Dr Tan Sue Yee is a lecturer at the International Medical University – she specialises in matters related to healthy diets and good nutrition – and an active member of the Nutrition Society of Malaysia. She is also the mother of Yong En, who will turn 4 this August, and Yong Hui, who just turned 5 months old in April. Dr Tan exclusively breastfed Yong En – this means offering her daughter only breast milk and not other kinds of milk for the first 6 months of life – and continued breastfeeding for nearly 2 years (even after her daughter started on complementary food at 6 months onwards), and she is currently doing the same with Yong Hui.

When HealthToday caught up with her recently, it was a perfect opportunity to ask her, “You’re a mother who breastfeeds both her darlings, so what was the experience really like?”

Mommy’s getting ready

Experts always tell mothers who are expecting their first baby to research as much as they can on breastfeeding. This helps to clear any doubt or confusion.

Dr Tan says, “I am on the panel of a programme called MyNutriBaby, which is spearheaded by the Nutrition Society of Malaysia to provide information and resources for mothers who wish to optimise their children’s nutrition. In this programme, I have the opportunity to work with Pn Fatimah Salim, a lactation specialist.

“I was carrying Yong En when we first met, so I peppered Pn Fatimah with so many questions! What was it like? What can go wrong, and how can I overcome the problem? What if the baby cries? How do I know when baby is hungry or full?

“Pn Fatimah was patient and kind enough to answer my questions, so when Yong En finally arrived in this world, I had a good idea on how to do things right.”

The experts are right: it is good to look up breastfeeding or discuss the matter with lactation specialists, mothers who have breastfed, etc. However, Dr Tan points out that it is important to get the correct information from reputable sources. Like everything else, breastfeeding has its share of misconceptions and urban legends! Interested or curious moms (and dads) can start with www.mynutribaby.org,my, the website of the programme Dr Tan participates in.

The first time

Welcome the baby with the best food Mom can provide: breast milk. So say the experts, who advise moms to breastfeed as soon as possible. Cradle the baby close – bare skin contact is preferred – and, if the baby does not instinctively reach for the nipple, gently guide the baby’s mouth to the right place.

“With my eldest, Yong En, everything went smoothly. Yong Hui, however, needs some guidance in getting the first time right – it took about 40 minutes before she could breastfeed properly,” says Dr Tan. “Believe it or not, I wasn’t too upset. I guided her and I was actually overjoyed when Yong Hui finally succeeded in latching on to my breast!”

Babies are just like their parents, they are born with their own personalities and quirks. Some learn fast, while others need a little nudge and guidance in the right direction. Therefore, if your baby takes some time to latch properly, Dr Tan advises patience. Relax to the calming sound of your little one’s heart beating against your skin. Your baby will get the hang of it soon. If you need any help, contact the nurse. Many baby-friendly maternity wards have nurses and lactation specialists who are always willing to lend a helping hand.

Breastfeeding on demand

The baby will probably get hungry every few hours, so mothers should observe for hunger cues – such as tears, grasping movements reaching towards the mother’s nipple, etc – and breastfeed when the cues are present. This practice is called “breastfeeding on demand”.

Many new mothers may find it challenging to switch from a past routine, in which they were always on the move, into one where they are now – as some mothers smilingly put it – their baby’s amazing milk factory. They will find themselves breastfeeding often – not surprising, as Dr Tan explains that a baby’s stomach has a small volume, so the baby will get hungry quickly.

She adds, “To many mothers, breastfeeding on demand may seem tiring or confining, but in my experience with both my kids, it is not so bad! Breastfeeding is an opportunity to bond with the little ones, an experience that is both emotionally rewarding and satisfying.”                               

Dr Tan’s tips for a less stressful breastfeeding on demand experience:

• Rest, even sleep, while breastfeeding. Babies tend to cuddle up for a nap after filling their tummies, so why not join them in dreamland?
• Play your favourite calming music or catch up on your favourite shows or books while breastfeeding. Make the experience more enjoyable by having drinks and snacks within easy reach.
• Breastfeed on a comfortable chair with good back support.
• Stay positive. Instead of groaning and focusing on the stress and exhaustion, think of the feelings of calm and joy you experience when you breastfeed your baby. If it makes you feel better, think also of the benefits you are getting. Breastfeeding helps new mothers lose those post-pregnancy kilos!
• Give and take a little. Because you are now breastfeeding on demand, you may not be able to keep the house as tidy as you used to, and sometimes you may not have the time or energy to cook or do housework. This is fine; don’t get worked up over it. Just ask your partner and other family members to help. You may be surprised at how willing they can be to give the new mother a helping hand as well as lots of emotional support!

