Breastfeeding with Love e-guide 2016 by New Age Pregnancy

Breastfeeding WITH LOVE

A comprehensive e-guide for mothers

Ready, Latch, Go

Preparing for your breastfeeding journey

Breastfeeding in Public How a first time mama did it

Pumping at Work MYTHS AND MISCONCEPTIONS

Q+A

WITH OUR EXPERTS

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www.newagepregnan c y.c o m

TABLE OF CONTENTS

Breastfeeding Mothers Can Understand

BREAST IS BEST 06

Milking-ly Good

Breast Care 101

26 P umping at Work: Myths and Misconceptions

SUCCESS STORIES 34

I’m Not Giving Up!

08 H ow Long Should I

30 B reastfeeding Hacks For

38 B reastfeeding in Public:

TIPS & TRICKS

31 I s Singapore Becoming More

Busy Mamas

Breastfeed?

Ready, Set, Latch

Breastfeeding-Friendly? Family First

12 D o’s and Don’ts of Breastfeeding

14 1 0 Breastfeeding MustHaves

Let it Flow

18 P IGEON Special:

Choosing the right pump

Got Milk?

Nursing on-the-Go

BACK TO WORK 22 C hallenges Only Working 2

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How I Did

Q&A

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EDITORIAL NOTE

Keeping Abreast

EDITORIAL TEAM

I read a comment by British actress Helena Bonham Carter, and as funny and trivial as it sounds, it made me sit up. “You know you're providing a real service. After carrying around your boobs for so long, it's nice to know they have an actual purpose.” The mother of two said. It may seem obvious, but I think this fact can sometimes be easily forgotten considering how our lady lumps have been potrayed and sexualized through the media. It’s not just about cleavages or cup size; I believe a woman’s breast is - first and foremost - about providing the best for our babies. Which is why we created this e-guide; to empower mothers as they embark on their breastfeeding journey. What are the benefits and importance of breastfeeding? How can you increase your milk supply and nurse on-the-go? Find answers to these questions in our sections Breast is Best and Tips and Tricks. We also discuss possible obstacles and offer solutions for working breastfeeding mothers in our Back to Work section. Feel like giving up? Read about other nursing mothers’ breastfeeding journey to get inspired in our Success Stories segment. We also compiled a list of commonly asked questions in our Q + A section. At some point, you may start to feel like a milking cow. You may start to feel pain when your breasts turn rock hard. You may start to feel frustrated when your baby refuses to latch on. No matter what bumps you face along the way, I hope this e-guide equips you with the right attitude and knowledge as you begin on your nursing journey.

Editor Michelle Ang Experts Loh Lee Lian (Mount Elizabeth Hospital) Yasa Yong Nyuk Yin (Mount Elizabeth Novena Hospital) Writers Dorothea Chow, Som Yew Ya, Jenny Tai, Marcie Mei, Noreen Yek Boussetta

Art & Design Art Director Michelle Ang

Marketing & Advertising

Business Development Manager Elaine Lau & Crystal Tan

Web Administration

All the breast and pump on!

Web Development Director Seow Poh Heng

P.S. We would love to have you in our discussions. Learn and grow with other breastfeeding mummies in our support group at: www.facebook. com/groups/breastfeedingwithlove/

For advertising enquiries, email us at advertise@thenewageparents.com

My best,

Do you have any stories, tips or any feedback to share? We love to hear from you! Drop us an email at mailbox@thenewageparents.com Connect with us on Facebook www.facebook.com/newagepregnancy www.facebook.com/newageparents

If you have any queries on any health condition for you and your child, you should seek professional medical advice.

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While every care is taken in the production of this e-guide, the publisher, editor and editorial team assume no responsibility for any inaccuracies and omission, which might arise. Opinions by the writers and advertisers are not necessarily those of the publisher and the editor. The articles in the e-guide are for references only.

2015 | Breastfeeding With Love E-guide

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Milking-ly Good Why should all mothers breastfeed? NOREEN YEK BOUSSETTA highlights eight benefits. Better immunity for babies

Breastmilk is designed to feed, nourish and protect the baby. It contains antibodies, vitamins and nutrients to prevent early childhood infections and illness. Reports have also shown that breastfed babies resist diseases like cancer and diabetes later on in their lives.

Mothers are less likely to develop illnesses

Research has proven that breastfeeding mothers are less likely to develop osteoporosis and have a lower risk of breast, uterine and ovarian cancer.

Economical

In Singapore, an average yearly milk expense per child varies from $500 to $800. Not only will you save on formula milk, but also on the milk bottles and accessories.

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Convenient and fuss-free

Most babies get up at night. This is especially frequent among newborns. By directly latching your baby and feeding them on demand, you save yourself the hassle of leaving the bedroom to prepare or warm up the milk.

No milk is wasted

There is no need to worry about preparing the bottle in public or wasting away a bottle of pre-prepared milk that has gone sour. Each time when our baby cries for milk, it is all 'ready' for their consumption.

Travel light

Because you don’t have to bring any bottles, milk supplies - packing and travelling is made simpler and lighter.

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Hassle-free

Bottle-fed babies are prone to allergies. Some may have reactions to formula milk and new mothers might have to do test-and-trial methods on the different types of formula brands before finding the most suitable one for their baby. On the other hand, breastfeeding mothers and their babies don’t have to go through this hassle as majority of babies do not reject their mothers’ milk.

Deeper bonds

Research has found that babies who are breastfed are closer to their mothers and have a special bonding with them. In an American study, scientists have found that “the breastfeeding mother has a stronger sense of confidence and connection with her baby while nursing him or her as compared to carrying the foetus in her womb”.

Breast Care 101 There may be times when you encounter pains and discomfort while breastfeeding your baby. Here are tips and prevention methods to help you care for you breasts.

Nipple soreness and pain

Is there pain and swelling around your nipples? This usually happens due to hormonal changes, skin diseases, breast infections, and infant positioning. SOLUTION Ensure your baby is positioned or latched onto your breast correctly Do not use creams, devices, ointments or other medications without consulting

health professionals as these might lead to more serious allergic complications To reduce the pain, try placing a warm compressor or tea bags Refrain from leaving wet breast pads on your breasts

Plugged milk ducts

This happens when the milk produced for a certain period is not released from the breast. SOLUTION Express as much milk as possible by breastfeeding regularly or pumping it manually.

Avoid wearing tight clothes or under wire bras If possible, you may try to increase your feeding times to extract more milk Avoid high-fat dairy products Alternate both breasts when you feed your baby

Engorgement

Engorgement is a condition characterised by the swelling of the breasts right after you begin breastfeeding your newborn. In most cases, you may feel some pain and experience some swelling. In the worst scenarios, your breasts may turn red, followed by fever. If it is not treated, the mother’s milk supply might be affected and nipples could be damaged. SOLUTION To decrease discomfort, express milk by hand and gently massage your breasts from time to time To feel more comfortable, apply gel packs or a cold towel Feed your baby regularly to extract your milk frequently

Breast infections

Mastitis is a breast infection condition where the breast is swollen, painful and red. This happens when the ducts are blocked and the breasts are not regularly emptied. SOLUTION A blocked milk duct can be remedied by gently massaging your breasts in feeding intervals When your milk is not totally consumed by your baby, try pumping out the milk left in your breasts Placing a moist, warm cloth on your breast can lessen the pain because of the warmth or heat Consult a medical specialist for antiinflammatory medicines Note: If you still experience prolonged pain or swelling, it is best to consult your doctor for professional advice.

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BREAST IS BEST

How Long Should I Breastfeed? Does the duration of breastfeeding matter? MARCIE MEI finds out.

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utrition-wise, breastmilk has many benefits, regardless of how long one manages to breastfeed. Even breastfeeding for the first few days of birth will give your baby the benefits of colostrum, which contains antibodies and helps with digestion. Breastmilk offers more than just nutrition for your baby in the first six months; it strengthens your baby's immune system, lowers the risk of infections and diarrheal disease. Breast-fed babies are also less likely to be obese, diabetic, develop cancer and have high blood pressure.

#1 Duration

The World Health Organization (WHO) and the American Academy of Pediatrics (AAP) recommends exclusive breastfeeding for six months and continued breastfeeding with solid foods for 12-24 months, or for as long as the mother and baby desire.

#2 Maintaining milk supply

Breastfeeding is controlled by hormones and one of which is prolactin that stimulates milk production. Every time the baby nurses, a signal is sent to the brain to trigger more prolactin release. If a mother ceases to feed for more than a few days, the prolactin hormone may drop so low that breastmilk production is affected. The best way to maintain milk supply is to continue breastfeeding, generally recommended to be on-demand especially for the first few months. Dr Bill Sears, America’s renowned paediatrician and author states that “on-demand feeding is increasingly recommended versus feeding babies on four-hour schedule. For working mothers, expressing milk at work is a way to maintain milk supply. Heidi Murkoff, author of the world's best-selling pregnancy and parenting series, "What to Expect", encourage mothers to ensure “each breast gets drained before you move on to the next.” That way mothers can ensure that their baby is getting both the foremilk (the thirst quencher, which is thinner) and the hindmilk (which is creamier, full of more fat and calories).

