Mama, it’s not easy… but it’s worth it

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By Abigail Ede, Guest Writer

 

Endless happiness, delicious moments and a heartfelt, overwhelming connection.

This is what breastfeeding became for me – but it did not start this way!

In reality, the first 3-4 weeks of nursing were arduous and painful.

So much so, I actually dreaded feeding time.

I would find myself delaying feeding my daughter just for a few minutes.

I would wince just thinking of that first sharp pinching grasp for milk.

I would be in tears as she latched.

The lactation nurses at the hospital were great, but it didn’t help the feelings I was having.

The pain was so bad initially that I chose to feed my daughter from a syringe just to have some respite. I bought nipple cream in bulk and spent huge sums of money on silver contraptions that promised to heal my bleeding nipples.

I fantasised about using formula.

It will get better, just persevere!” people would say, but in the moment, it was hard to see how.

It was even harder to understand why something that was supposed to be natural was hurting me.

I knew friends were using lactation consultants for support, but I decided to persist on my own.

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That first pinch took weeks to fade into memory but after that excruciating first month, things got easier.

I relaxed into it more, found positions that suited me better, used Silverettes relentlessly (best breastfeeding buy!) and learned to control my oversupply by hand expressing before a feed. 

The pain lessened.

Breastfeeding became everything I had hoped.

My daughter would put her little hand on my chest and look up at me and my heart would swell.

But I underestimated what it would take to get there.

I think it is important for healthcare providers not just to pump (no pun intended) out the message ‘Breast Is Best’ – but to be honest that breastfeeding can be tricky.

It’s important for women to know that just because it is natural, that doesn’t mean it will be easy.  It can hurt and it’s a learned skill for both of you.

It’s a case of putting together a jigsaw puzzle.

When all of the pieces fit together – the latch, milk supply, optimal positioning –  the experience and memories are incredible.

 It might take a little help or a little research but you can do it. 

 

  • Abigail Ede is a full-time mum to a 20-month-old daughter (with another baby on the way) and trained primary school teacher.  A true Welsh-speaking Welsh girl, I married my Australian/Sri Lankan husband this year and we live in Hong Kong.

Mama, donating breastmilk is beautiful

By Heather Lin, Guest Writer 

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Every day at work, I fill two bottles with glistening, pale, liquid love. 

My love chills in the fridge beside sandwiches, salad dressings and takeout boxes. My food is so different from theirs – because mine is made out of love.

Liquid love, maternal love made physical in the form of milk.

The milk trundles home in a taxi or on a city bus.  It gets poured into little bags, and patiently freezes amongst the salmon and the ice cubes.  

There, it awaits.  My liquid love awaits a reason to be needed.  It awaits a small mouth to feed, a small stomach to nourish, a small belly to fill.  It waits, unfulfilled, in the freezer. “One day my chance will come!”

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Then, such a day comes. Via Facebook, or via a mutual connection.  A dutiful husband shows up at the door.  A thankful mother. Some bear small gifts of appreciation.  I tell them “No, you are doing me the favour.” 

Out of the freezer, my liquid love goes.  Into a cooler bag, and hurriedly shepherded to a new home.  Another baby awaits it. Another pair of eager lips guzzles it from a bottle.  Another little tummy is soothed. 

I have too much.  You have too little.  Let me help you. 

I have donated roughly 10 litres of milk to about a dozen different babies.  I have pumped for over 2 years, for my two children. Very quickly, my own babies opted to wait the long hours till mama came home to nurse, and my liquid love piled up in the freezer, unwanted and unused. 

As my freezer stash grew, I wondered what to do with it. 

Make soap? Pour it in the bath? It’s supposed to be wonderful for all kinds of ailments or even as a moisturiser.

But my quantities seemed too large for such endeavours.  I poked around on social media and came across Human Milk 4 Human Babies; an informal milk donation page.  Excellent! I had always loved being useful, and donating milk seemed right down that path. 

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My first donation was to a friend, whom I messaged with as she was going through the first days with her newborn.  She was struggling with nursing and was considering supplementing. I suggested donor milk, my milk. Like many, my friend did not know that such options existed, or that donating human milk was even practised.  From then on, I regularly donated my stash each time it grew beyond a dozen bags.  

Sometimes, mothers posted “I need help.”  Other times, I posted “Who can I help?” The call was always promptly answered. 

I can only speak from the perspective of a mother who has donated milk.  I do not know of the bravery it takes to ask for help. I do not know of the confidence it takes to lean on others.  

What I do know is the joy of being able to help. 

The eagerness to be of service. The satisfaction of knowing my blessings won’t swirl pointlessly down the drain.

I’m often told: “That is amazing that you’ve donated so much!”

I disagree.  What is amazing is that so many mothers thought to reach out. 

So many mothers were so committed to breastfeeding, that they allowed a stranger to help.  So many mothers followed their urge to provide, all the way to the doorstep of another mother, to bring back food for their babies. 

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Using donor milk is a beautiful example of how raising children takes a village. 

We were not meant to go at it alone, isolated in our homes, cut off from our tribe. 

We were meant to rely on our fellow women, fellow mothers, unified by our common experiences. 

Just as how staring into a flickering fire can stir something primal in the depths of our being, feeding another’s baby from the milk our body produced, awakens a powerful sentiment.  

Let me help you.  I can help you. You are not alone. 

