Newsletter #34: Role of Dads in Breastfeeding Families (Part 1)

By BMSG Editorial Team

This is Part 1 of our newsletter article that discusses and offers suggestions on what fathers can do to support their breastfeeding wives. Part 1 focuses on the findings of a survey that we conducted on breastfeeding mothers to find out what form of support they most valued from their partners. Part 2 (to be released) will focus on speaking to dads who are supportive of and have assisted their breastfeeding wives, as well as line out suggestions of tasks and actions that fathers have done for other fathers to emulate.

 

Background

At BMSG, we have long recognised that a mother’s feeling of satisfaction towards breastfeeding has always been centred on the support that she receives from the people around her. From the hospital to bringing baby home and hereinafter, how a mother feels towards breastfeeding and how she progresses after are almost always tied to whom she anchors her support on.

There are many forms of this support. While we know that mothers love having a mummy tribe of their own, we have also learnt from mothers that how much their husbands do to support them in their breastfeeding journey is key to their eventual satisfaction towards breastfeeding.

The WHO recommendation on what fathers can do as part of the breastfeeding family. 
[Credits: World Health Organization]

Recently, we came up with a survey to find out just what sort of support mothers really need from their husbands and what they feel about dads helping out. We listed tasks that we felt mothers might appreciate from their husbands, citing examples from those that are recommended by the World Health Organization (WHO) in an earlier campaign. While we understand that “help” can be defined differently from family to family, we wanted to know how exactly mothers felt about the amount of help that they are/were receiving or feel that they need more of.

Intent

Another huge part of our intent in creating this survey is also to counter the perception that breastfeeding alienates the father, a reason that many mothers whom we counsel cite as the cause for tension between parents when it comes to breastfeeding their babies. In our counselling cases, some mothers have claimed that their partners feel this way because the breastfeeding mother seems to be spending lots of time breastfeeding the baby.

Screenshot of the New York Times article about a father’s feelings of helplessness and being left out as he watches his wife tries to breastfeed their then-newborn child.

In a recent New York Times article [What Baby Formula Does for Fathers], the writer, who is a father of two, recalls the helplessness he felt as he watched his wife trying to establish breastfeeding with their first newborn. Yet, after days of trying and eventually resulting to formula for reasons of inability to latch the baby well, the writer eventually states this: “Now that I had tasted this (the satisfaction of being able to feed a baby with the bottle), it seemed a little unfair that only my wife would have gotten to enjoy it.”

It was startling that the writer went on to belittle the benefits of breastfeeding, and it was also oddly apparent that nothing was being said about his wife’s feelings towards the turn of events. The saddest moment in the article was the final words of the article: when his second son was born, his wife yet again attempted to breastfeed. Yet, his parting remarks would definitely cut the heart of any mother who wants to try: “Part of me was hoping for the experiment to fail, which it eventually did. I didn’t want to miss out on all those endless hours of providing my baby with exactly what he needed.”

While we definitely do not want to dismiss the fact that many dads feel the same way as they watch their wives breastfeed their young babies for long hours, as mothers ourselves, we also know that there is more to raising a child; breastfeeding is only one of the many long list of things to do.

The Results

But before that, let us present the results and let the facts speak for themselves.

As mentioned before, our survey consisted of a list of specific tasks that we felt dads could do for mothers and the family in general. The following screenshot of the survey highlights the tasks:

What we found:

  • Close to 50 respondents (out of a total of 81 at the time of writing) cited that their husbands were already doing almost all or all of the items listed – this was extremely heartening to know!
  • Over 60 mothers reported that their husbands were already doing the following tasks:
    • Changing baby’s diapers and other non-feeding tasks (68 mothers)
    • Helping out with other chores around the house (63 mothers)
    • Simply being a listening ear (63 mothers)
    • Giving me positive encouragement and empathising words (64 mothers)
    • Defending my choice to breastfeed (64 mothers)

Instagram screengrab of the heartmelting moment when Dwayne Johnson, also known as The Rock, fed his wife food as she was breastfeeding their newborn. [Credits: The Rock’s Instagram account]

