Aug ’18 Newsletter: Babies, boobs & Zzzz

By Elaine Chow (BMSG President)

Across the various counselling channels that we have here at BMSG interacting with many mothers over the past several months has led us to notice a trend of a new recurring topic – sleep training. Many mums write to us, call our helpline or post on our Facebook group, asking how they can manage or improve baby’s sleep. I thought it timely for BMSG to put our position on this matter publicly.

Worrying about baby’s sleep?

Sleep is such a hot button topic among parents! So many mums worry about how much sleep baby is getting; whether it is enough, how we can get baby to sleep more or longer and many other concerns. There are also so many different, and often conflicting, viewpoints out there. Who should you listen to? Which approach best supports breastfeeding? If you want to learn more about infant sleep, and want to get information that supports breastfeeding, then this article is for you.

Myths & Misconceptions About Baby Sleep

The root of most of these worries and questions is an incorrect understanding of how babies are supposed to sleep, particularly at night. The general misconception is that babies should begin life with x number of night wakings, slowly decreasing to x-1 number of night wakings, then x-2, and all the way down to zero. The reality, though, is that there is a great variance in the number of night wakings that babies have, and this tends to go up and down for the first two years of life or longer. This is much later than many parenting books or “sleep experts” would have us believe.

Another misconception is that babies need to be taught how to sleep, or how to become “independent sleepers”. The reality is that babies do not need to be taught to sleep, in the same way that they do not need to be taught to walk. Babies will sleep best when they are put in an environment that encourages sleep – when they feel full, warm, loved and comforted. Breastfeeding your baby to sleep naturally creates such an environment.

Why Night Waking is Completely Okay

It is completely normal that babies, and even toddlers and children, need help to fall asleep. At such a young age, they can hardly do anything for themselves! They need you to feed them, change them, carry them around. So naturally, they will also need help to fall asleep. There are many ways to help them fall asleep, and breastfeeding is a great way to get this done. The act of breastfeeding, that close contact with mother, is always a surefire way of helping baby calm and settle down. Furthermore, breastmilk that is made at night contains higher levels of melatonin, a sleep-inducing hormone.

One of the lesser-mentioned benefits of breastfeeding is that it reduces the risk of SIDS (Sudden Infant Death Syndrome). The exact explanation for why breastfeeding reduces the incidence of SIDS is still unclear, in part because the reasons for SIDS are not clear. Night wakings protect babies from SIDS, and breastmilk, being easily digested and often consumed in smaller quantities at the breast than in the bottle, promotes night waking.

But with the strain of modern living, especially with mothers having to return to work so soon after giving birth, how can we ensure that we are also getting enough sleep ourselves?

CO-SLEEPING

Safe co-sleeping (or bed-sharing) is the main way in which breastfeeding experts recommend for mothers to get as much sleep as they can, while still tending to the needs of baby at night. For tens of thousands of years, bed-sharing between mother and infant has been the biological norm for humans. It is only in modern times, with the decline of breastfeeding, that authorities have begun to recommend infants sleeping separately from their mothers.

The basics of safe co-sleeping are for babies to be sleeping on the back, on a firm surface, in a smoke-free environment, with a light blanket. Babies should not have their head covered, and the bed should not have any stuffed toys or pillows around the baby. Parents should also be non-smokers, and not under the influence of sedating medication, other drugs, alcohol, or other substance that will impair their awareness of baby’s presence.

The dangers of sleep-training

What about the sleep training techniques which are mentioned so often in so many modern parenting books? Methods such as extinction, controlled crying, check and leave, pick-up-put-down, or any other time-based method of withholding feeding or comfort to your child have become part of the vocabulary of the modern mum. But science clearly shows that such methods have a detrimental impact on the child. Babies fare best when they have caregivers who are responsive to their needs.

From a breastfeeding perspective, limiting or scheduling feeds can affect milk supply and milk intake by baby, resulting in other health issues further on such as slow weight gain, early weaning or the need for formula supplementation.

Breastsleeping – yes, there’s such a thing!

All this knowledge and information about breastfeeding, night feeding and infant sleep, has come together in a new concept proposed by sleep researcher Dr James McKenna – BreastsleepingBreastsleeping occurs when a nursing mother is safely bed-sharing with her nursling. His research showed that:

“…breastsleeping dyads synchronize their breathing and sleep cycles so that baby latches on and mother adjusts coverings, kisses baby’s head, etc. without either waking up fully. Breastsleeping babies also maintain higher body temperatures and breastfeed double or triple the number of times during the night compared with solitary sleeping infants. Both increased nighttime arousals and breastfeeding protect against Sudden Infant Death Syndrome (SIDS).”

Understand What is Normal

Sleeping close to your baby at night, understanding and accepting his normal biological behaviour to wake at night, responding to his needs for comfort or feeding, all contribute to healthier and happier baby, and helps you maintain breastfeeding for longer. And of course, the longer you breastfeed, the greater the benefit to you and your baby. So don’t worry, your baby is normal, and they will all eventually learn how to sleep on their own when they are ready to do so.