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About the author: Heather Lin is a Canadian mom living in Hong Kong and is passionate about breastfeeding: She is an accredited La Leche League leader; a volunteer role which centres around offering mother-to-mother support and information.

 

 

Please Note:

  • Hong Kong currently does not have a regulated breast milk donation bank. 
  • All donations are made informally
  • Parents should do thorough research before accepting and using donor milk

Mama, you can breastfeed a preemie

By Lucy Mullens

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I hadn’t given much thought to breastfeeding during my pregnancy. I knew I would try it but if I’m being honest that was primarily because it’s free. If I’m being really honest, it was also because I thought it would help me shift the pregnancy weight (it might even have worked if I had stopped gorging!).

I didn’t know a lot about the magic of breastfeeding.

I knew it was supposed to be good for the baby but not a lot more, because, who learns about breastfeeding pre-birth. Really? The laissez-faire attitude was not because I didn’t care, it was because I am the kind of person who needs a deadline and at six months pregnant – no deadline was looming.

But when I was 29 weeks and one day pregnant my waters broke.

It happened suddenly in the middle of Hong Kong, a city I had moved to only 4 weeks earlier, some 6000 miles from my home near London. My daughter was born in a public hospital almost 24 hours later – she was not breathing and weighed just 1.09kg. She was almost small enough to lay in the palm of my hand with her legs dangling onto my wrist (so I learned later when I eventually held her).

So there I was, suddenly a mum three months earlier than anticipated in a country that was not yet my home with no support network to speak off (aside from my wonderful husband). I lived a taxi, ferry and bus ride away from my baby on a different island to the hospital.  There were no facilities for me to stay with her and NICU visiting hours are limited.  Fortunately, the medical care they gave was absolutely incredible.

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In those early days, my little girl was full of wires and needles, intubated with machines breathing for her, wrapped in cling film inside a humidifier. The precision and skill they use to save these tiny little beings with the smallest medical tools and needles you have ever seen is fantastic, but the emotional support for mothers is not.

There is no acknowledgement of how your heart aches to be with your baby or to touch them. I felt like a useless empty vessel that had simply carried her and the guilt of feeling that I had not done that very well, was an additional burden.

Those days felt like the longest I’d ever lived through.

I spent every second waiting (impatiently) and praying (religious or not, you pray) that today would be the day that my baby would come home. I have a particularly acute memory of sitting in my bath, milk leaking from my breasts, tears pouring down my face as I cried and repeated over and over: “This is not how it was meant to be”.

I was not allowed to soothe, change or bath her. There was almost nothing I was allowed to do for her.

Almost nothing… except for my one superpower: MAKING BREASTMILK!

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My teeny tiny nugget was being pumped with fluids to emulate what she would have in the womb but since she was already in the outside world, she needed to eat and only I could give her exactly what she needed.

My baby couldn’t direct feed from me so I had to learn to hand express. I spent the next few days squeezing my nipples, pinching and bruising my breasts all over with my terrible technique whilst my husband sat armed with the tiniest syringe ready to collect any colostrum I could get out.

In the first few days, we needed just 0.2- 0.5ml per feed – basically a drop or two.

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My body, however, didn’t make that easy and it seemed an impossible task. To their credit, the hospital was keen to help me exclusively breastfeed and so, with medical backing and my husband cheering me on we got through those first few days of milking.

As painful as it was (partly due to my awful technique) the knowledge this was something my baby needed that only I could give was my key motivation to try and try again.

It became a mantra, an act of true love from me to my baby girl.

I can’t remember exactly how many days it took, but approximately four to five days after I gave birth, my milk came in and I woke up with cleavage like (glamour model) Katie Price circa 2007. Except that I seemed to have sprung a leak – over myself and over the bed. I had no idea that the really challenging part was only just beginning…  I was full of milk with no baby to drink it.

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How and when you can breastfeed a premature baby will depend on:

  • their size,
  • their medical condition
  • their corrected age,
  • their ability to breathe, suck and swallow at the same time.

My little girl could not breathe on her own and I could not touch her or take her out of the incubator for the first week of her life. Plus her mouth was far too small to feed directly and latterly she suffered from apnoea and often just stopped breathing! This would happen particularly at night or during feeding for many months.

Preemies commonly struggle to breathe and drink at the same time. My little one would often choose to feed rather than breathe when it came down to it (a girl after my own heart).

So for the first month of breastfeeding, my daughter received my breastmilk via a feeding tube into her stomach.

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She only needed small quantities but I had to keep my supply up as her tolerance for milk was growing quickly and I had to pump a full 24 hours’ worth of milk each time I visited the hospital as my commute in high temperatures didn’t make transporting milk feasible.

In order to get my body to produce those quantities in that window of time, I had to pump, a lot! The best thing I did was to hire a hospital-grade pump.  I pumped every 2-3 hours around the clock. Looking back I should have let myself get a bit more sleep as rest and food are key to getting good milk but in my mind, any other new mum would be up every 2-3 hours so that’s what I did.

When she was strong enough for me to hold I thought my heart would burst.

We began kangaroo care when she was around 2 weeks old – no mean feat as we had so many wires and tubes to consider – but we were able to tuck her inside our tops and get her used to the smell of us and the sound of our heartbeats while milk was fed into her stomach via the tube.  We spent weeks just reading to our girl, cuddling her at every opportunity, letting her feel our warmth and hear our voices. Eventually, we started to get her ready for oral feeding by dipping a cotton bud into my expressed milk and letting her suck on it.