  • 59 mothers also wrote positive and touching examples of how their husbands supported their wives, be it physically, mentally or emotionally. Here are some of them (we have so many more we couldn’t include!):
    • Yes I am satisfied with my husband’s involvement. In the early days, he would wake up to change the baby’s diapers, bring baby to me for feeds, then burp baby and put him back to bed. I appreciate the small acts of help, such as setting up my nursing corner at home (prop up pillow, refill my water cup, switch on the fan/aircon etc), assisting me with the nursing cover in public, helping to keep a look out for me in public, feeding me food while I nurse baby. He doesn’t question my decision to breastfeed the baby, and have always been encouraging in his words and actions. He also helped to explain to his parents the benefits of breastfeeding, and how breastmilk can complement solids. Now that my baby is 1, and I have reached my long term goal, he doesn’t question when will I wean but is supportive of my intentions to gentle wean. He would listen whenever I tell him about an article I read etc. He also directs his colleagues/friends who are new mothers to me when he heard that they may need support with breastfeeding their newborn. He helps me to wash and sterilise my pump parts when I get home from work, and also reminds me to refrigerate the milk. He has also taught his mother how to handle the breast milk when I had to be away for work and she was my baby’s carer back in the days when I was still working on weekends.

    • Yes. He is already helping more than he should I feel. He made our parenthood easier for transition. He has made sure that I have enough rest to make it through the day and night. We took turns to ensure we have our own time for rest and at the same time looking after our newborn. He has been very helpful, diligent, proactive, positive and really loving towards me and baby throughout this journey.

    • My husband has been and is already setting the environment right for me to breastfeed our son from the start. He has been all out in ensuring that my pump parts are sanitized for pumping, also, has been the one helping with the chores at home & wholeheartedly supporting me in this entire journey. If it was not for his endless support from the beginning, I don’t think the journey would be any less easier. I’m grateful that I’ve been blessed with an understanding husband.

    • What I appreciate most is my husband staying up just to accompany me while I direct latch. He will talk to me and baby so that I will not feel bored or lonely. This time spent together is really precious and I am glad he is willing to sacrifice his sleep for this. Right after baby is done feeding, he will also take over and help to burp and change her diapers.

    • My husband is fully supportive of my choices and my approach to nursing my children. I nursed my son till he was 5 and my daughter is still nursing (she will be 4 this year) and he has always defended my choice to others who have their own (less than encouraging) opinions about this.

    • When I have blocked ducts, he tries his best to be there for me and has even tried to help massage the blocked duct out.

    • I know he would defend my breastfeeding choices in public when the need arises. He is not shy about me breastfeeding in public, either. He even helps me to adjust my nursing cover and carry our baby once I finish nursing.

    • I’m lucky to have a Paediatrician and IBCLC husband. This is something new for us to parent a preemie, breastfed baby, but at least we know the theories and we work together to make it work. So, I have received full support from the very beginning.

Maxamillian Neubauer became an Internet sensation when a photograph of him breastfeeding his newborn daughter using a Supplemental Nursing System (SNS) went viral. His wife had post-birth complications and was not able to breastfeed their baby. [Credits: smalljoy.tv]

  • While many of the respondents claimed that their husbands were already supporting them physically and emotionally, some of the husbands went beyond that. Some husbands became their wive’s biggest advocates and were well read on breastfeeding before and after pregnancy, and were ready to defend the family’s choice to breastfeed in social settings (i.e. in front of family, friends etc.)
    • So very satisfied. I have an amazing husband who can and does everything except lactate. I am aware that I am truly blessed. Before the birth of our first child, he attended antenatal classes with me, read up on breastfeeding, defended our decision to breastfeed against my mother-in-law and even tested out the breast pump on himself. He is a strong advocate of breastfeeding and never hesitates to encourage his friends to support their wives in breastfeeding too, even sharing breastfeeding knowledge.

  • We also saw a small percentage of mothers who wished that their husbands could do more; less than 10 mentioned that their partners were not supportive of breastfeeding in the first place and hence, were not forthcoming in helping these mums with breastfeeding-related duties
    • No . Husband has not been supportive. He kept urging me to give our baby formula after he turned six months as he believed it is better and can fatten baby up. I refused to give in and turned to Facebook support groups for mothers. I have managed to breastfeed my elder child till 45 months old when she self-weaned when I was 7 months pregnant with her younger sibling. I’m still breastfeeding my second child who is 15.5m month-old now, unsurprisingly with no emotional and mental support from husband. Friends, and breastfeeding groups for mothers are my support systems!

    • Not 100% satisfied. My husband shows his unhappiness frequently every time I sought his help to take care of  baby  when I needed to pump or when I was exhausted.

