15 Aug 2010
Some mums are unable to feed their children breastmilk for reasons ranging from stress to medical issues
If Brazilian supermodel Gisele Bundchen had her way, housewife Cindy Kok would probably be thrown in jail.
Bundchen, 30, recently told Harper’s Bazaar UK magazine that she thought there should be a worldwide law for mothers to breastfeed their babies for six months.
Should governments heed her advice, Mrs Kok, 36, would have been charged. Six years ago, she had already slapped herself with a guilty sentence when she could not breastfeed her elder daughter Kelly.
She had mastitis, a bacteria infection of the breast tissues, which commonly affects nursing mothers. Symptoms include soreness of the affected breast, high fever and fatigue.
Says Mrs Kok, who is still visibly frustrated by the memory: “I felt guilty and less of a mum. It was a personal failure, not being able to provide for my child.”
Exhausted from fighting the infection, she stopped breastfeeding Kelly after two months.
Bundchen has since backed down over her remarks, after sparking a global outcry. But, closer to home, Indonesia will enforce a law from Oct 13 which will jail or fine mothers who refuse to breastfeed, unless they have medical problems.
This has renewed the to-boob-or-not-to-boob debate.
The nutritional and emotional benefits associated with breastfeeding have been well-publicised, and few mothers need convincing that, as the awareness tagline goes, “breast is best”.
But some women cannot breastfeed for a number of reasons: from emotional stress, inverted nipples, damaged milk ducts after breast surgery, to medical conditions such as cancer and Human Immunodeficiency Virus (HIV).
Inverted nipples, which are difficult for babies, may be an initial stumbling block.
Mrs Wong Boh Boi, assistant director of clinical services at the Thomson ParentCraft Centre at Thomson Medical Centre, says the condition can be detected at pre-natal check-ups. Wearing a small device called a niplette during the second trimester can help pull the nipple out.
Dr Yong Tze Tein, obstetrics and gynaecology consultant at the Singapore General Hospital, explains that a HIV-positive mum may pass on the virus to an infant through her milk.
If a mother is undergoing chemotherapy for cancer, toxins from certain drugs may enter the milk and affect the child and his development.
Dr Yong, who is also president of the Association for Breastfeeding Advocacy (Singapore), adds: “Women who have undergone a breast reduction surgery may also have their milk ducts cut off.”
In addition, premature babies’ swallowing and sucking co-ordination may not be as developed as those of full-term infants.
Other newborns may be too small or have congenital conditions such as a cleft palate that prevent them from feeding efficiently from the breast.
Madam Teng Meng Hoon, 38, had a shock when her paediatrician discovered that her second child Alysha, who had been exclusively breastfed up till then, not only did not gain any weight, but lost 100g a month after birth – from 2.4kg to 2.3kg.
Alysha’s mouth was too small for her to suckle properly and she was not taking in enough milk from the breast. As a result, Madam Teng’s milk supply decreased.
“I was very worried. I felt that it was my oversight that my child was being deprived of the best infant food,” says Madam Teng, a vice-president at a global investment bank.
She had no problem breastfeeding her elder daughter Adelle, six, until the girl was 3½ years old.
With encouragement from lactation consultants, she increased her milk supply from 200ml to 800ml a day. Now three months old, Alysha nurses at her mother’s breast and drinks expressed breastmilk in a bottle, and has gained 2.1kg.
Ms Cynthia Pang, a nursing and lactation consultant at KK Women’s and Children’s Hospital, says a mum needs to understand that some situations may be beyond her control.
“A mother who cannot breastfeed can focus and bond with her baby by caring for the other needs of her baby,” she says.
In the cases of babies who take longer to learn how to feed efficiently, she advises that their mothers temporarily express breastmilk regularly, until they can breastfeed directly.
Looking back, Mrs Kok attributes her emotional turmoil then to overt pressure from the mass media, well-meaning doctors and the society on mothers to breastfeed. “The media makes breastfeeding sound so easy. Hence many first-time mums will question themselves if what they are doing is wrong.”
Determined to succeed at breastfeeding when she became a mother again, she quit her job as a public relations manager during her second pregnancy in 2007 to focus on motherhood.
Armed with experience, she managed to breastfeed her younger daughter Clara, now two, for a year.
She says: “I had a sense of achievement that I was able to provide for my child, after having tried so hard the first time. I was happy that I could share the bond with my daughter.”
She adds: “I realised I was not a failure. It was just that I wasn’t prepared and everything was against me the first time.”
“I was very worried. I felt that it was my oversight that my child was being deprived of the best infant food.”
MADAM TENG MENG HOON, whose second daughter, three-month- old Alysha, was unable to suckle properly during breastfeeding initially. They are seen here with her elder daughter Adelle, six, whom Madam Teng breastfed till the girl was 3½ years old
Tips for mums and dads
• Be prepared. Sign up for pre-natal classes, read up on breastfeeding techniques and seek help from lactation consultants early to address possible difficulties. Speak to mums who have breastfed successfully.
• Understand how milk is produced. Mothers often think they are producing insufficient milk or have none, especially in the first few days after childbirth, when the breasts produce small amounts of a liquid called colostrum. Colostrum is, in fact, a special kind of milk which delivers nutrients in a very concentrated form before the normal milk “comes in”.
Also, newborns have small digestive systems, so they drink small amounts but frequently – usually nursing for about 15 minutes, 10 to 12 times a day.
• Reduce stress. Get adequate rest and eat a balanced diet. Leave chores such as changing diapers to others, if possible.
• Husbands should support their wives’ decision to breastfeed. Do not suggest feeding the baby formula just because you think it will alleviate your wife’s stress. Encourage mothers who are determined to breastfeed.
• When well-meaning relatives make comments such as, “Your baby is feeding so much, he or she must not be getting enough milk” or “Your milk looks diluted”, husbands can mediate or deflect their remarks to keep the pressure off their wives.
Sources: Mrs Angeline Wee-Yew, president of Breastfeeding Mothers’ Support Group (Singapore); Mrs Wong Boh Boi, assistant director of clinical services at the Thomson ParentCraft Centre at Thomson Medical Centre; Dr Yong Tze Tein, obstetrics & gynaecology consultant at the Singapore General Hospital and president of the Association for Breastfeeding Advocacy (Singapore)
Click here for jpeg format
« Back to previous
page
back to top