Dec 2018 Newsletter: Why Artificial Feeding for Infants Should be the Last Resort: Observations from Maureen Minchin’s talk

By Khatim Hamidon, Vice-President, BMSG
Photos courtesy of Alexandria Neoh, Picspirations Photography

Formula milk shrinks penises.

At least, that was one of the revelations about artificial feeding that stuck in my mind during a talk by Maureen Minchin, a renowned Australian breastfeeding researcher. The talk, titled Infant Feeding and Modern Epidemics: Obesity, Allergy, Autism, Diabetes, was organised by the BMSG  last November.

Maureen Minchin has studied the effects of artificial feeding for the short and long term.

Minchin, who pioneered the field of lactation consultancy, was in Singapore under the invitation of the Association for Breastfeeding Advocacy (Singapore) (ABAS), and was also promoting her book, Milk Matters: Infant feeding & Immune Disorder, which took almost five years and not without sweat, tears and sacrifices to complete.

Formula feeding is wrought with sensitivity, with mothers pitted against each other on which mode of feeding is “better”. Minchin, however, did not shy away from the fact that formula milk should only be used as the last resort on what an infant should be fed during her talk. This was also an important tenet that underlies her writing.

Many people know about the benefits of breastfeeding (which is not a “benefit” to begin with, because breastfeeding should be the norm!). Breastfeeding reduces childhood illnesses, improves mothers’ health and promotes bonding between mother and child.

Minchin bravely delved into this further. She posited the milk hypothesis, in which breastfeeding is critical in transitioning a baby from a life inside the womb to a thriving life outside of it.

From health professionals, to breastfeeding counsellors, mothers and members of the public – all were interested to hear what Minchin had to share.

Breastmilk is the species-specific building blocks of the baby’s growth and development. An infant’s gut is permeable for this reason: to absorb stem cells and growth factors, besides the nutrients and antibodies in breastmilk, so as to develop optimally.

When breastfeeding is not realised, and the baby is exposed to formula milk instead, this will trigger epigenetic changes.

Babies exposed to formula milk are developing on ingredients that are not easily absorbed by their tiny bodies, and instead can be harmful to their gut – for example, synthetic nutrients derived from marine algae – which results in the baby’s development not following the same trajectory as that of a breastfed baby. This in turn affects babies right to the cellular level, skews the gut microbiome and this may be manifested both in the short and the long term hence why the various list of modern epidemics that Minchin shared with us in the title of her talk: obesity, eczema, PCOS, precocious puberty…and shrinking penises.

That is not all. These changes are also vertically communicated from the parent (either mother or father) to their children, and compounded through generations, as more and more babies are introduced to the supposedly modern artificial feeding.

It goes without saying that Minchin’s position is not shaming parents who are not breastfeeding their infants. On the contrary, she means that the majority of parents are not fully informed on the harms of artificial feeding. “How many OBGYNs actually talk to mothers about the importance of breastfeeding?” she asked the audience.

Minchin shared that a mother of a sick child cried when she read Minchin’s book, and exclaimed that she was relieved that whatever that her child was going through, was not her “fault” as a mother. That truly pierced my heart, because this was essentially a mother trying her best caring for her child and fighting the inadvertent product of previous generations.

It goes without saying that Minchin’s position is not shaming parents who are not breastfeeding their infants. On the contrary, she means that the majority of parents are not fully informed on the harms of artificial feeding. “How many OBGYNs actually talk to mothers about the importance of breastfeeding?” she asked the audience.

Some of BMSG’s volunteer counsellors and EXCO members with Minchin (centre, in black).

It feels quite bleak when you think about the generations of populations around the world introduced to unnecessary artificial feeding, and the well-meaning but damaging belief that it is a cure-all for almost any ailment: jaundice, weight loss, ineffective suckling, etc. Perhaps so many illnesses and health conditions could have been averted should young infants receive only what their sensitive tummies are meant to only fully digest: breastmilk.

But all is not lost. “Epigenetic changes do persist, but don’t persist forever,” Minchin explained, “…if we can manage to get the right care for breastfeeding babies for a few generations, we may be able to revert back to a better baseline genome.”

As the saying goes, when we know better, we do better. Let’s hope we continue to breastfeed, not just for ourselves, but also for our communities and society.

Minchin concluded with a stirring dénouement that, to me, simply cannot be summarised:

“Every one of you who is actually breastfeeding or has breastfed, has changed history for the better. You’ve helped to make the world a healthier place. You can regard yourself as (a) positive miracle worker, having succeeded in a society that stacked against success, structurally, in every way. If society just understood how really good breastmilk is, every mother would have been paid to stay home and breastfeed, or employ a wet nurse to do the job for her.”

I wanted to burst out crying. Mothers; we are miracle workers. Continue to advocate for breastfeeding for your child’s health, and for your child’s child’s health. We can make this world a better place.

Visit Maureen Minchin’s site here for more information on her work. You may also want to consider getting her book, Milk Matters: Infant feeding & Immune Disorder, which is sold at the BMSG website for $95. Part of the proceeds will go towards the BMSG.