Quick Tip: A good rest ensures good nutrition. Don’t forget to drink enough fluids to maintain milk supply. Stress, illness, smoking, birth control and certain medication may temporarily decrease milk supply. If there is a decline in your milk supply, seek a lactation consultant for advice as prolonged milk reduction may be irreversible. #3 Possible obstacles

Going back to work is a common obstacle to mother’s efforts in continuing breastfeeding. Even if expressing milk at the workplace is feasible, a working mother who has just given birth may feel too tired and stressed with juggling work and baby to persevere with breastfeeding. Spousal support and encouragement is an important factor too. Dads can help out during nightfeedings, doing household chores and help to prepare nutritious meals so that mums can rest and focus on breastfeeding. Medical conditions and infection may develop for some after starting breastfeeding, for instance, breast infection, abscess, breast engorgement and sore nipples. This may dampen a mother's morale to continue to breastfeed. Another obstacle is time commitment. Each family’s situation is unique and sometimes, the effort and time required to continue breastfeeding may overwhelm a mother.

months old should be seen as a discovery process as they experience new tastes and textures, rather than trying to get a complete nutrition from solid foods. It is important because it meets your baby’s changing nutritional needs, in particular an increased need for iron. Delay in starting solids has also been observed to affect oral motor function and linked to an aversion to solid foods. How long you choose to breastfeed your baby is a personal decision. Don’t be disheartened should you face any criticisms or judgements from others. Whether it’s three months, one year or three years, your baby will reap the benefits and your love for them.

#4 Weaning

The AAP recommends starting solids at about six months old, with continued breastfeeding. There are various signs to observe whether your baby is ready for starting solids, such as the ability to sit up, hold the head up, grasp objects and move foods in the mouth. Starting solids at six

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Ready, Set, Latch How can you prepare for your breastfeeding journey? DOROTHEA CHOW shares four steps to start off right. STEP #1: Start with confidence At least a month before your due date, start to read up on breastfeeding. Arm yourself with knowledge and know what to look out for. Feeling confident is a big first step. Right from first day, try to get the lactation consultant attached to your hospital to help baby latch correctly. Pay specific attention to your breastfeeding posture and ways to check if baby is latched on properly. It might be good to get the contact of the lactation consultant prior to delivery, so that you can call her if she’s not in the hospital and her advice over the phone. Before you get discharged, make sure you are confident of latching baby by yourself.

when well-meaning relatives and nurses tell you ‘You don’t have enough milk’. The one who can help to wake up your sleepy newborn in-between suckles. If you encounter any breastfeeding issues like sore nipples or engorgement, he can help get cool tea bags for soreness, or warm compresses to help ease your discomfort. On particularly down days, when you feel like giving up, he’ll remind you why you decided to start this in the first place and be your pillar of support that gets you through another day.

STEP #2: Hubby’s gotta be on board Having a husband who fully supports your decision to breastfeed will go a long way especially when the going gets rough and you feel like giving up. He’s the brave soul who’ll stick up for you

STEP #3: Mind over matter Motherhood builds character. There’s an inner strength and resolve that you’ll need to tap into as you become a mum – and not just where breastfeeding is concerned. Your first few days after labour will pass by in a daze of sorts. You’ll likely be sleep deprived, alternating between joy and despair, full of self-doubt and barraged by a

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stream of visitors. Not to mention having your first taste of latching baby on, bathing baby, bringing baby for various tests and recovering from the labour process. Many times, you may find yourself plagued by doubts, criticism and fears. Decide right now that you can do it! Going into ‘battle’ with that kind of confidence and mental preparation is key to success. STEP #4: Practice The best way to feel confident about bringing baby out is to have a feel of the experience. If you are planning to use a sling or carrier, put baby in it and walk around the house or the neighbourhood. Give yourself at least a week to practice breastfeeding with a nursing cover if you hope to nurse your baby in public. Breastfeeding is definitely not a bed of roses, but it is all worth it. After the initial pain wears off, there is really nothing quite as calming and peaceful like cradling your baby close and watching him drink.

Designing The Perfect Nursery 10 TIPS TO GET YOU STARTED

BABIES:

Are They Always Cute And Cuddly?

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Childproof Your Home: Gates, Locks, Drawers and Latches? W W W . N E W A G E P R E G N A N C Y . C O M

TIPS AND TRICKS

Dos and Don’ts of Breastfeeding By Som Yew Ya

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DO’S

DON’TS

#Do breastfeed for a full 6 months A baby who is breastfeeding well does not need additional supplements before 6 months unless for health reasons. If your baby is gaining weight, your breastmilk is sufficient for the first 6 months. Thereafter, babies can start taking solid food, with continued breastfeeding for up to 2 years of age or beyond. #Do get off on a good start from Day One After birth, it is recommended to breastfeed your baby as soon as possible. This helps to establish your breastfeeding routine with your newborn and to kick start your milk production. It may take some time to get the hang of breastfeeding positions and latching techniques. Seek advice from a lactation consultant or trained nurse during your time in the ward. For some hospitals, the lactation consultant service is offered when you are in the delivery ward. #Do continue to breastfeed during engorgement and sickness Engorgement usually goes away within 1 to 2 days (without any treatment). Besides direct breastfeeding, you may also express your milk to relieve the tension in the nipple and store the milk for subsequent use. Expressing your milk not only stimulates milk production but also relieves blocked ducts. With some exceptions, a mother who is ill should still be able to breastfeed. Continued breastfeeding will protect your baby from infection and less likely to fall sick. With a few exceptions, breastmilk is ideal for a baby’s gut infection e.g. diarrhoea and vomiting. Each conditions are unique, so do check with your paediatrician when in doubt. #Do plan ahead of time to prepare your caregiver Be prepared to have someone around who can look after your baby when you need to be away. Whether it is your husband, a relative, or a caregiver, it is vital that your caregiver is supportive and in line with your breastfeeding philosophy. Have a discussion with your caregiver and if required, educate and explain how you would like your baby to be cared for. Inform them that you have chosen to breastfeed your baby exclusively so that no additional liquids or formulas should be given without your permission. This will reduce misconceptions between you and your caregiver. Allow time for this transition to happen.

#Don't assume all doctors know you are breastfeeding Do inform your doctor that you are breastfeeding should you require any medications. It can be easy to assume this when you have been breastfeeding for a longer period, or if you are visiting different doctors or buying drugs over the counter. Some medications enter the milk and cause contraindications to breastfeeding. Some clinics may be unsure and just recommend the mother to stop breastfeeding (just in case) until recovery. In most situations, doctors are able to check against resources and prescribe alternative medications. Most medications also come with prescription leaflets to check if it is suitable for pregnant or lactating mothers. #Don't be discouraged in the first few days of breastfeeding The first milk is dense and is called colostrum. In the early days only a small quantity may be produced. There is no need to pump it out to see how much you have - this is not a reflection of your ability to breastfeed. Instead of being too concerned about the volume, focus on getting a proper latch so that your baby can feed well. Milk production acts on a demand and supply principle, and with perseverance, the milk production will build up into a stable supply over time. #Don’t introduce the baby to bottle feeding too early Early introduction of the pacifier or bottle feeding may interfere with breastfeeding. The baby may be confused as the sucking actions differ. Time should be given for good breastfeeding practices (e.g. latching and sucking) to be formed before bottles are introduced. Once the breastfeeding routine has been established, the baby can be adjusted to feeding expressed breastmilk from a bottle. It is recommended to introduce the bottle after 4 to 6 weeks. The frequency can be gradually increased and adjusted when you go back to work.

#Do know where you can get support Most hospitals provide lactation and post-partum care services. There are also online resources and breastfeeding groups, where you can engage and discuss with other mothers. Dr Jack Newman has an extensive online resources which includes articles and videos that you can refer to for additional information.

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TIPS AND TRICKS

Breastfeeding Must-Haves By Jenny Tai

BREAST PUMP PIGEON new range of breast pumps, Electric Breast Pump Pro, allows you to customise the pumping style according to your breast condition. The Expression Mode enables you to tailor the pressure suction power and speed to express hind milk faster, while

the Stimulation Mode mimics a baby’s natural sucking rhythm to gently stimulate your breast, initiating milk flow. For convenient pumping on-the-go or at work, try PIGEON Electric Breast Pump Portable, a lightweight one-part electric pump, or PIGEON Manual Breast Pump, which comes with an ergonomic easy-express handle that reduces hand fatigue. All the pumps come fitted with Comfort ProperFit™ Soft Silicone Cushion, made from soft and flexible silicone that is air-tight and moulds easily to your breast, preventing air leakage during expression.

BABY BOTTLES Breastfeeding and pumping is

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enough work as it is, so you’ll need the most reliable and practical bottle to complement your breastfeeding journey - one that enables you and your baby to transit easily from breast to bottle. PIGEON SofTouch™ Peristaltic PLUS bottle is designed from a baby’s perspective to enhance the unique undulating motion of a baby’s tongue, which removes milk from a mother’s nipple. This encourages your baby to use an accurate sucking pattern and replicate the natural feeding motion learned at the breast, minimising nipple confusion at the same time.

INSULATED COOLER BAG TO TRANSPORT YOUR HARDPUMPED MILK Have a cooler bag and ice packs on hand when you pump outside of home so that you can store and transport your milk without worrying about it going bad.

NUTRITIONAL SUPPLEMENT FOR BREASTFEEDING MOTHERS To ensure you’re meeting all the nutritional needs when breastfeeding, take a nutritional supplement on top of eating a wellbalanced diet. Nestlé Mom & Me Maternal Supplement is a premium milk supplement for pregnant and nursing mums that contains important nutrients like DHA, iron, calcium, folic acid, vitamin D, and probiotics to support your baby’s growth and development. It’s tasty on its own but feel free to add it in fruit smoothies or chocolate beverages.