  • Less than 5 respondents also said that while their husbands were trying their best, they wished that husbands would do things without being asked i.e. take a more proactive stance in helping mothers
    • As a breastfeeding mother, I would like my husband to help me more on caring our children. Just a simple change of diaper every night will do. I am not saying that my husband is not doing anything; he does what I asks him to do. Instead, I would like my husband to proactively offer some help without me asking for it or make me feel better just by saying “go rest, you are tired” because I was really exhausted and emotionally low during postpartum.

We were heartened that there was already a significant number of husbands out there, also a large number potentially untapped through our survey, who were already supporting their wives. This affirmed our beliefs that breastfeeding does not need to make a father feel alienated or helpless; he simply needs to redefine the assistance and support he can give his wife and child(ren). There are many other things a husband can do; breastfeeding is just one of the areas of caregiving and most importantly, it is the love and bond that transpire between a mother and father that greatly determines the happiness of the child.

In Part 2 (to be released soon), we speak to some fathers who have supported their breastfeeding wives to find out what they feel about the experience, as well as roll out a guideline of tasks that fathers have done that can be emulated by future and current fathers. Stay tuned!

Newsletter #33: Breastfeeding & Caesarean Sections

By the BMSG Editorial Team

Some mothers-to-be know that they are going to have a Caesarean-section, but some end up in the operating theatre with an emergency C-section – and may not know what to expect. Either way, you absolutely can breastfeed even after a C-section. Forewarned is forearmed; what are some of the difficulties of nursing after a major surgery and how can you prepare for them?

1.     General anaesthesia vs local anaesthesia

Most C-sections in Singapore are carried out under local anaesthesia; that is, a spinal block or epidural. With an epidural, mothers will be awake throughout the entire procedure and can even have skin-to-skin in the operating theatre. Having an epidural also means that once the baby is ready to be passed to you, you can initiate breastfeeding as soon as possible, whereas with GA, you may not be able to meet baby for a few hours after the procedure as you slowly awaken from the strong anaesthetic. In fact, both baby and you may be too groggy at the beginning to breastfeed effectively. However, even if you need to undergo GA for medical reasons, you can still breastfeed your baby.

Deborah Su, a mum of two children, breastfeeding her baby post-operation. (Photo credits: Deborah Su)

2.     After-effects of anaesthesia

Many mothers will endure some side-effects of anaesthesia, such as uncontrollable trembling, chills, and nausea. These side-effects can be quite strong as the dose of anaesthesia that is given for open surgery is much higher than the dose for a vaginal birth.

One mother, JoBeth Williams, recalls that she was trembling so hard after surgery that she did not dare to carry her baby at first as she was afraid she would drop her. It was not until the trembling subsided after about half an hour that she was able to initiate the first latch. Another mother, Wendy Sim, experienced dizziness and severe nausea for up to nine hours after the procedure. Wendy shared that even though she had such extreme side-effects, she persevered in having her baby close to her so that they could benefit from skin-to-skin contact. Despite this seemingly rocky start, both JoBeth and Wendy went on to have smooth breastfeeding journeys with their babies!

A mother who has had a c-section can initiate breastfeeding just like she would with a normal delivery,

Also, remember that after delivery, a C-section baby may be quite sleepy as she also feels the after-effects of the anaesthesia. Skin-to-skin contact will certainly help, as will rubbing baby’s feet or chest to rouse her. Secondly, C-section babies may post a higher birth weight and slightly higher initial weight loss due to IV fluids given during the surgery. Keep this in mind, as studies have shown that babies whose mothers received more IV fluids before birth urinated more during their first 24 hours and as a result lost more weight. Therefore you should not worry too much about a slightly higher initial weight loss, as long as you can see baby is drinking well and producing the right amount of wet and dirty diapers.

Wendy shared that even though she had such extreme side-effects, she persevered in having her baby close to her so that they could benefit from skin-to-skin contact. Despite this seemingly rocky start, both JoBeth and Wendy went on to have smooth breastfeeding journeys with their babies!

3.     Protecting your wound while nursing baby

The C-section wound can be very tender and painful in the first few days or even weeks. Many mothers have difficulties bending, sitting up, and walking. Try and arrange for as much help as possible to have baby brought to you, or safely co-sleep with your infant so that you do not have to move too much. Mother of four Chng Bee Wee recalls how after all her C-sections, all she did was rest in bed and breastfeed!