Finally, when she was around 5 weeks old, I put her to my breast.

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My nipple looked huge next to her tiny mouth and I had no idea how I would get her to latch. It took us a while to make it work.  She was so small she got tired very quickly but my word there was no doubt she had the suck of a Dyson and she was keen to learn. Once we got going our journey was much the same as a full-term baby in most respects, though the apnoea played an additional role and she had nasty reflux that required hospital meds to control.

The honest truth is that once on the breast she didn’t gain weight at first and it was a slog.

She fed slowly, sometimes taking up to 40 minutes – one nursing session seemed to melt into the next as she fed every two hours. Then there was the endless nappy changes and winding to reduce the reflux – plus the fact that I needed to pump so that we could bottle feed her my milk with added fortifier to help her gain weight. This was my life 24/7 for weeks.

Did I consider giving up at points? Absolutely.

Did I cry over her weight? Definitely!

I was heartbroken when at almost 2 months old she dropped below 2kg again and I thought we might have another hospital stay, but I never stopped believing that breastfeeding was the best thing I could do for her.

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I was lucky to have a guardian angel in the form of a private midwife who came for home visits and had enough confidence for both of us.  Sometimes that is all you need – a strong friend who believes in you to keep you on your path and it worked.

I fed T until she was 22 months old, only stopping as I was 5 months pregnant with my 2nd daughter and as a high-risk pregnancy I was advised not to feed into the 3rd trimester.

Giving up breastfeeding didn’t stop my second daughter though and she also arrived prematurely – a few weeks later. She was 31 weeks and four days gestation and weighed 1.7kg.

I was more confident I could handle things the second time around

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M was a little bigger so we were able to direct nurse from very early on. I also learned to accept help when I needed it. I mixed a few formula feeds into my second daughters’ diet in the early hospital days because I needed some help and that is exactly what formula exists for, but with time and a fabulous pump, the right support and motivation I was able to exclusively breastfeed her after we left the hospital.

No matter how long it took to get them to latch, no matter how many times I tried syringe, cup or bottle feeding, I persevered with my nursing journey and we found a way through.

So while it might be daunting, it is possible to breastfeed a preemie.

My youngest daughter and I finished our breastfeeding journey recently. She was 2 years and 5 months old.  After 5 years of pregnancy and breastfeeding, I was ready for a rest. I already miss the special feeds and time we had together but I will treasure those magical breastfeeding years forever

Today no one has any idea that my daughters were premature.  They have developed into beautiful, happy, strong little girls and I am so very proud of them and what they overcame in the first months of their life.

I am pretty proud of myself too.

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Mama, breastfeeding looks different for different women

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Breastfeeding: My story – by By Ziggy Makant

I delivered my son on a busy day. The public hospital didn’t have any beds available for me so the midwives let me do skin-to-skin and helped me latch for while we waited in the delivery room for a space in the postnatal ward.

Those early moments were heaven! I was so confident. 

I called on the lactation consultant every time I nursed and she commented on how well I was doing  – but mentioned the baby didn’t seem to have a deep enough latch which could make it harder for him to get the milk out, and leave me with sore nipples and breasts.

So between feeds, I expressed my excess colostrum – I was getting so much I fully filled syringes.

But I felt I had things under control. 

We were sent home on Christmas Eve and ventured out for a family Christmas lunch the next day. I realized I hadn’t packed enough nappies, clothes, and still didn’t know how to breastfeed. Luckily, my graceful, experienced sister was there to help me latch and burp my baby, she let me nap and let me cry about how overwhelmed I was feeling.

Anxiety struck me.  What was I thinking? 

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That night my real milk came through and I cried again and again: I couldn’t hand express a drop, and giant lumps were forming – the bags of frozen peas and warm compresses were little help.

But, thank goodness, I had a breast pump! It quickly became my saviour, and I found that it was much faster to feed my son that way. It was my saviour when I experienced bad latches, bleeding and damaged nipples, and it was my saviour in the sense that I could still feed my son from me without having to directly latch.

My life became pump, feed, sterilize on repeat. 

I struggled to feed myself as I was so focused on feeding the baby. Luckily my friends were sending boxes of home-cooked meals around to my house every few days.

My first month of breastfeeding was me attached to a breast pump while holding my son, who had reflux, upright for at least 30 minutes post-feed.  I felt anxious and unsure if my choices were the best for him or for us as a family.

But I really wanted to breastfeed.

By week eight of exclusive pumping, every 2 hours, 12 feeds per day and through the night,  I couldn’t see how the process would get any easier. A critical moment came when I ventured out with my son but hadn’t pumped enough milk, and forgot to bring top-up formula.

He was screaming in the carrier, clawing at my chest, and I just wished I knew how to feed him. I rushed back home trying to calm him down, knowing that he just needed milk.

But I wasn’t confident enough for us to try to latch, especially not in public.

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My head filled with doubts. What if he was so agitated he wouldn’t even try to latch? What if the latch was bad and left me bleeding again? Hadn’t we passed that magical six-week-mark that meant breastfeeding was impossible if you hadn’t managed it by then? Once home I desperately defrosted my stored milk while my son wailed, feeling so stressed and alone.

And that was the defining moment when I vowed I’d breastfeed directly again. 