NURSING PADS Stock up on nursing pads to absorb any leakages, and always pack some on-the-go in your purse and diaper bag. You can choose from disposable nursing pads or washable, reusable ones. PIGEON Breast Pads Honeycomb comes with a special absorbent polymer and stay-dry honeycomb lining to draw excess milk quickly and spreads evenly into the core of the pad, keeping the skin and clothing dry. This means leak proof coverage and no more embarrassing wet spots on your blouse or shirt!

NIPPLE CREAM Nipple cream is a lifesaver for sore, chapped nipples. Made of 100% ultra pure modified lanolin and hypoallergenic, PIGEON Nipple Care Cream is ideal for breastfeeding mothers to protect or heal their cracked nipples. Fragrance free, it contains no additives of any kind, making it safe for your baby.

NURSING BRAS Nursing bras make it easier to breastfeed without removing or unclasping your bra. They usually feature fold-down cups that unhook from the straps. There are many styles to choose from –

BREASTMILK STORAGE BAGS Freeze your milk in pre-sterilized, leakproof PIGEON Breastmilk Storage Bags for your backup stash. For optimal freshness and protection from tearing, place the breastmilk storage bags inside a hard food storage container with a tightly closed lid, and always put them in the back of the freezer where the temperature is coolest. including sexier options that look like lingerie, which are nice because let’s face it, it’s hard to feel cute or sexy when your breasts are leaking and you’ve got spit-up on you! Whatever style you go with, make sure it’s soft and comfortable.

NURSING COVER You’re outside, the baby’s hungry, and there’s no breastfeeding room in sight. Nervous about nursing in public? Throw on a nursing cover and you’re good to go. Choose one with a thinner fabric so that your little one won’t get too hot underneath the cover. Another option is to use an Aden + Anais muslin swaddle blanket as a nursing cover. Simply fold it in a triangle and tie the ends together around your neck. It’s large enough to provide full coverage, and extremely lightweight

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and breathable, ensuring comfort for the baby and yourself in warm weather.

#10

NURSING APPAREL Many nursing tops are designed with discreet slits near the breasts that can be pulled to the side, allowing you to nurse your baby modestly without being in an awkward state of undress. Even if you don’t want to buy nursing pieces, which can be expensive, it will save you a lot of time and stress if you add some nursingfriendly outfits to your wardrobe. These can be regular clothes that are simply functional enough for breastfeeding. Some options include button-downs, tops with built-in bra cups, or loose-fitting, deep v-neck tees that can easily be pulled down to breastfeed without requiring you to lift up your shirt.

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Let it

Flow Want to give your baby a steady flow of your liquid gold? Lactation consultant LOH LEE LIAN from Mount Elizabeth Hospital provides helpful tips on how to increase milk supply.

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TIPS AND TRICKS

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The first hour Nurse your newborn within an hour after birth and maintain as much skin-to-skin contact as possible because a baby feeds well when he is warm. When the baby is breastfeeding well, there is demand and thus milk supply will follow.

②

Rooming-in at the hospital Rooming-in day and night enables a mother to respond to a baby’s hunger cues and to feed frequently to maintain supply.

③

Feed on demand Feed your baby on demand, and not on a fixed schedule or time. Your baby should be fed based on hunger cues and demands, as the appetite varies with each feed. Frequent feeding stimulates your body to produce more milk and effective removal of milk helps to prevent stagnation and breast engorgement. Breastfeeding is based on demand and supply. Where there is regular demand, i.e. when a baby suckles on the breast, the body will stimulate the release of the hormones Prolactin and Oxytocin, which activates the milk supply. Supply may be affected by psychological causes such as anxiety, worry, and lack of sleep.

④

Massage your breasts Encourage milk letdown and flow by massaging your breasts and applying warmth to the breasts before nursing.

⑤

Get a good latch on Establish a good position and correct latching techniques to ensure effective milk transfer during suckling.

⑥

Avoid bottles, pacifiers or nipples shields Exposing baby to them too early may create nipple confusion. Avoid them during the first few weeks, unless necessary.

⑦

Avoid milk formula unless medically indicated.

⑧

Eat a balanced diet Nursing mothers should eat a healthy, balanced and nutritious diet, as 500 calories more are needed daily to produce breastmilk.

⑨

Drink plenty of fluids A mother needs to be sufficiently hydrated to maintain milk supply. Take plenty of fluids.

⑩

Get enough rest Support and encouragement from family members on breastfeeding and with sufficient rest and sleep in-between will provide positive emotional well-being and thus influence good milk production.

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Supplements Taking breastmilk supplements or galactogoques may help to increase milk flow. Examples of herbal supplements that may help are fennel tea, fenugreek capsules and blessed thistle tea. These can be bought off the counter. Doctors may also prescribe medication such as Domperidone and Metoclopromide.

⑫

Seek professional help To avoid any breastfeeding problems, do see a lactation consultant to ensure that position and latching is done correctly from the start. This will ensure that the baby is removing milk effectively at each nursing session.

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PIGEON SPECIAL

Choosing The Right Pump Magdalyn was ecstatic to finally meet her beautiful baby after ten months of waiting. As a new mum, she was enthusiastically applying all that she has read online and in parenting books. One thing’s for sure, Magdalyn knew she wanted to breastfeed baby Zac exclusively. After completing the routine check-up

her on how to breastfeed her newborn.

in the nursery, baby Zac was finally in

She tried alternating between latching

her arms! The lactation consultant came

Zac and expressing her milk out, but

by to check on Magdalyn and guided

nothing seemed to work. All Magdalyn

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had was just a few drops of colostrum. She was told that this was normal and the milk will slowly kick in after a few days. But after bringing Zac home, Magdalyn struggled with the daily feeding for a week. To add on, her baby boy didn’t seem to be gaining much weight. She was lost and saddened to hear her paediatrician asking her to top up with formula milk. Magdalyn didn’t give up. She was determined to give her baby the best.

She decided to invest in a breast pump to alternate between latching and pumping, hoping that it would help to stimulate more milk production. She bought an electric breast pump that allowed her to choose different pressure levels and suction power for easy use. Slowly but surely, her milk supply slowly increased over the days and she was able to supply sufficient milk for baby Zac’s daily feeds. Her hard work paid off with perseverance, and with the help of an effective breast pump. Find out which pumps you can go for with this simple checklist.

you can pump whenever there’s a need to. With an ergonomic easy-express handle, there is no need to deal with hand fatigue. Light in weight, this makes a handy pump for travelling mothers. 4. I need a pump that is easy to bring around to carry to-and-fro from work. 5. I want a pump that is not manual. 6. I want to be able to choose the suction pressure of the pump for comfort.

More milk or less fuss: All the pumps come with an adjustable 2-phase technology. Go for the Stimulation mode to gently perk your breasts. Looking for a stronger milk flow? Switch to Expression mode to control the suction power.

Which breast pump best suits your lifestyle? 1. I need a simple and affordable pump that allows me to express anytime and anywhere. 2. I want a breast bump that is easy to use and clean. 3. I want a breast pump that is light and durable.

No airy business: The pumps are

all fitted with two sizes of Comfort ProperFit™ flange made of soft silicon material. The air-tight ring fits snuggly on your breasts, preventing any air leakage during your pumping sessions.

Go for PIGEON Electric Breast Pump Portable. Electric or battery

operated, this pump allows you to choose the mode you want to suit the situation, without having to compromise your comfort. 7. I need a pump that is fast and efficient. 8. I want to be able to choose the speed and suction pressure of my breast pump.

Go for PIGEON Manual Breast Pump. The adjustable 2-phase

technology - Stimulation and Expression mode - allows you to express more milk with less hassle! Not electric operated,

Go for PIGEON Electric Breast Pump Pro This pump comes with 7

pressure levels and 4 levels of suction speed. An essential aid for every busy working mother, the customized pressure and speed pumping stimulates a natural feeding pattern which will help to increase milk production.

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PIGEON Manual Breast Pump is retailing at $79.90, Electric Breast Pump Portable is retailing at $159.00 and Electric Breast Pump Pro is retailing at $279.00. All PIGEON breast pumps are available at major departmental stores.

An Advocate for Breastfeeding

PIGEON understands the problems and worries breastfeeding mothers face. After years of extensive research, PIGEON new range of innovative breast pumps help all mothers to express for their babies comfortably and successfully. PIGEON also supports new parents on their breastfeeding journey with informative resources and advice. Visit www.facebook.com/ PigeonSingapore and www.pigeon. com.sg for more information.

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What time is it?

Empty your milk after each feed so that your breasts have sufficient time to be 'full' again for the next feed. If you are pumping outside of your home, do it at an appropriate time before your breasts become engorged. Try not to go more than 3 to 4 hours without expressing. If you are trying to build up a supply in the freezer, fit in an additional pumping session in the early morning. That's when milk supply is the highest.

Two is better than one

Pumping on both breasts yields more milk at a faster rate. Prolactin levels are also higher during a double-pumping session. Remember not to pump for more than 15 minutes on each side. If your baby is feeding on one side, your milk ejection reflex will be stimulated and this facilitates easy collection of milk on the other side.

If the pump fits

Got Milk?

