Nursing Mom’s Food For Thoughts

12 – 15 years ago the term BREASTFEEDING was not a cool word mothers want to associate themselves with, here in Malaysia. It simply was NOT chic to say you nurse your baby. In fact, I started breastfeeding feeling dejected because the nurse at the hospital from where I gave birth to my first son, Cheeky Koko, now 12, took one mean glance at the miserable 1 oz breast milk I managed to pump after hoarding the hospital pump for 2.5 hours at Day 4 postnatal (we have readmitted to treat Cheeky koko’s jaundice) and declared me a non-productive failure.

At home most visiting relatives told me I was starving my baby because he was crying to be fed every one to two hours. “He must be hungry because you don’t have enough milk!” was the most common comments because they got used to seeing placid, gentle babies who were formula fed and slept through 3 to 4 hours per stretch of nap time.

If there was only one good thing about me, it must be that I was courageous (and rebellious) in my love for my baby enough to prove them wrong. I embarked on a journey buying just about every nursing books on the book shelf and reading up just about every breastfeeding website information there were to know on what to do and how to do it right. Once I mastered the arts and loving every minute of it, I decided to share the knowledge with all the new breastfeeding moms out there who felt the failure as I did. With a writer friend we started a breastfeeding support forum that went on to be one of the most vocal groups to advocate nursing in Malaysia. From then I have been asked to visit some new moms we got to know during their first days in the journey to show them how to latch on right and basically give them the emotional support they need as they learn to give the best nature has intended to their babies.

Baby B

Baby B in action… Nutritional needs of a mom is an important aspect of the breastfeeding journey, especially when one nurses beyond the first year.

Some moms are a natural when it comes to breastfeeding their newborns and their babies come naturally adapted to “working” at this beautiful act with just the perfect latch and calm personality and without what is commonly known as the newborn tongue cut, or feeling too drowsy to nurse and etc, which could frustrate and make a new mom feels easily tired out at even trying further.

While I am no longer able to contribute in the online group due to my work commitment, I have continued to encourage friends, relatives, colleagues to trust in their maternal ability to nurse naturally in the last 7-8 years. Something that I always observe that is a major hurdle to breastfeeding among Asian moms is how traditional values can crash with the basic dietary needs of a nursing mom.

When I still had the loving support of my mother in law (who now resides in Heaven), she would gently and lovingly remind me not to drink too much plain cold water because I was supposed to be in confinement. Water is too “cold” for a new mom. But because I was breastfeeding, I was guzzling down 3.5L water everyday! I felt so thirsty I swear I could drink up a whole water tank! And that was on top of the 2L or so of the sweet red dates soups that I drank daily. The only thing I didn’t drink was those supplementary wines like what most moms would do because I just couldn’t take its bitter taste.

As I am also very Westernised in my health approach (thanks to my own mom who worked close to 30 years in the health field), I believe that there are certain health benefits to proper dietary supplementation for nursing mothers. It is in fact well-documented in the scientific literature that a mother’s diet (and her overall nutritional status) can influence the vitamin, mineral, and the essential fatty acid (EPA and DHA) composition of her breast milk, all of which impacts the overall nutritional quality of the breast milk, and ultimately the overall health of the breastfed infant.

In my case, I continued to take my pregnant multivitamins, and on alternate days, supplemented with colostrum supplement (a year after giving birth), fish oil, organic spirulina and milk alternative such as organic oat milk. And when I got sick, I took antioxidant supplements to get well faster and naturally.

Of course, all mothers intending to nurse should always consult with their own doctors about supplementing their own nutritional needs. Special thanks to Seven Seas Malaysia for sharing with me these findings when I told them that I was going to write an entry about the importance of eating well for nursing mothers:

1. Journal Title: Fatty acid composition in maternal milk and plasma during supplementation with cod liver oil

Cod liver oil influences the amount of essential fatty acids in mothers’ breast milk. Supplementation of lactating mothers with even small amounts of cod liver oil promotes increased DHA concentration in breast milk. Also, the amount of EPA in breast milk increased in all the supplemented groups.

2. Journal Title: The effect of maternal supplementation with linoleic and gamma-linolenic acids on the fat composition and content of human milk: a placebo-controlled trial.

Total fat content and therefore total energy content and the content of essential fatty acids (EFAs) in milk are known to decline with prolonged breast feeding. In a placebo-controlled study a variety of evening primrose oil rich in linoleic and gamma-linolenic acids, or a matching placebo were given to 39 women for a period of 8 months starting between the 2nd and 6th months of lactation. Total fat and EFA contents of the milk declined in the placebo group but rose in the primrose oil supplemented group. A surprisingly high proportion of the supplemented dietary fatty acids could be accounted for by appearance in the milk.

3. Journal Title: A randomized controlled trial of the effect of fish oil supplementation in late pregnancy and early lactation on the n-3 fatty acid content in human breast milk.

Dietary supplementation from week 30 of gestation and onward more than tripled the LCPUFA content in early breast milk; supplementation limited to pregnancy only was much less effective.

4. Journal Title: Antioxidant capacity of human milk

Studies have reported the effect of maternal dietary vitamin intakes and vitamin supplementation on human milk, showing that higher intakes results in a higher concentration of the respective vitamin in milk.

Because I am a working mother who eats out a lot, I don’t always have the convenience and much choice in choosing to eat healthy food always, supplement was also a necessity for my own well-being.

It’s also important to note that besides supplementing, a nursing mom must clock in sufficient good-quality sleep, especially because being a mother can be such a tiring and stressful job. In order to nurse well, do keep yourself hydrated sufficiently – think of your body as the ultimate milk machine, you just need to feed it well with the right ingredients such as water, protein, vitamins, fruits, vegetables, add in good emotional well-being and a good night rest, pretty much nothing else can defeat you!