We didn’t have a lot of money, so I couldn’t afford a private lactation consultant. I didn’t even know where to begin to help him learn to latch properly, he was so much bigger than that tiny newborn I had cradled in my arms. Luckily there was La Leche League and a local breastfeeding clinic,  where I sought the help of experienced women and realised getting him to directly nurse would come down to these three things.

  • Would my son take the nipple…Yes!

  • How was my supply? …Fantastic, because I’d been neurotically pumping every two hours.

  • How badly did I want to nurse?… For me, there was no other option

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I found in these breastfeeding groups help at some of my bleakest breastfeeding moments, support and empowerment, and of course the wisdom of generations of nursing mamas.  So I am sharing now, the best advice I got:

  1. Skin-to-skin: Spend time just cuddling your baby, topless and letting him be near the nipple. Offer him the breast every few minutes and just let him suckle for as long as he wants to.
  2. Forget about the schedule: Pumping/formula is very schedule based because you can see quantifiable amounts. Feeding on demand is trusting your baby and letting them guide you. Just keep offering the breast, never forcing the breast.

  3. Set yourself a time limit:  Mine was 20 minutes – if my son genuinely wouldn’t latch or feed for 20 minutes, but was trying to, I would pump my milk and then feed it to him. Or, I would walk around, calm him down, sing and bounce until he was settled, then attempt to offer the breast again.
  4.  Believe in yourself

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In those early days, I couldn’t see myself exclusively pumping beyond three months but I ended up nursing him well into toddlerhood – we had a successful direct breastfeeding relationship until he was 20 months old.

I’m so grateful for all the women who supported me in whatever means they could, whether that was feeding me or just sitting with me while I breastfed. It really takes a village and they loved me at one of my lowest points and helped me learn how to love myself again.

 

 

Mama, you are stronger than you think

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By Kristen Handford, Guest Writer 

I absolutely loved being pregnant. Yes, there were aches and pains, as well as nausea, fatigue, and the trials of a Hong Kong summer. But I had my little nugget growing in my belly and I felt empowered and in awe of what the female body can do. I worked as a personal trainer for the whole nine months. I was strong, healthy, and plugging along towards (and then past) my due date.

Labour was medically induced at 41 weeks and 5 days; membranes were swept, waters were broken, but after a long day, my beautiful son was brought into this world.

He was born via an emergency cesarean. It was not the plan… it was pretty much as far from the plan as we could get – but as long as the baby is okay, right?

Wrong. A mother’s wellbeing is also important.

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As it turned out, I was not okay. It became evident after a few days at home that my cesarean wound had a doozy of an infection. I was rushed to the hospital, where I stayed for the following three weeks.

Breastfeeding was important to me, it was the life preserver I clung to in an attempt to make my experience a little more “natural”, when everything else had become so very unnatural.

Our early days consisted of pumping every 4 hours around the clock, and direct feeding during visiting hours. I saw my son for 2-3 hours most days, and it was gut-wrenching to be apart from him.

On top of the pumping, I had a serious wound infection to battle.

And the battle was real.

I was brought to a treatment room once or twice a day for “cleanings”. These were horrible, and to make matters worse, I did them without the suggested pain medications so that I didn’t have to pour precious breastmilk down the drain.

Instead, to drown out the pain I listened to Bob Marley…

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At the end of my third week in the hospital, I had surgery to debride and close my wound. This time, when I woke from the general anaesthesia – damn right I took the morphine!

The weeks were emotionally and physically difficult not only for me but on my husband too, but you know what? We made it through.

An attitude of gratitude is better than morphine. 

I tried to remind myself as frequently as necessary that I had a lot to be grateful for.

If I allowed myself to focus on everything that had gone wrong, it would have completely robbed me of finding any enjoyment in my day, and it certainly wasn’t going to help me heal.

Instead, I practised gratefulness and found joy in the little things like sneaking outside to feel the sun on my skin, sharing a bubble tea with a friend, or finally getting to wash my hair.

We survived those tough weeks, and have been breastfeeding for ten months so far.

When I feed my son now, I feel strong and empowered, knowing everything that we went through to make it a reality.

When times get tough, as they invariably always do, remind yourself of the following:

  • You can do hard things.

  • You are stronger than you think.

  • This will not last forever.

  • #ittasteslikelove

 

About the author:

Kristen Handford is a breastfeeding mama and a certified personal trainer and has recently launched pre and postnatal services. 

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#Ittasteslikelove: The go-to breastfeeding survival guide

By LTThomas, founder of the #Ittasteslikelove campaign to normalise breastfeeding

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Breastfeeding is the final part of a wonderful, exhausting, and life-changing triathlon launching us into motherhood, but while we tend to plan and research for stages one and two – pregnancy and labour – it’s easy to put off thinking about this last bit. It’s understandable, there are wonderful little apps that help you navigate and understand your pregnancy, and there are an array of courses and books to help you plan your birth, but we tend to think of nursing as something that will just come to us.

Yes, breastfeeding is the biological norm, and yes it can be magical and rewarding, but it can also be unexpectedly painful, tiring, and time-consuming.

It is a learned skill for both mama and baby. And yes, for the most part, we instinctively know what to do, but how to do it takes time, perseverance, confidence, and above all HELP, to master. As with any challenge, we have the best chance of success by being prepared before we undertake it

1) Pregnancy preparation

In the same way, we have a birth plan, it’s good to have a breastfeeding plan. This shouldn’t be rigid or become a stick to beat ourselves with if things don’t turn out the way we hope, but simply a guide to help us, and the people around us, cope with the steeping learning curve.

