August 2019 Issue: Tandem Nursing an Infant + Toddler

By Elaine Chow, BMSG Vice-President

This month, we speak with our Vice-President, Elaine Chow, who gave birth to her fourth baby this year. Read the heartwarming moments as she shares how she manages and overcomes the roadblocks of tandem nursing her baby and her three-year-old toddler while managing her own emotions and expectations.

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I am a stay-at-home-mum (SAHM) with four children aged 11 years to five months. I was working full time when I had my first two children (and breastfed them both till age four, including tandem nursing them for nearly a year) but I have been a SAHM for the last four years. During that period, I have also been busy being part of BMSG’s EXCO and as a volunteer breastfeeding counsellor.

Tandem Nursing and Bonding

When I found out that I was pregnant with my fourth, I was still nursing my third child who was two years old at the time. Having nursed my older two children until the age of four, I felt it would only be “fair” if I continued nursing my third child. I also felt that he was too young to wean. Having already been through the experience of tandem nursing once, I knew that it would help manage the emotions of the older child through the rough transition of having another baby in the family. And so I made the decision to continue nursing through pregnancy.

After the gruelling nine months of nursing through pregnancy – when I endured nursing through sore nipples, dry nursing and nursing aversion – I was looking forward to tandem nursing. However, nothing beats the rollercoaster of emotions since the new baby was born!

At first, I was happy to nurse my toddler. It felt really nice to have both children at my breasts. I knew that continued breastfeeding was helping my toddler to stay connected with me during a time of immense change and upheaval, and it also helped him bond with his baby brother. I felt happy to be able to still be able to provide that bit of comfort and attention for him. Of course, breast milk is fantastic nutrition for children of any age; I loved that he could benefit from that instead of drinking other types of milk or beverages.

The Adaptation Period

Elaine’s fourth baby <3 Elaine had to adapt to the presence of her new baby while managing breastfeeding her older child.

But as the weeks wore on, I began to feel worn out by my toddler’s constant requests to nurse. I had wanted to let him nurse on demand, to meet his needs for comfort and security after the birth of his baby brother, but it turned out to be more demanding than I had expected.

Nursing aversion also made a return. Even though I had tandem nursed after my second child was born, I didn’t experience this at that time so it was a shock to me when it happened. It became very trying for me to nurse my toddler.

Finding Support is Key

I sought solace in a tandem nursing group chat in BMSG’s Facebook group. It helped so much to know that others were going through the same experience as I was. I even received some breastfeeding counselling myself from one of our fellow counsellors. I was really struggling. There were moments when I even contemplated doing cold turkey weaning. My commitment to child-led weaning was the only reason that kept me going.

With the support of my husband, I have night weaned my son and also weaned off nursing for naps. We now nurse three to four times a day, and this is much more manageable for me.

Managing Feeds and Taking Turns

During the day, I will try to get baby to switch sides. Nursing from both sides is important for baby’s even growth and development. I was initially worried about baby drinking too much of the watery milk and not getting to the cream, but it stopped being an issue after the first couple of weeks. Having my hungry toddler around was definitely helpful during the early days, and helped prevent any issues with engorgement or blocked ducts.

At night, it does get a bit tricky. I used to get baby to switch sides at every feed, but my toddler would usually come into my bed in the middle of the night, and I would worry about him stepping onto baby. So, I now fix baby on one side so that my toddler will know where he should go. With my toddler being night weaned, I am a bit lopsided now as one side remains full till morning. But I hope it will even out after some time.

Tandem nursing is a learning experience for everyone in the family, including toddlers.

Words of Encouragement for Other Mums

Tandem nursing can be really challenging. It usually means that you have two children who are close in age and that, in itself, is exhausting. On top of that, tandem nursing is mothering two children at the breasts and that is an even greater drain on you, so be kind to yourself. It is okay not to love every moment that you are breastfeeding but there will be moments which will touch your heart and make it all worth it — hold on to those. For me, it is seeing my two children nurse together. They are now able to hold hands when nursing and that is just the sweetest thing to witness every day.

