“So are you planning to breastfeed?”
I was often asked when I was pregnant. I had always looked forward to motherhood but breastfeeding was not something I had given deep thought to. Since there was a breastfeeding renaissance, I simply assumed that breastfeeding would be something I would do if I could.
Only after I left my job in my third trimester did I find the time to pore over the posts on Facebook breastfeeding groups that some mummy friends had kindly added me to. I started to realise that whilst breastfeeding was a natural thing, it may not come naturally.
I am blessed with a good husband. Knowing he would be there to face the “you don’t have enough milk” mantra chanting mob together with me was half the battle won really. His support is probably why I managed to breastfeed our twins. He roomed in with me at the hospital and shared all my experiences, save the physical act of breastfeeding! We decided that whilst I should try my best to breastfeed, I needed to remain flexible to adapt to any changes needed for my and our babies’ well-being. This simple goal guided us through many challenges.
We benefited from a pre-delivery session with Jennifer, the experienced midwife from Jenlia Maternal Services. She advised us on breastfeeding twins, my nursing diet and how to manage the confinement lady. Her “realist” approach resonated with me. We agreed that whilst I would try my best to breastfeed exclusively, I should also (for my own sanity) have a back-up plan that involved some level of mixed feeding.
Her suggestion of rotational feeding – whereby each twin would get both breasts at one feed and a bottle at the next – would not sit well with some “lactavists” on my breastfeeding forums, but it felt like a practical solution. The plan was far from a “cop-out”. It gave me peace of mind and took away the pressure my postnatal hormonal self came to feel. She demonstrated what a good and bad latch was by pinching (bad) and pulling (good) me on my arm with her fingers. This later helped me recognise inappropriate latching behaviour requiring correction.
Fortunately, we also chose the right hospital. We had originally selected Prince Court Medical Centre for my gynae, their efficient systems (mostly online) and excellent facilities. However, we discovered how good the nursing care and breastfeeding friendly it was in the days following my delivery. The nurses and lactation consultant visited me daily to check on my latch and progress. We received top class medical care but also valuable education on breastfeeding and baby care. We were able to practice the theory we had picked up from their prenatal class. They made us feel like family instead of just faceless patients they could profit from.
I had a smooth elective C-section with a spinal block. I gave each newborn a quick kiss before they were whisked away to the nursery for the necessary. I was happy but physically exhausted and very numb from the epidural when a nurse peeked in later to ask if I was ready to try breastfeeding my babies. I steeled myself for this first attempt. After some fidgeting, my son latched on to my nipple almost perfectly. However, whilst he was a good latcher, he was not an efficient drinker – consistently drinking for short durations before falling asleep on my bosom. My daughter naturally seeked out my nipple on her own but had problems staying latched on and kept slipping off as she suckled.
We don’t remember much of our “zombie life” during those first few days. I nursed the twins consecutively almost every hour, even well into the night. As I wasn’t mobile due to my caesarian wound, hubby had to stay awake to bring the babies to me and to prop up my arms with pillows each time I nursed. He also burped and soothed them to sleep after feeds. There was one night when we were so dog-tired because our son would just not fall asleep; crying each time we tried to put him down even after many feeds were given to fill and pacify him. We sat in the dark missing the silence and feeling quite helpless; held ransom by our tiny yet rather terrifying offspring.
In those early days, our babies seemed to have insatiable appetites. I began to doubt if my breast milk was actually sufficient. They also suffered from low glucose levels at several points. So, we had to sign off on some minimal formula feeds offered via cup. My confidence was further dented on the fourth night when I attempted to pump out some of my milk. To my great dismay, the pumping of both my breasts only yielded an amount (maybe 5ml) sufficient to cover the base of the bottle!
Fortunately, the nurses assured us that all our newborns needed then was colostrum i.e. the “liquid gold” that I was already producing well before delivery as their stomachs were only as large as cherries. Their constant need to feed was not due to lack of milk on my part but because breast milk, being high in nutrients, was absorbed quickly and more efficiently by their bodies, compared with processed formula milk.
When we got home, we were seriously sleep deprived. To rest and regain our strength, we reluctantly relinquished the night feeds to our confinement lady, Aunty Apple (the joke was that Aunty Apple had come to look after a “pear”). Aunty Apple wasn’t 100% breastfeeding-friendly but due to our commitment to the cause, she cooperated by making me milk boosting soups and going easy on the ginger and herbal remedies. The Breastfeeding Advocates Network (TBAN) founder Gina Yong also advised me to direct latch or pump at around 3am daily if I wanted to increase my supply. This is because between 12am and 5am, the hormone Prolactin (responsible for triggering more milk production the next day) is secreted the most. So between my blocks of sleep and while Apple bottle fed our kids, I religiously pumped out around 120ml to 150ml nightly. Not quite enough to build a frozen breast milk empire but sufficient to replace one bottle feed a day. A kind friend also helped me avert nipple soreness by advising me to check on the fit of my breast pump shields. Once I obtained larger shields, pumping immediately felt more comfortable and the volume pumped out increased.
I seldom pump any more but today, four months plus an episode of nipple confusion and one blocked milk duct later, I have a good mixed feeding routine going. I use their bottle feeds (in the mid morning and evening) to eat my breakfast, take a bath and to catch my breath. For their remaining feeds (during the day, midnight and early morning), I prefer to breastfeed on demand via direct latching. I do believe breast is best, but you need to find your own happy balance. Breastfeeding is hard but if you stick together as a couple, surround yourselves with support you can trust and stay the course, it can be a really rewarding ride.