Sept 2018 Newsletter: Breastfeeding a Jaundiced Baby

By Nur Azrin Binte Abdul Wahab (BMSG Volunteer)

Nur Azrin, a mum of one, shares her initial struggle when she first started breastfeeding her jaundiced baby and how she persevered through the challenges.

Azrin and her beautiful daugther Azrah Adarina.

My pregnancy and birth were manageable with minimal to no issues. I was able to direct latch my baby immediately after I birthed her. The best part? My husband was also very supportive and encouraged me to breastfeed my baby. He even clapped when our baby girl burped on her own after latching. I was extremely grateful for this turn of events as I had been anxiously praying to have a smooth start to breastfeeding. It was beautiful in the hospital during my stay as the nurses and lactation consultants (LCs) praised my supply and how my baby girl had no pressing issues so far.

Unfortunately, the nightmare began the moment I was about to check out of the hospital. My daughter had developed a dangerously high level of jaundice, which caused her to have a fever. She had to be warded in the Neonatal Intensive Care Unit (NICU) and as a first time mother, I was at a loss and caved in to the hospital’s insistence that infant formula would reduce her jaundice. I was torn; a part of me wanted to continue giving my baby breastmilk while another part of me wanted my one and only daughter to get well as soon as possible as she was only three days old.

Upon reaching home, I continued to pump every three hours as suggested by my LC to keep up my milk supply. That same night, I received a call from the hospital that my baby girl did not want to drink or even have a sip of the formula milk the hospital was providing, not even through a syringe or a cup. However, the nurses told me to give it some time and that she would provide me with an update the following day.

Fortunately, she was discharged the next day in the morning at 8am with no fever. She was very hungry as she had drank very little the night before. I immediately latched her and, lo and behold, she latched like a champ for an hour. I wanted to cry because I knew deep down that she must have been extremely hungry.

A baby undergoing UV light therapy for treatment of jaundice. Azrin’s baby had to go through a similar treatment at the NICU.

We brought her home subsequently but her jaundice levels rose again on her third day at home, resulting in another episode of high fever. We rushed back to the hospital and the doctors said my baby girl and I had different blood types and that this was a case of breastmilk jaundice; it was suggested that I supplement with formula again to quickly bring her levels down. Knowing that my daughter was thriving on her breastmilk, judging from her healthy diaper output and very good latch as assessed by the LCs, I informed the doctor that I would like to continue to provide baby with breastmilk on demand. However, should her fever persists or gets worse, I will bring her back to the hospital and provide a supply of expressed breastmilk during her stay.

This time round, her fever did not subside as quickly as the first time and it took about three to four days before her fever went away. I latched her as much as possible and as much as she wanted to. I also carried her a lot so there was ample skin-to-skin contact between us. I did not feed her based on any sort of schedule but just waited for my daughter’s cues. I also noticed that her fever went down bit by bit after longer latching sessions so I picked up on that and latched a lot. However, I was extremely tired from it.

It was all good though because there was a follow up after a week from the second visit and by then her fever was completely gone. Although her jaundice level was still high, it was no longer in the danger zone and she didn’t need to be warded. We had follow-ups at the hospital once a month and by the third month, she was completely cleared of any signs of jaundice and was a perfectly healthy baby.

With God’s blessings, my baby girl has just turned a year old and has been purely on my breastmilk with direct latching. We’ve had no issues so far other than the fact that I was on oversupply. My goal is to continue breastfeeding her until she turns two. With my strong faith in my ability to breastfeed, I believe I can manage this. Because I fell in love with breastfeeding my daughter, I may just go beyond two years old.

I hope to inspire and create awareness to all mothers who are struggling or having issues to breastfeed. Don’t stop until your child wants to and is ready to. Believe in yourself and your ability to provide breastmilk for your child, especially if you are obviously making enough milk for your baby. If your baby is thriving on your milk, stand up for your right to breastfeed and trust that you are providing enough for your baby.

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.