Mother’s Sharing: Sending Breastmilk Back Home

As told to the BMSG Editorial Team

For many of us, being separated geographically from our breastfeeding babies would take a severe toll on our breastfeeding relationships. Felirose Bartolome, however, was absolutely determined to make it work. She is a medical technologist at a Singaporean hospital, and the mother of two young children aged two years old and six months old has been pumping and transporting milk back to her children ever since they were born. She had breastfed her older child till she turned one and is now still breastfeeding her younger child.

Felirose with her sweet baby boy. [Credits: Felirose Bartolome]

Coupled with the pressure of having to pump while at work with a hectic schedule, Felirose faces another headache: having to transport her frozen milk back home to the Philippines. She shares how she sends her milk all the way back home:

“I bring my milk with me when I return to the Philippines every month. If any of my colleagues or friends are going to the Philippines, I would usually ask them to bring my milk with them. I put the milk in a cooler box (a Coleman or Pinnacle box) and use Techni-ice (a type of ice pack that can last up to 18 hours) to keep my milk frozen.

I freeze all my milk in the same quantity so I know how many I can put in the cooler box and how many Techni-ice I need to use. The breastmilk must always be in the check-in luggage,  so I pay for my friends’ extra luggage space.

My parents pick up the milk at the airport and bring it back home. So far, no milk is wasted, and every pack has remained totally frozen. I’m really thankful for the support system that I have and for being able to find tools to help me keep my milk frozen.”

Felirose’s older child, Gianna, who is 2 years old. [Credits: Felirose Bartolome]

When asked what was the biggest challenge in the whole process, she replied: “Time is the most challenging to me, as I need to make sure that I do not pack my milk too early in the event of a flight delay. My milk needs to be packed at least two hours before the flight and I need to factor in the journey of going to the airport.”

Felirose also recounted how one of her friends had faced a flight delay and that was one of the most stressful times for her. “My friend’s flight had been delayed for three hours and I really prayed that my milk was all okay. Imagine having packed the milk earlier than two hours before the actual flight time and then having the milk wait out another four hours during the flight to the Philippines. He also had to queue for immigration and collecting his luggage before handing the milk over to my parents. My parents will then make a two-hour journey to reach our home.”

Felirose emphasises how important it is to ensure that you use as many ice packs as possible, especially ones of good quality that are guaranteed to keep milk frozen for as long as possible. She also maintained that a cooler is the best way to transport everything and keep the milk intact.

Felirose usually packs her milk in a securely sealed cooler box filled with ample Techni-ice packs. [Credits: Felirose Bartolome]

The pressure of managing the logistics of the whole process is truly unimaginable. For Felirose, her resolve to give her breastmilk to her children keeps her going. When her older daughter was still a baby, Felirose had to return to work in Singapore and was unsure if she could continue to breastfeed her child. Many of her other colleagues had given up breastfeeding prematurely because of the strain and stress of work and pumping. However, she soon discovered that she was able to maintain her supply. There was also a time she had an oversupply and was able to donate some of her milk to her friend’s child.

“Expressing milk is hard work, really, but when I see my kids growing healthily, I feel my sacrifices have paid off. My children don’t fall sick easily and this reassures me especially since I live so far away from them and can’t nurse them when they are ill,” Felirose said. She wants to give her children as much of her breastmilk for as long as she can, right up to the last drop.

Felirose has also had her fair share of challenges as a pumping mum. She has experienced engorgement and subsequently suffered from blocked ducts and mastitis due to the irregular schedule of her work. There was also a time when she struggled to produce enough as she was facing stress from work and missing her children; during that time she was only able to produce 10ml per breast.

“But I never surrendered,” she added. “I did all I could to boost my supply again and when I’m expressing my milk, I always look at the pictures and videos of my children that my mother sends me.” She advises other mothers who might be facing a similar situation: “Don’t give up and try your best! Do everything you can for your children.”

Felirose intends to continue to pump and send her milk to her hometown against all odds as she wants to breastfeed her younger boy till he turns two. We wish all mothers like Felirose the very best, even as you strive to provide your children with precious breastmilk despite the gruelling challenges, whether living apart from your children or travelling for work. You are indeed an inspiration to all of us!

“Expressing milk is hard work, really, but when I see my kids growing healthily, I feel my sacrifices have paid off. My children don’t fall sick easily and this reassures me especially since I live so far away from them and can’t nurse them when they are ill.”

Felirose Bartolome

BMSG’s infographic for mums who want to know how to pack their frozen breastmilk for a long-haul trip.

May 2018 Newsletter: Managing Breastfeeding & Diabetes

By Cheng Yong (BMSG Volunteer)

This month’s Mother’s Sharing strikes a chord as we speak to Cheng Yong, a stay-at-home-mother of 1, who has had Type I Diabetes Mellitus* for nine years now. Hear from Cheng Yong how diabetics can include breastfeeding as part of their parenting goals and how they can manage breastfeeding while maintaining their blood glucose levels.

*About Type I Diabetes Mellitus: Type 1 Diabetes Mellitus is an autoimmune condition in which the beta cells of the pancreas are destroyed by the body’s own immune system. It can occur at any age but is more common in children and young adults. The exact cause of Type 1 Diabetes is still not clear. It is likely to be due to both genetic factors and environmental triggers which include viruses. In general, T1DM comprises around 5-10% of the total diabetes prevalence. In Singapore, the incidence of childhood type 1 diabetes mellitus is the predominant form of diabetes affecting children in Singapore (1).

