Hard work and an irreplaceable chapter of our lives: Breastfeeding is best for baby and it comes with adjustments mothers naturally have to make

Media, and choice of words.

The people with power in the media can use the media for good and for bad. I am on the side of using the media to educate, inform and empower. There are enough negative stories in the media. But surprise surprise, bad and/or sad news sells.

I came across this article online in one of Singapore’s mainstream media. The article was parked under the Women Lifestyle section where their tagline goes “Stories, life hacks and advice to inform, empower and inspire the modern woman”.

Just put a pin on that first.

This writer detailed how breastfeeding comes with tons of maternal sacrifices. Yes, I absolutely agree with this. She furthered the persuasion to us, the society, to avoid “romanticising breastfeeding”. 

There are a couple of misinformation in the article that I would like to take this chance to clarify and debunk. Before you read on, please read the said article here. So you will be able to understand the context and its entirety.

A note to highlight: Breastfeeding also includes mothers whom are exclusively pumping.

Buying breastfeeding essentials

The article stated this:

“This means, to make food for their babies, they put in hard work, time and money; breast milk may be free but breast pumps and storage bags are expensive.”

There are a range of breast pumps based on varied degrees of affordability. Many mothers do have their primary pump. A primary pump is when they use it the most. Only some mothers have a secondary pump - a pump that they may just use moderately perhaps once or twice a day. 

The thing about pumps is, depending on your breastfeeding lifestyle, getting a breast pump is not compulsory. Not all mothers touch a breast pump at all. Yes, a majority of mothers, especially in Singapore, us being city-dwellers, we do need a pump because we need to work and all. And some mothers turn to be an Exclusive Pumping (EP) mother, some by choice, some not by choice.

Therefore, it is known that breastfeeding essentials like breast pumps and storage bags cost money. Most times, it is usually a one-time investment. Same as other baby essentials - they cost money (I can say the same of formula milk, they cost perhaps more money overall).

Breastfeeding comes with adjustments

Yes, it does come with sacrifices and it can NOT be an absolutely scary thing. I always tell mothers during my lactation consultations with them that breastfeeding is indeed natural but it is a learned skill for many, I repeat, many mothers. 

If any mother is struggling with breastfeeding, it is not breastfeeding that is failing her. It is the lack of trained lactation support and a chunk of judgemental society that is failing her. We do not blame mother nature for climate change, don’t we? We blame industrialization and humans for climate change, right?

So, breastfeeding is not the scary thing here. The scary thing is the lack of support and the troughs of outdated and untrue breastfeeding advice from non-lactation-trained professionals and many other random people everywhere.

I also would prefer a better word to avoid misinformed fear-mongering. Sacrifice is a term we use when we feel like we are giving up something much more valuable to be a mother, to be a breastfeeding mother. To go into a different stage of life, any normal human being needs time to adjust

The adjustments mothers make in their lives to breastfeed, isn’t it proof that women are made amazing this way? Any adjustments mothers make for themselves, their babies, their families are absolutely commendable. We go through life, adjusting to many things. I am not downplaying maternal sacrifices here when it comes to breastfeeding. It can be tough at times, indeed.

Whatever we do as mothers, we have to sacrifice, yes, to a certain extent, but we adjust to so many aspects of our lives to nurture and provide. This is a natural part of being a mother. I strongly believe that we all need to emphasise with mothers to find the right trained necessary support and their moral support village. We are social creatures. We need our own village to tide us through our challenges and celebrate our wins.

Food and milk supply

The article continued on about breastmilk supply and quality in relation to food - “sticking to a strict diet for months, and sometimes, years”.

Just because we are breastfeeding mothers, does not mean we have to restrict our diet. Your lactating breasts are extremely protective of your baby. It takes whatever it needs from your blood to make the perfect milk your baby needs. If you are consuming an unbalanced diet, your body is going to feel the effects of it first instead.

Coffee: Studies have shown that caffeine does not diffuse freely into breastmilk. Mothers still can have their daily cup of coffee especially if their babies are full-term, healthy with no medical conditions. It is considered excessive when mothers consume more than five cups of coffee. But, realistically, one cup of coffee just to start the day - it’s fine! Just continue to monitor young infants’ overall day-to-day behaviour.

Helpful article here on Breastfeeding and Caffeine.

Alcohol: Go by this rule of thumb - if you’re sober enough to function normally, you’re sober enough to breastfeed. If you’d like to consume alcohol, you can breastfeed/pump first, then consume alcohol. Studies have shown that alcohol peaks 30 to 60 minutes after consumption. To err on the safe side, mothers can breastfeed after 2 hours. There is no need to pump and dump if you’ve consumed just a glass of alcohol.

Helpful article on Breastfeeding and Alcohol.