Breastfeeding has been hidden away in many modern societies, so the realities can come as a shock – not just for mothers but for their partners, who may never have seen a nursing woman. It’s helpful to set out and talk about hopes and expectations because as with many parenting discussions, it is best not to wait till baby arrives to make sure everyone is on the same page.

A good time to start research is the second trimester, once the fatigue and nausea have passed, but before the discomfort of the last few months hits.

There are some excellent books to read, but these three come highly recommended:

  • Dr William Sears, TheBreastfeedingBook: Everything You Need to Know About Nursing Your Child from Birth Through Weaning;

  • Dr Jack Newman’s Guide to Breastfeeding,

  • La Leche League International,  The Womanly Art of Breastfeeding.

It might seem bizarre to read about nursing before delivery, but it’s helpful to become familiar with this brave new world in order to better cope with common issues such as tongue-tie, mastitis, and jaundice.

Most ante-natal classes cover breastfeeding in their range of topics, but La Leche League often offers dedicated Prenatal Breastfeeding Classes that tackles core issues including good positioning, latch, and how to know if the baby is getting enough.

2) Hospitals and Paediatricians

Those giving birth in the public system will be allocated a hospital according to residential area, but it still pays to do some research in advance on the breastfeeding policy. All government hospitals purport to support nursing, but the extent they do so varies, plus attitudes vary depending on the duty team during your stay.

Such variables are not in our control, but if we set out what we want, and make sure it’s on the birth plan, it is far easier to advocate when the time comes.

Mothers can make clear no artificial nipples or pacifiers, or formula is to be given to baby unless medically required and agreed to by a parent. If formula is needed or it’s necessary to express milk instead of direct nursing, insist the staff cup or syringe feed the babies to help prevent nipple confusion.

If medically possible ensure the baby has skin to skin and nurses in the first ‘golden hour’ and also request a visit from the hospital’s lactation consultant within the first 24 hours. Make sure the baby stays close to aid frequent breastfeeding and to ensure staff follow the care requests set out.

Assessing weight gain the days following discharge can be stressful, so it helps to see a doctor who understands the breastfed baby.

3) Boob Squad

Assemble your boob squad to help navigate the chaotic early days:

  • Supportive partners: This could be hubby, could be grandma, could it be a trusted mummy friend or a wonderful helper but this core group should provide emotional, physical, and nutritional support. This means getting water to drink and snacks to eat, holding the fort so mama can shower, swaddling, changing and rocking baby, or simply answering texts about ‘what’s normal’ in the wee hours.
  • Lactation consultants: It is worth saving for a private lactation consultant to do a home visit. Some health insurance also covers this but if not it is worth remembering that help from a qualified professional may mean you can avoid spending money on formula, which costs thousands of dollars per month.  Home visits are particularly good if you had a difficult birth and mobility is restricted, but also just as a sanity saver. The first days home from the hospital can be terrifying as the reality of being totally responsible for the tiny person hits you and it can be helpful to have a calm influence advise on latch, creative positioning for mother and baby (options such as rugby hold, side-lying, or laid-back can be feeding game changers), check weight gain, and assess your well-being. If you book a package these occasional appearances can be a welcome breath of fresh air as you navigate the fourth trimester and beyond.
  • La Leche League: Often reachable by email and text, the women here can be a lifeline, plus the regular meetings are a great way to meet other new mothers

4) Self Care and Self Belief

In the early days, women often feel that all they do is nurse, that they’ve managed to do nothing all day. But it’s worth reframing that thought from ‘endless breastfeeding’ to ‘growing a human with a specially created super fuel’ and appreciating the wonder of that achievement. It’s an old adage but it’s true: The days are long but the years are short. Let the housework and life admin wait and just enjoy the newborn bubble. Why worry about getting back the pre-pregnancy body when the post-pregnancy body is doing incredible things. It is an intense period and it’s vital to accept help, where we can, and take time to rest when we can. It’s vital to remember that using formula is not failing, and many people do so and then go on to breastfeed successfully and extensively. Don’t be held hostage to a constructed idea of perfection as the nursing journey will have ups and downs, so it is important to be flexible. Choose what is right for both you and your baby

It’s normal for self-doubt to creep in and to worry about everything from whether baby is getting enough milk, gaining enough weight to why they feed so often,  but it’s worth remembering that the human race would not have survived if breastfeeding failed us as regularly as has been claimed. It’s also worth remembering newborn stomachs are tiny and untested. Colostrum, that first milk often dubbed liquid gold for its intense colour and remarkable nutritional and immunological properties, and the breast milk that follows is easily digestible to account for that. This means breastfed babies nurse more frequently. They also nurse when they are thirsty, tired, need comfort coping with the wild world, or just want reassurance from mama, and they cluster feed to boost milk supply. To the uninitiated, this seemingly constant feeding is taken to mean a problem with their milk production when actually the problem is with society’s expectations of what newborns should do. We have been taught to expect the three-hourly formula feeding schedule as normal, but it simply doesn’t work for breastfed babies, and if adopting it can be catastrophic for your nursing plans.

