September 2017: Milk Talk

By Namrata Trivedi, BMSG Board Member and Dietitian

Once breastfeeding is well established, our breastmilk volume would increase from a meagre 50ml to as much as 750ml a day to meet a baby’s demand. So it would be prudent to assume that the rise in our milk volume coupled with the hot climate we live in would increase our requirement for fluids during this crucial time. We should aim to drink at least 1.5 to 2 litres of water each day in general, although requirements may vary, as some mothers may need to drink more water each day when breastfeeding is well established. Some mothers may end up getting hemorrhoids when they don’t drink enough water.

Thirst is a good indicator of your fluid needs. If you are worried that you may forget, pour out water in a jug in the morning and try to drink it all up by the end of the day. Your water needs can be also be met by including a variety of nutritious fluids such as milk, unsweetened juices and soup. (1)

Whilst the long term risks of consuming alcohol during breastfeeding are not as well defined as during pregnancy, it is established that alcohol passes through to the breastmilk and excess consumption may decrease your milk supply and cause the baby to suckle less. (2) Therefore, it would be wise to limit alcohol to an occasional glass and wait for a few hours before breastfeeding to minimize the amount of alcohol that’s passed on to your baby.

Some extra fluid tips when breastfeeding:

– Keep a large bottle of water at the places where you usually breastfeed or pump.

– Drink a glass of water or other beverage every time you sit to breastfeed or pump.

– Limit tea and coffee to in-between meals in order not to interfere too much with iron absorption.

– Caffeine, found in coffee, tea and some soft drinks is a diuretic that causes us to pass out more fluids and cause dehydration so limit your caffeine intake. Do note that alcohol is also a diuretic.

– Some beverages, such as soft drinks and fruit drinks, also contain added sugars. Limit your intake of these beverages especially if you are gaining too much weight.

Reference:

1) Ministry of Health, HealthHub, contributed by Health Promotion Board 2015, accessed 16 August 2017, https://www.healthhub.sg/live-healthy/159/eating_guide_breastfeeding_mothers

2) American Academy of Pediatrics. Policy Statement. Breastfeeding and the Use of Human Milk. Pediatrics 2012;129;e827; originally published online February 27,2012. http://pediatrics.aappublications.org/content/129/3/e827.full

 

 

August 2017: Milk Talk

By Hafizah Rafie, BMSG Breastfeeding Counsellor

 

Launch of KK Human Milk Bank on 17 August 2017

On 17 August 2017, the KK Women’s and Children’s Hospital together with Temasek Foundation, launched a 3-year pilot programme known as the ‘Temasek Foundation Cares- Donor Human Milk Bank’ programme. This programme is a non-profit initiative launched to provide pasteurised human donor milk to premature (less than 34 weeks) and sick infants. It will begin at KK hospital in the first year, after which the Singapore General Hospital (SGH) and National University Hospital (NUH) will follow.

Breastmilk can be life-saving for premature and sick babies as their immature digestive system is prone to feeding intolerance. They are also at risk of developing a life-threatening condition known as “necrotising enterocolitis”, a serious intestinal disease among premature babies. These premature babies are not able to process infant formula milk. Furthermore, mothers of premature babies may sometimes experience difficulty in producing breast milk especially in the initial days. With this initiative, mothers of premature babies can receive human donor milk from other breastfeeding mothers without worrying about the impact of the milk on their babies’ sensitive digestive system.

Under this programme, the donor milk will be screened, processed and dispensed by prescription in accordance to the international guidelines. The donated milk will be tested for infections before and after the process of pasteurisation. Milk collected from each donor will be kept at 50ml per bottle. Small volumes of feed of 1-5ml will be administered every 2 to 3 hours. Each bottle of 50ml will not be given to a specific baby. Instead, the 50ml of milk will be distributed to as many premature babies as possible. This means that each baby will receive only 1 feed from that particular bottle of 50ml. Thus, a baby will receive milk from about 20 women throughout the time in the NICU, without knowing the amount of milk consumed from each individual donor. In addition, all donors will be kept anonymous. However, if the baby’s own mother starts to produce milk at any point, the mother’s breastmilk will be given first, followed by any added amount required from the human milk bank.

It is important to note that the premature babies will continue to receive donor milk until they are 34 weeks old or until their weight exceeds 1.8kg.

The criteria to be a donor is rather stringent. The breastfeeding mother has to be breastfeeding a baby who is less than 1 year old; a non-smoker; not tested positive for HIV, Hepatitis B and C or Syphilis. Apart from that, the mother cannot be taking any illegal drugs, not consume more than 2 alcoholic drinks a day and not drink more than 3 cups of coffee or tea a day. This strict criteria is to ensure that the babies receive as much nutritional value from the donated breastmilk as possible.

All premature babies regardless of their religion will benefit from the donated human milk bank. The Islamic Religious Council in Singapore (MUIS) has issued a ‘fatwa’ (religious ruling) that Muslim babies who receive milk from the donated milk bank will not be related to the donors by any kinship ties. Thus, Muslim parents in Singapore can be reassured that they can receive the human milk for their premature babies if the mother has difficulty in producing milk in the initial days. With the launch of the human milk bank, parents with premature babies can breathe easy as their babies will now be able to receive human breastmilk and not depend on formula. This will aid in their recovery and wellbeing.

BMSG counselors at the Milk Bank Launch