My Breastfeeding Experience and Tips (Part 2)

What I dread most in breastfeeding was... engorgement! This is a phase that every breastfeeding mother will go through, and some can be very tough to overcome.

For my first baby, although I did not have a lot of excess milk, I still experienced engorgement from time to time. The situation became worse, as I returned to work 4 months after delivery.

My engorgement was normally due to blocked ducts in some areas of my breast, so sometimes only part of the breast was harden and I might even feel one (or more) hard "pipe" on my breast where the milk was stucked! (It felt something like the root of a plant.) I tried massaging and applying warm cloth (or a milk bottle with hot water inside) on my breast, hopefully to drain the milk. It required a lot of patience and effort, and most of the time I exhausted myself before I could clear the engorgement. To reduce the pain in the breast and nipple, I also tried applying ice pad or cold cabbage on my breast, especially on the nipple. I found myself always in a dilemma, wondering if I should apply hot or cold objects on my breast. On one hand, I wanted to clear the engorgement; on the other hand, I had to protect my nipple from getting hurt so that I could continue breastfeeding. The most effective way was to let the baby suck out the milk, but the tricky part was that sometimes as he sucked, more milk was produced (more demand -> more supply) and the "pipe" became even harder! I couldn't use breast pump because it hurt a lot and it wasn't as effective as the baby's natural suck. A lot of times, I ended up going to the clinic to get some medicine to help to soften my breast. Most of the time, it was my baby who was my savior, or the medicine that helped, or the combination of both. It was such a relief every time my engorgement was cleared...

In the first four months, as I breastfed my baby directly most of the time, I had less problem with engorgement. But as soon as I returned to work and started using breast pump to extract my breast milk, I started to have frequent engorgement, at least twice per month that required visits to clinic to get the medicine. This happened because no breast pump could compare with direct breastfeeding to drain my breast. I first used Medela's electric breast pump, and later on switched to Avent manual breast pump. Although I found the latter more comfortable, it did not help much with my engorgement problem. Direct breastfeeding was still the best. I prefer the Avent manual pump because it is less noisy and more convenient - There is no need to use an adapter; although an electric pump can be battery operated as well, the battery does not last long. However, I haven't tried out the recent double breast pump (pump both sides at the same time), which I heard is efficient and saves time.

Another problem was my reduced milk supply once I started working. Breastfeeding my baby directly was the best way to trigger the supply of breast milk, and even the best breast pump had no way to compete. Returning to work also means busier life for me to cope, and more or less it did impact my breast milk production. I found it really challenging to continue breastfeeding exclusively while working on a full time job, even in my case where both my employer and my boss were very supportive. (Intel worldwide provides the facility of mother's room to enable working mothers to extract breast milk at work.) It was very stressful for me, struggling to cope with the demand of my baby with the reduced milk supply while facing the frequent engorgements that led to visits to clinic for the medicine...

Anyway, I eventually got through this tough time, and reached the milestone - 6 months after birth, I started giving formula milk to mix with my breast milk and across the next few months, slowly reducing breastfeeding. Luckily, this phase of weaning off breast milk was a smooth transition for my baby and me without any problem.

My second baby was born almost 4 years later, and this time I was much more prepared and experienced. It was a good start as I had more than enough breast milk from the moment she was born. I started storing breast milk in the freezer from the very first month and during the peak my freezer was occupied with about 35 milk bottles! (with the average of 5oz/bottle). Some people may use special disposable plastic bags or containers to store breast milk, but I found it convenient to use cheap milk bottles just to store the milk, as it was easy to pump directly into the bottle, to read and label the volume(e.g. 6oz), to transport the milk (from office to home), and to heat up the milk by soaking the milk bottles in hot water (Never use microwave to heat up breast milk as it will kill the nutrition!). The breast milk would be transferred to Dr. Brown's milk bottle of better quality to feed my baby.

