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.”

A mother bonding with her baby after birth. Despite not being able to carry out skin-to-skin with baby after birth due to complications, Sarah persevered and ensured that her baby latched ample times at the ward later on. [Stock Photo]

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. 

Video conferencing and calls are inevitable in the new normal. Sarah was able to remedy her problems through a Zoom session with an International Board Certified Lactation Consultant (IBCLC), whom she found very knowledgeable. [Stock Photo]

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: Breastfeeding with Chronic Eczema

By Hazami Hamidon, BMSG Volunteer

Hazami Hamidon is a stay-at-home mother to an almost three year old boy. She had a rocky start to her breastfeeding journey due to eczema that became infected at 3 weeks postpartum. With grit, support and breastmilk donations from other mothers, she has successfully breastfed her son till toddlerhood. Her inspiring story teaches us that when we are clear about our goals, the rest comes easy.

Eczema Before & During Pregnancy

My eczema started a few years before I was pregnant. I was treating it through natural means and was going through Topical Steroid Withdrawal Syndrome. During pregnancy, expectedly with the changes in hormones, I had a full eczema flare-up all over my body including on my legs, arms, hands, and even on my face.

As my pregnancy progressed, the eczema began to spread to my chest. Deeply concerned, I met with a Lactation Consultant (LC) at a local hospital to get some insights about what I could do to prepare beforehand for a, hopefully, uneventful breastfeeding journey. Although the skin on my nipple was broken and covered with what looked like pus, I didn’t want to apply steroid creams to heal the wounds following the advice from the LC. I then turned to natural remedies: I ground turmeric and applied the paste daily on my nipple to help dry the skin out. After a few weeks of consistently doing it, the broken skin began to heal and by the time I was about to give birth, I felt a little positive that I could actually breastfeed my baby.

Treating my eczema this way was important to me as I just couldn’t take the chance of my pregnant body reacting to any medication. I even reacted to the ultrasound gel used in a simple routine procedure at a check-up and endured weeks of itchy, flaky skin on my stomach. I became very cautious about what I put on my body.

I was hospitalised for an eczema infection for three weeks shortly after giving birth. My movement was restricted as I had to soak my hands in iodine as part of the treatment. While there, my husband helped to hand express my breastmilk so that my body would still produce milk in the hopes that I would still get to breastfeed after being discharged.
[Credits: Hazami Hamidon]

Early Days of Breastfeeding

I had a smooth drug-free natural birth. The first latch however, wasn’t so easy but I had my doula and LC from the hospital to guide me, and they  were incredibly encouraging and helpful, so I became very optimistic. From the start, my husband and I both agreed that we wanted our son to consume only breastmilk. This was due to concerns for the baby about possible allergies to formula milk due to my history with eczema, and also because we deeply believe in God’s sustenance. With that in mind, I kept latching as much as I could and did breast massages and techniques that I was taught. After much perseverance, I saw my milk coming in on the seventh day. However, I experienced engorgement in the second week and had a high fever.

My body was incredibly stressed out with so many things going on at once; healing after birth, the eczema, struggling with breastfeeding, and of course managing a newborn. I had a lot of help around me, but my postpartum body was still weak and my immunity low.

Severe Eczema Infection 

Unfortunately, a few weeks after I gave birth, I had a severe eczema infection on my hands and legs and had to be hospitalised for three weeks. That also meant three weeks of being away from my newborn. At that point in time I was incredibly blessed to have my sister, Khatim, who was breastfeeding her two-year-old son. She also took on caring for and breastfeeding my newborn.

While at the hospital my husband had to help me hand express my milk so that I could  keep producing milk. We decided to discard the expressed milk due to the very strong medications that I was on. We had to find alternatives as I knew I couldn’t just depend on my sister since she had to work and also had her own two children to care for.

While at the hospital, my sister took on caring for and breastfeeding our newborn. Here I was looking at my baby during a video call with my family. It was truly a challenging period of time.
[Credits: Hazami Hamidon]

We used whatever resources we could think of – we called extended family members and friends who we knew were still breastfeeding. We also used the BMSG online platforms to ask for temporary milk supply.

That was one of the lowest points and the most desperate I have ever felt in my life. We were completely at the mercy of people’s kindness to feed our child. I felt like a failure for not being able to provide for my own baby. However, I knew I had to keep focusing on getting better in order to care for him later in the long run. I was still hopeful and optimistic despite my condition.

We also had faith that if breastmilk is the best and most natural food for any baby, surely there is a way we can get it. It doesn’t matter if it is not from me; surely milk from other mothers will be equally beneficial too. It was quite an emotional decision to come to but it was the most obvious thing to do. Luckily, my cousin donated a dozen bags of her stash while I kept looking for a suitable match who could donate more for later.

It was quite an emotional decision to come to but it was the most obvious thing to do.

Hazami Hamidon, when she and her husband decided to turn to donated milk to feed her baby while she was warded.

Milk Siblings: A Consideration for Muslim Families

Being Muslim, taking on donated milk from another mother also meant that my child will be bound as milk siblings with the children of the mothers who donated milk for my baby. This meant that we had to be meticulous with details, such as keeping in touch with these mothers and getting to know them and their families. This is to extend familiarity, so that all our children would know of and understand their relationship as they grow up together.

We were fortunate that we found another two mothers who donated their expressed breast milk. One in particular, continued to supply milk up till my son was about six months old. I was beyond relieved that I had a “back-up stash”. I felt that having this helped me relax and was one of the reasons that I was able to restart my breastfeeding journey again.