Night feeding

Babies get hungry at night too, so experts advise mothers to be prepared to breastfeed at night too.

The bane of every mother contemplating breastfeeding: having to wake up at ungodly hours of the night to the cries of a hungry baby, not to mention feeling a considerable degree of resentment for the slumbering hubby… especially if he is the one who wakes up the mother and tells her to go feed the baby as the baby’s crying is interrupting his sleep!

“It’s not easy,” said Dr Tan with a laugh, “but it’s not impossible either. For me, when I choose to breastfeed, it is a commitment I have made to myself and my babies. It is my choice, to do something that I know is best for my children, so I always try to focus on the positive aspects of what I am doing.”

Furthermore, night feeding is also important for a mother to have a more successful breastfeeding experience, as mothers produce more milk at night.

Night parenting tips for new moms:

• Have realistic expectations. Some babies may need more feeding throughout the night, others less. If your baby falls into the first group, make adjustments to accommodate night feeding. For example, you can try catching more naps during the day.   
• You can wake the baby for a breastfeeding session before you go to sleep. That way, your baby will feel hungry a bit later, thus giving you some decent amount of sleep before your night feeding sessions start.                                                
• Try to offer both breasts, so that your baby will have a full tummy each time. 
• Check your baby’s diapers each time before a feed, and change them if necessary. Babies sleep easier when their diapers are dry and comfortable.
• Have the baby sleep in the same room so he or she is closer to you, to make night feedings more convenient.
• When things get tough, remember why you wanted to breastfeed, and revisit your goals if you need some extra motivation. Also, if you approach night feedings with a positive attitude, you may begin to appreciate how each session is a peaceful moment for just the two of you – magical moments that you will cherish for life.

The importance of support

Experts point out that a breastfeeding mom’s chances of success improve significantly if she receives support from the people around her, especially her spouse and close family members.

Dr Tan agrees. “My husband was – is! – fantastic when it comes to supporting me,” she gushes. “My mother and mother-in-law are fabulous too. They help me around the house, as well as encouraging me and keeping my spirits high!”

If your husband, parents or in-laws do not share your views on breastfeeding, Dr Tan recommends involving them in your medical appointments, antenatal/parenting classes, etc. She frequently gives talks on child nutrition, and she has seen doubtful attendees eventually becoming interested in breastfeeding once the topic is discussed. “Often, their doubts or reluctance come from having incomplete or inaccurate information,” she says. “But when they learn of the benefits of breastfeeding, they often come around!”

Milk supply woes

Experts say that the more you breastfeed on demand, the more milk your body will produce, so there should not be any supply shortage problem.

Dr Tan never encountered any milk supply issues while breastfeeding both her daughters.

First, she addresses some common misconceptions. Women can breastfeed even if they have small breasts, flat nipples or inverted nipples. Breast milk production is regulated by hormones, and is not affected by breast size or nipple shape.

“If a mother is unable to produce breast milk, often it is not an issue of inadequate breast milk; usually it’s due to stress or the baby not latching properly to initiate the ‘let down’ which releases milk,” explains Dr Tan. A family member once found that she could not produce enough milk for her baby, but once the other family members cared for the baby to give her some time to compose herself and relax, she could breastfeed the next time she tried. “Some mothers, especially first-time mothers, can become anxious or worried when they try to breastfeed, and the stress affects the hormones and hence breast milk flow.”

She recommends relaxation methods such as listening to music or even getting some “me time” to calm one’s nerves before trying again.

On the other hand, hormone imbalance could affect breast milk production (although this is not a very common occurrence). If all efforts to calm down still fail to resolve the milk supply issue, it may be worthwhile to see a doctor to investigate the matter further. For issues of baby latching, seek the help of a lactation specialist.

If you like this article, do subscribe here.