Pregnancy

Prior to being pregnant, I had heard from many relatives and friends that they could not breastfeed due to their various conditions. Thus, initially, I was not very confident myself about breastfeeding as a diabetic patient. However,  when I brought up the idea to my endocrinologist, she did not specifically raise any concerns. Hence, I worked on taking care of my blood glucose during my pregnancy and hoped that things would work out.

Medical & Healthcare Support

My health care team comprised an endocrinologist, a dietitian, a diabetic specialist nurse and an obstetrician. During pregnancy, my endocrinologist helped me switch from insulin pens to a pump. She helped me immensely in titrating my insulin dosage which doubled by the end of the pregnancy! She is still helping me titrate my requirements now that I’m breastfeeding. My dietitian helped me plan my caloric intake with regards to carbohydrate, protein and fat during pregnancy and breastfeeding. As my pregnancy was considered high risk, I had more frequent checkups and ultrasounds. Above all, my husband provided the most important support as he reassured me whenever I broke down crying over unexplained high blood sugars. He was also my personal nurse during labour and recovery.

 

Post-Birth: Initiating Breastfeeding

My baby was taken to the High Dependency Unit right after the C-section to monitor his blood glucose levels. He was born at about 10pm and I was only able to meet him the next morning. I was still recovering and had to go up in a wheelchair. The nurses at the Singapore General Hospital (SGH) were really helpful as they patiently helped me express colostrum and delivered it to my baby. My baby had a mixture of formula and colostrum after birth. When I saw my baby for the first time, there was a Lactation Consultant (LC) present who helped me latch. He did manage to latch but it was still a struggle the next few times and I always buzzed for the nurses to help.

Monitoring Glucose Levels

Diabetic patients need to monitor their blood glucose levels several times a day. For myself, the minimum would be four times (before bed, breakfast, lunch and dinner). However, now that I’m breastfeeding, I will check my sugar levels about eight to ten times a day as my blood glucose levels are much harder to predict. There is also an increased risk of hypoglycaemia*. I definitely check my levels after each breastfeeding session during the night and whenever I experience hypoglycaemia symptoms.

*hypoglycaemia: When blood sugar levels drop below what is normal.

I do experience hypoglycaemic symptoms frequently. I usually have a few in a week but thankfully I get symptoms before they go dangerously low. My symptoms are shaky hands, hunger, cold sweat and tingling tongue. Suggestions to prevent hypoglycaemia (or hypos for short) would be to count one’s carbohydrate intake as accurately as possible if you are doing dosage adjustment for normal eating. Never ignore hypo symptoms and always keep hypo treatments near you. I usually keep my test kit and sweets within reach whenever I am breastfeeding.

 

A Typical Day

I breastfeed on demand so my days are not really structured, just like many SAHMs. At one point, my baby would only go to bed between 1 to 2 am and his sleepy period would last till 1-3pm! I would get some sleep then and an uninterrupted lunch. Now that he is eight months old, he typically sleeps around 10 or 11 pm, feeds once or twice in the middle of the night and wakes up between 7 to 9 am. My day is spent breastfeeding, changing diapers and entertaining him. Whenever he is taking a nap or is contented playing by himself, I slot in some household chores, online courses and prepare dinner, all this while making sure that I never miss including my routines to check my blood sugar levels too.

 

Snacks to Maintain Consistent Blood Sugar Levels

If I’m having a hypo (below 4 mmol/L), I eat a piece of candy which is considered as 6g carbs, followed by another 5-10g carbs with a biscuit, milk or chocolate. During the night after a breastfeeding session, if my levels are between 5-6 mmol/L, I would have a 5g carb snack which could be a biscuit or 100ml of milk. I don’t usually snack in between meals unless my levels are dipping. I find the following bite-sized food handy to have around: soft jellies (these are fast enough for me to treat hypos), caramelised biscuits, digestive biscuits, mini chocolate bars, easy-to-eat fruits like kiwis, milk in the fridge and a tub of ice cream in the freezer which I can weigh out any amount of carbs that I like.

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Interesting Fact:

Scientific studies have shown that youths who received any breastfeeding for at least 12 months or full breastfeeding for at least six months had lower odds of developing Type 1 Diabetes(2) and children who were never breastfed had twice the risk of Type 1 Diabetes compared with those who were breastfed.(3)

Cheng Yong’s story shows us that breastfeeding with Diabetes is possible and can provide far-reaching benefits to both mother and child. Whether you have Type 1, 2 or even if you have had Gestational Diabetes, you can and should continue to breastfeed.

 

References:

  1. https://www.singhealth.com.sg/DoctorsAndHealthcareProfessionals/Medical-News/2012/Pages/Type1-Diabetes-Mellitus-Contemporary-Management.aspx
  2. Diabetes Care 2017 May; dc170016. https://doi.org/10.2337/dc17-0016 Martens PJ, et al. Abstract #0511. Presented at: World Diabetes Congress; Nov. 30-Dec. 4, 2015.
  3. Infant Feeding and Risk of Type 1 Diabetes in Two Large Scandinavian Birth Cohorts. Diabetes Care 2017 Jul;40(7):920-927. doi: 10.2337/dc17-0016. Epub 2017 May.