Nov 2018 Newsletter – Nur’s Story: Nursing Through Pregnancy & Tandem Nursing

As told to the BMSG Editorial Team

For many of us who are expecting our second or subsequent baby while still nursing our older baby, nursing through pregnancy and tandem feeding may seem to be an uphill task. We speak to our EXCO member and breastfeeding counsellor Nur Shirhaini, a mother of four, as she shares her experience nursing her third child during her fourth pregnancy and how she survived tandem nursing with the arrival of her youngest.

Nur (centre) managed to tandem nurse her two younger daughters, Dyana and Maria (in stroller), who were born 18 months apart. [Photo courtesy of Nur Shirhaini]

Making the Decision to Nurse During Pregnancy

Nur, a working mother of four, loved breastfeeding her children. When she was pregnant with her fourth child, her third baby was a mere seven-month old. As breastfeeding had gone rather smoothly since her little baby was a newborn, she was keen to continue breastfeeding her third child. “When my OBGYN confirmed my pregnancy, he advised me to quit breastfeeding as it was believed that it could cause early miscarriage,” said Nur.

The early childhood educator refused to stop breastfeeding and was positive that her pregnancy would turn out well. Having done her research, she knew that as long as she had an uncomplicated pregnancy, any possible risks of breastfeeding were low.

More importantly, she felt her third child was much too young to be weaned. “I did not want to put my very young baby through the trauma of weaning off breastfeeding,” said Nur.

A Temporary Bout of Nursing Aversion

All was smooth-sailing during the first two trimesters and the thought of prematurely weaning her third was never on her mind. However, when she arrived at the third trimester, things took an unexpected turn.

“I suddenly had nursing aversion. My nipples were always sore and hot from nursing my toddler to sleep. I found it difficult to wear a bra or a t-shirt without feeling uncomfortable,” said Nur, who felt that it took every bit of willpower to keep on breastfeeding.  The struggle was real and it was an ordeal during every feed. She would feel her daughter’s tongue grating on her nipples and the pain was so hard to bear that she couldn’t wait for each session to end. At times, Nur would avoid breastfeeding her baby but her cries were too much to bear for her mother’s instinct. She would then cave in to her baby.

Nur describes the dilemma of wanting to nurse her baby but fearing the pain: “I would ask my husband to put my daughter to sleep because I was afraid to nurse her. However, whenever she cried, it would crush my soul and I would run back into the room and offer her my breasts.” Her third baby was the first child she had breastfed for so long; she loved breastfeeding and enjoyed nursing her previously. “But at that moment, I dreaded it so much that I prayed she would just self wean,” said Nur.

However, luck was on her side in the form of robust family support from her spouse, her mother and her in-laws. She bit her tongue and endured for a few more months until the day her newborn arrived.

With good family support especially from her husband, Nur managed to tandem nurse Dyana and Maria for seven months. [Photo courtesy of Nur Shirhaini]

How Tandem Nursing All Began

The moment was surreal; there was her precious newborn on one side and her 18 month-old daughter on the other. “I remembered Maria (the toddler) looking at me while I was breastfeeding Dyana (the newborn). She then went over to the other breast and helped herself to it!” Nur continued to tandem feed her babies for another seven months until her fourth child was hospitalised for bronchitis. Her toddler then self-weaned at that point.

Nur acknowledges that tandem feeding was not without its challenges. She had her fair share of sore and cracked nipples, coupled with exhaustion especially with her newborn. However, she reminisced about the feelings of bonding and positive association with her children that breastfeeding offered to her and her children, especially as a working mother: “I felt somehow that when I managed to tandem nurse as a working mom, I represented the possibility to other working moms that it was possible. Although it was hard, it was achievable.”

Dyana (left) and Maria (right) share a special bond as tandem nursing siblings. They almost look like twins! [Photo courtesy of Nur Shirhaini]

Tips on Breastfeeding Through Pregnancy & Tandem Nursing

Nur’s advice to other mothers who are apprehensive about tandem nursing include the following:

  • Do lots of research on breastfeeding during pregnancy and tandem nursing. Your OBGYN may not recommend that you continue breastfeeding while pregnant. However, it is important that you read up and make an informed decision.
  • Be mentally prepared. Tough times build resilience. It will get easier with each passing day. Nur’s toddler would always help herself to the right breast and she would say the left one is for the little sister. This made it easier for her as she knew her daughter was finding a way to cope and adapt with the change in circumstances. Tandem nursing also helped to tighten the bonds between the two sisters.
  • Make things easier around the house as tandem feeding may mean that you are spending more time with your children at the breast. Nur chose to invest in healthy foods and snacks so that she had one less task to worry about.
  • Find ways to connect with your toddler or older child. Talking to your older baby/child and doing some simple activities like reading and playing can greatly help to assure your older children that you still love them.
  • Babywear your younger child so that you have your hands free. Nur found that her baby slept better when she wore her, which gave her more time to bond with her toddler.

Nov 2018 Newsletter: Indian Confinement Practices

By Namrata Trivedi, BMSG EXCO Member

I can hear mum’s footsteps as she walks into the house while the maalishwali* is vigorously rubbing me down with a concoction of warm oils and herbs. My newborn is snoozing away in the cot nearby after being given a bath and massage, which he violently protests daily. I wonder why, though, because he seems peaceful now, all wrapped up and tightly bound like a cigar, as my husband calls it.

