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!

Newsletter #45: A Breastfeeding Frontliner’s Struggle During Covid-19

As told to Nabila Hanim, BMSG Staff

Frontliners have made headlines with the sheer amount of sacrifice and selflessness that they have shown for the sake of the nation. For breastfeeding frontliners, the experience is raised a notch when they have to tweak their pumping routines or make changes at home due to their work commitments. We speak to Angeline Tan* (not her real name), an exclusively pumping mother who is also a healthcare worker, who shares about the challenges of having to juggle pumping on-the-job while working in a healthcare institution.

Hi there mummy! Tell us more about yourself. As a healthcare worker, what is the scope of your job right now?

I am a Medical Technologist (MT) and I perform electrodiagnostic tests for patients, somewhat similar to what a radiographer does. As MTs, we perform tests and provide results for doctors to help them make diagnoses for ill patients. These are not Covid-19 tests but tests related to their illness.

How old is your baby right now and how is your baby receiving your breastmilk?

My baby boy is 6.5 months old now. He has been on bottle feeding since birth as we had some challenges getting him to latch in the newborn days. I pump at work and provide him with what he needs for the following day.

For exclusively pumping (EP) mothers like Angeline, pumping is necessary to ensure her supply remains sustained so that baby has enough when she is at work. [Stock Photo]

What has changed since the arrival of Covid-19 in terms of your job scope? You mentioned that your time to pump has been largely affected. Could you tell us more?

We are deferring more outpatients and non-urgent cases so that we can minimize patient contact and reduce the risks of infection. We are also on a split team work arrangement, therefore we have lesser staff working together now. Yet, we do not reduce our commitment to inpatient and urgent services. With lesser people in the team, it has become harder for me to set aside time to pump because we might be stuck in the Intensive Care Unit (ICU) or with a complicated case for hours. It is just not easy to get a change of hands during our shifts and hence, I am not able to run out to pump for awhile during this period. 

It is really difficult to even just step out and hand express for a bit! I just rush off to pump whenever these long procedures end and I am very, very thankful for supportive colleagues who help me out with disinfecting machines and clearing reports so that I can have time to pump.

Angeline Tan (not her real name), a Medical Technologist (MT)

Having said this, I acknowledge that it is extremely challenging for many healthcare workers to even pump at times! I often see comments by other mothers on how to deal with engorgement, such as to hand express a bit for relief if pumping is not possible. However, sometimes we have to be in full Personal Protective Equipment (PPE) in a full ICU setting with many colleagues from different departments coming together at a certain time to perform procedures for a patient. 

It is really difficult to even just step out and hand express for a bit! I just rush off to pump whenever these long procedures end and I am very, very thankful for supportive colleagues who help me out with disinfecting machines and clearing reports so that I can have time to pump.

For breastfeeding mothers who are healthcare workers and work closely with patients, Personal Protective Equipments (PPE) can pose an extra challenge to rush out to pump in between long shifts. [Stock Photo]

With these changes in your job right now, have you coped? 

Thankfully my supply has more or less regulated! I try to pump every 4 hours. Otherwise, I will pump during the next available slot that I can. 

What are some of the things that you do to ensure that your baby still gets some of your breastmilk? 

As my supply has regulated, I pretty much get the same yield each day regardless of my pumping schedule. I pump today to provide for tomorrow’s feed. This also means that I travel back to my mom’s place and live there for now as it is too tiring to travel from work to my mother’s home and then back to my own place after that. 

The Covid-19 season has extended longer than expected and we know that these are challenging times for everyone, especially for frontline workers. We hope that individuals like Angeline continue to remain resilient and always reach out for support when they need it. BMSG (Singapore) is behind all breastfeeding mothers who are in essential services and frontliners, and we will always have your back. 

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