It’s good to talk to a lactation consultant about any concerns and to keep an eye on wet and soiled nappies, but it’s also good to have confidence in our bodies. Speak with medical professionals about the best way to proceed if your baby is premature, as their requirements can be different from babies born at term.

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5) Survival Tools

Seasoned breastfeeders will say all you really need are boobs and baby to breastfeed. Arguably it’s true, but there are a few things that will help make it easier for you sail from nursing novice to veteran in a matter of months.

Stock up: Around a month before due date, order a bumper iHerb delivery including your favourite snacks, stack the freezer with easy meals, and stash some sweet treats. The aim is simply to give you easy access to nourishment once bub arrives and commands all attention.

Water bottle: Nursing is thirsty work so it’s a good idea to have a couple of refillable 1l water bottles dotted around your key nursing spots so that you can swig as you go. Keeping hydrated also helps with your milk supply. Some mothers say coconut water provides an energy and supply boost.

Muslins: There will be spit-ups, there will be poonamis, so a collection of these versatile cloths is a must

Breast pads: When your milk comes in, for some there’s no stopping it. Re-usable breast pads are ideal to soak up the overflow without it seeping into your outfit. Some women opt for shells, which can be placed over the nipple and collect any milk that has leaked.

Lanolin or Coconut Oil: It’s rarely mentioned but the truth is for many women, breastfeeding can be painful at first. Put simply our nipples, previously delicately encased in pretty bras, need time to toughen up. In the first few weeks, as mama and baby work on the art of latching, there can be a few seconds of stinging pain. It’s normal and it will fade, but dabbing coconut oil, or lanolin cream on nipples between feeds can soothe in the interim. It’s ideal to have a lactation consultant check for issues such as tongue tie or baby’s latching skills to catch problems early on. If the pain is unbearable, seek medical advice to rule out underlying issues.

Breastmilk and Silverettes: Breastmilk has anti-bacterial properties so can be a useful tool for minor scrapes and ailments for mama and baby. Silverettes are a really helpful product for anyone dealing with cracked, bitten, or chafed nipples. Simply drop some breast milk into the tiny cups, made of 925 silver, which is anti-inflammatory and anti-microbial, and place on the nipples between feedings to help speed the healing process.

Gel Pads: Gel-filled pads that can be gently heated are really helpful if you have persistent lumps or clogs, or are just in need of some soothing. The bonus is that you can use them for sporting injuries once your nursing needs for them have finished.

Lecithin:  Some mothers find lecithin help with issues such as persistently blocked ducts but discuss with a healthcare professional before taking supplements

Supply boosters: Mother’s Milk Tea and Fenugreek are fairly good starting points to improve supply, while lactation cookies have the benefit of being both yummy and helpful. Opt for a recipe with brewer’s yeast, such as this one.

Netflix: Whether its Gilmore Girls, Friends, and Friday Night Lights, a feel-good series (or ten) is helpful to get through the times when the days and nights seem to stretch on endlessly.

6) Online resources

A great benefit of being a 21st-century mother is the ease with which we can access resources. This doesn’t replace the importance of talking to doctors or midwives, but it does mean we have a chance to do some research and make a judgement about seeking further help.

When it comes to breastfeeding, there are a few that are trusted and reliable. KellyMom uses evidence-based research and articles to tackle and answer all the key issues you may come up against when nursing.

Dr William Sears, a passionate advocate of breastfeeding, has an excellent website that looks at all the big questions you may have – from the importance of breast milk for brain development to nursing while pregnant and tandem-feeding.

Low Milk Supply, despite its fairly basic look, is a helpful site for those looking for explanations about their own milk production.

Breastfeeding and Medication, a website run by UK-based advocate and trained pharmacist  Wendy Jones, which helps evaluate what medicines can be taken if you are nursing.

7) Create Your Village

Breastfeeding evolved in a social setting, we were never meant to be doing it alone. But the modern world can be a lonely place for nursing mothers. Somehow we’ve ended up trying to handle the considerable task of nourishing a human – solo. The matriarchal village has been lost, but there are ways to recreate a version that works for you. The online resources above help with all the questions new mothers have, but it is also nice to feel there is a sisterhood to support you.

Useful global Facebook communities include Dr Jack Newman’s page; the Milk Meg; and Breastfeeding Younger Babies and Beyond

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8) Stepping out 

Going out for the first time solo can be daunting but one of the great benefits of breastfeeding is that we are already carrying what we need in terms of equipment and nourishment: breasts are the original zero waste packaging and the milk is ‘on tap’.

A structured baby carrier can make it easier to nurse discreetly but it’s best to have a few practice runs before heading out as it can take a little time to master nursing on the go in this way.

It’s normal to feel self-conscious nursing in public for the first few times, breastfeeding may be the biological norm but society has forgotten that, and those initial trips can feel stressful. Take a deep breath, focus on meeting the baby’s needs, and remember the world is full of smartphone zombies that rarely look up. Don’t worry about what anyone else is doing or thinking.

Breastfeeding advocates worldwide are campaigning for a situation where women feel free to nurse unfettered, but that remains a push for freedom so that no one is penalised for their personal choices. There are an array of firms selling beautiful nursing covers, but it is worth keeping in mind, not all babies comply.

9)  Pumps and Bottles 

Lactation consultants generally advise waiting until breastfeeding is well established – usually around four weeks – before introducing a bottle feed (it is still possible to syringe or cup feed express milk before this) to avoid nipple confusion.