Despite the initial doubts and hurdles, I went on to nurse all three kids spanning the last 12 years, each baby for 2 to 2.5 years of extended breastfeeding. At the end of the day, I reckon I couldn’t have done it all without the most important ingredients of all — the tremendous love and support I got from Daddy Joe, my mom and also my sister in law, Cathy.

May you believe in what you are capable of as a mother and do it fearlessly anyway and may you live each moment count. Happy breastfeeding, moomies!

Confession of A BMW! (Breastfeeding Mom Who Works)

pumpingI opened up the big plastic container at the corner of our kitchen and started admiring the collection of electrical and manual pumps I have collected over the years like how a fashionista would admire her collection of Jimmy Choos.

It’s not an obsession, really, but to me, having the right breast pump can help a mother carry on breastfeeding even if she had to go back to a full time work after her two months maternity leave. Over a span of a decade, I have had six pumps to carry me through nursing of 3 babies and working at a demanding job all at the same time. With Cheeky Koko, now 11 years old, I inherited a first generation hand-held Medela battery-operated pump from my sister in law which did not work as well for me with its over powerful suction and overwhelming motor noise (To be fair, I heard Medela has since improved its design, ease and comfort of usage since then).

After just one month, I saved hard on every cent and decided to invest in the award-winning Avent ISIS manual breast pump. Although this was a manual pump, its cushy massage cushion was a delight to use as it encouraged a good let-down, in that I felt like my baby was with me although I was pumping in the office’s store room. Its excellent ergonomic design allowed a mother to control the pumping speed which mimicked the nursing rhythm of her baby.

When Pumpkin Mei-Mei came along, I continued using the same Avent breast pump for a good 8 months, before buying a new set of the same pump from a sale in Singapore (seriously, who could resist a great deal?!!) that came in a cool sleek black cooler bag. With Pumpkin Mei-Mei, I was slowly moving up the career ladder and as such had an office room to pump in absolute privacy. To make sure that I get an uninterrupted pumping session, what I’d do is to stick a nicely printed mini poster with a picture of her head next to a dialog bubble that said, “Please excuse my mom for 20 mins as she is making my lunch for tomorrow!”

With Baby B, I am using a Spectra Electrical Breast Pump now that has worked out just as well for me in terms of comfort, efficiency and low maintenance for a good 14 months before I stopped pumping altogether since Baby B likes all things fresh, and prefers only direct feeding all of a sudden as he turned one year old.

This is what I do daily with the expressed breast milk (EBM):

1) Get ready two milk collectors which come in handy when pumping on one side, and for collecting letdown from the other side of the breast. You don’t need these if you have a double pump.
2) Pump 10-15 minutes on each breast. If you can control the speed of pumping on the breast pump, try to start with a gentler suction speed for about a few minutes and once the let-down takes place, gradually adjust the speed to a comfortable suction level.
3) When done, carefully close back the lids of the bottles, clean up the surface, label and date the collected EBM.
4) Leave the used pump or breast phalange (the shield part that comes in contact with breast) with the EBM inside a half-opened cooler bag and store in the fridge until the next pumping session.
5) Take out the cooling/ice pack from the freezer and put it into the cooler bag to keep the milk cooler for a longer time (since no one can predict traffic jam in KL!)
5) When reach home, wash, sterilise and dry all the bottles and breast pump parts carefully.
6) Pack the breast pumps, the milk collectors, cooling/ice pack and milk bottles into the cooler bag to get ready for the next day’s labour of love. 🙂

All of the EBM from my pumping sessions were kept in small quantity of 2.5 to 3 oz per bottle, and kept in the office refrigerator to keep them chilled. Then just before leaving the office for the day, I would bring back 4 to 6 bottles of EBM in a cooler box or bag together with some cooling pads to help keep them cool until I reach home.

I would then store the EBM at the back of the refrigerator for the baby’s next day consumption. If it was a Friday, I would straight away freeze the EBM, since I nurse directly at night, on my off days and weekends. On Monday morning before I go to work, my MIL or the babysitter would thaw 3 bottles of EBM from the freezer by moving it into the refrigerator compartment and only heat it up about 15 mins before feeding.

Do work out a system of first pumped first served where the grandparent or babysitter knows exactly which bottle to thaw or feed first, and occasionally do remind them to shake the bottle gently before feeding to ensure that the super antibodies from mama milk that got stuck to the wall of the bottle will not be left behind during each feed. To ensure that the antibodies do not get destroyed by varied temperature in the fridge, do remember that the cooling coils are located just behind the refrigerator, which means the bottles with the EBM should NOT be placed in contact with the back wall of the fridge.

I usually pump once during lunch time at 1pm and another time at 4pm. I kept at pumping twice before the baby turned 9 months old and reduced to once a day after the baby turned about 8-9 months old and was taking solids well. I usually continue pumping until the baby turns 12 to 15 months old, before introducing formula as supplementary milk drink for day time, but I’d continue breastfeeding my baby until he or she turned two years old. Since we went with a child-led weaning, in Pumpkin Mei-Mei’s case, she only weaned at close to 28 months old. When she turned 24 months old I wondered when I could regain my life sans the nursing. But when she finally did get ready to wean, I had the hardest time letting go of this act! 🙂

Nursing needs not take a break just because mama has to work. Imagine all the mama milk goodness one can carry on providing for her baby even though she is at work. Of course, not every employer is understanding and kind enough to support one’s decision to pump at work, but with a little bit of persistency, persuasion (get them to see the economic value of you not calling in for emergency off frequently to take care of your bub since breastfed baby is healthier in general) and wonderful help from all these modern breastfeeding pumps and accessories, breastfeeding can be an easy yet nurturing act of ensuring our baby continues to get the best start in life.