What have I learned from breastfeeding Little Princess?

In autumn 2016, I breastfed Little Princess who could latch and suckle well. She has shown a love for drinking breast milk and I am grateful for this. Throughout this journey, I reflect on lessons grasped and learned from breastfeeding Little Princess.

***
No pain no gain. On 20160923, in an attempt to ensure my breast milk was meant for Little Princess’ age, I stopped using the nipple shields [8] as I felt that I have been healed of sore nipples and realized that I had more lochia. Baby’s saliva can affect mother’s body so much! On 20160924, I found my right nipple was bleeding, the blood stained the breast pad.

When I pumped for the 20160926_0815 batch of frozen EBM, I only noticed that my right nipple bled again upon seeing the blood stain on the breast shield. I pumped in the dark, with a little sunshine seeped through the space of window roll, to prevent disturbing the light-responsive Little Princess. A lesson here is to pump with lights on and other lessons are not to pump for too long [4] and to use the lowest force (it’s ok if I have lower yield, 极少称多). For double pumping, I used the lowest recommended level 2 (for single pumping) of Unimom,  will use level 1. Maternal grandmother of Little Princess also told to apply nipple cream, I used medela 100% lanolin. While Honey Panda told me not to use too much lanolin, the severity of not being able to pump or express or allow Little Princess to latch at all, it’s greater. Sometimes, I apply my own breast milk for its healing effects.

Since reaching home from the immigration @ 1.30pm on 20161005 , Little Princess had been drinking milk for 6x until 6pm and still did not manage to sleep deeply — she would drink then fall asleep in my lap, when I put her down, she would wake up and cry in less than half-an-hour! I had tried helping her to drink fully so that she could sleep deeply, e.g. pressing the milk duct so that there would still be milk flowing to her mouth when she was too tired to suckle. Yes In between 1.30pm and 6pm, I managed to quickly had my lunch, bathed with confinement herb, answered a phone call from a lactation consultant [6] of the hospital where I delivered Little Princess. After a day out and this prolonged awake period of Little Princess, my back and waist badly need a break, they are hurting so badly. Thankfully, Little Princess’ maternal grandfather is around and I requested him to carry her to sleep, because Little Princess did not seem to be hungry.

***

Be disciplined.

After Little Princess turned 3 weeks old, I had done my best to pump at least 400 ml of breastmilk daily for freezing. Honestly, there were days when I did not pump hitting the target, especially if I had to visit physicians or buy groceries. Consistent efforts matter! Be disciplined.

After a week of pumping only, I was reminded on 20170114 that if nursing mothers don’t nurse or pump during the day, the milk supply will diminish! We need grit to care for our little loved ones.

***

Ask Seek Knock.

Maternal grandmother of Little Princess shared that the mother of Little Princess did not cry much while she was a baby. While she was easier for the caregivers, she might miss getting what really matters, hence she needs to learn #pandaAskSeekKnock. In contrast, if Little Princess could not get milk, she would cry louder. 会哭的孩子有奶喝 [11]!

***

People cherish things with limited time. Robert Cialdini has observed this human nature, in which people are more easily persuaded to buy things on limited time offers. Since I would not be able to provide Little Princess with fresh breast milk for the complete first 6 months of her life, albeit I would do my best to give her frozen expressed breast milk (EBM) [1], I cherished every moment of Little Princess drinking directly from my breasts [2].

***

Experts can be wrong. Little Princess’ maternal grandmother reminded me how Little Prince’s paternal grandmother, who has cared for two older cousins of Little Prince, on the first day of Little Prince returned home from the hospital, insisted not to feed Little Prince any formula and not allowing Honey Panda to buy a breast pump. Poor Little Prince cried for very long and Happy Green Panda was inexperienced and did not argue with Little Prince’s paternal grandmother out of respect for her and ‘expertise’ [3]. Thankfully, Honey Panda did not listen to his mother. He went to buy formula and an expensive Medela breast pump. The cousins were born through vagina, whereas Little Prince was born through cesarean surgery, hence Little Prince’s mother had to wait for the milk to come in. A single solution does not necessarily fit all, we must be adaptable.