A less talked about issue is that some babies refuse the bottle, particularly if it is introduced after eight weeks, so women on limited maternity leave should keep in mind that some little ones need to be coaxed to take milk from anything other than the breast.

It’s not unusual to need to try an array of bottles before baby settles on a favourite, with Pigeon, Dr Brown’s, Avent, Nuk, and Mam all regularly featuring on most bought lists. Newer brands, purporting to better mimic a mother’s breast and nipple, include Nanobebe, Comotomo, and Olababy. One baby has settled on an acceptable option, invest in a few, as it will be easier to match parts after sterilisation.

It’s important to spend a little time researching pumps, as there’s a vast array on the market, for varying needs.

Medela, Spectra, and Youha are the ‘big names’, offering everything from hospital grade to ‘travel’ options. Mothers that will be intensively pumping and away from baby for much of the day or night with work, should invest in the more powerful machines – the Medela Symphony and Spectra S1 and S2 – are sometimes provided in Hong Kong public hospitals, even if they are more cumbersome to transport to the office. A dual pump and hands-free pumping bras are also valuable time savers. It’s a big initial financial outlay but worth it to make best use of time, and to protect milk supply.

There are plenty of options for milk storage bags, but Wean Green and Life Factory offer environmentally friendly options. Industrial pumpers may need to invest in a small ‘milk’ fridge which can later be converted into a wine fridge.

For those that pump less frequently, there are lighter, portable styles such as the Spectra S9 that can fit neatly into a handbag but have less power.

Women who prefer a manual option should opt for the Haakaa silicon pump, which enables simultaneous nursing and pumping. But it is worth assessing it’s long term value as some have found the suction fades over time.

10) Returning to work

Paid maternity leave in Hong Kong is woefully short, currently set at 10 weeks (though expected to rise to 14 weeks this year), and many women return to work before they are really emotionally, or physically ready.

Financial realities can mean there’s no way of avoiding that, but being prepared can help. Companies are rarely set up to consider nursing needs so the first step is to have a frank discussion of what those are. Be firm and unapologetic with senior managers or HR, and if necessary highlight government recommendations for pumping mothers.

Do not accept any suggestions to pump in the bathroom, or anywhere that could be unsanitary.

The wider world is not pumping savvy, so colleagues can be a challenge. Some will be disgusted by the idea, others irritated by the ‘extra breaks, others will worry about breast milk contaminating their lunch. Keep in mind that these are the idiotic responses of the ill-informed and try to practice the art of being polite but not giving a damn.

Seek out support from others in the same situation as it can be an invaluable boost on days when pump parts are forgotten and there is crying over spilt milk.

Take heart from the fact there are many working women in the same position, and each step taken to normalise pumping now makes the path so much easier for the next generation.

11) Breastfeeding older babies

There seems to be an arbitrary time period – around three months – where breastfeeding is commended and accepted. But around 12 weeks, just ahead of the 4-month sleep regression where a new mother’s sanity is pushed to the limit, is the precise point that the insidious undermining begins with gusto. This is the time where questions about sleep, size, and schedules, always seem to be answered with the word ‘formula’.  Despite the World Health Organisation recommending exclusively breastfeeding for at least six months and thereafter with food to aged two and beyond, this is regarded as strange behaviour. Six months is usually the point people talk about the need to encourage ‘independence’, and once bub passes their first birthday, then mother’s who continue to nurse are often accused of ‘only doing it for themselves’. Those that breastfeed beyond two years are regarded as freaks.

Isn’t it more bizarre to be disgusted when women opt to give their children breastmilk, which is uniquely tailored for each human baby, rather than cow breast milk?

It’s time to rethink our attitudes: It is wonderful that support at the newborn stage is slowly becoming the new normal, but we should be celebrating every milestone and every hurdle that nursing mothers clear.

It is wrong to say breastmilk loses nutritional value once babies celebrate their first babies. It still retains all the nutritional value it always had. But even if it didn’t, breastfeeding and breast milk still offer immunological, emotional, and developmental benefits.

The age range for natural term weaning in humans is actually anywhere between aged two and aged seven. Most women who continue nursing their smalls in toddlerhood will tell you it is a parenting superpower that helps children in times of illness, anxiety, rage, fear, sadness, as well as boosting confidence for exploration and independence.

Nonetheless, it can be lonely nursing an older baby, toddler, or child as it is less accepted and understood. For those that want to continue, it is vital to find like-minded souls to help navigate the challenges at home, and in wider society.  Breastfeeding Older Babies and Beyond is an excellent and well-moderated group where you will find mothers dedicated to natural term weaning and many nursing kids aged two, three and four.

The #Ittasteslikelove campaign aims to normalise natural term breastfeeding, encouraging women to nurse their children – of any age, however, wherever and whenever they need to.

If you’re looking at fertility treatment and want to continue breastfeeding, this group on Facebook comes highly recommended, and there is also a dedicated group for those already pregnant, or who have multiple children and want to tandem nurse.

 

Want more women to breastfeed? Drop the cover… and the misogyny

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“Cover yourself,” she screamed before leaping from her seat, shoving past me and my baby, taking a position by the bus door to glare and tut in disgust.
My crime? Nursing my baby – uncovered and in public.
I refused, adding simply: “I am more covered up than you are”.
In her hysteria at seeing a slither of breast as a mother met her infant’s needs, she had failed to realise her outfit was more revealing than mine and succinctly summed up the hypocrisy that surrounds nursing mothers in Hong Kong – and in cities throughout the world.