Peppermint, sage, etc: Everyone’s body reacts differently to various foods and drinks. Some mothers may not see any impact after consuming these herbs. In general, consume anything in moderation. If you are concerned about peppermint tea affecting milk supply, it is only when you consume in large quantities such as close to 1 litre. Simply because the peppermint in the tea is “a weak form of peppermint”. Now, who really drinks that much peppermint tea in a day?

Again, everything in moderation! To put it simply on how the body makes more or less milk:

The more frequently milk is being removed from the breasts, you are signalling to your breasts to make more milk faster. If your breasts are full for a longer period of time, the breasts will eventually get the signal to make less milk over time. 

Engorgement and breast pain

For the article to state that “engorged breasts are a rite of passage for breastfeeding mums”, is somewhat instilling fear and misinformation about establishing breastfeeding. 

There are two types of engorgement: physiological and pathologic.

For lactation to begin, it is all hormones in the work. Many mothers go through physiological (early-stage) engorgement within the first week postpartum, where breasts get fuller and heavier. This is when breastmilk is transiting from colostrum to mature milk. Most of the time, engorgement can be managed with proper lactation education and techniques such as ensuring an effective latch, removing milk on demand, learning how to hand express, use cold compress, etc.

Physiological engorgement does not always mean the breasts are full of milk. It also includes tissue/cell fluids and this can be managed with lymphatic drainage where mothers themselves or their partners can help with this for those few days when engorgement happens. Yes, it can be uncomfortable but not all physiological engorgement is painful. If it starts to get painful, the next thing is to seek help from an International Board Certified Lactation Consultant (IBCLC).

Warning: Do not engage in any vigorous breast massages for your engorged breasts. When any part of your body has some form of swelling, we do not put tons of forceful pressure, right? Please be gentle with your breasts.

The article went on to share about the worst case scenario - “a pocket of pus may form and it will need to be drained.” This is called breast abscess. A research shows that an incident of breast abscess ranges from 0.5% to 11% of lactating mothers. It is not common, but yes, it does happen to some women. Many breastfeeding mothers are able to avoid escalating to that worst case scenario and are able to manage engorgement, blocked ducts or mastitis if they intervene early and get trained lactation support. 

I guess this statement may be related more towards pathological engorgement:

“Meanwhile, the poor mum frets about her reduced milk supply. She will also be kicking herself for not having pumped/fed regularly enough, and allowing her breasts to be so engorged that mastitis developed.”

Engorgement may occur on an occasional basis throughout the breastfeeding journey, especially if milk stays too long in the breast. Life happens, sometimes mothers may unintentionally skip a latch or a pump. Humans are meant to be living in a village with help and support from tribe members. In this modern world, we are only left with ourselves to manage a baby, or for some, babies. It is so important to get help from friends and family to manage other aspects at home while the mother cares for her baby. Not everyone has good help. If you do, take a moment to appreciate your blessings!

On this note, be assured that not all engorgement or blocked ducts will escalate to mastitis. If left untreated, like any other inflammations, of course it will naturally escalate.

Medications and breastfeeding

This is also another point the article made of how mothers err on the safe side and not take medications which then slow down their recovery. Look, I get it. I did that too, as a first time mother back then. Many of us worry about medications going into our breastmilk. According to various studies, most drugs do not enter breast milk at high levels that pose risks to infants. 

Some physicians are more inclined to be more cautious about drugs and may advise mothers to pump and dump or to cease breastfeeding, even if the medication is deemed as breastfeeding compatible. As an IBCLC, myself and hundreds of thousands of healthcare professionals worldwide, use this website to check for drug compatibility: https://www.e-lactancia.org/

E-Lactancia is founded by the Association for the Promotion and Scientific and Cultural Research of Breastfeeding (APILAM), they are a non-profit association to promote breastfeeding with science, training, culture and communication.

If in doubt, consult an IBCLC and most importantly, anything to do with medications and drugs, consult a breastfeeding-friendly doctor.

Life as a breastfeeding working mother

This part of the article is so relatable to many working mothers. This again is another proof that breastfeeding mothers go through a lot of adjustments to provide for their baby. Pumping at work, pumping on the go, managing with breastmilk storage and transportation and many more. 

This is also another way of confirming that our workplaces can do much more to better support breastfeeding mothers. Why do some mothers need to constantly still be told to pump in the washroom? Back then, I was told to pump in the washroom because the meeting room (which I had already booked in advance) was being used for an urgent meeting. I also had to explicitly tell a male colleague straight in his eye as he asked why I booked this meeting room. 

“To pump my breast milk”.