How can we have a successful pumping session? SOM YEW YA delves into the art of expressing breastmilk. 20

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If not done properly, pumping may cause nipple soreness. Be clear of how to use the pump; read the guidelines thoroughly and ask for help if you’re unsure. Pumping should not cause any pain. If it does, try reducing the suction power, ensure your nipple is in the center of the flange and shorten your session. The nipple should not rub against the flange when you’re expressing. If you’ve tried all the above and still feel pain or discomfort, it is best to try another pump.

Set up a routine

Having a routine conditions your milk ejection reflex. These include the place, time and things you do before your session. For example, the area at home where you express your milk, preparing your

equipment, drinking a glass of water or listening to a special playlist. If you are at work, identify a place and time where you can comfortably express without distractions.

Stimulating the "let-down" reflex

If you are expressing milk and your baby is not present with you, some ways to facilitate a let-down reflex would be to think of your baby, look at your baby’s photo or listen to a song or music that makes you think of your baby.

Prime your session

Massage your breasts before you pump. Using your fingertips, make small circles on the breast tissue starting from the armpit area. Continue doing this around the perimeter of the breast moving towards the areola in a spiral pattern. Finish the massage by making a few long strokes from the chest wall towards the areola, doing this around your breast. Breast massages also help if your milk flow decelerates during pumping.

Pump regularly

If possible, it would be good to express every three hours. Expressing regularly helps to decrease the possibility for engorgement and helps maintain your milk supply. Adding more pumping sessions is more helpful then extending existing sessions. However, if you have to work, pump during breaks or at night.

Trial and error

If certain methods are not working for you or making you uncomfortable, try to vary what you are doing until it works. Try not to multitask and add in more pumping sessions if you can.

TIPS AND TRICKS

Nursing On-The-Go Five quick nursing tips and tricks for the out-and-about mamas. By NOREEN YEK BOUSSETTA TIP #1 BAG IT

TIP #3 PUMP IT

Going out with babies means more things to bring! Go for totes and diaper bags and be prepared to leave home at least with two bags or put all your items in a big diaper bag.

Breast pumps are used to express your milk and especially useful when you can’t be around to nurse your baby the whole day. Electric or manual? Which pump should you get?

Trick: The “baby” bag or diaper bag has to be large to accommodate all the necessary baby items such as diapers, bottles, accessories and extra clothing. Go for a bag that has compartments for easy storage. Sort your small items in transparent zip-lock plastic bags. This way, it is easier to search for them when the need arises.

Trick: Electric pumps can be a little costly and heavier to carry around, but effective for babies who need frequent feedings. Breastmilk can be expressed quickly and safely with an electrical pump. The manual one is cheaper, lighter in weight and can be slipped into the diaper bag easily. Since it is hand-operated, there’s no need to worry about the pump ‘dying’ on you.

TIP #2 GET COVERED Invest in a nursing wrap, cotton poncho or cover. They are designed to help mothers feed their babies comfortably, with some privacy and security. These will come in handy when you need to nurse discreetly in public. Trick: Choose an elegant-looking nursing cover in your favourite color and design. Pick one that is made of soft fabric material, as it is more comfortable and promotes air flow.

TIP #4 NURSING PILLOW Breastfeeding mums tend to hunch when they breastfeed their babies. Imagine if your baby demands to be fed six to seven times per day, it can really take a toll on your posture. A nursing pillow helps to lessen the stress on your shoulders and get your baby in the right position for the perfect latch-on. Trick: Look out for various and special features that come together with the

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nursing pillow. Some have pockets and inserts where you can store baby’s toys or accessories. Others may come with a Velcro strap that will help your baby stay put while he or she feeds. Do check the pillow’s washing instructions. Some nursing pillows can only be hand-washed, while others are machine-washable or come with a removable cover.

I NVEST IN A GOOD TIP #5 BOTTLE WARMER Warming bottles can be a difficult task, especially when you are constantly on the move. Mothers may approach the nearest restaurant to heat up the baby bottles in their microwave ovens. However, there have been studies that show microwave heating of milk and food is harmful for babies. Getting a bottle warmer might be a better solution. Trick: There are various types of models in the market. Make sure to choose a bottle warmer that can heat up both baby bottles and jars in minutes. Consider a portable one which can be activated with a push-on button; it saves time, easy to use and practical.

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Challenges Only Working Breastfeeding Mothers Can Understand Breastfeeding alone has its own set of challenges. You may experience sore nipples and engorgement, or go through an emotional rollercoaster ride of dealing with your baby’s refusal to feed. For mummies returning to work, there’s an added factor – expressing breastmilk at work.

lthough health experts recommend all mothers to breastfeed their newborn for at least the first six months, sadly, mothers are often discouraged to give up breastfeeding when they return to work, before the 6 months. In a survey conducted by NTUC U Family, 51% of the mothers said they stopped providing breastmilk to their child because of workplace challenges. CHALLENGE #1: Lack of time to express breastmilk Due to the nature of some industries and professions, it may be difficult for mothers to make use of the full maternity leave

entitlement at one go. Sometimes, mothers have to go back to work after two or three months, depending on their job, where the remaining leave will be used over time. With such work schedules, it can be tough for mothers to find the time to express their breastmilk regularly. Talk to your boss, and be familiar with your pumping equipment Sit down and speak to your boss about your current situation and discuss if an alternative work arrangement or schedule is possible during this period. To maximise your pumping sessions at work, it’s important to have practice sessions at home beforehand, for a

Breastfeeding in session! Legal Counsel Chu Wen Ling makes breastfeeding work for her with a little innovation and lots of perseverance.

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seamless and fuss-free transition. Before getting a pump, assess your work activities to see what types of pump best fits your job role. Manual or Electronic? Dual or single pump? CHALLENGE #2: Lack of proper nursing facilities or resources Some workplaces do not have proper nursing rooms for breastfeeding mothers due to various reasons. As a result, some mothers resort to pumping their milk in the store room or office toilet. This is strongly discouraged as there could be a chance of milk contamination from touching the toilet door handles, toilet seats, and toilet bowl. Improvise No nursing rooms at work? That’s okay. All you need is a little innovation and improvisation. Take Legal Counsel Chu Wen Ling as an example. A mother of two who breastfed for six months, Wen Ling created her own nursing corner at her work desk. She used a big umbrella with signs to inform people that she was breastfeeding and to cover herself while she expressed her milk. CHALLENGE #3: Unsupportive bosses or returning to a male dominated industry Even if the workplace has facilities that accomodate to working mothers, many companies have not implemented flexible working hours for their employees. It’s important to have employers who are profamily; to foster a company culture that is empathetic to the needs of mothers returning to work after birth.

community and workplaces. U Family started the Project Liquid Gold to raise awareness of the importance of breastfeeding, to advocate for more support for new mothers who are returning to work after their maternity leave. CHALLENGE #4: Colleagues who are not aware Getting the weird looks from your colleagues when you go for all these ‘breaks’ during the day? Without proper communication, they may misunderstand your frequent ‘breaks’ as something else. This may lead to unwanted tension and unhappiness. Tell your colleagues Don’t be shy to let them know why you are taking these ‘breaks’ to avoid any misunderstanding or assumptions. If you have a fellow colleague who just came back from maternity leave, show some concern and offer your help. Little gestures go a long way. Even though she was not a mother herself, Ms Wan Fen, who works at the Singapore Eye Research Institute, went out of her way for her breastfeeding colleague. She converted a room in the office to a lactation room by covering up a glass panel in the room with huge posters. CHALLENGE #5: Change in lifestyle Breastfeeding requires significant mental and emotional commitment as well as investment in time. You may need to sacrifice ‘me’ time to express milk or make special efforts to take care of your baby. It requires sheer will power and discipline to express regularly and nurse your baby for the long haul.

Prep youself and plan ahead To get a headstart, practice pumping at home and check if you have easy-access clothes that are also formal enough to wear to work. Make a schedule of when you need to pump so you can plan ahead to avoid clashes with any meetings. A short first week back at work will also help to ease your transition. You can plan to start on a Wednesday or Thursday after your maternity leave. For mothers who run their own business, it can be difficult to squeeze in time to pump especially when there is a shortage of manpower. But that did not deter Kristy Melissa, owner and cafe manager of Little Pancakes. Even though she had a hectic schedule of running her own cafe, she was set on breastfeeding for as long as she can. After her first month, she went back to work and used a hands-free pump set so that she can pump while taking orders, scrambling eggs, making coffee or washing the dishes. Now that’s one committed and determined mama! WORKING AND BREASTFEEDING IS POSSIBLE No matter what breastfeeding challenges you face at work, know that it is possible to continue your breastfeeding journey. With the right set of attitude, knowledge and practice, coupled with a supportive environment, breastfeeding can become a natural part of your working life. Don’t lose faith!

Speak up Sometimes, bosses do not know the benefits and importance of breastfeeding. They could also be unaware of the needs of a working mother. Play your part by voicing your struggles and letting them know about the benefits of breastfeeding. Maintain an open and honest communication with your supervisors. If a flexible work arrangement is in place, ensure that your performance and productivity remain consistent. Need help to talk to your supervisor? U Family, an NTUC initiative, is the voice for working families. They advocate the building of strong and happy families by championing pro-family measures at the

Pumping on-the-go made possible using a hands-free pump set.

