The Breastfeeding Talk

The perfect diet

General rule:  Human's milk is naturally-tailored for human babies and thus, it explains why mother's breast milk is best for baby.  But what about in situations when the ideal is challenged?

A history so brief?

Experience-sharing

There are many good resources on the benefits of breastfeeding available online, so I shall not discuss them here.  Instead, I'll go specifically into my recent experience.

I'm not a lactation consultant and therefore only wish to share my humble experience as someone who'd gone through it at one point of my life, and in a different manner from the majority. It's a brief, yet valuable experience.  It's something that I wish I'm able to do as planned, but alas!  There are many things that we humans can only plan, but the ultimate outcome is beyond our control.

An advocator of breastfeeding who uses formula - a treachery, or not?

Just in case if you're curious as to who that person is, I'm referring to no one but myself.  Ahaxxx.... why and how on Earth did I betray myself?

Long ago, I used to wonder why does infant formula sell so well despite breast milk being superior to formula.  Surely there are many reasons to it, but why?  

I used to pledge to myself that I'll try my best to breastfeed and express my milk for as long as possible. 

Mother's milk is not only highly-economical, but it provides all the necessary nutrients for a baby in the right proportion, crucial antibodies, and there's generally no need to worry about intolerance or constipation when it comes to mother's milk.

So what forced me to suddenly change in just 2 months' time?  Here's the story:

Ensuring continuity

In order to sustain lactation for a long duration, say 6 months, 1 year or more, there are some practices that need to be done.

Apart from a nutritionally-balanced diet and enough rest, a mother needs sufficient stimulation in order to lactate smoothly.  The more frequently you breastfeed, the longer you get to continue lactating. Direct latching is best, followed by pump.  As for the latter, if you're pumping exclusively, then you must be very consistent to pump once in every 2, 3 or max 4 hours round the clock.

The challenges that arise when you deliver very prematurely 

When a baby is delivered very prematurely, he/she is thus very small in size and physically not strong enough to suckle from the breast.  Or else why do NICUs resort to OG tube to feed our "mini babies", whether slightly bigger, as small, or smaller than Alvin?  

In my case, by the time my Alvin is strong enough to suck reasonably (when he's around 1.6 kg), my milk production had decreased by 80%, despite expressing milk religiously. 

If it had been the case of a baby who's much bigger and developed, and thus able to start breastfeeding sooner (say 1 week after birth), then perhaps lactation may not be as greatly affected as in the case of a baby who's only able to start breastfeeding more than a month after birth.  In the case of the latter, who knows if my body started giving wrong signals for it to stop lactating and resume fertility because "after so long, there's no baby around to feed, maybe the baby didn't survive, and so we need to start reproducing soon".   Well, I do not know. 

Babies of other people keep quiet and turn serene upon being offered to feed directly from their moms.  But my baby screamed at me when I tried to do the same with him, because I do not have sufficient milk to satisfy him. And his appetite isn't even tremendous, though considered OK for his size and age.

That's right before our discharge from Ward 4A.  And so, I had resorted to using my final resources, namely frozen EBM (expressed breast milk) to feed him until we're home and out of "stock".

 

Hard work but low yield

Relactation is not easy but I just gave it a try without much positive expectation.  Medication didn't work out for me.  Attempts to stimulate production by ways of letting the baby suck and expressing milk did not result in any difference, with a maximum yield of only a few cc per 30 minutes session.  That's a lot of hard work, but the result is negligible.

And thus, breastfeeding is only a sort of comfort or snack in between meals for Alvin as opposed to other babies who receive their full meals via the same.   Although having a few drops of milk is almost useless, a little is arguably better than none.  And of course, it comes with a string of screaming from the angry baby, unless he's falling asleep or if I bring in formula.   

So many reasons for using the formula

Having looked into the goodness of breastfeeding and some of the challenges in this case, let's divulge now into the pros and cons of formula-feeding.

 

The good and bad

Infant formula is costly because it's highly-taxed, it may or may not suit the baby, and is never the same as breast milk no matter how much fortification is added to it.   

Trying out infant formula is somewhat similar to trying out contact lenses; what's good for one person may be lousy for another, and vice versa.  Not surprising, this is why sometimes we see why a number of families (who use formula) use different brand for each child.  What's well-tolerated by Child A may not be the case for Child B.   

Formula-feeding requires stringent practice of hygiene, and any neglect in doing so puts the baby at risk for serious food-poisoning.  Bottle-feeding causes a lot more gas to be gulped in compared to direct breastfeeding.  But of course not many of us have the privilege to breastfeed directly due to work and thus the second best option is to express milk to be bottle-fed to the baby.  

Some babies become constipated as a result of formula-consumption.  As a result, special formula has to be resorted to, which costs a lot more than ordinary infant formula. 

Apply not the blanket rule

Before we outwardly criticise or condemn mothers who formula-feed their babies, we have to first ascertain the reasons why they do it.  

Is formula-feeding done for convenience reason per se, or with the belief that it's better than breastfeeding, or is it due to the body's inability to produce sufficient milk for its baby due to unavoidable circumstances?  What about the case of mothers who are prevented from breastfeeding due to genuine medical reasons that do not allow them to?

Is this kiasu attitude?

Contrary from people's impression that I'd "go private", I let Alvin receive his vaccinations at the Government clinic (Klinik Kesihatan Ibu dan Anak, or KKIA).  Ever since the shocking delivery incident, I'm have no qualms going to some Government clinic/hospital because they're actually much better than what most of us expect.

Despite the long waiting time as there are many other babies going there, and despite having to go on-leave for that purpose, because it's free.  And since the nurses and doctors at the local KKIA near my place are generally nice, I don't mind the waiting time.  

I don't mind anything, except when it comes to going into the "Bilik Penyusuan" (feeding room) at the KKIA to feed Alvin or to change his diapers in the midst of our queue.  Wait........... didn't I praise the availability of such a facility in the past? 

During the first time I went into the room, I saw many mothers breastfeeding their babies there.  I seldom see anyone who bottle-feed babies as small as mine in that room.  It made me feel "paiseh"  (or embarassed in Hokkien dialect) when I wasn't doing the same, and yes, I was bothered by what others may possibly think of me. 

Conclusion

Having said the above, if anyone were to ask me about my opinion on breastfeeding, I'd still maintain my stand, that breastfeeding is the best for your baby and you should thus do it for as long as your body permits.  It's even beneficial for the mother herself, because breastfeeding may help (note: I say may, because everyone is different) in shedding extra pounds, and in the prevention of breast-cancer (speaking of estrogen levels and stuff hormone-related).

P/S (26.09.2014):  After going through extensive reading up (books, articles and TBAN group), and in analysing where did I go wrong, I am of the opinion that my early cessation of lactation after Alvin's delivery was due to - 1) Not using a good pump; 2) I should have pumped milk once in every 3 hours instead of 4 and above; 3) I shouldn't have skipped midnight and early AM pumping because prolactin is high during these hours; and 4) I should have bought and brought a more silent pump along with me when rooming in at the NICU because the queue to use the only breast pump at the NICU was long most of the time.  I regret my past ignorance, so please do not commit the same mistake as mine.