Work From Home: Breastfeeding in the New Normal

By BMSG Editorial Team

Working from home (WFH) may sound like the perfect arrangement for breastfeeding mothers and their babies but it is not without challenges. With no end in sight for the pandemic, WFH may be here to stay for a long time to come. We speak with some breastfeeding mothers who have been WFH for a while now to find out just what it is like juggling a breastfeed baby and work deadlines at home.

The Baby Who Won’t Take Bottles

Not everyone is able to send their babies to childcare or find external help. For such mothers, there is no choice but to be at home with their babies. For Priya, who works in the professional training and education industry, nursing her baby has become the norm in between meetings and work demands. “My baby doesn’t take a bottle so I have to excuse myself from work to nurse him, which can be very time consuming,” said the mother of one. Priya’s mother cares for her baby while she works but she added that it is especially challenging when she has meetings to attend and her baby needs to nurse. “I (find it) really challenging to explain that to my colleagues so it’s a struggle,” she added.

Switching Between Bottles & Latching

But not all babies who are cared for at home struggle with switching between bottle and latching. Fadillah A. Rahman, an Assistant Manager in the education sector, works at her mother’s home on most days while grandma cares for her nine month-old baby. The extra help that she gets by working at her mother’s home was a vast improvement over the Circuit Breaker period where she received no help in caring for a very young infant, especially when her baby was much younger then and nursing more frequently. “My baby directly latches unless I have meetings or have to go to the office but he has no issues with taking the bottle now even when I am around,” said Fadillah. “As I am quite familiar with baby’s feeding times, I will take him in to nurse. Otherwise, my mum will bring him to me,” Fadillah added.

Similarly, Jia Qi, who does project management in the IT industry, still latches her 17 month-old throughout the day. “I plan my days in advance although at times, there may be sudden issues that arise or meetings to attend,” she added. She works when her baby naps or when her daughter is able to play independently on her own. “When she is fussy, I will turn to babywearing while working.”

Turning to Alternative Feeding Methods

For Nancy Lai, an adjunct trainer and lecturer, switching to a fully WFH arrangement has been a blessing and she is able to directly latch her baby most of the time in between her lectures. If her baby needs to feed at a time when she is unavailable, her family will try the bottle. However, it is a struggle to bottle-feed her baby because of her presence at home. More recently, her family members have been open to using alternative methods of feeding baby. “My helper and mother care for my baby during my working hours. Sometimes, when my baby fusses over the bottle, they will painstakingly feed my baby with a cup and straw,” says Nancy, who also manages a start-up on the sidelines. Nancy will still need to pump milk when her baby takes the bottle while working or during meetings: “If necessary, I will express milk under a nursing cover while I deliver my lessons or when I have to attend online meetings,” said the mother-of-two. 

Just like other working mums, WFH mummies may find it useful to adopt other feeding methods such as cup feeding (above), straw or syringe feeding to protect the breastfeeding relationship or when baby rejects the bottle. [Credits: breastfeeding.support]

Flexibility with WFH

For some of the mums we spoke to, having flexibility at work has nonetheless been another benefit of WFH, which bodes well for the future of job opportunities for mothers who want to return to work. Some companies have allowed employees who WFH to be able to work at their own hours. Leona, who is a writer for a family-centric, multi-channel startup, is able to be the default parent at home despite also being employed full-time. “The work arrangement for my company has always been remote working, so I am actually very blessed to be offered this job opportunity that allows me to earn an income while giving me the flexibility to WFH and be there for my children,” said the mother-of-two who is currently direct latching both her children.

“I try to work when my younger boy is napping but when he’s particularly clingy (like now, as I am typing down the answers to this interview), he is either latching and/or sitting on my lap while I work,” said Leona, whose children are 1 and 3 years of age. She also has had to work from her phone sometimes, especially when she has her hands full with the boys at home or when they are out. The family currently has no helper.

Despite the challenges, Leona still prefers to work from home. “I really do enjoy this WFH arrangement with my current job, mainly because it allows me the flexibility and provides me with some sense of work-life balance. And because I WFH, I am still able to be there for my children, and tend to them whenever needed,” she added. 

