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Problems And Solutions Of Breastfeeding: Experts Weigh In For An In-Depth Look At The Barriers To Breastfeeding And Why Some Mums Give Up In The First Three Months

Breastfeeding has long been strongly recommended by health experts. Let's hear from these experts about the highs and lows of this journey.
There are many benefits of breastfeeding for both mum and baby. Breast milk contains antibodies that boost your baby’s immune system and also protects mum against cancer, heart disease and diabetes. Photo Credit: Pxfuel
By Seraphina Khoo
September 17, 2021

Breastfeeding has long been strongly recommended by health experts and we hear so much about the many benefits of breast milk from being great source of nutrition to providing fat, protein, vitamins and antibodies, as well as boosting your baby’s immune system. This is why paediatricians all over the world often recommend mums to breastfeed for at least six months. Although it is an all-natural process, the breastfeeding journey often has its challenges and these obstacles can become a major source of anxiety or guilt for brand new mums. Let’s hear from these experts as they provide a very honest perspective on breastfeeding and share with you the highs and the lows as well as what makes this a magical journey.

Benefits of Breastfeeding for Mum and Baby

Breastfeeding has been proven beneficial for both mum and baby. According to Dr Adrian Tan, Medical Director of Babysteps Medical, breastfeeding reduces the risk of post-delivery blood loss. There’s also a delay in the resumption of ovulation and hence breastfeeding acts as a natural contraception. He goes on to say that the long-term benefits for mothers include protection from breasts, ovarian, and endometrial cancer, as well as heart disease and diabetes. The benefits of breastfeeding for baby include maternal-infant bonding, antibodies from mum, and also gut development and function. Dr Tan says that it has been shown that in the long-term, breastmilk also prevents your baby from falling sick from acute illnesses.

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Dr Adrian Tan, Medical Director of Babysteps Medical, pictured here with his family. Photo Credit: Babysteps Medical

Expectations of Breastfeeding

Those who have gone through the experience will tell you that everyone’s breastfeeding journey is different. Beyond a doubt, it will be tiring. For some it’ll be stressful and painful, while others will breeze through it. It’s important to set your expectations from the start or better yet, as doula, Leila Ng-Caceres of Leila & Co. says, let go of any expectations at all. She says that, “Instagram is not a good place to be scrolling through in the early days of motherhood, because you’re going to be looking through people like having a chubby baby or they’re slimming down in two weeks.”

Leila Ng-Caceres, Doula, Birth & Baby Coach, Leila & Co., pictured here with her son. Photo Credit: Leila & Co. Blog

Leila goes on to share that a mum’s mindset during the newborn days is important as it will help to set her trajectory and breastfeeding journey. The first six weeks with your newborn is going to be the toughest time and you’ll need a good support group like your husband or a close friend. “Don’t listen to your confinement nannies, Leila quips. She states that confinement nannies are there to take care of mums; they are not there to take care of babies. “They clean, they cook. They make sure you eat well so that you are in a better state of mind.” She says, “When you’re in the mentally good space, you will be able to breastfeed better because breastfeeding like birth is actually centred around the hormone called oxytocin.”

Uma Thambidurai, a British trained nurse and midwife, founder of Mother and Child, and a IBCLC Lactation Consultant, says that antenatal preparations help new mums to manage their expectations and better prepare them for what lies ahead. Start by attending antenatal classes and at around 37 weeks, you can meet with a lactation consultant and have a plan of what you’d like to do. “What happens in the early weeks makes or breaks your breastfeeding experience.”

Uma Thambidurai, Lactation Consultant, dressed in blue, pictured here with her team at Mother and Child Singapore. Photo Credit: Mother and Child Singapore

Breastmilk Supply Levels

Supply levels can definitely be a barrier to breastfeeding. How much breast milk is produced is always a concern for first-time mums – too low or too much is never ideal, but it’s a reality that has to be faced. “I think eventually almost all mums will be able to reach that supply. It’s just how the human body works, but some mums do take a bit longer than other mums. Do not compare, just seek support. That’s the most important thing,” advises Dr Tan. “And if all fails, see a lactation consultant and they will be able to help you.” There are also medications that are safe for both mum and baby that can be prescribed to help with increasing breastmilk.

So how to increase milk supply? “You eat well and you rest. The recommendations are to eat 500 calories more and drink enough water,” says Uma. She goes on to say that milk has to be removed from the breast between 1:00 am and 5:00 am because that’s when your prolactin levels are the highest. She recommends not to miss a feed, or if you aren’t doing so, then you’ve to wake up and do it.

Sometimes where mums produce too much milk, their breasts will get engorged and it does cause pain. The key to overcoming this according to Dr Tan, is to find out the cause of this problem. Is it because you are producing too much milk? Is it because you are not feeding as frequently as you should? Is it because of a cracked nipple meaning you might be facing an infection? Whatever the source, seek help. Once the pain goes away, your breastfeeding journey will be so much more pleasurable.