I can hear mum chatting with my helper, giving her instructions as she places my daily lunch tiffin on the table. The maalishwali asks me what’s on the menu today and whether my lunch will be dripping with ghee like yesterday’s meal. “Why of course!” mum exclaims as she walks into the room. She’s overheard our conversation and begins describing to her why it’s imperative that I eat ghee after giving birth. Their voices drown out as I begin piecing together in my mind every bit of advice on Indian confinement practices and diet I’ve overheard over the years from all the ladies in my family.

*Maalishwali – a female traditional Indian masseuse

The Crucial First 40 Days

For most Indians, the confinement period lasts for forty days after the day of delivery. This period provides the delicate newborn physical protection and allows the mother complete rest and recuperation, and also to establish breastfeeding. Tradition calls for the new mother to get daily massages and binding to help strengthen and heal her body, have hot showers or baths every day, cover her head with a scarf so that she doesn’t expose her ears and catch a cold, and have a diet rich in ingredients that promote lactation, digestion and resistance against infections.

A Nutritional Diet for Mums

Foods that promote lactation would include coconut, fenugreek seeds (methi), fennel seeds (saunf), dill seeds (sawa), cumin (jeera), carom (ajwain) and sesame seeds (til).

Green leafy vegetables such as spinach, fenugreek and mustard greens, and especially from the gourd family such as bottle gourd (lauki), apple gourd (tinda), and sponge gourd (tori) are traditionally believed to improve milk supply.

Carbohydrate sources such as oats, whole wheat and broken wheat (daliya), elephant yam (suran) and jaggery provide much needed energy.

Ginger, dry ginger powder (saunth), garlic, spring onions are encouraged because they promote circulation. However, the latter two should not be consumed with dairy products in the same meal. According to Ayurveda, milk generally does not tend to go with any food. It is best consumed on its own, and if mixed with garlic and onions, may tend to cause gas.

Many Indians, being vegetarian, rely on pulses and lentils as a source of protein and iron such as masoor and moong dal. Therefore, on my plate daily would be porridge (khichdi) made of moong dal and rice as opposed to just the latter on its own, which, according to the elders, would be gassy.

Nuts and dried fruits are a daily accompaniment to most main meals and snacks for the calories they provide. Ghee is encouraged in copious amounts because a mother is thought to have lost a lot of energy during childbirth and ghee helps one to regain strength, repair her pelvic muscles and promote bowel movement.

Turmeric is synonymous with Indian cuisine. Just as Salt Bae flamboyantly sprinkles salt over his meat like shimmering magic, imagine our Indian mothers doing the same with turmeric over our milk, stir fries and porridge after childbirth. This anti-inflammatory, antiseptic and antifungal agent is sure to be found in every Indian household.

Gondh (edible gum taken from the bark of Acacia trees) was another one of those magical ingredients that my grandmother extensively talked about and encouraged daily. It has been used for centuries in the Middle East, Africa and Ayurveda after childbirth as it helps with wound healing, digestion and bone health.

Foods Mums Should Avoid

Foods that should be avoided during the first forty days and gradually introduced back into the diet would include those that are believed to cause gas (even for the baby) and constipation, such as cauliflower, cabbage, okra, broccoli, onions, urad ( split black gram) and toor dal (pigeon peas), chickpeas (channa), kidney beans (rajma), black eyed peas (chawli), potatoes, foods fried with chickpea flour (besan), pickles, green peas and dry peas.

I think about the foods that were discouraged during confinement and came to the conclusion that all the knowledge from my western-educated degree (I happen to be a dietitian) had to take a back seat when debating with my mother about why I couldn’t have my favourite okra stew or chickpea curry just after childbirth. Surely the hundreds of years of experience and knowledge of our cultural practices passed down through generations of women should hold some weight? Plus, I was assured, again and again, that this is only for a short time!

I snap out of my thoughts as I am told that the massage is done. I grumble at the maalishwali as she wraps my belly so tight it feels as though she’s cut off my air supply. I waddle over the dining table to eat before the little one wakes up again. “Remember, what you eat for these 40 days will affect your next 40 years!” quips Mum as she walks out the door.

Confinement Diet Tips from the Author:

  • Start with eating easily digestible food and gradually go back to a regular diet towards the end of your confinement period.
  • Note that the above-mentioned foods and practices vary from family to family, and region to region. If a particular food doesn’t cause you any side effects such as bloating, constipation or gas, then go ahead and have it in moderation. These recommendations are general and each person should look at what suits their body type.
  • Eat local and seasonal produce.
  • Eat warm, freshly prepared foods and avoid cold leftovers (this makes sense as food poisoning is the last thing you want to get during this period).
  • Eat every few hours, rather than infrequent big meals that can cause discomfort.
  • As long as you are breastfeeding, you should aim to have more calories to produce more breastmilk for your baby. Do note that you should avoid filling up with empty calories. Rather, try and have nourishing foods packed with nutrients like green leafy vegetables, whole grains, fruits and nuts.