Another mother, Cátia, echoes similar sentiments. The mother of 15 week-old twins and a three year-old, is currently working full-time as a manager in the payments industry. She had returned to part-time work when her babies were eight weeks old and gradually returned to full-time work in November, all the while latching her twins and managing the home. “I have been lucky to have amazing managers who are very understanding,” said Cátia, who also faced similar flexibility at work after giving birth to her first child. Due to her flexible working hours, she is able to have a routine where she completes some work in the morning and then tend to her children before completing more rounds of work in between nursing and caring for her babies throughout the day. 

“As a manager I do need to be around for my team but a lot of work can be done out of the common working hours. I wake up early usually with the twins and after feeding them I take that time to do some work while I have breakfast. I try not to look at the clock to feed or work and focus on goals to avoid stress and pressure. I have a list of things I want to complete for the day and I try to keep the babies entertained and feed them when they need,” she added. Fortunately, her heavy burdens at home have eased off a little, as her twin babies are starting infantcare soon. 

“I try not to look at the clock to feed or work and focus on goals to avoid stress and pressure.”

Cátia, WFH mum of 15-week old twins and 3 year old toddler

Blended Work Routines

For some mothers, a blended work routine has worked out well for them. For these mums, being able to be at home on some days has its perks. Lydia Nah, a financial adviser, is able to work at home on Thursdays and Fridays while her one year-old baby is cared for by her husband and in-laws from Monday to Wednesday. “I am still able to latch my baby at the start and end of the day when I work outside,” said Lydia. Her baby currently also takes fresh cow’s milk during the day. 

Beauty of Working From Home

As Lydia needs to meet clients for her work, she recalls how the CB was a saving grace for her as she did not need to pump for her baby then. “If it weren’t for CB, I would be running in and out of various nursing rooms carrying my cooler bag, pump and flanges everywhere. I can’t imagine what a hassle that would be,” said Lydia. She was exclusively latching then, and had to take breaks to nurse her child in between work. “I would be working on my desk and then when it is time for his feed, I’d have a short 15-minute break and out again. While it can be interruptive sometimes, I chose to channel my breaktime during these nursing sessions. It is a great reminder of why I am working so hard everyday day in day out,” she added.

While it is natural that many mothers found it challenging to juggle between work demands and their babies, especially those with no live-in helper or support, a lot of the mothers we spoke to expressed their satisfaction of being able to be with their babies for a significant amount of time. For Fadillah, being able to WFH for over nine months now has made her appreciate being able to see her baby grow. “It’s quite a breeze now,” she added, since she found that she and her baby had adapted well to the routines of WFH. 

It is also heartwarming and promising to know that many mothers continue to be able to have employment while still providing breastmilk for their babies. Mothers with WFH arrangements also appreciate that they are able to express milk while still conducting lessons or attending meetings and shows that WFH can ease up mummy duties while still allowing mums to multi-task between being mum and employee.

We hope that this will bode well for future employment opportunities for mothers who wish to expand their career while still wanting to nourish and bond with their babies. This pandemic may indeed have led to positive repercussions and transformations of career options and opportunities to allow the harmonising of work opportunities and breastfeeding.

TWB in Review: Breastfeeding & Postpartum Mental Wellness (Part 2)

By BMSG Editorial Committee

While Dr Elizabeth Siak’s sharing was focused on the symptoms of PND and what sort of treatments are available for mothers, Cindy Khong, a counsellor of mental health at Clarity Singapore, highlighted the importance of social support that a mother needs during the postpartum period. She also spoke at great length about the need for self-care and how family members can be sensitive and support mothers appropriately.

Cindy Khong (top right), counsellor in mental health from Clarity Singapore, spoke at great length about social support and coping measures to help mothers find peace during postpartum. [Credits: BMSG Singapore]

Pressures of Societal Expectations

Cindy shared that the main struggle of mothers lies in the fact there is a difference between what society expects of motherhood with what mothers really experience for themselves. In popular culture, motherhood is often portrayed as natural, instinctive and enjoyable while in reality, mothers go through a lot of changes of which many are not prepared for. It is natural for new mothers to feel overwhelmed with the many new responsibilities on her shoulders. Cindy gave the analogy she received from her client about motherhood: that it is like filling up a fruit basket to the brim which then overflows. 