You can also experiment to figure out which breastfeeding holds work best for you. Many websites will recommend side-lying to nurse, but some mothers actually find this very difficult as the wound is not comfortable when lying on the side. You may find it easier (although it might take a bit longer for you to get ready) to sit up and nurse with cradle hold instead. Deborah Su, who had two C-sections, is one of many mothers who prefer to use a breastfeeding pillow which can help to protect the wound area, while other mothers may find that the pillow presses on the wound and is very uncomfortable. Many lactation consultants recommend the football hold as this keeps baby’s body away from the wound, but again, some mothers find the position unnatural while others welcome how easy it is!

In the end, it is really a matter of figuring out what works for you! The most important thing is to keep an open mind and be willing to try as many things as possible so you can decide what is the most comfortable and effective position for you and baby to breastfeed in.

Nursing pillows can help to cushion the c-sect wound during breastfeeding.

4.     Preparing for your milk to kick in

Contrary to popular belief, a C-section actually does not affect how fast your milk comes in. Since milk production is kickstarted by the removal of the placenta from the uterus, a mother who has had a C-section will make milk at the same rate as a mother who has had a vaginal birth. As always, it is important to nurse your baby on demand and latch baby as often as he cues for it with rooting motions, small sounds, and rubbing his face with his hands. The best way to get your milk supply up and running is to tell your breasts to make more by nursing your baby as often as possible.

Since you will likely be at the hospital for a couple of days, make use of your time there to get as much assistance from the hospital lactation consultants as possible. Enlist your hospital LC to help you attach baby to the breast as soon as possible after delivery, and ask for them to check the baby’s latch and milk transfer if you are not sure if things are right. Don’t forget that you can and should continue to seek professional support after going home! Nurul Huda Alkhatib was lucky to have picked a hospital with a proactive parent support system. “The lactation clinic from the hospital called me post-discharge just to ask how I was doing and if my breastfeeding was okay. They assured me that I could just call them if I had any questions or worries,” she says.

Ask your doctor for breastfeeding-friendly painkillers.

5.     Ease your pain

Some mothers are afraid to take painkillers, worried about the effects that the medication might have on baby. Don’t worry – after a C-section, it is standard practice for doctors to prescribe antibiotics and painkillers that are safe for breastfeeding; if you are concerned, it is always good to check in with your gynaecologist or even the nurses in the maternity ward.

Why is it important to take your meds? Firstly, the antibiotics serve to ward off possible infection of your wound. Secondly, remember that a C-section is in fact major surgery, and you need to take care of yourself as well. This includes relieving any post-operative pain, especially if it is making it difficult for you to cope with caring for your baby or even with day-to-day life. While it is true that what you eat and drink while you are breastfeeding make their way into your milk supply, where it can then be transferred to your nursing baby, it is important to remember that your baby only gets a tiny fraction of what you put into your body – and that these breastfeeding-friendly medicines, at their appropriate dosages, should not have an adverse effect on your nursing baby. Of course, the painkillers are optional, and if you are able to manage well with your level of unmedicated pain, you may wish to go without.

Surround yourself with good support and getting your partner on board can make way for a smooth start to breastfeeding.

6.     Surrounding yourself with support

One thing that all the C-section mums we spoke to agreed on was that support was vital to successful breastfeeding. Some mothers recruited their relatives to help out, such as their own mothers or sisters who fully supported their decision to exclusively breastfeed their baby. Others were lucky enough to have spouses who could make flexible work arrangements to stay home and help. Some of them were even able to hire pro-breastfeeding confinement nannies who were knowledgeable and experienced in assisting C-section mothers nurse their babies.

This sort of support is invaluable also in settling things like all the household chores and childcare for older kids so that the new mama can stay in bed, rest, recuperate, and concentrate on feeding the newborn. According to mother of two Ashtalaxmi Dinakaran, having a supportive husband and family was crucial when it came to breastfeeding. Nurul Huda agrees, saying, “If my mother had not given me words of encouragement, to remind me to pump especially when I was already so exhausted, I don’t think I would have the perseverance to exclusively breastfeed for the last 11 months.”

Another way that your support network can help is to prop mama up in her decision to breastfeed. Nili Seah, who has a baby daughter, absolutely hated people asking her to give the bottle to baby, as well as other unconstructive remarks. “I feel that I want to nurse her whenever we both feel she needs or just wants to nurse,” she says. Making sure that you have someone solidly on your side at home can be really uplifting for a vulnerable new mother, who needs encouragement that she is doing the right thing for her baby.

“I feel that I want to nurse her whenever we both feel she needs or just wants to nurse,”