My son was about 2 months old, meeting his “milk mother”, Liana, for the first time. Liana had donated continuously throughout the recovery period after my hospitalisation. We are eternally grateful for such generosity from someone we had met through the BMSG platform.
[Credits: Hazami Hamidon]

Relatching After a Month’s Break

I was eventually discharged but I still had remnants of infections on the palms of my hands. My husband literally became my hands during this period; he bathed our son before going to work and even requested to work from home as much as he could. He would bottle feed the donated milk to our baby first and helped me adjust the baby to practice latching afterwards.

It was like latching the baby for the first time again; we had to relearn everything. It was also back to square one; I started having cracked nipples until latching became painful and even bloody.

What helped me greatly was putting coconut oil on the breasts right before and after feeding. Coconut oil is naturally antibacterial and helps to keep the skin moisturised and elastic. I also made sure to squirt the milk out before feeding and applied it on my breasts to take advantage of the active properties of breastmilk. Although it took slightly longer, doing this helped to heal the wounded nipple naturally.

I persevered and slowly we tried to reduce the bottle feeds and latched more but I noticed that our baby was still not gaining weight and was not as settled as when he was bottle fed with expressed milk. So we went to a private lactation clinic to get things checked. True enough, we still had issues with the latching and this explained why my son was not able to get enough milk from me. The IBCLC suggested syringe feeding to encourage a better latch, as bottle-feeding is thought to contribute to nipple confusion.

After a follow-up with the LC a few weeks after, I only started to latch properly again on the fourth month. By then I had to return to work! I did try continuing to work for a while. After three weeks of trying to pump in the office with literally no output, I decided to quit my job. I figured that if I wanted to continue and reach my goal to breastfeed till the two-year mark, I had to make the most obvious decision. My body was too stressed out from being at work, I was still recovering from the infection and had only just got a stable milk supply, so it was a little too much on my plate.

Despite all that, I will repeat this in a heartbeat.

Despite all the challenges that appeared insurmountable at first, Hazami will still do her best for her baby.

Support Extremely Important 

I am incredibly fortunate that my husband has always been extremely supportive of all my decisions. We discussed issues on natural birth, breastfeeding and everything related to it at length before I gave birth, while he also did some research and reading on his own. Hence, we both had the same goal. For example, we agreed beforehand that getting formula milk was not an option at all in any situation. So he knew not to suggest it at any point no matter how sick I became. We knew there were other alternatives and understood that we just had to be open about it and look for it. This was extremely important to me especially since I was in such a fragile condition during postpartum.

With the support of my husband, Zaweer, and the generous help of other nursing mothers at the start, I was able to breastfeed my son into toddlerhood. [Credits: Hazami Hamidon]

Fast Forward to Today

My son will turn three this September. We have managed to breastfeed him all the way till he weaned off on his own at 30 months. As gradual as he was at having my milk, he was the same with weaning off. We talked a lot about it to him and offered alternative fresh goat’s milk at the beginning of the weaning process. Now, he accepts anything as a replacement; even no milk at all. He will accept water as he’s full on normal meals. So, yay!

Advice for Other Mothers

  • Having Clear Goals, Being Adequately Prepared

I could have been in a less stressful position if I had just resorted to feeding my newborn with formula milk to focus on my wellbeing, but I was adamant on wanting my baby to have his right to breastmilk and a good start in life. Having that mindset helped us to focus on our goals together.

As much preparation one will do for birth, the postpartum period needs an equal amount of preparation in terms of expectations. I truly wished I was more prepared. It is a sacred period of adjustment that we often neglect.

While Hazami had a rocky start to breastfeeding due to her condition, she went on to breastfeed her son till he weaned off at 30 months. [Credits: Hazami Hamidon]
  • Knowledge and Support

My husband’s support is the pillar of my strength to keep going. He was the positive vibe that I needed when things were very gloomy and challenging. I am incredibly blessed to also have supportive extended family members such as my sisters and cousins who were breastfeeding, too.

Information is aplenty online but it is so hard to filter which ones to follow. I would absolutely encourage expecting mums to attend breastfeeding classes, get themselves equipped with proper knowledge and acquainted with the available support systems, so that they can…

  • …ask for help!

I cannot even begin to emphasise how this is the reason that led me to reach my breastfeeding goals. Often, breastfeeding can make mums feel isolated, as if we need to figure it out all on our own. However, there are so many people, including other mothers out there, who would eagerly help you out in whatever way they can if they only knew what you needed. Communicating your needs is an important part of receiving help and support during postpartum.

While I knew that breastfeeding will be challenging based on my readings about the experiences of other mothers, I truly didn’t expect it to be as hard as it had been. It was a physical, mental and emotional rollercoaster ride. Despite all that, I will repeat this in a heartbeat. Breastfeeding benefits are innumerable and, seeing my son now thriving, it was worth all that struggle.

If anyone had looked at my condition before I gave birth, one would have thought it would be a miracle that I could eventually breastfeed my son, let alone up till this stage! It IS a miracle along with determination and hard work. Have faith! We just need to get past the initial hurdles and it will get easier. With hardship comes ease 🙂 

My hope is that those experiencing the same condition know that it IS possible to breastfeed your baby. It often feels impossible as your body is going through so much, but with the right help, support, knowledge, mindset and actions, you can do this, mummies!