Wellness & Importance of Self-Care

When this happens, a typical mother then overlooks the need for her own self-care as she struggles to complete her tasks and duties. With guilt and the difficulty to find time, it was enlightening to hear from Cindy that self-care actually allows a new mother (or any mother for that matter) to cope with a new baby. “You need to care for yourself before you can care for others” was a quote that Cindy shared about the importance of mothers taking care of their own physical and emotional needs. 

One often overlooked aspect of self-care is that it allows a mother to be more emotionally present for her children and also allows her to build a strong connection with their partner.  This then allows her to turn to her partners for support and comfort, which then decreases the probability of depression in the mother. 

Self-care also prepares a mother for a secure attachment bond with her baby, which is a good foundation for child development. When a parent takes care of herself, she will be able to better respond to her child’s verbal cues. Such interactions optimize the baby’s nervous system and brain development, which are necessary for a child’s cognitive development. Babies with a history of secure attachment patterns have greater sense of self-agency, have higher self-esteem as teens and adults, and are better at regulating themselves emotionally.

One often overlooked aspect of self-care is that it allows a mother to be more emotionally present for her children and also allows her to build a strong connection with their partner.  This then allows her to turn to her partners for support and comfort, which then decreases the probability of depression in the mother. 

Recognising the Obstacles to Self-Care

Cindy then conducted a poll on the audience to understand what the audience felt about mothers taking time off for self-care. She then went on to explore the various reasons why mothers avoid taking the time to care for her well-being. 

It was interesting to note several reasons that mothers avoid finding time for self-care, among them being:

What Mothers Feel About Self-CareWhy They Feel this WayWhat Can Mothers Do to Overcome This
GuiltMothers do not find their needs as important as their children’sThey feel they are weak if they request for it as their parents were able to care for many children without needing itAsking for help and time to rest are not signs of weaknessAsking partners to be more involved actually increases their confidence to build strong relationships with the childrenUnderstand that self-care has positive side effects on caring for babyMake it a habit to put yourself first at least one a dayTake short breaks such as having 10 minutes of deep breathing or doing something you enjoyHave smaller tasks in a day to give you a semblance of control
Finding the need to be perfectExpecting ourselves to be as productive at home and work as before we had children is unrealisticWanting to do things in a specific, rigid wayBut nobody has it all togetherBe prepared to let some things go and prioritise what is critical and importantDo one thing well at a time instead of moreTell yourself there are good and bad days; don’t concentrate on the negative all the timeCelebrate small achievementsIf there are changes that need to be made, break up small steps into smaller plans to move towards that changeAllow yourself to feel sad, angry and irritable and get your partner to validate you; this may mean that you no longer have to put up a front
‘I don’t deserve it.’Mothers devalue themselves and think that ‘I am just a mother’These mothers may have issues with their self-worth and belittle themselvesMothers should avoid putting themselves down as they should recognise that their babies deserve the best mother and hence, mothers deserve to be cared forBe kind to yourself and give time to recover emotionally and physically after birthSeek professional help to make sense of these beliefs

Cindy also encouraged mothers to do several other things to help their recovery and adaptation during the postpartum period:

  • Seek suitable social support to share similar concerns and needs
  • When we see other mums who struggle with the same problem, we feel validated and not alone
  • Spend time with our partners to nurture the relationship and to understand that we are not alone in the struggle
  • Couple time is challenging to implement but promotes open communication and marital harmony
  • Couple time also lowers the risks for PND
  • Practise gratitude instead of comparing with other mothers or even our spouses; it can fuel loss of motivation, confidence and self-esteem 
  • Understand that every mother is different and we have different starting points, resources and capacities

How Spouses, Family Members & Friends Can Support New Mums

If you are supporting a new mother, Cindy reminds us that mums are looking for someone to listen and find out what they need help with without judgment or sympathy. When a mother expresses her struggles, our reactions matter very much in what she feels after. 