References & Further reading:

Counsellor Spotlight: Kwan Xiuwen – June 2018 Newsletter

By the BMSG Editorial Team

This month, we celebrate the graduation of our new counsellors who have completed their 10-week training in June. They have officially started their new duties a few days ago and are raring to go! One of them is Kwan Xiuwen, a full-time mother of two boys who was previously working as a technical writer for 10 years before leaving the workforce. We speak with her to find out how the training went and what her aspirations are, as a newly-minted breastfeeding counsellor with the BMSG.

Xiuwen (in blue) with her lovely family. [Credits: Kwan Xiuwen]

Congratulations on graduating from the 2018 intake of the BMSG Breastfeeding Counselling Training! How does it feel to finally become a #bmsgcounsellor?

Thank you! The BMSG counselling training was a great bonding experience, thanks to all the wise, warm, and generous ladies involved. I have mixed feelings about the completion of my training. I’m sad that I won’t be seeing everyone on a regular basis anymore. I’m nervous about whether I can identify what each mum who I will counsel really wants to know, and yet make sure that I’m also identifying what they need to know, so that mums can find the best solutions for both themselves and baby. However, I’m confident that the experienced counsellors will be compassionate and helpful in guiding me to improve my skills further. And I’m elated that I can do my bit to help mums make informed decisions about breastfeeding their babies.

Could you tell us about the whole training process from the start right up to graduation? What were some of the things you had to do during training to equip you with the necessary skills to become a breastfeeding counsellor?

The training process was focused on empowering each mum to make the right decision for her family’s unique situation. In order to do so, the training consisted of three parts: breastfeeding knowledge, counseling skills, and lastly how to interact with ethics and inclusiveness.

During the breastfeeding knowledge component, we learned the mechanics of breastfeeding: how the body is designed to work with the baby to produce milk. We also learned about many related areas: the importance of breastfeeding during the first hour after birth, the capacity of a newborn’s stomach as well as the benefits of skin to skin. The training also touched on areas that are not strictly breastfeeding-related, but essential to mothers of newborns: baby sleeping patterns, first foods, and how to deal with the chaos that is early motherhood. This first component of the training taught us the ‘hard skills’: the information to be communicated.

Our baby-friendly counselling training in session.

During the  second component of the course, we learned counselling skills: how to speak to mums that would make them feel heard and understood. To do this, we tried to internalize the concept of unconditional positive regard: supporting mothers without judging them, no matter what the situation. Besides this overarching mindset, we also learned ways of identifying what the mum wants  to know, filling in any knowledge gaps that she may not be aware of, while ensuring that baby is well. We also practiced many counselling micro-skills: for example, we learned responses that would help mums retain information even when they are frustrated and sleep-deficient. This second component of the training taught us the ‘soft’ skills: how to communicate the information in an appropriate way.

During the third component of the course, we learned about how the BMSG code of ethics protects the various participants: for example, it protects mums from exploitation, protects BMSG’s reputation, and protects counsellors from conflicts of interest. This component of the course also included elements of inclusivity: how to communicate in a way that respects people who may differ from ourselves in terms of culture, language, family type, or economic situation. The third component of the training taught us to be aware of the broader environment: the community of which the BMSG is a part.  

Our newly-minted counsellors will serve on board our remote and physical counselling platforms.

Any memorable moments during training that you would like to share?

One of our assignments required us to reframe a negative part of our real lives to put a positive spin on it. Many of us shared deeply personal experiences and showed how meaningful it is to reframe and shift stubbornly negative perspectives. In our current social-media-heavy culture, it seems that triumphs are celebrated and everyday frustrations swept out of sight, so I was amazed to hear that the other mums were facing problems similar to mine. I felt that although it is thrilling to achieve externally-validated results, what sustains the spirit in the long term is the ability to make such shifts in perspective that allow us to validate our own day-to-day experiences.

What would you say to mums who are aspiring to become breastfeeding counsellors? Any words of advice or encouragement?

Volunteering takes time, effort and resources, with seemingly little personal benefit. However, attending the training alone has convinced me that volunteering can be a fulfilling experience. Besides having a positive impact on the health of breastfeeding mums and their children, you can also remind mums that what they do is valuable beyond measure, even when they are neck-deep in newborns, toddlers, and yet-to-be-folded laundry. In addition, in the role of a breastfeeding counsellor, there are so many skills that you can practice that are relevant to building healthy relationships with those around you, such as active listening, respecting others’ choices, and developing empathy for those with different values and beliefs.

What a great win-win situation: helping others, while improving your own interpersonal skills!

Interested in joining the BMSG as a breastfeeding counsellor? Email nabila@breastfeeding.org.sg to be placed on the waitlist for the 2019 intake of counselling training!