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Pumping At Work M Y T H S

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Most working mothers are usually too shy to seek help from their employers, out of fear of being judged as too ‘demanding’ or ‘unprofessional’. MICHELLE ANG debunks some common myths of breastfeeding at work.

“Can’t mothers express their milk before and after work? Why should my colleague’s or employee's breastfeeding routine matter to me?”

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A mother needs to express milk about 2 to 3 times a day in order to sustain her milk supply for her baby. Not expressing breastmilk regularly may also cause engorgement, which can be very uncomfortable and painful. Engorgement

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can lead to a condition called Mastitis, which is an infection of the breast tissue and can cause fever and chills. For optimum nutrition, babies should be breastfeed exclusively for the first 6 months, recommended by the World Health Organisation (WHO). As maternity leave in Singapore is only four months, many mothers need to continue breastfeeding after going back to work. The WHO also recommends mothers to continue to breastfeed for up to 2 years

and beyond, while introducing solid foods.

“Breastfeeding is a mother’s job. It doesn’t concern the workplace.”

In a survey about breastfeeding at the workplace conducted by NTUC U Family, 51% of mothers stopped providing breastmilk to their child because of workplace challenges such as the lack of time, flexibility, lack of space, nature of work and lack of support. 65% claimed they did not have exclusive nursing space in their office. This shows that working breastfeeding mothers feel unsupported at their workplace and employers’ support is crucial in cultivating an encouraging and family-friendly culture at work.

“Wouldn’t breastfeeding at work affect productivity?”

Breastmilk helps in a baby’s immunity. Studies in the USA have shown that breastfed babies had statistically fewer episodes of illness as compared to formula-fed infants. This means reduced absenteeism in the work place. With less absenteeism, work will not be disrupted. Breastfeeding mothers are also more likely to return to work and do so earlier if employers extend support to continue breastfeeding. This saves employers the cost of replacing and training new workers. Mothers usually take about 20 to 30 minutes to express milk. Phua Pek Lin, a working mum clarifies, “Yes, we can multi-task while expressing. We can be replying emails or planning for some important presentations.” Joyce Yap, another working mum adds, “I can still answer calls, do tele-conferencing, I can still work on my laptop. So expressing milk doesn’t really affect my work life.”

It is shown that employees are more loyal to companies with family-friendly policies. This leads to easier employee recruitment, better public image and higher shareholder value. Bosses who support their workers to continue to breastfeed find that the savings in reduced absenteeism and recruitment costs far outweigh that of providing breaks and facilities for breastfeeding.

“Okay, I’m in the breastfeeding bandwagon. But I don’t have the resources and skills to educate my people.”

To prepare workplaces to be baby friendly, NTUC U Family and The Association for Breastfeeding Advocacy Singapore (ABAS) have jointly developed a Workplace Breastfeeding Mentor Programme to provide information and support to working mums who are new to breastfeeding. Participants will learn the basics of breastfeeding, how to make the transition to expressing milk at work after their maternity leave, and how to support

other breastfeeding colleagues.

“As a mum, I think this is a great idea! But how can I inform and convince my employer about this?”

Interested mothers can seek their employers support to let them attend the 1-day course. You can forward this information to your HR department or inform your supervisor. You can also highlight the benefits of breastfeeding and share why you think why your supervisor’s support is invaluable. Sometimes, as the only nursing mother in the office, you may feel alone or shy to ask for space and time to express milk at work. It’s not a common topic or a conversation starter where you can openly discuss at the office, unless your workplace consists of mostly women and mothers. But you don’t and shouldn’t have to feel that way. Breastfeeding at the workplace is feasible and possible when employers and employees communicate honestly and work together towards a common goal.

“How can this benefit my team if there is only a small percentage of females and mothers?”

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Workplace Breastfeeding Mentor Programme

A 1-day course held in NTUC Centre at One Marina Boulevard, participants from the programme would be trained by accredited trainers from The Association for Breastfeeding Advocacy Singapore. The course is suitable for expectant mums who are keen to continue breastfeeding at work after their

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maternity leave, mums who are currently breastfeeding or have breastfeeding experience and would like to support other colleagues in their breastfeeding journey. To find out more about the Workplace Breastfeeding Mentor Programme, contact U Family at ufamily@ntuc.org.sg An NTUC initiative, U Family is the voice for working families. They advocate the building of strong and

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happy families by championing worklife harmony. Join U Family at www. ufamily.org.sg Project Liquid Gold is an initiative by U Family targeted to raise awareness of the importance of breastfeeding to advocate for more support for new mothers who are returning to work after their maternity leave. For more information, go to www.ufamily.org.sg

WORKING MUMS CAN BREASTFEED Are you a mum who would love to see more baby-friendly workplaces? Tell us how we can help you or join us as a Workplace Breastfeeding Mentor today! Drop us an email at ufamily@ntuc.org.sg and we will be in touch with you. For more details on Project Liquid Gold, please visit www.ufamily.org.sg/plg

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Breastfeeding Hacks For Busy Mamas MARCIE MEI spills the beans on how you can find more time to pump after returning to work.

1 Co-sleep with baby

Consider to co-sleep in the initial few months and get a baby cot that you can place right beside your bed. This will help parents to get more rest, especially with the frequent nursing during the first few months.

2 Get a hands-free pump and nursing bra Invest in a breast pump that directly collects the pumped milk into a cup, allowing you to pump hands-free with your clothes on. With these pumps, you can pump and complete other tasks on hand. Go for nursing bras that are specially designed for hands-free pumping. There are also bras that allow mothers to nurse on one breast and pump on the other. The fitting of the bra has to be the top priority in order to support the hands-free pumping.

3 Store breastmilk in smaller quantities

For the extra milk that has been pumped, you can freeze them in storage bags. Storing breastmilk in smaller quantity allows the milk to be thawed quickly.

4 Breastmilk popsicles

For babies who are teething, why not give them a breastmilk pop? Your baby not only gets a nutritional snack, they also get to soothe their gums.

5 Get your beauty sleep

It may seem strange to suggest resting when a busy mum does not have enough time! Not resting enough is likely to cause more issues such as low breast milk supply, poor immunity, possibly recurring mastitis and the lack of motivation to persist in breastfeeding.

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Is Singapore Becoming More BreastfeedingFriendly? Do you know that there are more than 150 breastfeeding-friendly spaces in Singapore? And that’s excluding indoor playgrounds! But it’s not just the nursing rooms that have been increasing in numbers. Parents, companies and the community are more aware of the benefits and practice of breastfeeding.

1. Shop and breastfeed with ease

Shopping malls and attractions in Singapore today are equipped with nursing rooms. The facilities, hygiene and quality of each nursing room may differ from various malls, but most of them are equipped with the basic amenities. For mamas on-the-go, you can refer to this list for easy reference on the public spaces with nursing rooms in Singapore: www.thenewageparents.com/ public-places-to-breastfeed-in-singapore.

2. Nursing rooms at community centres and public spaces

Community centres are now upgrading their facilities to cater to young families. If you stay around Yishun, check out the newly revamped Nee Soon East Community Club which boasts a well-furbished breastfeeding room. It not only comes equipped with a diaper changing table, it even has toys to keep your other kids occupied while you nurse your baby! The direction for the

Community Club to be baby-friendly was put forth by Mr Patrick Tay, the previous Member of Parliment for Nee Soon East, who saw the need for more places to be accessible to young families.

3. ‘Liquid Gold’ companies For companies with pro breastfeeding policies and set aside lactation space and breaks for working mothers, their efforts have not gone unnoticed. NTUC U Family hands out the Liquid Gold Awards every year, in recognition of their work and dedication in implementing breastfeedingfriendly policies and facilities at the work place. One company who has received the Liquid Gold award is DBS Bank. The office building which is serviced by three different lift lobbies has a lactation room at each lobby. The bank, which won the Liquid Gold Nurturing Workplace award, also took the initiative to upgrade the size of the fridge in the lactation room, when more breastfeeding mums returned to work. Even companies that have predominantly male workers have been recongised. Keppel Fels set up a room just for nursing mums and provided flexible nursing breaks, despite being a male dominated workplace.

4. All the help you need

U Family, an NTUC initiative, is the voice for working families. They advocate

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the building of strong and happy families by championing pro-family measures at the community and workplaces. U Family started theProject Liquid Gold to raise awareness of the importance of breastfeeding, to advocate for more support for new mothers who are returning to work after their maternity leave. The Association for Breastfeeding Advocacy Singapore (ABAS) is an alliance of healthcare institutions, healthcare professionals’ associations, mother-support groups and individual healthcare professionals in private practice who see breastfeeding of infants as an important fundamental building block. To urge employers to look into the provision of adequate facilities, probreastfeeding policies, and foster a culture of understanding and support among employees, NTUC U Family and The Association for Breastfeeding Advocacy Singapore (ABAS) have jointly developed a Workplace Breastfeeding Mentor Programme to provide information and support to new mothers in breastfeeding. In the programme, participants will learn the basics of breastfeeding; how to make the transition to expressing milk at work after returning from their maternity leave, and how to support other breastfeeding colleagues. After attending the course, Low E-wen and Jeslyn Thong of Public Utilities Board were inspired to promote a supportive culture in their workplace - they organised a talk and sharing session for their other breastfeeding colleagues. Interested to learn more? Seek your employers’ support to let you attend this 1-day course. If you wish to find out more about the programme, contact U Family at ufamily@ntuc.org.sg Online Support Groups There are many support groups for breastfeeding mothers, both offline and online. Do a quick search on Facebook and you will be able to find private and closed breastfeeding groups available. One such group you can join is Breastfeeding with Love (www.facebook. com/groups/breastfeedingwithlove)

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Family First If you had a choice to choose your ideal company to work for, what sort of entitlements or benefits do you look out for? One that gives you work-life balance? A handsome pay? Opportunities for professional growth? Or all of the above? We round up our top five familyfriendly companies in Singapore.