  • Judgment vs Validating

    When we validate a mother instead of judging her abilities, she feels understood and will be more open to receiving help for her anxiety. When we judge a mother, she feels shame and not good enough and may perpetuate the behaviour she displays when having anxiety
Cindy shares with the audience how partners and even family and friends can better word their conversations with new mothers to respect her feelings and space. [Credits: BMSG Singapore]

Cindy shares how spouses and other people around a new mother can be more mindful in how they speak to her.

  • Partner Support

    Partners are one of the key contributing factors in the recovery of a mother’s postpartum well-being. For mothers who are not depressed, having good partner support shields the mother and her baby against stressors during this period.

    Spouses may find it helpful to praise a mother and validate her, and provide constant encouragement. Show appreciation instead of thanking her and encourage her to talk about her feelings. Understand that a mother wants to be understood so partners should try to reflect back her feelings.

    Being familiar with signs of postpartum stress and where to seek help are also important especially if her condition turns serious. It would be helpful for everyone if partners encourage mothers to seek treatment and support especially if symptoms get overwhelming and persistent over time.

Lastly, being active in the household can lay off a lot of the burdens on the mother. Be clear about your roles to avoid misunderstanding and conflicts with the mother.

  • Family Members & Friends

    Many of us would fawn over newborn babies but never ask about the mother. For a start, showing care for a new mother would do well to help her feel appreciated and validated. Being available to talk to her and spending time to listen to her struggles, especially without comparing yourself or others to her, would be valuable for her well-being.

    Be very careful of appearing to be an “expert” as it can affect her confidence. Cindy suggested that it would be better instead to show more understanding and ask how you can help.

It Takes a Village

A lot of us would be familiar with the saying ‘It takes a village to raise a child’. But Cindy reminded us a village is also required to support parents, especially new mothers. Nurturing a strong circle of support will be valuable both for mother and baby to grow and thrive in the community that they are in. Mothers should also remind themselves that when they focus on their personal well-being, they will have more energy and peace of mind to care for their children.

Look out for Part 3 soon!

TWB in Review: Breastfeeding & Postpartum Mental Wellness (Part 1)

By BMSG Editorial Team

In November 2020, BMSG’s signature forum event, Tea with Breastmilk (TWB),  made a comeback after almost 2 years since it was first started. TWB aims to provide a platform for breastfeeding mothers, advocates and experts to converse about breastfeeding-related topics with more depth.

This year, BMSG spotlighted the topic of postpartum mental wellness during the TWB forum. Over the years, our BMSG counsellors have met mothers who have struggled mentally either due to breastfeeding or juggling new roles as mothers. BMSG sees this topic as a long overdue topic that needs inter-organizational support and education for the community to better support mothers in their journey, especially if they are breastfeeding.

The event did not disappoint. Together with speakers from the KK Women’s & Children’s Hospital (KKH) and Clarity Singapore, a charity that provides support and services in mental health, TWB provided wider insights, solutions and knowledge to the wider community about the impact of good or lack of support can bring on breastfeeding mothers.

Our speakers at the panel discussion. [Credits: BMSG Singapore]

Postnatal Depression & Baby Blues: What’s the Difference?

Many of us would have heard about Postnatal Depression (PND) happening to women during the postpartum period. Dr Elizabeth Siak, Consultant Psychiatrist from KKH, provided a very detailed overview of what constitutes PND and how to differentiate it from postnatal blues.

Dr Siak clarified that baby blues most commonly occur immediately after birth and is a result of adjusting to motherhood. Feeling sad or blue may occur to mothers for a few hours to a few days but it usually resolves with reassurance, good support from the people around the mother as well as familiarity with her role. 

A local studies done on mothers in Singapore have show that PND afflicts about 7% of mothers, with many developing symptoms during pregnancy itself. According to Dr Siak, PND usually occurs two to three months after birth and mothers who suffer from PND will usually display anhedonia, or a pervasive loss of interest to feel joy or pleasure for the whole day or most part of the day for a period of about two weeks or more. Some mothers will also show increased irritability. Some mothers may also become more withdrawn and prefer to isolate themselves.