Second baby sounds easy? True for the initial phase as I did not have to relearn how to breastfeed, resulting in less muscle pain in neck and back. But I had the same problem, may be even worse, with engorgement, because contrary to my first baby, this time my milk supply was more than my baby's demand, and I returned to work after only 2 months. Having too much milk can also be a problem! Although I extracted breast milk twice a day in office, at least once per week I would be facing engorgement problem, sometimes minor and cured within 24 hours, sometimes more serious and needed medicine... Again, I struggled through, until my baby was fully breastfed for 6 months. I was very unwilling to reduce and stop breastfeeding with so much milk supply (as most mothers struggle to keep up with demand), but I could not bare with the engorgement problem and had to let go eventually...

I found my breastfeeding experience for both kids equally challenging, probably because I really wanted to breastfeed them exclusively for the first six months without formula milk. Thinking back now, I think I might have tried too hard and could have let go a little. As long as I had tried my best, I shouldn't feel bad or guilty or stressful about it... Breastfeeding may be the best for the baby (and the mother), but I do not think that it should come to the extend of straining the mother. On the other hand, if I had thought that way from the very beginning, just trying my best without setting a 6 months target, I might have failed without a strong will to succeed.

I would strongly recommend at least 6 months of exclusive breastfeeding, if possible direct breastfeeding would be even better as it saves a lot of trouble, but that may be difficult for working mothers especially in Asia as we usually return to work after 2-3 months' maternity leave. I have a few friends (all are stay-at-home-mums) who managed to breastfeed their kids until 2 years old, but most working mothers breastfeed less than a year. However, it's still not an excuse to stop breastfeeding any time before 6 months - let me share a true story - a mother to a newborn in Penang worked as a sales person who was on the road frequently, and she often extracted breast milk in her car by the road side, covering the windows. I really salute this lady! She makes me feel ashamed every time I complain that extracting breast milk ("comfortably" in the mother's room at my work place) is troublesome. If she can do that, what excuse do the rest of us in the office or at home have for not able to fully breastfeed our babies?

Breastfeeding is indeed a very tough job, and every mother may face different challenges. Love, patience, perseverance and endurance led me through. I was exhausted all the time, I felt helpless whenever engorgement happened, from time to time I felt that I could not continue anymore... Strong support and encouragement from family members and friends with breastfeeding experience certainly helped me to get through this. Thank you to all of you. Also thank you to Penang Adventist Hospital's Breastfeeding Support Group, especially Ms. Christine Neoh who was guiding the group. I wish that every new mother could get the same support as me. I wish that more mothers would succeed in breastfeeding, because it's the best for you and your baby!

My Breastfeeding Experience and Tips (Part 1)

Before I became pregnant, I had never thought much about breastfeeding (well, who would?). However, I did have the thought of wanting to breastfeed my baby to decrease the likelihood of getting breast cancer, the disease that took my mother away from my family.

Knowing nothing much about breastfeeding, I attended the antenatal class prepared by Penang Adventist Hospital in which I was going to deliver my baby. The speaker was a peaditrician, Dr. Pong Kwai Meng. Within an hour, he shared with us the importance of breastfeeding, the difficulties we might face and the possible solutions, the myths of breastfeeding etc. He was indeed a breastfeeding guru. He joked that the only thing he lacked of was the hands-on breastfeeding experience - because a man can't possibly breastfeed! Among the statements that I remember clearly were, "Cow milk is meant for cow, human should take human milk", "Nothing can replace breast milk. What your baby needs most is not an expensive toy nor pretty clothes, but your breast milk". I thank Dr. Pong for enlighting my spouse and I about breastfeeding. Without his talk and his support in the later days as my son's peadiatrician, I would not have succeeded in breastfeeding. Breastfeeding is the most challenging task I have ever faced in my life and I had a very tough time. (comparable to handling my mother's death, or rather, managing my emotions to face her sickness as well as her death.)