Deciding to tandem nurse is part of the decision to embrace (or at least try) child-led weaning. Too often, society, and even other breastfeeding mothers, may find it hard to accept full-term nursing i.e. breastfeeding until your child decides to wean on his or her own. You are a hero for choosing this path: do not make light of this.

For mums who are trying to tandem nurse for the first time, I would highly recommend reading the book “Adventures in Tandem Nursing”. It helped me prepare my heart to bring another baby into my family and gave me practical tips on nursing two children at a go. I loved reading the many heartwarming stories in there. I cannot recommend it enough.

Through the challenges of tandem nursing, one thing that has kept me going is the realisation that my toddler is still very small. He may seem big next to my baby but he really is still a very small person, with a brain that is still developing, and who still needs lots of intense mothering at close quarters. I know my decision to continue nursing him will help him with that. And it is my hope that we will be able to continue breastfeeding until he is ready to wean on his own. Until then, I will enjoy the view of two babies at my breast – watching them hold hands, poke each other and give me milky smiles.

August 2019 Issue: BMSG’s Big Latch On 2019

By BMSG Editorial Team

On 3 August this year, the Breastfeeding Mothers’ Support Group (Singapore) (BMSG) held its annual Big Latch On event together with its co-organiser, the Association for Breastfeeding Advocacy (Singapore) (ABAS). This was in conjunction with World Breastfeeding Week, which is celebrated during the first week of August every year. It was the first time that BMSG had collaborated with ActiveSG, a movement in Singapore which encourages an active and healthy lifestyle, as part of its National Day celebrations in the heartlands. 

Our BLO attendees chilling out picnic-style at SKH campus.

Part of the Global Big Latch On

The Big Latch On (BLO) is BMSG’s flagship event but is also part of the Global BLO, a not-for-profit movement founded in New Zealand which rallies breastfeeding mothers and communities all over the world to come together every year. Participants who have registered their events gather on any day between 3 to 5 August in similar meetups to BMSG’s BLO. For just one minute or so, mothers are encouraged to either latch their babies to their breasts, pump or feed their babies with breastmilk in any method during the synchronised latching segment. The number of women who attend the event is then added and pooled together with numbers from other venues to create a record for the year. This is also the tenth year anniversary of the BLO since it first started out in New Zealand. The Global BLO has turned into a global event that breastfeeding mothers and advocates look forward to every year.

First Time in the Heartlands

BMSG has held its BLO events in many places all over Singapore including Hong Lim Park, Emily Hill, and National University Hospital just last year. This year, the BLO was held on the compounds of SKH Campus located at Sengkang General Hospital together with other ActiveSG events. 

Held picnic-style, attendees sat around in the allocated compound at the venue on mats sponsored by ABAS. The mats were included in the goodie bags which attendees received during registration. It was heartwarming to see families, including fathers, grandparents, aunts and uncles, chilling and gathering together while mothers breastfed their babies. This truly contributed to normalizing breastfeeding in a public setting! 

BMSG President, Khatim Hamidon, giving her opening speech.

Conducting in the heartland also made it easier for mothers and their families to travel to the event. Amirah Diyana Kemat, a mother of a two year-old toddler, who is currently back in Singapore for a visit, felt encouraged to attend the BLO since the event was so near her parents’ home. “I attended the BLO because I wanted to feel a sense of solidarity with other mothers,” said Amirah, who lives overseas with her husband.

BMSG EXCO member and counsellor Siti Nuraidah, who led the organising committee for the BLO, agrees that attending the event was important for parents to see that there is a community that backs their decision to breastfeed. “When organizing the event, the team had hoped for parents to come together to not only show their support for breastfeeding but to also know that there is a community of support for them.” Siti also added that partnering other organisations helped to normalize breastfeeding: “We also partnered various organizations to change their perspective on breastfeeding and garner their support.”

Largest Turnout 

This year also made headlines for BMSG as it was one of the largest turnouts for our events. Over 250 people were present at the event! We were also honoured to have Mdm Rahayu Mahzam, Member-of-Parliament and Advisor to Bukit Batok East GRC, to be our Guest-of-Honour. This was also Mdm Rahayu’s second time in 2 years to grace our BLO and we are extremely heartened by her presence and support for breastfeeding mothers. 