FAMILY-FRIENDLY AMENITIES AND PRACTICES AT KKH Fully equipped lactation room

Provides hospital grade pumps, steam sterilisers and baby bottle detergent for their staff’s usage Workplace child care centre (solely for children of employees) Medical benefits coverage for eligible family members Family relocation expenses for foreign employees Marriage gift, newborn gift, get well gift ‘Wind Beneath My Wings’ award, to recognise supportive family members KKH Family Day and supporting initiatives KKH values people and views employment as a long-term commitment towards enabling their staff with the skills and the environment to perform their best and excel in their areas of work.

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KK Women’s and Children’s Hospital (KKH)

WHY IT'S FAMILY-FRIENDLY Females account for a whopping 89% of the hospital’s workforce. Many of their employees who used to work 5.5 days or 6 days a week are now working the same number of hours but over a shorter period (e.g. 5 day 40-hour week). This arrangement has benefitted many of their nurses who now have 2 days off a week. Employees can also work a compressed schedule of 4 days a week, 10 hours a day instead of 8 hours.

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Sharon Ling Ai Chien, who works as a medical technologist at the Department of Pathology and Laboratory Medicine at KKH acknowledges that having an understanding supervisor coupled with a flexible work scheme has helped ease her transition back to work after her maternity leave. “I was able to convert my full-time working status to a regular part-time after becoming a mother to take care of my newborn. When I made the switch, my superior covered my duties during my absence. When my children were unwell and I needed to take urgent leave, he would assure me not to worry about work and that my kids are my priority.”

NTUC Income

WHY IT'S FAMILY-FRIENDLY With a total staff strength of 1,479, of which 63.9% are women, NTUC Income employees can request to work from home or to work part-time, e.g. a few work days per week or half days. FAMILY-FRIENDLY AMENITIES AND PRACTICES AT NTUC INCOME Provision of lactation room Nancy Sim Tung Lik, a senior human

resources executive who has been with NTUC Income since 2007, is grateful for the breastfeeding facilities at the office when she returned from her maternity leave. “I was provided a locker in the room to keep my pumping equipment. The relevant department also checked the fridge regularly to ensure that it was not used to store anything other than breastmilk.” Employee can utilise the i-flex dollar for their child, e.g. medical expenses, dental expenses, child Care expenses (such as childcare registration/enrolment fees, school text books and uniforms) and holiday expenses.

BOSSES TAKE NOTE! To prepare workplaces to be baby friendly, NTUC U Family and The Association for Breastfeeding Advocacy Singapore (ABAS) have jointly developed a 1-day Workplace Breastfeeding Mentor Programme to provide information and support to new mothers in breastfeeding. Employers can support their staff to attend the course to learn how to continue their breastfeeding journey while at work, and how to mentor other colleagues who are new mothers too. Companies can also tap on the Work-Life Grant and U Flex Family Friendly Grant to help working caregivers manage responsibilities both at work and at home. Contact U Family at ufamily@ntuc.org.sg for more info.

Ernst & Young LLP

WHY IT'S FAMILY-FRIENDLY With a total staff strength of 2375, and women making up 56% of the total count, the company believes that flexibility at the workplace motivates and energizes staff, resulting in increased engagement and productivity. FlexPlace: staff can work anywhere,

either in client’s place, office or from home  FlexTime: permits fluctuating start and end times during the workday, although the employee still has the same number of regularly scheduled weekly hours  FlexWork: promotes a flexible work culture by assisting individuals to balance their work and personal responsibilities. OTHER FAMILY-FRIENDLY AMENITIES AND PRACTICES AT ERNST & YOUNG SOLUTIONS LLP  Lactation rooms  Employees can apply for medical leave to look after their children if their childcare leave has been exhausted Human Resource Specialist Seet Kok Heng explained how the flexible working arrangement in his company allowed him to be at home to support his wife to take care of their baby girl. “At Ernst & Young, I am given the option to start work at 8.00am and knock off at 5.00pm. I am also able to bring my baby for vaccination and medical checkups as I could apply for medical leave, even if my childcare leave has been exhausted.”

OCBC Bank

WHY IT'S FAMILY-FRIENDLY With a total strength of 6426, with 57% female staff, OCBC grants their staff the flexibility to manage their working hours on a short or longer term basis.  Flexible work arrangement scheme  Part-time employment scheme  My Flexi Hour OTHER FAMILY-FRIENDLY AMENITIES AND PRACTICES AT OCBC  OCBC Flex Plan  Onsite childcare facility Heng Swee Chong is one of the many parents who has benefitted from the onsite childcare facility. “As the childcare centre is near my work place, this has reduced the travelling time for my family during the rush hour. We also have one hour earlier (time-off) every Friday, which I use to dine with

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my family. These schemes have enabled me to play bigger roles in my work and family.” said the father of one, who works at the bank’s Global Consumer Banking Operations Support and Systems. His child attends The Little Skool-House childcare centre at OCBC.  Recreation Club@OCBC  Lactation rooms  Personal effectiveness programmes  Bursary scheme & scholarships for tertiary education  Congratulatory gift, condolence wreath  Family activities & Kids@Work  Corporate passes

Republic Polytechnic (RP)

WHY IT'S FAMILY-FRIENDLY With a total staff strength of 1032, with 49% of the staff comprising of female workers, employees have the flexibility to choose their starting time anytime between 7.30am to 9.30am. They can also work from home once a week. On Fridays, the school staff are allowed to leave work 30 minutes earlier. This is to encourage staff to spend time with their family or engage in sports. FAMILY-FRIENDLY AMENITIES AND PRACTICES AT RP  Nursing room and pantries with dedicated refrigerators for nursing mothers  On-campus childcare centre (Kinderland)  Corporate passes for staff to bring their families to popular places of interests such as the Zoo, Bird Park, etc.  DVD loans for staff to enjoy music/ movies with their families The Polytechnic also won the Work-Life Sustained Excellence Award in 2014 and receives ongoing requests from Schools and public agencies to conduct learning journeys for their staff to learn from their work-life policies and initiatives. Supporting the large percentage of working mothers in their school has proven that working mothers are able to contribute to the workplace, while carrying out their personal roles.

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I’m Not Giving Up! No matter what challenges were thrown at them, these mothers stuck through and continued to breastfeed.

“Breastfeeding was among the most intimate and cozy mother-to-baby connections.” Jenny Tai, 27, mother of two, breastfed for two and half years Right after she was born, the nurse plopped her naked on my chest – my flushed skin, perspiring from the exertion of labor, against the soft, slippery skin of my newborn. I could feel the weight of her,

my heart beating gloriously under her tiny balled fists. But what stood out most of all was the first time she latched onto my breast and I thought, “Oh. Oh, so that’s how it feels.” As trite as it sounds, the closest I can get to describing that sensation is life flowing from my body to hers. Yes, I knew that was already happening inside the womb, but now I could actually see her in my arms, feeding. I was in awe.

It’s worth it

After nursing Chloe intermittently from midnight till morning, I was starting to

wince from the growing soreness. Even the thin fabric of my hospital gown felt abrasive against my nipples, for they had become raw and swollen, and remained so for the first week. Nipple cream provided little relief. A proper latch is everything. I learned the truth of that when a lactation expert helped me correct Chloe’s latch. “She should take in a bigger mouthful of your areola, not just your nipple.” Still, nothing had prepared me for how much work breastfeeding actually was. Or how you could get neck and arm cramps from continually holding the same position. Or how you could be so engorged that even your armpits hurt. But much of what makes a breastfeeding experience a successful one has to do with sheer will. It means

Jenny and her daughter, Chloe, right after a nursing session.

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feeding through the ache until you grow accustomed to it – much like blisters toughening up to become callouses. The breastfeeding journey doesn’t just involve nursing by breast, it’s also grappling with the pump, doing everything to increase your milk supply, and puffing up with pride when your freezer is stacked with storage bags of your liquid gold.

And all the work is worth it

Breastfeeding made me feel closer to Chloe and will always be one of my favourite parts about being a mum. It was among the most intimate and cozy motherto-baby connections. Nothing compared to gazing down at that little milk drunk face after she passed out from feeding. Or how, in the middle of feeding vigorously, she’d suddenly stop and look into my eyes with quiet intensity as if to make sure I was still there, before smiling and continuing to eat. Sometimes when Chloe was inconsolably fussy, the only way to calm her down was to hold her to my chest.

Facing ‘unwanted’ questions

As Chloe grew older into her toddler years, friends, relatives, and even strangers made remarks like, “Isn’t she too old for that now? When are you planning to stop breastfeeding?” or “She doesn’t actually need the nutrition as much anymore, does she?” Some questions were innocent enough while others came across as judgmental. It’s one of those things that breastfeeding mums have to weather, in the same vein as ignoring strangers’ glances when you nurse in public. Soon you stop giving them the time of day. In fact, an unexpected breastfeeding bonus was acquiring more confidence and no longer sweating the small things. I was focused on my child’s needs first and foremost. There was something about being a mother that empowered me to go ahead and do what I believed was best.