Skin-to-skin contact not only promotes maternal-infant bonding but also helps accelerate the onset of breast milk. Photo Credit: cookie_studio on Freepik

Colostrum Harvesting as a Prelude to Breastfeeding

What is colostrum harvesting and how does it help kickstart your breastfeeding journey? Colostrum harvesting is what lactation consultant and founder of Mother and Child, Uma Thambidurai, discusses with her clients. Colostrum is the first milk that you produce once you start breastfeeding. It is highly-concentrated and packed with protein and nutrients. She says that colostrum is harvested safely at 37 weeks through hand expression and frozen. Once you’re headed to the hospital, bring along the colostrum and as soon as baby is born, you can feed him/her the colostrum within the first hour apart from latching.

The advantage of colostrum harvesting is that it helps mum and baby transition to breastfeeding. Some babies are also born with low blood sugar so feeding them with the harvested colostrum from the start helps increase their blood sugar level. What’s more, Uma says this colostrum harvesting experience has been a positive one for her clients and their milk supply also comes in earlier.

The Magic of Skin-to-Skin Contact after Birth

Skin-to-skin contact, letting your baby lie on you after birth, is “like turning on a switch,” Uma adds. Very soon, milk production begins and within a few days, you’ll start producing more. She recommends that your baby stays in your room 24/7 as this increases the opportunity for more skin-to-skin contact which is crucial not just for the first hour but for the next six weeks! Not only does your baby lying on your chest increases the success of breastfeeding, but it also regulates his/her heart rate, temperature, blood sugar level, and calms him/her down. Uma goes on to say that that “the proximity of your baby on the chest helps the hormones to push the milk out so ideally your milk supply would come in a bit earlier.”

Effective Latching Helps Breastfeeding

You might have heard the general advice that in order to maintain a steady breastmilk supply, you’ve got to get into the routine of latch and pump and latch and pump and repeat! Uma says that proper latching is so important and what you do in the first weeks of your baby’s life is an investment for the milk supply. However, it is not necessary to latch, pump, latch, pump. This feeding-pumping regime really gets mums down and they are so tired after each day-in-day-out process until they want to give up. This is clearly a hurdle to breastfeeding so Uma reiterates, stop pumping. Improper latching also leads to bleeding nipples that will surely deter breastfeeding, so a perfect latch is crucial.

At Mother and Child, they teach a natural way of latching called the biological position. At the hospital, there still a lot of emphasis on pushing and ramming your newborn’s face to your breast in order to achieve the perfect latch. However, with the biological position, this is not necessary as you hold your baby to your skin and then just slide him/her across to your breasts. Uma states that a research in Italy on the biological position found that babies who latched in this position were able to latch much better and for longer periods.

You might ask, what about pre-mature babies? Some babies at 34 weeks are able to latch and some can’t latch it all. Uma says to get help early from a lactation consultant. As well, if your baby arrives early, you’d need to start pumping because he/she may need to go to an ICU.

When latching is not an option, pumping then feeding your baby with a bottle is your next best bet and your partner can help you out. Photo Credit: Lucy Wolski on Unsplash

A Good Breast Pump Goes a Long Way

Latching and pumping go hand in hand and as Sharon Wong, CEO of Motherswork says, “it is an insurance policy.” She recommends that new mums invest in a breastfeeding starter kit that includes an electric breast pump, manual breast pump and lanolin cream. A nursing pillow also helps so that you can prop your baby up to just the right height where your breast level is. In the long run, if you are going back to work, items such a wet wipes, nursing breast pads, milk storage bag, cooler bag, and nursing scarves might prove useful.

Sharon Wong, Founder of Motherswork, Leading Premium Retailer of Mother, Baby and Kids Products. Photo Credit: Sharon Wong

Jaundice, Vaccination and Breastfeeding

“There are not many medical reasons that we advise mums to stop breastfeeding completely,” Dr Adrian Tan says. He says that some mums decide to temporarily stop breastfeeding because of pathological jaundice, meaning that it is a medical issue that’s causing the jaundice and needs a closer follow up. He reveals that it is not a myth that breastfeeding can cause jaundice because of certain proteins in mum’s breastmilk that are not able to be broken down efficiently by baby’s immature organs. However, this type of jaundice is harmless. In any case if you’re advised to stop breastfeeding, he suggests to continue pumping to keep up your milk supply.

 

Some mums are concerned about breastfeeding after receiving the Covid vaccination, but Dr Tan says that there are no reported cases of the virus transmission from the vaccine to the baby. Instead, there are reports that show antibodies present in breast milk are transferred to babies which protect them.

 

Most of the challenges that you may experience with breastfeeding will resolve in a few days. However, if any of these issues continue beyond that or persist, seek help immediately from your doctor or a lactation consultant. The earlier you identify and rectify a problem, the better it’ll be for you and your baby, and the more positive your breastfeeding experience will be.