Mdm Rahayu Mahzam (centre in white hijab) graced the BLO. Here, she is seen with representatives from BMSG, ABAS & ActiveSG.

We were also honoured to have celebrity mummy Joanne-Marie Sim hosting our BLO event despite being close to 27 weeks of pregnancy, expecting her third child. Joanne-Marie has also been a breastfeeding mother to her two older children so her presence made it all the more special! 

Synchronised Latching

We are proud to announce that 48 mothers had latched their babies, with one mother successfully tandem nursing her toddler and baby during the BLO. This also included one mother who pumped during the segment. On a global scale, BMSG’s BLO event was one of 814 events held in 28 countries. Breaking down the numbers, around the world:

    • 58,000 people came together to support breastfeeding (this includes spouses, partners, family members, breastfeeding advocates and volunteers)
    • 18,414 breastfeeding parents attended events in their communities and virtually through social media
  • 18,500 children latched and were breastfed 

Joanna Edwards, the organiser of the Global BLO, commented in a press release:

“This year was our milestone tenth anniversary year and as in every year prior, this event continues to inspire me as it supports more families each year and nurtures lasting cultural change. All the hosts who arranged an event in their community have my complete gratitude and I am so happy to have their support: the Global Big Latch On would not work without them. This event is about normalizing breastfeeding journeys, however they look and that’s often not the same for everyone. Just a quick look on our social media feeds over this World Breastfeeding Week 2019 shows this.”

The BMSG BLO was one of the many Global BLO events happening around the world, just like this one in Lansing, Michigan [Screenshot from Wilx.com]

JoBeth Williams, who is also a BMSG staff and counsellor, was the only mother who pumped during the BLO. JoBeth, who is still nursing her toddler, used a Haakaa to express her milk on that day. “I was glad to be able to contribute and do my part for the BLO even though my baby was not able to attend with me that day. I hope that we can promote next year’s event to more pumping moms and help to normalize pumping in public as well!”

Highlights

Apart from the synchronized latching and pumping segment, as part of the Active SG celebrations, we also held a babywearing zumba segment which was led by the amazing (pregnant!) team from Nawal Haddad Fitness. The zumba was definitely the crowd’s favorite, seeing how mothers were energetically swaying with their babies safely attached to them in babywearing gear, dancing their stress and worries away – it was lovely to see our mothers letting their hair down while daddies and other family members cheered them on. 

The Nawal Haddad Fitness trainers (centre) led the zumba session with mothers and their babies.

Safety remains our top concern and we appreciated the presence of our partner for the day, Warabee, a certified babywearing consultancy, to check on our mums who participated in the zumba activity that day. We were also heartened that one daddy joined the zumba segment too!

“It was amazing to see the whole “village” made up of parents and their children coming together and having a good time! Their excitement was apparent especially during the Babywearing Zumba segment!” added Siti.

Other Happenings at the BLO

Knowing that families were coming together, we knew that it was an opportunity to educate families and attendees on how they can support breastfeeding mothers. We were glad to have included the following segments in raising awareness on breastfeeding to families and children:

Dr Mythili Pandi, ABAS Vice-Chair and representative, presenting her speech on empowering women to enable breastfeeding.

Talk by ABAS: Empowering Mothers, Enabling Breastfeeding

Vice-Chairperson of ABAS, Dr Mythili Pandi, talked about how empowering mothers is a key factor to breastfeeding success in families in her talk at the beginning of the BLO event. 

While mothers in the past had a big community or village to support them especially after they had given birth, the reality of the world today is that mothers are living separately from their extended families. As such, they struggle with breastfeeding and managing other motherly duties. As they had grown up not being normalized by breastfeeding, it becomes something that is foreign to them.

Mothers then have to juggle between the tasks of mothering as well as going back to the workforce, a possible threat to breastfeeding especially if mothers are not prepared and are faced with unsupportive or misinformed management.

Breastfeeding Quiz

Daddies took part in the breastfeeding quiz too, to help mummies win some of the awesome sponsored prizes!