“I had mastitis and pumped out ‘strawberry’ milk.” Evelyn Lim, 35, mother of three, breastfed her two children for one and a half years and currently breastfeeding her new born child When my firstborn came along, I was determined to breastfeed him. To prepare ourselves, my husband and I read up extensively and went for breastfeeding courses. However, little did we know that it was not as easy as we thought it was going to be. I tried to breastfeed my boy to my best ability, but he did not seem to latch on well. I was frustrated with myself as a new mum. On top of the daily distress, engorgement soon kicked in and I found it harder to breastfeed day by day. We visited our lactation consultant at the hospital several times to re-learn the techniques and to have my breast massaged as my hard-rock breasts were causing a lot of pain and discomfort. By the time my boy was about 2 months old, I was down with fever and shivers every other week. It was so bad that our consultant recommended me to see a breast surgeon.

Treating my mastitis

The breast surgeon was very patient and explained to us what mastitis is. She also assured us that even as I underwent treatment, I did not have to give up breastfeeding if I was determined to continue. She said, 'The only thing that will stop you from breastfeeding is your fear of pain'. With her advice, I began receiving treatment and told myself to persevere. To treat my mastitis, she cut a slit right underneath my nipple to extract the pus. The wound had to be kept open for 2 weeks so that I could continue to extract the pus daily after my shower.

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It was both milk and pus that came out whenever I had to clean up the wound. I was told to continue to breastfeed my baby with my other breast. As for my wounded breast, I had to pump out the milk at 2 - 3 hour interval to keep the milk supply coming. I remember crying my heart out as my milk supply fell to 10-20ml and no matter how much I massaged, nothing seemed to flow. I was scared that I was going to fail big-time as a breastfeeding mum.

‘Strawberry’ milk

Enduring the pain while pumping was one thing; the other was seeing 'strawberry milk' that came out of my breast. My breast surgeon said it was all right for my baby to drink the milk as long as there was no pus in it. However, my mum who was helping me was so disgusted that she made me throw away the milk after each pump. I was devastated but I knew that the period would soon be over if I took good care of myself during this recovery process. A month later, it all paid off. My wound healed nicely but my milk supply was still low. My surgeon gave me antibiotics just in case if the mastitis came back. Slowly and steadily, my boy and I continued our breastfeeding routine. It was not the most successful but I was thankful that we still bonded over the sessions we had together. And yes, the economic principle of supply meeting demand is real eventually I managed to breastfeed him till he was a few months older and when I returned to work, I managed to express a sufficient amount of milk. My boy was on breastmilk till he was one and a half years old!

Don’t give up

To all new mothers who are struggling you are new at this, so is your baby. Be patient with each other. Equip yourself with the right knowledge and don't be afraid to seek help. It will get better. The beautiful moments you share with your baby as he suckles and looks at you with those angelic eyes will make everything worthwhile!

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Yew Ya keeping her son Evan close in a baby wrap.

In the end, I fed only when my baby called for it. Demand and supply really works as not long after, my milk supply was in full swing.

Mini milestone achieved! Nursing in public

Before any outing, I did a fair bit of advance planning. Which shopping mall has nursing facilities? If I go out after this feed, approximately how much time do I have to make that purchase before I have to go to the nursing room? I remember nursing in the car on several occasions, or even especially making a trip out to the car just for an enclosed space to nurse. Over time, my confidence increased with a nursing cover and this really expanded my travelling circumference. Some normal clothes do the job, but some clothes do ride up a fair bit which becomes obvious if the chair you are sitting on is back-less. At 3 months, this was my mini-milestone, nursing anywhere and being able to meet people with my baby.

Juggling studying and nursing

Right from the get-go, I had it in my mind to breastfeed. The initial stages of latching on and getting the positions were very unfamiliar but thankfully

there were nurses and visiting lactation consultants to help me at the hospital. Milk flow was not heavy in the first few days, but that’s expected, so I didn’t stress too much about it. Nevertheless, the feeding time was a bonding session with the newborn and that was really special. Back home, I was plagued with all these questions - Should I pump periodically, even at night? Should I wake my baby up to feed? Should I time my feeding or practice demand feeding?

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“I studied in the day and pumped at night for my boy.” Som Yew Ya, 33, mother of one, breastfed for two years

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I was pursuing a Masters degree when I gave birth to my son in my second year of studies. I resumed studies on partial load about three months after birth. Before that, I had my family around who had a hand at feeding expressed breastmilk by the bottle, which really helped on days when I had to attend lectures. As some school days can take up the whole day, I started pumping in school and slowly, breastmilk bags, storage and transporting milk with ice bags became a routine for me. The fridge at home was full of breastmilk stored in bottles and in milkbags. Sleep was a rare commodity, as I pumped extensively in the night to supply for days when I was in school. By this time, I was quite confident with breastfeeding in public using my cover and could even eat a meal or read a book with the other hand, while

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my baby is nursing on the other arm. During this time, my breasts were also engorged and some days I was not able to pump as regularly between classes. On a few occasions, the pain and hardening became so bad that I consulted a lactation consultant and had some other checks done. Eventually it was nothing serious and the pain and hardening went down. It was a lesson learnt; I had to be more disciplined with expressing!

With support and help, you can do it!

My gynaecologist once told me that breastfeeding is actually more difficult than giving birth. Indeed, it has been a journey and I couldn’t have gone through

it without a supportive husband who has always been very hands-on; helping me with my breastfeeding chores. Not forgetting the encouragement from my doctors. The journey may be difficult, but it’s all worth it. Keep pressing on confidently!

Travelling abroad

By the first year, I could breastfeed anywhere with ease. I also travelled to the States for three weeks and breastfeeding was such a help! My son was contented on the flight and nursing was done as and when he needed it. We stayed in San Francisco, San Diego and Los Angeles with friends and family and drove considerably. Breastfeeding was really “meals-on-thego” and was really valuable, especially when we were on the road. Organic fruits were readily available and we fed purees and mashed food as part of the diet, with breastmilk making up half of his diet.

Back to work

I had completed my Masters and returned to the clinical field full-time. I introduced fresh milk to my boy, which he took in school while I continued to nurse him at night. It was an adjustment for me from being a stay-at-home-mum to a full-fledged working mother, and I really treasured the night feeds.

Getting the “looks”

I have received a fair share of “looks” from strangers and even unsolicited advice about how formula milk is better; how it makes babies chubbier. When I got such responses, I would usually ask for the basis of the theory, and take the chance to share about the benefits of breastmilk. However, I do see that society is slowly becoming more informed and supportive of breastfeeding mothers.

Yew Ya, with her husband Timothy Pang and 11 month old Evan at a fair in Los Angeles.

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Wan Ee and her baby boy, Kenny

“You should only stop breastfeeding when you have H.I.V.” Wong Wan Ee, 30, mother of one, breastfed her son for 20 months My first skin-to-skin moment with my son Kenny, was also the first time he latched on to me. After my delivery, the first thing that came to my mind was: “Faster, faster give me my child!” I did not want to miss the golden moment of skin contact and his first latch.

Support from family and work

I was very fortunate as I spent my confinement at my mum’s place, and had all the support to breastfeed. I did hours of research online and even resorted to seek help from a polyclinic nurse to ensure that I was latching on correctly. I fixed a standard routine or timing everyday for latching, and pumped regularly when I went back to work, to maintain my supply. Work wise, I was lucky that I had a rather ‘private’ space. There was no one behind me at my desk (it was a wall), so

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it was easy to pump with a hands-free electric breast pump, while remaining at my workstation. Surprisingly, no one noticed until I told them or they started to get suspicious of the pump sounds! On the down side, I faced pressure from elders who did not believe in a full breastmilk diet. Most of them (elders) did not know of any mum who had breastfeed for so long and hence, they were against my decision to do so. However, my husband’s full support helped me to pull through all the negativity. I am happy to have made it this far and believe that this has resulted in my boy having a stronger immune system.

Words of advice

To all the new mothers who will be starting on their new breastfeeding journey, here are words of advice I “survived” on:  “Massage and squeeze" My husband helped to massage my breasts twice during the first week. I cried till my tear ducts were dry but after that, I didn’t

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experience any major difficulties.  “ You should only stop breastfeed when you have H.I.V” This is what I was told by my nurse. Even when I had fever (there was once I had HFMD), I still continued breastfeeding my boy.  “ Place your baby’s head to your breast like a soccer ball" Initially, I did not dare to apply too much force, but this method really encouraged my baby’s mouth to open wide and hence a proper latch.  “Pull through for six months and the money you save will be worth it” I compared the items purchased for breastfeeding to milk formula and found out that I broke even when I was six months into my breastfeeding journey. I pulled through that six months with this ‘thrifty’ thinking. I realised my breastmilk supply became rather stable after that.

