Breastfeeding basics

Okok, I promised a breastfeeding post for some of my preggy friends, so here it is!  I'm no expert, but having been able to feed baby J up til now and after surviving almost every problem described in the breastfeeding books, I thought I'll just share what I've learnt so far!

Things to get for breastfeeding:

1. A double electric pump (especially if you are intending to go back to work), most of the mummies I know recommend the Medela pumps.

2. Bottles/storage bags for keeping milk, along with a insulated carrier if you have to pump milk outside.  Check that your plastic bottles are certified BPA free, or use glass bottles.  For feeding baby, use those bottles with wider teats (clear silicon teats are better, yellow latex ones can taste funny) to simulate breastfeeding. 

3. A nursing cover, which allows you to breastfeed in public.  Very useful especially since not all public spaces in Singapore have nursing rooms.  For example, most parks (including botanic gardens!) do not have nursing rooms, and some shopping malls have only one or two rooms which may be occupied when you need to feed.  Its important to cover up since our society here isn't very open about breastfeeding in public *rolls eyes*. 

4. Nursing bras, which allow for easy access during feeding.  Moms in mind sells pretty good ones and a wide variety, including those that can be worn under tube tops etc.  Get them nearer to your due date as your size may change.

5. This sounds odd, but get a small tin of formula on standby for the first few days, just in case.  Or see if the hospital can give you samples in bottles.  For my case, baby J cried non-stop the first night he was home and we had no formula in the house, so hubby had to drive out late at night to see if the hospital had samples! We ended up feeding him formula for 3 days before the milk came in.  Of course, if the baby nurses and seems satisfied (but note baby'll nurse very very frequently initially), then you won't need to give formula, but best to have some, just in case.

6. Lanolin nursing cream, which can be applied after every feed to reduce the dryness.  I'm using the Medela PureLan nursing cream, which is pretty good...

7. Fenugreek capsules, which you can eat to increase milk supply.  But take these only if you find that your milk supply is insufficient even after the milk comes in around the 4/5th day... otherwise you might end up with an oversupply which also causes problems!

8. A steriliser for all those milk bottles and your pump (alternatively, you might just want to sterilise using a normal pot and boiling water).

Before you pop: Things to note

1. Read up on breastfeeding, by visiting websites or reading books.  Learn how to latch the baby on properly, and what to expect in the weeks to come!

Useful websites to check out will be:

Kellymom (her site is very useful and I like the way it presents scientifically sound information based on research papers)

Dr Jack Newman's website (has videos to observe latching etc)

2. Have chats with breastfeeding mums to know what to expect.  I had so many problems in the first few weeks, that if not for all the mummies who gave advice and encouragement, I would have just given up and stopped breastfeeding altogether!

3. Determine how long you intend to stick to breastfeeding, that'll keep you going if you encounter any problems along the way...

Directly after popping: Things to note

1. Request to breastfeed baby immediately after the delivery if possible.  Its recommended to do so as baby will be most alert then and will be willing to latch on and feed.

2. Inform the hospital that you would like baby to room-in with you, or if the nurses take baby to the nursery, ask the nurses to bring baby to you when he/she is hungry, and request that no formula be fed to your baby.  This way you can start nursing and that will help to stimulate the milk to come in.

3. Make an appointment to see a lactation consultant during your stay in hospital.   Use the time with the LC to learn how to latch the baby on if you are not sure, and to trouble-shoot any problems you have.  So far, my experience is that the nurses will tell you all sorts of different things which can be confusing, so the LC's the best way to go.  If possible, see if your LC is willing to give you her work/mobile number so that you can call her in the future if you encounter problems.  Do note that LCs in Singapore will charge consultation fees if you make appointments to see them later on after you are discharged, and it costs way more than seeing a GP!

4. Most hospitals will provide you with a nursing cushion to use.  Try it out when you are there, and if you find it helps with feeding, you may want to get one of your own.

The first few weeks: Things to note

1. In the first few days, what will be produced will be colostrum, which will then be replaced by milk.  Sometimes, due to the milk "coming in" there might be engorgement, which can be relieved by using cabbage leaves chilled in the fridge.

2. You will need to feed frequently in the initial weeks.  To start off, even if baby is sleepy, you'll have to feed baby at least once every 3 hours around the clock, and you may have to wake baby up to do so.  This is important cos it'll help to establish your milk supply.

3.  Initially feeding may hurt, and most mums that I spoke to talked about soreness.  However, if it really hurts alot, you may want to check that baby is latching on correctly.  Usually babies will improve their latch after 1 month when they gets better head control.  The lanolin cream will help alot of terms of combat dryness from the frequent feeds.

4. For those having someone else to cook for you and are on confinement food, you may want to request for green papaya (the unripe fruit) slices to be added to your sliced fish soup and for the herb dang sheng to be added to the red date drink.  Both are supposed to help with milk supply.

5. It will be very tiring with such frequent feeds, so take it easy and concentrate on feeding.  Nap when baby naps and leave the housework to others initially.   If you can master it, try breastfeeding lying down with baby next to you, and it'll be easier for you if baby sleeps in the same room as you at least for the first 2-3 months.

6. Try to avoid using pacifiers and bottles for the first few weeks if possible, as it'll help baby to learn how to breastfeed properly.  If introduced early, baby may get "nipple confusion".  As we had to formula feed baby J in the first few days, he gave me alot of problems after that as he got very impatient with the flow of milk during breastfeeding! 

7. Bear in mind that breastmilk jaundice (jaundice caused by breastfeeding) is pretty common and not harmful.  One of my friends who has 3 breastfed kids told me all 3 kids had jaundice for a pretty long time each, and baby J also had it too.  Some people will advise against breastfeeding if baby has breastmilk jaundice (but the doctor should run tests to see that its not jaundice due to other reasons), but do stick to it as the jaundice will clear up eventually.

Continuing after the first few weeks: Things to note

1. Your milk supply would be set by the first month, so the first 4-6 weeks are crucial in setting up a good supply, so feed frequently during these weeks.  Bear in mind that milk supply works on a supply demand basis, the more you feed, the more you produce.

2. Milk supply may drop in the 4th month sometimes due to unknown reasons.  Mine did, and it freaked me out as suddenly I couldn't pump enough for baby when I had to leave the house for research, and the stress made the pumping output even lower!  In such cases, you may have to resort to eating fenugreek.

3. If you fall sick, continue breastfeeding as its the best protection you can give your baby, as antibodies pass over from you to him in the milk.  So far, I've fallen sick a few times (caught some flu and cold bugs), and even though baby J had to be with me most of the time during those periods, he's never fallen sick so far. 

4. Storing breastmilk: Breastmilk stored in the fridge can keep up to 8 days (at least its mentioned in some sites), but the CDC recommends a 5 day period instead.  I find that after 5 days, it starts to smell different, and baby J doesn't really like it.  If you freeze breastmilk, it can keep up to a few months, depending on what kind of freezer you use. 

5. The recommendation now is for mummies to exclusively breastfeed for 6 months.  Solid food should not be introduced until baby is 6 months old, so try to explain nicely to your mother or MIL if they try to push porridge on your baby when he's 4 months old (which used to be the case).  My mother was aghast and thought I was torturing baby J when I refused to feed the boy rice cereal when he was 4 months old!

All in all, I would say that these 8 months of to trying to breastfeed baby J even through mastitis and blocked ducts etc was worth it.  So to all the mummies-to-be, happy breastfeeding!  And all breastfeeding mummies, do feel free to comment and share your tips too! :)