There are plenty of myths that have marred the reputation of breastfeeding and we thought a breastfeeding quiz would be a great opportunity for some breastfeeding education for the masses. What’s more, with over 20 sponsored prizes to be won, it was lovely to see very eager participants during the quiz. Our host, Joanne-Marie, made the quiz fun by also receiving responses from daddies – one mummy even kissed her hubby for winning her a much-coveted prize 😀 

Storytelling

BMSG EXCO member & counsellor Far’ain Jaafar (centre) telling stories with her companion Maria the Monkey!

Far’ain Jaafar, who is our volunteer counsellor and EXCO member, is an avid children’s book fan. Being a mum to 2 gorgeous children, she exposed her children very early to reading. We invited Far’ain to share some interesting reads to the older children attending the BLO and she read aloud a few stories centred on the theme of breastfeeding for children. And the children loved it – judging by their eager faces and bright-eyed expressions. There is nothing quite like sharing the love for breastfeeding with young minds.

Power team! Preggers host Joanne-Marie and trainers from Nawal Haddad Fitness (on stage) together with our babywearing photographer Aditi Chivate <3

Well-Received

We are glad that mothers came and enjoyed themselves, and more importantly, felt united and supported in the presence of other nursing mothers. Tina Shroff, a mother-of-two who came to the BLO and latched her one year-old baby, said that it was “incredible” to see so many mothers coming together. “The fact that so many mummies were coming together to get their babies to latch on collectively and be a part of such an amazing community is what inspired me to be a part of this lovely event,” said Tina, who also happens to be a counsellor with the BMSG.

That is exactly what the intent of the founders of the BLO movement and we hope that we can continue to provide this opportunity for breastfeeding mothers and their family members to come together again for next year’s BLO. 

Thank you to our partners and sponsors:

Click here to view our official photographs. Till BLO 2020!

July 2019 Newsletter: Breastfeeding a Premature Baby

By Agnes Nemes-Chow, BMSG Volunteer
Photo credits: Agnes-Nemes Chow

Agnes is a stay-at-home mother of seven children aged between 2.5 months and 11 years. Originally from Hungary, Agnes married a Singaporean and has been living in Singapore for 16 years. She and her family stayed briefly in Australia prior to 2011, and returned to Singapore in January that year when she unexpectedly gave birth to a premature baby. The following is her story on how she was thrown into the waters of breastfeeding a premature baby back then.

Agnes’ son was born at 33 weeks gestation and had to stay in the Neonatal Intensive Care Unit (NICU) for three weeks.

How it All Began

When we moved back from Australia to Singapore in January 2011, I was then expecting our third child and I didn’t realise that the place where we were living in then was a dengue cluster. I was feeling unwell for a few weeks during my second trimester but I just assumed they were pregnancy symptoms. I only casually mentioned to my gynaecologist that the General Practitioner (GP) I had been seeing had suspected I had dengue. During a growth scan later on, they found that my baby was too small for his gestational age but there was nothing we could do about it at that time. A few days later, at 33 weeks, I went into labour and gave birth to a baby weighing only 1.6 kg baby, but thankfully, he was healthy baby. Our son had to stay in the NICU for almost three weeks till he was able to be fed expressed milk from a bottle.

Initiating Breastfeeding

Agnes (masked) with her baby at the NICU doing kangaroo care. Agnes and her husband spent many days and nights at the NICU to ensure that they were able to feed their baby expressed breastmilk before he could attempt to latch.

I had experience in breastfeeding full-term babies but I had no idea about breastfeeding a premature baby. After birth, my baby was taken to the Neonatal Intensive Care Unit (NICU) straight away so I had no chance to breastfeed him. I was wheeled to the maternity ward and I could only see my baby later at night. There was a very kind nurse, who taught me how to express colostrum into a syringe so I kept doing that and it was encouraging to see that after 1-2 mls at the beginning, I could express more and more subsequently.

My baby only took 2 ml of milk for his first feed, but that was all that was needed then. He was fed through a feeding tube. After I was discharged, I was very determined to express as much milk as I could for my baby and we delivered the milk to the hospital every day, sometimes twice a day. In the NICU, the doctors told me that it was very important, especially for a premature baby, to receive breastmilk instead of formula so that he receives all the antibodies to fight infections.

