Newsletter #47: Mother’s Sharing – Sarah’s Story

As told to Nabila Hanim, BMSG Staff

The Circuit Breaker (CB) was a two-month lockdown that was implemented by the Singapore government beginning April 2020. During this period, only essential services were allowed to continue functioning. This impacted accessory services (otherwise known as non-essential services), including home visits for breastfeeding support. Mothers were encouraged to visit the hospital for lactation help, which also meant exposing mother and baby to lurking viruses in the midst of the Covid-19 pandemic. 

Giving birth and breastfeeding during CB were interesting experiences for Sarah, seen here with her lovely family. [Credits: Sarah Chen]

Giving Birth in the Middle of CB

Sarah Chen (not her real name), now a mother of two, gave birth to her second child on 23 May, right in the middle of the CB. Leading up to the start of labour, Sarah was naturally worried about giving birth at the hospital during that time. 

“I was worried that the hospitals in Singapore might be overrun with critical Covid patients, that i would be at risk of cross contamination, or worst (actually I don’t know which is worst), being told to give birth at home instead,” said Sarah, citing her friend staying overseas who was told not to come to the hospital when her labour started.  

Sarah managed to give birth at a local private hospital in the end. She felt fortunate that staff at the hospital she gave birth at were able to assure her and her baby’s safety throughout their stay there. The hospital staff were masked up and provided her with adequate information and reassurance, which allowed her “to forget about the virus for a few days and focus on giving birth and recovery.” She also added: “Truthfully speaking, thoughts of CB and Covid-19 left my mind the moment my water broke.”

Breastfeeding the Second Time

Once her baby was born, Sarah was unable to carry out skin-to-skin with her newborn due some complications. Despite that, she was adamant to ensure that breastfeeding started right and was able to latch her baby at the ward later on. “It was something I wanted to ace this time round with my second child. My goal was to ensure proper latching, thus reducing any nipple damage or blisters. I think that is the key to ensuring a smooth start to breastfeeding,” she said. Sarah was also motivated to breastfeed her second-born longer this time round after hearing the plight of hospitals in the United States. “Some people in the US did encounter formula and diaper shortages at the beginning of the pandemic, which made me consider wanting to breastfeed for longer this time in case that happened in Singapore, but alas that is not the case here.”

During her stay at the hospital, she also ensured that she obtained a visit from the Lactation Consultant (LC) and also urged the nurses in the ward to help her latch her baby correctly or to check her baby’s latch everytime she nursed. She was also happy to find that her baby was latching well and she also felt she had a good amount of colostrum. 

Finding a Knowledgeable LC

Despite the positive experience in the hospital, Sarah faced other hurdles when she returned home. As her milk supply kicked in, she started to experience engorgement and had trouble latching her baby. She then decided to obtain a consult from a LC remotely to look at her problems. Although she only managed to attend one Zoom consult, she felt that she received adequate support. “She helped me to fix the problem overnight,” Sarah said, adding that she learnt a lot of things about breastfeeding just from the consult alone. “What I’ve learnt this time round is that when latching is problematic, sometimes it’s not just about textbook techniques. Physiology also comes into play – my baby had a high palate, I had a huge gushing supply, my boobs were big but nipples were not long, and so on,” she added. She was able to better appreciate what was happening because she understood what was happening to her body. 

This was a huge contrast to her experience after she gave birth to her first child. “With my first child, every problem (that I mentioned before happened), but the LCs I had engaged at that time were not able to guide me properly,” she said. She ended up “Exclusively Pumping (EP) for 4.5 months with a massive oversupply and 101 clogged ducts.”

Despite the challenges of being confined at home, Sarah was more confident this time around and knew what to expect. Ultimately, she knew that she needed to be positive and reach out to others for help and support at a time when she must have felt vulnerable and overwhelmed with a new baby.

Advice for Mothers

When asked what she would change if she had to go through the experience again, Sarah admitted that she was happy with her experience. “I think despite the challenges, everything went as well as it could,” she said, adding that she was glad she was able to exclusively direct latch and has also managed to introduce the bottle to her baby.  

She also added that mothers should be brave, embrace the challenges and not to hesitate to reach out for support such as talking to other mothers in support groups such as that of the BMSG. “Sleep more, shower to boost your spirits (and) read lots,” she also added, alluding to the fact that being prepared, well-recharged and knowledgeable are things that can well-equip a new mother. 

