Posted on September 14 2023
When one thinks of breastfeeding, oftentimes images of peaceful mothers holding gentle sleeping babies comes to mind. Social media and online articles also typically show happy women with contented little ones nuzzled at their breasts as if breastfeeding was the most natural thing in the world.
And while it is biologically natural for a new mother to produce milk and to breastfeed her baby, breastfeeding is also a new skill that both mother and baby have to learn. And as with all new skills, the first few steps can be bumpy, painful, and even a little bit scary.
In 2013, researchers at the UC Davis Medical Center surveyed 418 first-time mothers about breastfeeding. Prior to giving birth, nearly all of the women said they intended to breastfeed.
Three days after giving birth, 92 per cent of the new mothers said they were having problems breastfeeding.
50 per cent of the mothers reported problems with getting the baby to latch on to the breast, or other feeding issues like nipple confusion, when a baby may prefer a bottle. And 44 per cent said pain was a problem. 40 per cent also said they felt that they weren't producing enough milk.
According to the American Academy of Pediatrics, about 25 per cent of women in the US manage to breastfeed exclusively for the six months that are recommended for a baby's health.
So what can new mothers do to better prepare for breastfeeding? Aside from reading up on different techniques and watching videos on how to manage your milk supply, mothers can also look to doctors and lactation consultants for expert advice. Lactation consultants can also be good guides who offer support for struggling mothers.
Dr Mythili Pandi is one such doctor and family physician. The mother-of-three has been working with the Breastfeeding Mothers’ Support Group (BMSG) for 12 years after receiving help with lactation for her firstborn. She has been an International Board Certified Lactation Consultant (IBCLC) for the last five years.
Dr Mythili says: “The best thing about being an IBCLC is that I get to guide the new parents and the baby along their breastfeeding journey shaped with their values and goals. It’s never a one-size-fits-all so each plan will have to be bespoke to each family. And that’s where the challenge lies and that’s where I get excited!”
Dr Mythili also runs Mother and Child at Tanglin Mall, Singapore’s very first prenatal, postnatal and lactation centre. It provides a rich array of classes and courses, including childbirth education, pre-lactation consultation, first aid courses for parents and caregivers, child and baby music groups and solids workshops for new and to-be parents.
While it might be common for parents to attend prenatal classes or pick up books on what to expect during pregnancy and childbirth, not all parents learn as much about breastfeeding until the baby is born.
Dr Mythili says: “Getting armed with the knowledge early is the one thing I always tell my patients and clients who are pregnant or are going to start a family.”
She says: “Starting off without much breastfeeding information, is much akin to driving a car without a licence isn’t it? So many folks get childbirth education but birthing typically takes less than 3-24hrs. Breastfeeding instead usually lasts for months and sometimes years!”
She advises parents to consider a pre-lactation consultation with an IBCLC or to attend a breastfeeding workshop to help themselves learn how to get started.
Dr Mythili answers three common questions that many mothers have when starting to breastfeed.
Q: How do I know if my baby is latching correctly?
A: A good latch is not painful. A good latch usually means that the baby is latched on with a really good fit; tummy to tummy, chin into the breast, and with the nose lifted up just a little bit. The baby’s lips should not be visible and the baby should be held really close to the mother. Ideally the mother should also be leaning back at a 40 degree angle and both she and her baby should be comfortable. So there shouldn’t;t be any neck strain for the mother and no back aches either.
Q: How do I know if I’m producing enough milk for my baby?
A: The only way to really tell is by watching the baby’s output. Parents should make sure that the baby is producing about six to eight wet nappies a day and one to three poos. And that the baby looks quite satisfied after each feed. You also want the baby to be feeding at least eight to twelve times or more over 24 hours. And you don’t have to time the feeds, you want the baby to have flexible and frequent feeds so that they will be able to get what they need. Timed feeds and scheduled feeds can lead to a downward spiral of not having enough milk and also having an unsettled baby.
Q: How do I deal with clogged ducts or lumps in the breasts even after baby has had a feed?
A: I often advise mothers not to pump or use any other means if your baby is latching onto the breast because the best recipe for mastitis or engorgement is really when there is an oversupply. So to deal with clogged ducts, mothers should allow the baby to feed as much as they need and leave things as they are. If there is pain or the breasts feel too full, the best thing to do would be to use ice packs liberally.
I often tell mothers that if they feel that they have a very plentiful supply, ice packs are their best friend. They do not have to be fancy ice packs, even a bag of frozen peas will work. Placing the ice pack on the breast will reduce the amount of blood flow to the breast which will then reduce milk production. This is the best way to deal with clogged ducts.