In the NICU, the doctors told me that it was very important, especially for a premature baby, to receive breastmilk instead of formula so that he receives all the antibodies to fight infections.

Conflicting Advice

Some of the doctors also encouraged me to keep trying to breastfeed, so I did. Others told me that such small babies may not end up breastfeeding so the advice was conflicting. My baby never seemed to show any interest in breastfeeding in the initial days when I tried to feed him and I didn’t receive any practical help from the medical personnel. I think the problem was that I was unsure about when he had already been given EBM so when I was allowed to hold him, he was not hungry. The main concern was for him to gain weight and we were told that he could be discharged when he reached two kilograms and was able to drink from a bottle.

Agnes’ son (middle) continued to thrive into a healthy baby and was able to eventually fully direct latch.

The Importance of Support

When he was transferred to the nursery, I asked if it was possible for me to try breastfeeding and they allowed me to try. I made sure that I was there for many hours so that I didn’t miss the feeding times this time around. My baby’s weight was already 2 kilos then but his mouth was still tiny and he struggled to latch and got tired and fell asleep very easily. My husband was my greatest support at that time. He wanted me to spend as much time in the hospital as possible so that I could keep trying to breastfeed my baby. He thought it was the critical time to establish breastfeeding and he was right!

Agnes’ 3rd child (middle) happy with his siblings!

Going Home!

After 3 weeks in the hospital, we finally got to bring our baby home! The older two children were 3.5 years and 20 months old then. I had to continue expressing milk at home. My routine was to wake my baby up (as he tended to sleep throughout the whole day), breastfeed, give expressed milk from a bottle and then pump for each feed. It was very tiring for me and my older kids were especially needy as I was previously away from them so much when I had to go to the hospital. When my 1.5 years old son, who could already drink from a cup, saw the bottle, he also asked me to give him milk from a bottle! It was total chaos at home those days.  At that stage, my baby was only taking a small amount through direct latch and drank a good amount from the bottle. As the days passed, I noticed he was drinking less and less from the bottle and that was a sign to me that he was able to get more from the breast. After about two weeks, when he wasn’t really drinking much from the bottle anymore, I did away with it and we just continued with direct latch. Finally, my life got easier!

Agnes’ son is now a bubbly and healthy 8 year old!

Advice for Parents

From my experience, I believe that it is important to inform the hospital staff that you want to breastfeed your baby and to coordinate the feeding times so that the baby is hungry enough at the time you want to try latching baby. Even if the baby seems too small and weak to feed, through skin-to-skin contact (kangaroo care), the baby can be encouraged to be near the breast. Mums must make sure they express milk at least every three hours, not only to provide milk for the baby but also to establish a good supply so that when the baby can direct latch, there will be plenty of milk available. It is important to spend as much time as possible in the hospital to give kangaroo care to the baby and to keep on trying to breastfeed. It’s a good idea, too, to also ask for help from a lactation consultant.

Breastfeeding a premature baby is very challenging but with good support and perseverance, it is definitely possible. It’s important to start to direct latch the baby as soon as possible and not to give up even if it doesn’t work at the beginning. They will grow and get stronger faster and will be able to latch eventually. If the baby is discharged on bottle-feeding, it’s important to always latch the baby first for each feed and only give expressed milk as a top-up. This way, the bottle can be removed after a while and the baby can be directly breastfed.


Notes for Parents with Premature Infants

  • Ask questions! Don’t be afraid of the medical personnel as they are really there to help you and your baby
  • Offer your baby donor milk such as from the KKH Milk Bank.
  • As soon as baby has been admitted to the nursery and separated from you, ask for a hospital-grade breast pump so that you can start stimulating your breast milk supply! It is recommended that this happens within the first three hours after birth.
  • Hand express colostrum into cups or syringes so that baby can be fed with these precious drops. Colostrum is an extremely potent source of antibodies and no single drop should be wasted!
  • Get help from the hospital lactation nurses and lactation consultants.
  • Kangaroo care and spending lots of time skin-to-skin with your baby helps you reconnect with your baby! Grab every opportunity to bond with your baby! Studies show that skin to skin is a great way to kickstart milk production. Mothers who pump beside their babies tend to yield more milk.