***

Value ratio matters more than price to decide on quality. On 20160922 at ~ 9am, I was about to test the T-shaped connector, before I managed to do so, I found out that my Medela swing breast pump was no longer working. I’m not sure if the pump or the power adaptor is spoilt. If using 4 AA batteries can operate the Medela breast pump, it means that the adapter is spoilt; otherwise the breast pump is spoilt. I’m disappointed with medela. Mine has been spoilt twice, the first time was within the 1 year warranty; today is the 2nd time it’s spoilt. Thankfully, I just got a much cheaper Unimom allegro# breast pump. Expensive does not necessarily means high quality or durability!

***

Be practical. On 20160927, after directly breastfeeding Little Princess since early hours of the day [5], for the 5.30pm feed, I fed her the fresh breast milk pumped at 5.20pm (10 minutes to pump both sides to obtain 100 ml) while lying down to give a relief to my back ache, waist ache, and bleeding edges between nipples and areola. The exertion on nipples and waist were hence shortened. Many times, I would spend 15-20 minutes for directly breastfeeding a side, a good 5 minutes for burping, adjusting pillows, unswaddling and re-swaddling her; for both sides it’s about 50 minutes and Little Princess might not consume as much as 100 ml.

***

Be service-oriented
I labeled the frozen EBM with color papers (for unique month) for the caregivers (when I am not around) to easily distinguish different batches of milk.

***

Make notes

To observe and understand the drinking patterns of Little Princess, I kept breastfeeding logs [7].

Some of the most successful leaders in the fields of politics, business, science and technology have been known for diligently writing notes and logging, for example Bill Clinton (his index cards helped him to be a ridicuolously good networker), Richard Branson (who carries an old-fashioned notebook with him everywhere he goes), have used his archived notebooks to improve his business, to document his daughter’s growing moments, and as an evidence in lawsuits), Charles Darwin, Leonardo Da Vinci.

Additionally, I find that the habit of making notes has helped me to ask better questions. For example, how do antibodies in the breastmilk survive the harsh acidic environment in stomach to protect babies [9]?

In brief,(i) secretory IgA antibodies in breastmilk are in the form that is resistant to stomach acid and to protect babies’ mucosal surface (gut wall), but do not enter blood circulation, (ii) newborns’ stomach are not very acidic. See also

  • ref2016/quora_breastmilk_antibodies_20161021.pdf
  • Ctrl+F “breastmilk” options “within Notebook” in Asia2016/classic_questions_ideas_*.xlsx

***

Change is the law of life.

Our knowledge and best practices are changing. Thus, we need to do research and development, or at least follow the latest results of R&D. Note that for every every hypothesis, there will be supporting evidences to both sides, hence we also need to be judicious in making decisions.

For example, Honey Panda did not have a chance to enjoy mother’s milk because during his newborn age, formula was perceived to be superior to mother’s milk. In contrast, when both Little Prince and Little Princess were born, WHO recommends exclusive breastfeeding for 6 months, then introducing solid food at 6 months old with breast milk.

***

Timing, timing, timing

According to SmartParents (Asia2016/*smartparents*babies*jpg), “newborn is most alert in the first 60 minutes after birth, so she is primed to latch on. Known as the golden hour, it could make or break your breastfeeding attempts.” Both Little Prince and Little Princess missed the golden hours due to cesarean deliveries. However, with perseverance and endurance facing early challenges (bleeding, sore nipples, engorgements, etc), I managed to breastfeed them. Experience helped too. Since I specified in my birth plan that I want to breastfeed as soon as possible, in the recovery room, though it’s not allowed, Little Princess was brought to me faster post-partum, than Little Prince was.

