Monday, August 30, 2010

World Breastfeeding Week 2010
Essay Competition

Breastfeeding Mothers' Support Group (BMSG) organised an essay competition for this year's World Breastfeeding Week. The aim of the competition was to determine how hospitals can help mothers establish successful breastfeeding through implementing the Baby Friendly Hospital Initiative (BFHI) starting by first finding out what mothers want. I submitted the following entry - it's not a great piece of work as I did it at the last minute and had only 1 night to write. But I won a consolation prize - a $20 New Maternity Voucher. Guess that can help me add 1 more nursing top to my collection! :)

I stumbled into the breastfeeding world as a teenager, when I came across a La Leche League Singapore calendar. The photos of the breastfeeding mums and babes look so calm and blissful; it became a memory that resurfaced when I conceived. Hence, I did not hesitate to aim for the gold standard of exclusive breastfeeding for the first 6 months.

While pregnant, I voraciously read any breastfeeding material that I could get and attended BMSG workshops. My husband and I decided not to stock any formula and milk bottles to deliberately make giving up breastfeeding difficult. We also invested in a Medela PISA. I involved my mother, who would be helping out during confinement and she joined me at the workshops when my husband was unable to make it. That turned out to be a good move as she came from a generation when formula milk was the ‘in’ thing and she was pretty ignorant about breastfeeding. The workshops were an eye-opener for her, an experienced mom of two!

All my research was very handy as my doctor shocked me during a pre-labour workshop that he conducts for all his patients a month prior to their due date. To quote, he said, “It is ok if you can’t or don’t want to breastfeed, formula is just as good.” I suppose that his goal was to ease the anxieties of new moms but I don’t think that helped anyone who wasn’t adequately prepared. I also couldn’t help but notice that a formula manufacturer representative was at the talk. We left with a full-size ‘sample’ tin of infant formula – dashing my hopes of not stocking any at home. I had to hide it in a corner to avoid its temptation!!

As part of my labour preparations, I took a Hypnobirthing course and developed a birth plan which I subsequently discussed with my doctor. Achieving a drug-free delivery was my main goal. Aside from my concerns about a previous spinal injury, I also read that it will help pave the way towards establishing breastfeeding. Now, I think that this was a major factor in facilitating my short and easy labour as well as breastfeeding in the delivery suite mainly because my wishes were made known to the staff, allowing me to avoid dealing with questions immediately post-labour.

Shortly after my son was born, the nurse approached me and proceeded to knead my nipple to extract the very first bit of colostrum. I’m unsure if that was necessary, as it was rather painful and I would have preferred to let him approach me at his own pace. However, that first whiff of colostrum enticed him to start suckling immediately for the next 20 – 30 minutes.

After we left the delivery suite at about 5am, I was left alone in the room with my newborn and when he cried around 7am, I tried to latch him on by myself. Unfortunately, I did not realize that the latching was incorrect and ended up with sore nipples! The LC came for a quick visit in the morning and tried to show me how to position the baby, etc but she was speaking very quickly and somehow I just couldn’t absorb everything. Subsequently, I’ll page for the nurses at almost every feed. They were usually helpful, adjusting piles of pillows to get the right position and giving me lots of support and encouragement. But no one told me how to get the right position when I’m home. It was a case of giving a man a fish and he eats for a day, instead of teaching him to fish so that he eats for life. Occasionally, I encountered some unhelpful nurses. One accused me of not wearing a nursing bra (untrue!), another suggested formula milk when all I needed was some positioning help and yet another insisted that I had to rest, therefore my baby should be in the nursery till it’s time for his next feed. I was too exhausted to fight the last one and caved in but I found little rest as his welfare was on my mind all the time and I worried that he might be given formula without my consent.

As I delivered on a Saturday, there wasn’t an LC present to help out the next day. I finally got to see one again just before being discharged on Monday. However, I felt that her explanations were overly technical and I couldn’t relate to it. I wondered if she had ever breastfed before and left feeling that I just had to grit my teeth and get on with it by myself at home. We left the hospital with a bunch of brochures - thankfully no formula samples, but there wasn’t any information about BMSG or similar support groups. After our discharge, it took quite a long while before we finally found a comfortable position. I often wished that someone would visit and show me how, just like the post-natal support that my friends in Europe get, with a midwife visiting every couple of days for the first month or so to check on the baby and mom. While I was aware that I could arrange for a private visit with an LC, the cost was a prohibitive factor.

As a first-time mom, I felt that post-maternity support is severely lacking. 1 week later, my son suddenly refused to feed throughout the day; he would latch and cry in frustration a short while later. Finally, close to midnight, I realized that he was dehydrating. In desperation, I called the hospital’s emergency line, only to be transferred from person to person. My call was eventually answered by the duty nurse at the ward where we stayed – her response was disheartening: “Why did you call so late?!? What do you expect me to do? Just give him formula!” I refused to give him formula and she told me I could express if I wanted. I hung up feeling angry, discouraged and upset. We raced to the 24-hour NTUC to get milk bottles and I started expressing for the first time. True enough, my poor baby was starving and gulped down the entire bottle before falling sound asleep. It turned out that he caught a viral infection and a stuffy nose was preventing him from nursing.

We became more proficient as the weeks went by, but it was a rocky road paved with pain, discouragement and tears. At 6 weeks, I developed an abscess which required surgery under GA. Subsequently, I encountered countless painful blocked ducts, sometimes, as often as once a week, at least 2 bouts of mastitis and an episode of thrush. Thankfully, I am blessed with angels who held my hand and helped me along the way:
- my supportive husband, who did much more than I can list here;
- my mom who would drop everything to help out;
- my Hypnobirthing instructor (Ginny Phang of Four Trimesters) who always answered my calls for help and massaged away countless blocked ducts and for her encouraging words;
- my very skilful breast surgeon, Dr Joy Lee, for her patience, kind demeanor and encouragement;
- the unnamed counselors at BMSG who answered my calls when I was at my wits’ end.

All the trials and tribulations I’ve endured only made me more determined to persevere. I am now proud to say that we managed to achieve the gold standard. Today, my son is a healthy, bubbly 19-month old who is still breastfeeding and shows no sign of weaning. Although I sometimes tire of his breastfeeding antics and long to not wear nursing clothes anymore, I think we both enjoy the closeness too much to give up anytime soon.