Managing Expectations & Timely Responses: Keys to Positive Breastfeeding Experiences

Sarah’s story is one which reminds us that knowing what to expect and responding in a timely manner to breastfeeding challenges are important in ensuring a sustained and long-term breastfeeding journey. She also proved that seeking information and support were key to her well-being as well, both for breastfeeding and for her mental health. Despite the circumstances, Sarah was able to troubleshoot the challenges she faced early to prevent them from getting worse.

Newsletter #46: Milk Talk – Milk Sharing: Always a Viable Option

By BMSG Editorial Committee

Historically, milk sharing has always been an option for mothers who were not able to breastfeed their babies for one reason or another. Wet-nursing (compensating a lactating woman to breastfeed) or cross-nursing (breastfeeding someone else’s child) were some of the common practices of past communities all over the world to keep babies alive. Mothers who died at childbirth or who were too ill to breastfeed were able to depend on other mothers in the community to provide for their newborns. In this century, milk sharing has once again become a popular choice as breastmilk is now considered a valuable resource.

Another Mother’s Milk Preferred Over Other Milk Substitutes

The demand for donor milk has increased over the last few years in Singapore and the world. An increasing number of people are now more aware about the benefits of breastmilk for babies, even if it comes from other than the babies’ mothers. 

Reasons why mothers sought donor milk vary. Some were due to insufficient milk supply or a preference for their babies to drink breastmilk over formula. Some mothers also stated that their babies react unfavourably to formula due to food sensitivities and allergies. 

One mother we spoke to, who only wanted to be known as Saphira, had received donor milk for her baby when she became ill after giving birth and had to be separated from her baby. “I was given strong antibiotics that were supposedly not breastfeeding-friendly. My baby was also hospitalised separately from me,” she added. Separation after birth and being unwell are one of the reasons that impede a smooth start to breastfeeding. 

Additionally, babies who do not fit certain requirements were not able to receive donor milk from the only human milk bank in Singapore. Donor milk from the bank is reserved for the most sick preterm babies. Milk sharing then becomes an option to ensure a baby is still able to receive breastmilk, if the mother is unable to breastfeed or extract sufficient milk. 

Other Ways of Milk Sharing

Some mothers also opt for cross-nursing, where a lactating mother directly latches another baby who is not her own. Far’ain Jaafar, a mother of two, had helped to breastfeed her sister’s newborn to help boost her sister’s confidence to breastfeed. She nursed her nephew frequently for about four months and occasionally after that, usually when his mother was away at work or if Far’ain happened to be around. “My sister was mixed feeding initially so I fed my nephew to lessen his formula intake and to help my sister become accustomed to breastfeeding,” said Far’ain, who went on to nurse her nephew till he was almost a year old.

Families who adopt their children have also turned to milk sharing platforms if they choose not to induce lactation or require some time before they successfully do so. Another mother we interviewed, Lina Tan (not her real name), had donated to a friend who had adopted a newborn. She felt that it was an easy process of providing for the baby. “My only concern was that the parents and other caregivers are informed about how to handle breastmilk,” said Lina.

Donor Milk as an Option

The rise of milk banks around the world are also testament to this need for breastmilk. Milk banks are manifestations of milk sharing platforms that have been institutionalised for the needs of fragile, premature babies who are not able to feed on anything else but human milk. Premature babies, or preemies, are prone to necrotising enterocolitis, a life-threatening condition in the gut and human milk is necessary to sustain their health and can very well be the only food they can stomach. Usually, mothers of premature babies would try to provide their own breastmilk but difficulties in latching very tiny preemies may make this challenging to achieve. 

Breastmilk donated to milk banks are pooled together and then pasteurised. Usually, breastmilk from milk banks are for extremely premature babies. In Singapore, this would be babies born before 37 weeks. [Stock Photo]

According to the World Health Organization (WHO) in its Global Strategy for Infant and Young Child Feeding guidelines, another mother’s milk would be preferred over formula should the baby’s mother be unable to breastfeed her own baby:

“Only under exceptional circumstances can a mother’s milk be considered unsuitable for her infant. For those few health situations where infants cannot, or should not, be breastfed, the choice of the best alternative – expressed breast milk from an infant’s own mother, breast milk from a healthy wet-nurse or a human-milk bank, or a breast-milk substitute fed with a cup, which is a safer method than a feeding bottle and teat – depends on individual circumstances.”