Oh, the look on his face as his eyes widened in shock and embarrassment. I even had to ensure that my previous new office must have a meeting room with a curtain and a lock to be the designated nursing room. Even though I am no longer in that company, I know that will help future breastfeeding employees at that office enjoy having that facility.

This is a social and political condition. We need more workplaces to better support breastfeeding women.

TAFEP have this “Employee Support Schemes” recommendations for lactation support at work: “The promotion of a breastfeeding-friendly culture, flexible lactation breaks, and the provision of a private lactation room for mothers. Having such protection and support at the workplace encourages and enables new mothers to return to work. The lactation room should come equipped with chairs, electric sockets for breast pumps, refrigerators, hot water, and sinks.”

Are all companies doing that? No. Some breastfeeding mothers were even told that they are not allowed to pump at work and many times, that caused an early cessation of their breastfeeding journey. The audacity of some workplaces to dictate mothers that they cannot continue providing breastmilk for their child. The surprising thing is, yes, companies can do that if they want. Breastfeeding mothers do not have any law that protects us to be able to be entitled to pump at work. Besides, many mothers pumping at work are working on their laptops at the same time. That is productivity for you!

Then again, pumping at work is not necessarily a stressful thing forever. In actual fact, many companies do allow mothers to pump at work. It can be a challenge to adjust as a pumping mother at work, but eventually, many mothers do find their groove and balance - again, with evidence-based lactation advice, help and support.

Breasts sagginess

So often in this modern world, bodily aesthetics seems to be placed on a high pedestal. Our postpartum bodies are meant to change. Your body went through a lot such as months of pregnancy, birthing a child, lactating for your little one. 

Give your body a break especially for the first few months. Studies have shown that breastfeeding does not worsen breast sagginess - pregnancy does. The more times a woman is pregnant, breast ptosis (sagginess) increases. 

Romanticising breastfeeding?

Now, I am saying this with full conviction: no one has the right to force you to breastfeed if you do not want to. 

Indeed, there are some health issues that may impact breastfeeding possibilities for some women. But to say not to romanticise breastfeeding is like downplaying the many wonderful moments many breastfeeding mothers do experience.

Yes, breastfeeding is supposed to be personal and intimate, like what the article says. It is also challenging at times with some adjustments in life but it is also amazing, beautiful and privileged all at once.

I disagree with the article stating “She is not looking for pats on the back. She is too busy just trying to make things work.”

I always tell mothers during their lactation consultations with me that they are doing such an amazing job, they are doing the best they can, they are enough. I always give them pats on the back. Mothers need to know that. Mothers need to hear they are doing so much. They need someone to understand what they are going through. I can go on and on about the importance of encouraging mothers. 

We are all busy trying to make things work in our lives, more so a breastfeeding mother and more so, all mothers. If a breastfeeding mother is trying to make things work, give her the support to help her achieve her personal breastfeeding goal. 

I even had this canvas tote bag produced and for anyone to purchase. Because I know at times things can be hard and little words of encouragement can go a long way for many mothers!

Please indulge me as I romanticise breastfeeding

I want to start off with addressing exclusive pumping mothers. You are the most hardworking group. You may choose to be an EP mum, some of you may be an EP mum not by choice. Nonetheless, you balance your time between your pump and your baby, it is laborious work. You are amazing and we are awed by the sheer amount of work you do to provide breastmilk for your child.

Next, breastfeeding is a quiet time between a mother and baby. It is that unique bond and love bubble that no one else can come in between that. Latching is the ultimate source of comfort for babies. It is a way for mothers and babies to connect back with each other after a full day of separation. It is that extra boost of immunity for the baby that no other alternative milk can provide. It is a time to both nurture and provide. It is also a time for mothers to trust their bodies to make the perfect milk for their babies. Our body was built for this. The feeling you get when that smile baby makes while he suckles.

Breastfeeding (and pumping) is not forever, it is a very short period of time in your baby’s entire life. It can range from weeks, months or even years. That short period of time during your baby’s first few years of life and it will eventually be a memory etched in your mind. That tons of snuggle time during latching is something so precious. Too precious. Take a moment to hug your baby now, if you may.

There are ways to get lactation help

Lactation Consultants (ideally IBCLCs - they are the gold and highest international standard of LCs) operate either in clinics or in private practice. You can get lactation help from Parentcrafts in hospitals or polyclinics, though not all may be IBCLCs, but most do provide great help nonetheless.

I highly encourage you to join BMSG’s Facebook Group to be with like-minded breastfeeding community of mothers, learn and get counselling support from their counsellors. Don’t feel like you need to struggle with breastfeeding alone. Your own breastfeeding journey, your own informed decision to make. 

I hope this article manages to give better advice to inform, empower and inspire the modern woman.

Love,
Eliza, IBCLC, Tender Loving Milk


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