Experts Highlight 2 Lesser-Known Breastfeeding Issues & How to Overcome Them

WORDS DR AISHAH MOHD HAFIZ & DR DURGA VETTIVEL

FEATURED EXPERTS

DR AISHAH MOHD HAFIZ
Senior Lecturer in Emergency Medicine
School of Medicine
Faculty of Health and Medical Sciences
Taylor’s University
DR DURGA VETTIVEL
Senior Lecturer in Family Medicine
School of Medicine
Faculty of Health and Medical Sciences
Taylor’s University
Lesser-Known Breastfeeding Issue 1
DYSPHORIC MILK EJECTION REFLEX (D-MER)
  • This describes a sudden, intense, onset of negative emotions, just before a ‘let down’ or the release of milk occurs.
  • It is estimated that 5% to 9% of breastfeeding mothers experience this at some point.
  • It can take place during direct feeding, expressing of milk, or whenever let down occurs—for example in response to a crying child.
  • Not much is known as to why D-MER occurs, but it could be due to a sudden drop in the level of dopamine or ‘happy hormones’ in the brain. What could have happened is that the suckling action during direct feed or mimicked by a breast pump secretes the hormone oxytocin, which stimulates milk production and release. Studies have shown that it also inhibits dopamine release.
  • Symptoms last only for a few minutes and disappear when the milk flow is established.
  • Most women who have experienced D-MER reports decreased frequency after the first 3 months, although it can persist as long as the mother breastfeeds or pumps her breast milk.
SYMPTOMS OF DYSPHORIC MILK EJECTION REFLEX (D-MER)
  • Sudden anxiety and irritability.
  • Sadness or hopelessness.
  • Anger.
  • Self-hate or low self-esteem.
  • Asinking feeling in the stomach or dread.
  • In some cases, the symptoms can be severe, such as suicidal ideation.
Lesser-Known Breastfeeding Issue 2
BREASTFEEDING AVERSION RESPONSE (BAR)
  • This describes a feeling of aversion (strong dislike or wanting to stop) while breastfeeding, which occurs the entire time the child is latched on to the mother’s breast. This can result in the mother developing a compulsion to unlatch.
  • Currently, there isn’t much research done into this matter.
  • An empirical study done in Australia concluded that BAR is unexpected and difficult for mothers. It may result in detrimental effects on maternal identity, mother-child bonds, and intimate family relationships. Some of the participants in this study described the experience as ‘skin crawling’ while others reported negative sensations that were ‘visceral’, ‘overwhelming’ and ‘uncontrollable’.
  • As of now, there has been no research done to study the prevalence of BAR among Malaysian women. We can only speculate whether BAR may be a key factor for the low rate of exclusive breastfeeding.
FACTORS THAT COULD UP THE RISK OF DEVELOPING BAR
  • Breastfeeding for the first time.
  • Breastfeeding 2 or more children at the same time.
  • Menstruation.
  • Breastfeeding during pregnancy.
WHAT TO DO IF YOU THINK YOU HAVE D-MER OR BAR
  1. Recognizing these conditions is an important first step.
  2. Experts recommend self-help strategies such as meditation, positive self-talk, and personal distraction (listening to music, etc) during the feeding or pumping sessions to better manage the negative emotions associated with these conditions. These little actions can help increase the mother’s levels of happy hormones.
  3. Don’t face these challenges alone. Talk about these negative emotions with your partner and loved ones and seek help from healthcare professionals such as lactation consultants, counsellors, or therapists.

Diets & Exercise Tips to Regain Your Pre-Pregnancy Body Shape

WORDS DR VICKY KOH

FEATURED EXPERT
DR VICKY KOH
Medical Director
Clinic RX
WELL, READ THIS FIRST

Every woman’s body is unique. Therefore, the question of the ‘right option’ or ‘best option’ is something that each and every woman has to figure out on her own.

For example, mothers that breastfeed often experience rapid weight loss and may benefit from an increased intake of certain nutrients or supplements. Women that gave birth via caesarean section may need a longer time to recover. Existing health issues and lifestyle variables also need to be considered.

If you are interested to find out more about the topics discussed below, you should discuss the matter further with your doctor.

BREASTFEEDING CONSIDERATIONS

Postpartum weight loss averages about 4.5 to 5.5 kg in the first 6 weeks. Women often return to their pre-pregnancy weight within a year, though this time frame varies depending on how much weight was gained during their pregnancy.

Breastfeeding aids in weight loss since it consumes extra calories, resulting in a natural weight loss for many women.

Breastfeeding women should pay special attention to their diets at this time.

While experiencing weight loss after giving birth may seem like a good idea, doing so too quickly will actually hinder healing!

POST-PREGNANCY DIETARY RECOMMENDATIONS

Dietary recommendations should include a variety of fresh produce, whole grains, lean proteins, and healthy fats.

Breastfeeding mothers, in particular, should drink a lot of water (6-10 glasses daily). Try to stay away from sodas and other sugary drinks.

Meanwhile, for moms that had a C-section, they should focus on eating foods that are high in protein. Avoid junk foods and take vitamin supplements, especially if they are nursing.

Vitamin and mineral supplements are crucial for moms during and after pregnancy.

This is because nutrients such as calcium, iron, vitamin D, folic acid, zinc, and more are normally redirected from the mother’s bloodstream to the developing infant.

Furthermore, the delivery process as well as breastfeeding depletes the body of essential vitamins.

Hence, postnatal supplements such as calcium, vitamin D, B vitamins, docosahexaenoic acid (DHA), magnesium, selenium, iodine, and choline may be helpful in replenishing nutrients that were used up during pregnancy and after childbirth.

EXERCISE RECOMMENDATIONS

Regular exercise after childbirth will help strengthen and tone your muscles while increasing your energy levels and making you feel less weary.

It also aids in the loss of excess weight.

During the first 6 weeks, the uterus returns to its pre-pregnancy size, and some women may feel uterine cramping and discharge.

However, mothers are recommended to gradually resume their exercise habits, starting with less strenuous activities during the first few weeks after giving birth.

A few days after delivery, you can start doing gentle abdominal and pelvic floor exercises if they don’t cause you any pain.

Try to proceed at your own pace—you can gradually increase the duration and tempo of your workout of over time.

Swimming, cycling, yoga, pilates, mild weight training, and low-impact aerobics are all good alternatives after the first few weeks.