PND may also manifest itself in physical and mental symptoms in the mother. Some mothers may show changes in sleep and appetite. Some mothers may not be able to sleep or sleep longer than usual but do not get refreshed when they wake up. In terms of eating, some may have significantly reduced appetites while others may eat excessively. These symptoms may include negative thoughts and attitudes, and possibly even suicidality or psychosis in more serious cases. Professional treatment may also become necessary upon diagnosis by a medical personnel. 

“…mothers who suffer from PND will usually display anhedonia, or a pervasive loss of interest to feel joy or pleasure for the whole day or most part of the day for a period of about two weeks or more.”

One thing is for sure, PND is something that is difficult for the mother because it is disabling, and especially so during a period of time where babies may need more care. Mothers may also have reduced energy and lots of fatigue, and are not able to concentrate well, making it challenging both at home or at work. 

Sadly, many mothers with PND will also have lots of negative thoughts and may become pessimistic, suffer from debilitating guilt and self-blame. 

What Causes Depression?

According to Dr Siak, it is hard to pinpoint to a single cause and instead, multiple stressors may contribute to it. Mothers who have a past psychiatric history or family history of PND may be more prone to be diagnosed with PND. Some women may also be more susceptible to fluctuation in hormonal levels, making it easy for them to be tipped with PND. Mothers who have had traumatic childhood events may also find it difficult to cope with PND. 

The arrival of a new child is naturally overwhelming; mothers with PND and their family members require their support. Additional strains on the family such as financial challenges or strained relationships can further worsen the situation. If a mother becomes so overwhelmed to the point of losing touch with reality such as having hallucinations or wanting to harm herself and others, she must be brought to A&E for urgent treatment.

Mothers with postnatal depression may feel disabled by their overwhelming anxiety, thoughts and emotions.
[Stock Photo]

Perinatal Anxiety

Another common and frequent occurrence in new mothers is perinatal anxiety, which is characterised by becoming excessively worried to the point of becoming overwhelmed. Mothers may become overprotective of their babies as they feel a strong sense of inadequacy as a mother to care for their babies’ well-being. As a result, they overcompensate with being overly protective and are inflicted with repetitive and intrusive thoughts about baby falling sick or being exposed to germs. Some of these mothers may also have obsessive thoughts about dropping their babies or constantly bringing their babies to see a doctor. Fortunately, there are treatments that can work for such mothers.

Receiving Treatment

Dr Siak rightly pointed out that a lot of women may feel afraid of the stigmatization that comes with reaching out for help. However, seeking early treatment is crucial for the well-being of mothers and their babies.

Treatment-wise, mothers who have been diagnosed with PND will be able to receive psychiatric treatment in the forms of supportive counselling and case management as well as medication. Mothers will be able to talk to psychiatrists and counsellors to explore the transition to motherhood as well as discuss practical suggestions to overcome this challenging period. Most importantly, mothers will be given a safe place to express difficult feelings and thoughts. At KKH, there are also support groups where mothers with PND can participate in for further support.

It is important to receive prompt treatment for PND as the well-being of mums and their babies are at stake. [Stock Photo]

Dr Siak also emphasised that mothers are still able to continue breastfeeding even with treatment and medication, and breastfeeding should not be a reason to stop going for treatment. Antidepressants and medication given for treatment are compatible with breastfeeding. People around the mother should also encourage her to seek help if they feel that she needs it. Dr Siak reports that 98% of mothers report improved functional status after treatment and 89% reported better quality of life. 

Where to Seek Help

If a mother or her family member believes that she needs to receive medical care, especially if mothers report uncontrollable suicidal thoughts, then bringing the mother to the nearest Accident & Emergency department of any public hospitals or at the National Institute of Mental Health (IMH) would be advantageous. For less urgent cases, mothers can consider three perinatal psychiatry services located at KKH, National University Hospital (NUH) and NIMH. If a mother prefers to obtain the subsidised route, she can walk into any polyclinics to obtain a referral to see a psychiatrist. Mothers are also free to approach these three institutions to set an appointment to see a private psychiatrist.

For Part 2 of TWB, please click here.