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Managing breastfeeding

Media seems to depict breastfeeding as being the most natural thing in the world. However, most women had never done such a thing for all their lives until they had their first baby, and so it most certainly is something entirely new to new mothers. Furthermore, every woman and every baby is different and so the breastfeeding experience might be very different each time.

In my opinion, breastfeeding is one of, if not *THE*, most painful part of having a baby. Yes, you’ve read that right. I find it a lot more difficult than giving birth (that’s what happy-durial is for!), pregnancy (ok, this comes a close second), or even the sleepless nights caring for a sick child (since these tend to be short-lived…though longer than the labour process). However, the benefits of providing breastmilk are high, and so I do recommend new mothers to at least give it their best try. However, I strongly disagree with the immense pressure placed on mothers today where the success or failure of a newborn’s mother seems to be tied to the amount of breastmilk they are able to provide their baby. A mother’s sanity is of utmost importance to be able to provide the best care to her baby, herself and her family. Fed is best, however much or little breastmilk is involved.

Breastmilk production is largely based on how much demand is signaled to a lactating mother’s body. New mothers are usually advised to provide this demand is by directly latching the baby to the breast whenever the baby needs to feed. The mother’s body is supposed to respond by producing the appropriate amount of milk. However, this “ideal” situation is not always what a new mother finds she has or wants. For eg, the baby could be born premature or have tongue/lip ties which prevent them from latching, the mother could have short/inverted nipples which make it difficult for baby the suck, the mother could have too few/many holes so baby doesn’t like sucking, the mother might need to be away from the baby for long periods of time very soon after birth, etc. The possible situations are countless. Every family has a different preferred lifestyle and so could learn to manage breastfeeding differently. Today, there are many types of breastpumps available to help simulate the demand for breastmilk production.

After fumbling terribly through breastfeeding for #1, I finally figured how to make my body make enough milk after 2 months. I learnt many lessons and so my initial priorities immediately after birth of babies #2 and #3 were to (i) try to increase the supply of breastmilk as soon as my body starts producing it (usually between days 3-5 from giving birth) and (ii) establish a good latch for the baby. As such, I try to latch the baby for as long as the baby wants every 3 hours at the hospital. However, at that point, if baby refuses to latch long or seems to be very hungry way before 3 hours is up, I usually give the go-ahead for a formula top-up. I do this in order to ensure baby can pee and poop enough to reduce the risks of getting jaundice. Once I get home on Day 2, I pump until I am empty every 4 hours and latch baby according to the intended routine’s feeding time only if it was at least an hour after I had emptied my breasts using the pump. I stick to this until my production stabilises and then decide if I want to regulate the amount of milk I produce.

I had no live-in help at home when I had my first 2 babies, and when I had my third, there was quite a hectic schedule to follow since my older 2 kids were attending a half-day kindergarten. As such, for both baby #2 and baby #3, I made decisions to extend my pump intervals fairly early after delivery. This was at 4 weeks post partum (“4wpp”) and 2.5wpp for babies #2 and #3 respectively. In order to do this, I wrote out clear schedules for daily pumps in order to slowly extend the intervals to avoid losing my supply or getting mastitis. In order to ensure I could take all the time I needed to fully empty my breasts at each pump, I made sure I had help around the house during pumping times so I need not keep getting interrupted by the baby. In this way, i could reach 4 pumps per day (“4ppd”), or even 3ppd very quickly. This made it a lot more comfortable for me to spend the time I needed with the baby, the older kid(s), the husband and work or run errands. Weekend schedules were also much easier to plan since I did not keep having to rush home to pump.

In order to maintain my supply at 3ppd, I strictly pumped at the same times every day, plus/minus 15minus. More importantly, I made sure I fully emptied both breasts at every pump, which meant each pump took longer than when I was pumping more often. Also, 8-hour pump intervals meant I have a lot more foremilk or the milk appears thinner and so I overcame this problem by eating healthy fats daily. Also, whenever the feeding time was appropriate and the baby was willing, I latched the baby in between pumps.

This approach is not for everyone of course – the right approach depends on each mother/family’s goals and intended lifestyle. Whatever your priorities are, it can be hard for a new mother to read a baby’s cues, understand how to use a breastpump properly or recognize the feelings of “being empty”, “letting down” and the other peculiar feelings breastfeeding brings. I do therefore encourage any new mothers who are struggling with breastfeeding to seek help, either from lactation consultants or reach out to me as I will be happy to make a visit to your home to help with troubleshooting or provide guidance or reassurances, whichever is needed!

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