a) sleep when I could – quite difficult, really.  But it helped that Timmy came to nurse on the bed so I could continue to rest.
b) Panadol for the 1st 3 days to keep fever down, also that excruciating headache that came with the high fever.

c) don’t wear bra.  When I went out, I was happy that I had my Cami Bras. These looked much better than sleep bras under “going-out” clothes but did provide support while at the same time having super-comfy & stretchy material that does not restrict breast tissue in anyway. Soft & stretchy enough for my swollen breast *sob* and it did not irritate the sensitive skin on my affected breast.  One of the days, I wore my Spaghetti Strap Tank Top because it had a built-in bra and I did not need to wear bra at all with that!  But it was a little tight-fitting with my one huge swollen breast.

d) massage gently – had little success expressing milk though

e) hot compress with the warm packs at least 4 to 5 times a day.  YMicrowave for 1 minute.  This heating pad is flexible and can mold to any shape of your body, and in this case breast.  The heat will help in healing and also helps to some extent in killing the bacteria.  You can make a very simple rice pack at home by simply taking a clean old sock (long ones are good).  Fill it with uncooked rice grains (whatever kind – brown, white, wheat), and then knot it at one end, and voila, a rice pack is all ready for you to warm up or freeze!  Or … you can use commercially available warm/cold packs like the Therapy Packs.

f) cold packs & cold cabbage.  The cold cabbage will alleviate the engorgement if any.  Also the coldness of the cold icepacks & the cold cabbage would help relieve the pain from the soreness – in between the applications of hotpacks.  The rice packs can also be frozen (in a ziplock bag), in the freezer and used as a cold pack.  Again, you may use Therapy Packs. 

g) lots of fluids.  I downed lots of Icy Cold Lime Juice & Hot Echinacea Root Tea.  I had an immense craving for cold lime juice, so I guess it must have been what’s good for me!  Echinacea Root Infusion is known to help fight infection.  You could also boil some garlic to eat neat.  Or boil a pot of ginger tea, add lime and honey and drink it regularly to fight infection.  This is a great remedy for cold/flu too.

h) went on high dosages of Vit C & took Echinacea tablets & tea to help fight infection.

i) continue to nurse frequently.  Nursing frequently helps the milk ducts stay relatively empty to avoid risk of breast absess.  Also the increased milk flow would mean increased blood flow to the breast and help enhance the healing process.  Flow of milk out of the breast ducts also mean that the bacteria or germs are being expelled from the breast.  Baby/child will not be affected by the milk because they would have come into contact with the bacteria which would have been present in the milk even before mother shows any symptoms of illness.  The only problem would be whether the child is willing to nurse with milk that tastes a bit “off”. Thankfully for me, Timothy did not think anything of the funny tasting “milk’ and happily nursed away many times a day.  If not for his regular nursing, I think the situation would have gotten even worse!

After the whole episode and getting better, I was advised by my LC Mrs Doris Fok to keep activities as low-key as possible for another week. Continue taking Vitamin C & Echinacea or the Ginger Tea, as you wish, to keep your immunity levels up.

Preparing to go “Back to Work”

Breastfeeding even after going back to work is possible and practised by many mothers.  It is a great commitment but manageable with planning.   Prime nutrition that has been started off in the early months during your maternity leave will be continued.  Breastfed babies do not fall sick as easily; you can thus be more assured of your baby’s well-being and concentrate better at work.  Breastfeeding is also a great way to re-connect with baby after a day of separation and to relax when back from work .

Depending on your circumstances, you may consider either
(1) continuing to exclusively breastfeed your baby, or
(2) partially breastfeeding.
In the first instance, your baby would have expressed breastmilk (EBM) while you are away and breastfeed directly when you are with baby.  For partial breastfeeding, babies would usually have formula milk while mother is apart but continue to breastfeed directly when with baby.

 

Some points to consider in planning for your return to work are
– Caregiver: supportive of breastfeeding, willing to feed EBM, understands EBM handling
– Expressing Milk: where to express at work
– Schedule: how often and when to express at work
– Storage: where to store EBM at work (is there a fridge for use)

Some items you may find useful as you embark on your “Pumping Career” are:

1) Breastpump  / Hand Expression
– to express milk so as to build up a store of express breastmilk for  baby
– to express milk when away from babySeveral types available
a) MANUAL pumps , the one-handed ones are especially good, such as.:b) Single Electric – good, but not for everyday pumping though – occasional only. 
Motor may not be durable enough for everyday pumping.

c) Double Electric: Get the higher-end models for heavy-duty pumping
(approximately pumping around 8 times a day)

d) Rental Hospital Grade pumps – need to check with pump suppliers:
eg. Medela Lactina: 

e)  A mother can also consider hand-expression.
No pumps needed!!!  Saves money!  And don’t have to worry about forgetting to pack your breastpump!
Some working mothers only hand express for their babies, even up to  2 years!!

2) Cooler Storage Bags / Boxes:
To transport expressed breastmilk from work to home, or to caregivers’ place.
Many types available in the stores.  And many sizes.  Find the type that most suits the your lifestyle:

3) Cooling Elements – to keep the milk COLD inside the Insulated Storage Bag/Box:
Again , various styles for mothers to choose:

4) Milk Storage Bags:
for mothers who prefer to use pre-sterilised bags to store their milk instead of milk bottles:
Again, several types:

You should ideally start off pumping around 3 times a day when you go back to work.  This can be
1. Morning – just before you start work
2. Lunchtime
3. Late Afternoon / Early Evening – just before you leave work.
Mothers will generally find the timings that best suit their schedule.  So do be flexible and you will find that expressing milk, preparing EBM, will soon become much a part of your new life as a working mum!
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