World Health Organization (Global Strategy for Infant & Young Child Feeding Guidleines)

It is clear from the statement that the priority for a newborn is to receive breastmilk from his/her own mother and then from another mother before other milk substitutes should be considered. 

Satisfaction in Receiving and Donating Milk

Despite the risks that have been highlighted in milk sharing, and with the downplaying of the risks of formula, mothers continue to seek the benefits and satisfaction from the milk sharing relationship. 

Donors we spoke to highlighted how they felt happy to have been able to help babies who were in need. Some of them went on to become long-time donors and in turn became good friends with the recipient mum. Some donors were already friends with the recipient family and donating strengthened the bond. One mother felt honoured that her friend had specifically chosen her to donate milk.

Elaine Chow, a mother of four, had shared that her friend who was pregnant had asked her to donate some expressed breastmilk. “She wanted some expressed breastmilk (EBM) just in case her milk came in late after giving birth. I felt really honoured that she chose me and it was a testament to our bonds friends. Milk sharing connects mothers with one another in the sisterhood of motherhood,” said Elaine.

Some donors were also mothers who had earlier received milk when they were previously struggling with their young babies. These mothers then felt the need to pay the good deed forward. 

For Kwan Xiuwen, a mother of two, fearing that her baby would inherit intolerance for lactose led her to accept milk donations from other mothers. She then went on to pass along the good deed by donating her milk after she had her second child. “I felt determined to pass the good deed onto other mums and was very grateful to have a chance to do so. I felt that I was giving back to the community,” said Xiuwen, who had also shared how she was touched that the mother who donated milk to her son did not even ask for milk bags in return. This was a common practice in the milk-sharing community as a form of favour in place of monetary transactions. Financial transactions are discouraged in most breastmilk sharing platforms. “In hindsight, I should have provided her with them (breastmilk bags) since I was a long term recipient of her milk. But when I finally realised it, she was at the end of her milk donation,” said Xiuwen.

Such altruistic reasons show the positive impact of milk sharing and how it has created chains of support among mothers and families who practise milk-sharing. For another mother, Sharon, knowing that her milk has helped another baby to grow and remain healthy makes her happy. “I’m glad to be able to feed not only my own child, but help feed another baby as well. In a way, I feel like I’m paying it forward to help another baby and mummy in need, and that more mummies out there need help and support in their breastfeeding journeys. I understand fully the pain and guilt of feeling inadequate… so knowing that I can help another mum through this difficult journey, makes me feel good about it also,” she added.

Breastmilk is Food Security for Babies During Pandemic

While milk sharing has traditionally been about helping mothers and

While milk sharing has traditionally been about helping mothers and babies have enough supply of breastmilk, in the current pandemic, milk sharing has never been more important. As parents and families struggle with securing food and sustenance for the family, ensuring sufficient food for the young should never be ignored.

Milk sharing can very well be a necessity to be shared in the community for the benefit of the very young or sick babies and children. When either mothers or babies fall ill, breastfeeding can be disrupted if both are separated. This is when donor milk can become a useful resource to rely on when a mother is unable to breastfeed her baby because of separation. Caregivers who are tending to the baby left behind can very well be equipped with a resource that provides protection to the baby, and not just a form of sustenance. 

Furthermore, with supply chains disrupted all over the world, the reality is that formula can become an expensive resource that can be difficult to find in the event of mass hoarding. Breastmilk, on the other hand, is a viable option since mothers in the community can help sustain a child by milk sharing or cross-nursing.

Is Milk Sharing Safe?

There is an abundance of literature on the concerns about milk sharing from research papers to news articles. A lot of concern centres on the safety of milk sharing especially since there is an assumption that babies who receive donor milk are also at risk falling ill from poor handling and hygiene of donated breastmilk as well as illnesses obtained from the milk donor. 

Some medical professionals such as paediatricians and doctors dismiss informal milk sharing platforms because of the concern that the donors are not screened and the donated milk not pasteurised. 