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Responding to naysayers

BREASTFEEDING IN PUBLIC

How I Did It With some practice and the right mindset, anyone can survive breastfeeding in public. JENNY TAI tells us how she overcame her initial anxiety. Breastfeeding is a beautiful, arduous experience. As any breastfeeding mum would tell you, it takes a lot of work. You’re literally feeding your baby the sustenance of life from your own body. This is something to be proud of – not to feel embarrassed about. Yet many women still do when it comes to breastfeeding in public. The first time I breastfed in public, I was queuing in the hospital and didn’t want to risk missing my number. So there

in the waiting room, I tried as discreetly as possible to nurse Chloe. My anxiety rose with each undone button and I held my breath until she latched under the nursing cover. My face was red and I was afraid to look up, certain that I’d meet judgmental, disapproving stares. A few minutes passed before I risked glancing around, only to find that nobody seemed to mind. They were too preoccupied with their own sick, runny-nosed children to pay attention to what I was doing with mine. That’s the thing about public breastfeeding: I’ve found that usually people are busy doing their own thing so even if you feel like all eyes are on you, that’s hardly the case. A passerby or two might have a double take, but I’ve yet to encounter any rude admonishments or shaming to the tune of, “You should cover up” – although I’ve heard that some mums were unfortunate enough to experience it.

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To prepare myself for ignorant remarks like that, I came up with an automatic response to put any disrespectful strangers in their place. That way, I wouldn’t have to fumble for a reply on the spot. My go-to line was, “It’s my right to feed my baby anywhere, in public or private. If you don’t like it, look away.” As Chloe grew bigger, she stopped tolerating the nursing cover hanging over her face. She often got very sweaty underneath, and I felt bad that she had to eat in discomfort. After all, nobody asks adults to eat with their heads under blankets. She’d wriggle and grunt until she pushed it off, making a big scene that called even more attention to us. Initially I was nervous about the extra exposure. But actually, not much was exposed because Chloe’s head covered most of my breast. She nursed peacefully and quietly without anything hanging over her. After a few times, I grew accustomed to it too, and happily breastfed her when we were out. It was much more convenient than lugging around a cooler bag with bottles of expressed milk and a heavy thermos to heat them up. With some practice and the right mindset, anyone can survive breastfeeding in public. You’re not doing it to put yourself on display; you are a mother who needs to feed her child, and what could be more natural than that?

"That’s the thing about public breastfeeding: I’ve found that usually people are busy doing their own thing so even if you feel like all eyes are on you, that’s hardly the case."

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Q&A 40

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Yasa Yong Nyuk Yin, Senior Lactation Consultant, Mount Elizabeth Novena Hospital.

What are the essential breastfeeding products and accessories I should get before my baby is born? Enjoy the first few days of your babyâ&#x20AC;&#x2122;s life before deciding on your breastfeeding journey. Usually, accessories are not needed if your baby is breastfeeding on demand. They are mostly needed when a mother is preparing and going back to work, where storage of breastmilk is required. 1. A breast pump is needed if you plan to bottle feed your breastmilk for as long

as you wish to. Make sure the breast shield size fits well onto your nipples. If you are planning to pump frequently, consider to get an electrical pump that can express simultaneously on both breasts. This would save you time and have more rest. 2. Bags or milk bottle to collect and store your breastmilk. 3. A sterilizer to ensure the bottles and bottle teats are properly sterile before use. 4. A small tube of nipple cream to apply on sensitive nipples during the early feeding days. 5. A few pieces of comfortable wireless bras. Do make sure there are no supporting wires as they may cause blocked ducts. 6. Reusable breast pad such as LilyPadz from Ardo, helps to stop milk from leaking on one breast while nursing the newborn on the other side.

When should I start shopping for breastfeeding essentials and accessories? Start scouting around during the early stage of your pregnancy so that you can choose the most suitable breast pump and accessories needed. In the event that you haven’t bought the items before your delivery, most of the items are easily available around the maternity hospitals. The nurses or lactation consultant would be able to advise on what is required and assist you during the process of breastfeeding.

Through our observations, couples who have the opportunity to prepare and ask questions before the arrival of their newborn, are more likely to be successful at breastfeeding than those who do not. The knowledge gained also motivates mothers to be committed to breastfeeding.

Do I need to inform my doctor or the hospital that I want to breastfeed exclusively? How does having a birth plan help in this instance? Yes, do inform your obstetrician that you are committed to breastfeeding your new-born, so that he or she would be able to refer to a paediatrician who is supportive of the process. It is encouraged to indicate your decision in the birth plan so that the nursing team will do their best to assist you from the beginning of your hospital stay.

How will my body prepare for breastfeeding? A women’s breasts are prepared to produce milk as early as the 16th to the 20th week of gestation. The breasts increase in size due to an increase in lobules and alveoli. The nipples grow darker to help the newborn search

for his or her milk after birth. Milk production is initiated in the breasts during the post-partum period, after delivery of the placenta. Women who underwent an urgent caesarean section or had a long labour before their vaginal delivery, are more likely to have a delayed onset of breast fullness and lactogenesis (the production of breastmilk) in the first few days after delivery.

What are the recommended websites or reading materials for breastfeeding information and tips? The resources you turn to can either help you succeed or discourage and undermine your capability. Go to the experts and specialised websites such as the ones below:  American Association of Paediatrics – Breastfeeding Initiatives  Australian Breastfeeding Association  Dr. Jack Newman – Breastfeeding  International Lactation Consultant Association  Singapore Health Promotion Board – Baby Friendly Hospital Initiation  The Academy of Breastfeeding Medicine  World Health Organisation – Steps toward successful breastfeeding

Is attending antenatal or breastfeeding classes necessary? Such classes are usually run by accredited and recognised lactation consultants who have observed thousands of mothers with successful and unsuccessful breastfeeding outcomes. It covers information on avoiding potential breastfeeding pitfalls in the early weeks like sore nipples and engorgement. Other topics such as how to massage the mother’s breasts and how to handexpress and collect breastmilk will be included.

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should appear contented and alert after breastfeeding.

How do I prevent sore nipples? Ensure that babyâ&#x20AC;&#x2122;s mouth is open when moving your baby to latch-on. They should be sucking on the areola instead of the nipple. Remove your baby and re-latch if he is sucking on the nipple. Prolong sucking on one breast may cause soreness. Use both breasts each time, and if your nipples are sore, go for frequent and short feedings.

Can I continue breastfeeding if my breasts hurt or if I have a cold or the flu? Breasts tend to feel tender when milk supply starts. Massages and warm compress before breastfeeding helps to stimulate milk flow and relief hardness. Continue frequent breastfeeding to avoid engorgement. The discomfort will ease when the breastfeeding demand and supply is more regular. A cold compress may be used after to relieve discomfort. If you have a cold or flu, you should continue to breastfeed as breastmilk has high content of antibodies that protect babies against infection.

How often should I breastfeed? How will I know whether my baby is getting enough milk? Breastfeeding should be based on

your babyâ&#x20AC;&#x2122;s demand, regardless of the frequencies. Ideally, babies should be fed every 2 to 3 hourly. They should have enough milk if they latch and suckle on each breast for about 15 to 20 minutes, 8 to 12 times a day. Regular bowel movements consisting of 5 to 6 wet diapers daily also indicate a sufficient milk intake. Your baby

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Loh Lee Lian, Lactation Consultant, Mount Elizabeth Hospital

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Are there foods I should avoid eating while breastfeeding? What about alcohol or caffeine? Breastfeeding mothers should eat a well-balanced diet, and allow for an excess of 500 calories daily. All foods can be taken in moderation. Alcohol is not encouraged and may be used in moderation for cooking. 200gms (100gm per cup)of caffine per day is safe, but is best to drink it soon after a feed, as caffeine takes about 1-2 hours to be absorbed and dissipated to the body.

Are there any medications that I should stop taking? Generally, less that 1 percent of medications are not suitable for breasted babies. It should be avoided if a mother

is on Chemotherapy drugs, sedations, antidepressant medication or radium therapy. Mothers who are breastfeeding should highlight to their doctors so that they can prescribe baby safe medications.

What should I look for in a breast pump? A good pump should effectively express your milk. While manual breast pumps are great for stay-at-home mothers who are exclusively breastfeeding, electric breast pumps may make a better choice for mums who are frequently away from their babies because of work or other reasons. I’ve heard that I can’t get pregnant while breastfeeding. Is this true? Total breastfeeding (not missing any breastfeeds) does prevent the onset of menstrual period and acts as a natural contraceptive measure to certain extent. However, it is not 100 percent safe and

a second contraceptive method may be needed.

maintain a smooth milk flow and supply. For comfort, use cold packs after a feed.

How do I prevent my breasts from becoming engorged? Engorged breasts are usually due to stagnant breastmilk. Total and frequent breastfeeding day and night will maintain the flow. Breast massages and use of warm compressors before breastfeeding will help to stimulate flow.

When should I introduce a bottle? Bottle feeding is best introduced after the 4th week in order to avoid nipple confusion. Sucking from the breast and drinking from a bottle requires different techniques. If bottles are introduced too early, some babies may refuse to latch on to a mother’s breast.

What happens when I have engorged breasts? Engorged breasts will cause discomfort and fever. You may take analgesia to lower the fever and relieve some pain. It will be hard and difficult for baby to latch on and your milk flow will also be impeded. Breast pumps may not be effective as well when your breasts are engorged. Breast massage, warm compress, hand expression and continued frequent breastfeedings will

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How often should I pump when I go back to work? Regualr breast pumping for every 3 hours should maintain the supply of breastmilk and avoid breast engorgement. For more information about the maternity ward services at Mount Elizabeth Hospital and to book a maternity tour, visit www. mountematernity.sg.

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Breastfeeding with Love e-guide 2016

Articles inside

Breastfeeding E-guide For Mothers