Inexplicable disgust 

Breasts are routinely used on billboards to advertise everything from underwear and perfume to jewellery and plastic surgery, and a casual walk through a city where thigh high boots, mini skirts, string tops and short shorts are part of the sartorial lexicon, gives no suggestion women are expected to dress modestly for cultural reasons. This is true across the West and much of East Asia.

But breastfeeding in public is still met with disapproval, and breastfeeding without a cover is often met with outright disgust.
Authorities in Hong Kong desperately want more women to breastfeed and they want them to do it for longer – just 27.9% of women here reach the minimum six-month exclusive breastfeeding milestone recommended by the World Health Organisation, which has long extolled the health benefits for both mother and baby.

#Dropthecover

But even as they invest millions in city-wide health campaigns and education programmes in public hospitals to promote breastfeeding, the practice is being undermined by institutional misogyny masquerading as cultural concerns, inadequate maternity leave, and few workplace provisions for mothers to pump when they do go back.
Other world cities are embracing the #Dropthecover and other campaigns to normalise unfettered nursing, in the realisation that it’s better to support rather than ostracize the women doing it but Hong Kong lags behind – even in the very places instructed to promote it.

Biological norm

In 2015, my eldest was born preterm at Queen Mary Hospital, I needed emergency surgery and he needed special care. My recovery time meant I lost precious hours and when I finally saw him, tiny, in an incubator, attached to monitors due to hypoglycemia, but breathing fine by himself, I instinctively wanted to hold and nurse him. Surrounded by posters hailing the importance of breastfeeding, I assumed I was in a safe place to try.
The nurses had other ideas – and insisted I go into a private room because ‘male doctors may mind’.
What kind of doctors are upset by basic human biology? What kind of message are we sending new mothers when we prioritise imagined offence over maternal and infant wellbeing?
Mine is not an isolated case (it happened again at Princess Margaret with my second) and it’s happened to hundreds (if not thousands) of other women: not just at the city’s hospitals, but with their families, and in public spaces – from museums to the MTR. According to a Unicef poll, some 40% of women who breastfeed in public in Hong Kong have had complaints or unpleasant experiences.

Breastfeeding is NOT easy 

The tired explanation is people might be upset for ‘cultural reasons’, followed swiftly by fears ‘men and children might see’.
Two generations ago, it was not unusual to see women in Hong Kong nurse in the open, so this culture of offence is new and arguably a puritanical hangover from the colonial period.
Breastfeeding is the biological norm and yet somehow today we are fighting to normalise it. It was always meant to be public, social, woven seamlessly into our daily lives – done whenever, however, and wherever was necessary – and our partners and children were meant to be part of it.
Breastfeeding is a learned skill and in the beginning, it is not easy. How can it be? Mothers are trying to grow a human with their own specially created super fuel at a time when their body has been through its biggest, most brutal challenge.
And yet because it is so hidden, it is often a shock to new parents that it can be painful, exhausting, that infants nurse not just when they are hungry, but when they are thirsty, overwhelmed, in need of comfort, or simply wanting to be close.
Nursing in public for the first time is already awkward, particularly in a hot, humid city, and babies don’t necessarily comply with covers.
For those that prefer privacy, Hong Kong’s malls offer excellent nursing rooms, but they are few and in demand.
Far better if we could make it easier on women, and end the stigma as it’s clear the desire to breastfeed is there.

Valuing women

The number of mothers who try before discharge is slowly rising and now sits at 86.7% but the system is working against them.
In some countries, it is illegal to separate puppies from their mothers before they reach eight weeks. Until January this year, Hong Kong’s statutory maternity leave effectively afforded human babies, arguably born more helpless, the same time frame with their mothers.
It’s now increased to 14 weeks but that remains woefully short and fundamentally shows how little what women do is valued.
Authorities expect us to deliver on its goals to grow and nurture Hong Kong’s population, whilst also delivering on its economic targets but has put in few provisions to help them.
The government issues guidelines for employers to enable working women to pump in the workplace but there is no law to insist on implementation. As a result mothers are still being forced to pump in toilets, storerooms, even stairwells or corridors. And instead of being commended for their commitment, they are treated as a nuisance.
Little wonder then that women feel breastfeeding is simply not worth the effort – why persevere through the pain and exhaustion if you’re met with a barrage of disgust at every step.

Time for rebellion 

But there are signs of rebellion against this restrictive and reductive mindset. Mamamilk Baby Alliance organise breastfeeding flashmobs, albeit under cover, and this weekend sees the start of #PumpItUp a collective photoshoot inspired by the bold pictures of actress Rachel McAdams pumping milk while clad in diamonds and Versace. The aim is simply to raise awareness about the realities of nursing, working, and motherhood.
If we insist breastfeeding remains in the shadows, then the only images young people will see of breasts are either to sell or to seduce.
If we insist breastfeeding remains in the shadows, then the only images young people will see of breasts are either to sell or to seduce. We need to change the narrative and bring it into the light.

This article was written by @Itttasteslikelove for the South China Morning Post

https://www.scmp.com/comment/insight-opinion/hong-kong/article/2188687/hong-kong-culture-isnt-blame-stigma-breastfeeding