Some literature also urged families to acquire breastmilk only from official milk banks that has a non-profit status. While these are available elsewhere in the world, Singapore only has one official milk bank which only provides the milk to premature babies in government hospitals, the KK Hospital Milk Bank. Unfortunately, the bank is only accessible to premature babies who are warded in local government hospitals. Families who wish to feed their babies with breastmilk therefore have no official platforms to go to should they require milk donations. In other countries, milk banks are considered an expensive options because costs to maintain a milk bank is expensive, making them a less attractive option.

Double Standards in Discussing Risks of Milk Sharing

Dr Karleen Gribble and  Dr Bernice Hausman, researchers who studied the trend of milk sharing, have found that there are double standards when it comes to discussing the risks of milk sharing. They wrote that:

“Breastfeeding is perceived as a risk to livelihood, while infant formulas solve problems for mothers, employers and society as a whole. In this paradigm, risks associated with feeding formula to infants are identified as a bad batch or manufacturing glitch, while risks associated with breastfeeding are represented as problems that any or all breastfeeding infants might face.”

Gribble and Hausman (2012)

The researchers observed that the risks of formula have been shadowed by economic reasons (women having to return to work, breastfeeding as impeding women working) and are downplayed while the risks of milk sharing is always considered as a be-all reason why it should never be done. 

The main fear around milk sharing usually involves contamination of milk and passing diseases to baby. However, contamination can happen in formula feeding as well. Contaminated formula milk such as salmonella and melamine poisoning have happened before that caused illnesses and deaths in babies. Improper reconstitution, dilution of formula milk and many other risks of formula have been left out in discussions surrounding its risks.

This imbalance in talking about risks seems to navigate the discussion to fear and revulsion towards milk-sharing as it is seen as a bodily fluid and not food. Hence, there is a need to educate the breastfeeding community on safe handling of breastmilk and how it can be given to babies safely.

A spokesperson for Human Milk for Human Babies (Singapore), an informal milk sharing platform, also added that the bad press surrounding online milk sharing in mainstream media is also due to how the sharing of human milk due to altruism is often conflated with the buying and selling of human milk, which is often sold for a profit. “Sharing of milk is different from selling it – a mother is simply donating her excess milk out of her own goodwill, to spread the love. She will not have any incentive to dilute the milk in order to stretch profits.”

Safe Milk Sharing is Possible

Dr Gribble and Dr Hausman argue that instead of scoffing at the practice of milk sharing, experts should offer guidelines to how mothers can make informed decisions about doing so. 

Observing many informal platforms around the world such as the Human Milk for Human Babies networks and other online milk sharing platforms, some suggestions on safe milk sharing practices can include the following:

  • Encouraging informed choice
    • Parents should accept and understand that there are risks and benefits of milk sharing, just as there are risks and benefits to other ways of infant feeding, by doing their own research.
  • Screening of Donors
    • Informed choice would also mean that donors and recipients be open about sharing information that is important to the other party, such as diet (vegan diet, food allergies, food sensitivities etc), medical and social concerns (e.g. consumption habits such as diet, medication and if they are involved in smoking), and who the milk is for.
  • Proper Arrangement on the Logistics 
    • Arrange meticulously how the milk will be transported or exchanged.

Other parents would also prioritise different aspects of good practices, such as how long ago was the milk expressed, and the age of the donor’s babies. What is important to a set of prantes may be different to another; it is not rigid. For example, a parent of a sick baby may also ask for a specific way, such as stepped-up hygiene practices while pumping. Some parties may have to reconcile certain considerations if a match is difficult to procure.

According to HM4HB Singapore, the point of this exercise between potential matches of donor and recipient is to ensure transparency and trust between them:

“No one should donate or receive milk from someone they are uncomfortable with.”

HM4HB Singapore


The fears that encircle the discussions on milk-sharing understandably point out the fact that breastmilk is a bodily fluid and sharing it with other babies results in risks for the receiving babies. However, the community at large is still understanding very little about breastmilk. 

Donor milk remains a very valuable option and resource for families who want to provide breastmilk to their babies. However, feeding babies with other substitutes comes its own sets of risks as well that are not commonly discussed despite the dangers being real – chemical poisoning, contamination and scarcity of formula feeding, for example, are very rarely discussed openly while breastmilk sharing is frowned upon and faced with revulsion by members of the community. 

With time, we hope that more parents and families will be more open to the idea of informed milk sharing as the next best thing to a mother breastfeeding her own children.