Before my delivery I was very determined and all prepared mentally to breastfeed exclusively my baby for as long as possible, at least for the first 6 months. However, breastfeeding did not "just happen naturally". It needs to be learnt and it takes practice to master the skill. Like holding a newborn for the first time, I felt so awkward trying to adjust my position, turning the baby towards my breast, making sure he latched on properly, and when everything was set, I had to remind myself to relax. My baby boy who was born after 36 hours of labor pain was a very impatient infant. When he was hungry he would start crying and his voice got louder with each passing second, until he got the milk in his mouth. It always took a while before he was able to latch on properly and after a few failures, he would start screaming until his face turned red. I needed to try again and again, putting his mouth next to my breast until the position was right. Finally, when he could latch on properly, he would start to calm down. However, the first few sucks were always so strong (because he was hungry) that I almost screamed as it hurt. In addition, as a first time mother, my breast milk was not produced instantly; because he did not get enough food for each feed, within an hour or two he would start crying again. The cycle repeated. By the end of the thrid day, I was so exhausted, both physically and mentally. I had painful nipples due to frequent sucking; my neck and back ached as a result of long attempts to breastfeed; I did not have enough sleep. This was the time I was discharged from the hospital and I could not get help or support from nurses anymore at home.

I was fortunate that my husband was as determined as I was to make exclusive breastfeeding a success. Without his support I would not have succeeded. We did not purchase any infant milk powder at home and the only food the baby could get was my breast milk. Again and again, we tried and tried, ignoring "friendly advice" and nags from the confinement lady (For Chinese in Asia, it's common to hire a confinement lady to help taking care of mummy and baby for one month after delivery) that my breast milk was not sufficient and the baby was starving. As my son's name suggests, determination is the key to success. By the end of the first week, we were coping well and the only problem was the sharp pain I had to endure during the first few sucks after latching on. By the end of the second week, I could multitask while breastfeeding - reading a book, talking on phone, even surfing Internet! Practice makes perfect! I found pillows very useful to support my hand during breastfeeding. I also used lying down position to breastfeed sometimes, especially at nights so that I could rest while breastfeeding.

It's a wonderful feeling once you master the skills. I enjoyed every moment when I breastfed, knowing that's the best for both of us, and seeing the baby enjoying the milk was the best of motherhood. In terms of nutrition, breast milk is the best, babies can absorb everything and digest very fast, some (including my son) pooh after every feed with watery stools. They also feel most secure and comfortable in mummy's arm, sucking mummy's breast milk. As I breastfed my baby exclusively, I did not need to prepare nor boil milk bottles. When I went out with my baby, I did not need to pack a bag for milk bottles, milk powder and warm water. When the baby needed a feed, I just needed to find a place to breastfeed him. Nowadays most shopping malls prepare such facilities to support breastfeeding mothers. Or sometimes I did it in the car. I found it convenient to wear breastfeeding bra with a breastfeeding pad (to absorb breast milk when it leaks) under a T-shirt. I prefer washable pad to disposable as I found it more comfortable and cost-saving.

For a mother who plans to return to work, or to be away from the baby sometimes, it's best to start pumping breast milk in between the feeds as early as possible and storing them in the fridge so that someone else can feed the baby when the mother is away. Breast milk can last 6 hours under normal room temperature, 3 days in fridge and 3 months in freezer. As a first time mother, it was tough for me to stock up the breast milk in the fridge as I hardly had any left after each feed and I was tired most of the time. But to make sure that I had at least sufficient if not extra breast milk for the baby, I drank a lot of liquid, including water, soup, milk. Warm liquid especially will trigger milk production almost immediately. I also tried to rest as much as possible, relax, be happy... all these help in producing breast milk. Massaging the breast can help to improve milk flow. The most important point however, is mentality. If you believe that you do not have enough breast milk for the baby, then you will not. Parents start to give babies supplement (milk powder) thinking they do not have enough from breast milk, causing less demand on breast milk, and less supply to be produced. The actual fact is that every mother has the ability to produce enough milk for her baby. When the baby sucks it will trigger the production of breast milk and our body will naturally adjust to provide the right amount of breast milk. It's a simple theory of supply and demand. There will only be supply if there is demand.

I was happy and proud that I went through the first hurdle to be able to breastfeed my baby exclusively. The next challenge is, how long can it last? My next challenge came as I returned to work...

...to be continued...