Similarly, investments (in e.g. stocks, properties) also have their own timings. The same goes for savings, the earlier one starts, the more compounding interests one earns.

***

The act of balancing

Since I have to pump extra for the days when I am physically-separated from Little Princess [10], I am consuming supplements. Consuming supplements will also ensure that I continue producing high-quality milk while working, doing exclusive pumping, and being too busy to eat a balanced diet (though I’ll do my best to eat a balanced diet!)

Some essentials:

  1. Vitamin D from sunlight, milk, fish, shellfish, and egg yolks
  2. Fe (iron)
  3. Ca (calcium) min 1000 mg (~ 4 dairy servings)
  4. Folic Acid (Vitamin B9) from beans, leafy vegetables, citrus fruits, and grains. Min 400 microgram, max 500 microgram.
  5. Omega 3 DHS from oily fish.

Notes:

  1. Folic acid max 500 microgram
  2. Se (selenium) max 150 microgram (toxic if exceeded!)

***

[1] While frozen EBM has lost some of its nutrition, due to denaturation of proteins e.g. antibodies, hormones (leptin, adiponectin) and antioxidants, frozen EBM has been suggested to be better than formula.

[2] Cherished visual memories: Asia2016/*breastfeed*pte_fav*.jpg + Asia2016/201609_breastfeeding_pte.zip

[3] Experts such as physicians, scientists, engineers can also be wrong. Do not 100% believe experts and nowadays it is getting easier for people to self-declare themselves as experts.

[4] To ensure that the expressed & frozen EBM has foremilk and hindmilk, I alternate pumping between before and after latching. Little Princess has put efforts in drinking directly from breasts, but she gets tired and falls asleep before emptying the breasts.

[5] She drank 60ml from bottle @ 2.30am, right breast for 15+5 minutes @ 3.41am and 4.05am, 60ml from bottle @ 6am, right breast for 15 minutes @ 7.02am, left breast for 15 minutes @ 7.53am, left breast for 10 minutes @ 8.24am, left breast for 10 minutes @ 8.50am, 65ml from freshly-pumped bottle @ 10am. Only starting time is shown. The right nipple edge was bleeding @ am hours, then the left nipple edge was bleeding @ pm hours.

[6] She is the one who prepared the useful booklet of breastfeeding information. According to her today, I should not follow the practice of feeding 15 minutes each for both sides that I used while in hospital. Instead, I should feed the baby until a breast is emptied, if not pump it out, to ensure that baby obtains both foremilk and hindmilk. I told her that sometimes if Little Princess has been asleep for 3 hours more, I would pump out and leave some milk for her. The lactation consultation said this is also fine, as the baby would get the hindmilk.

She sounded happy when I told her that I have still been breastfeeding and started pumping. The more I pump, the more breast milk would be available for Little Princess, but I need to ensure I consume enough fluid and nutritious food.

If the baby falls asleep after drinking fast directly from breast, burp the baby to wake her up. Honestly, I had a little fear of latching Little Princess, because sometimes she was too eager like a little tiger. Burping halfway means more latching.

Regarding that Little Princess occasionally bites me after she is full from drinking (let say 10 minutes) and before unlatching herself, the lactation consultant thinks that the baby is unsecured.

The lactation consultant also warns me on the growth spurts ~ 4 weeks and 12 weeks.

[7] also available in Asia2016/*breastfeeding*log*jpg

[8] I am grateful for the knowledge of using nipple shield (不经一事,不长一智). While Little Princess can directly latch without aid for many times, sometimes she grows tense* due to hunger in her first two months. I think this usage contributes to Little Princess drinking more fresh breast milk directly (hence the antibodies and vitamins have not degraded much) than Little Prince did. I had never learned about the nipple shield when I delivered Little Prince, and honestly the lactation consultants at the hospital where I delivered Little Princess are much better than especially the first (physically hurting, in my opinion) lactation consultant at the hospital where I delivered Little Prince.

For this experience, Little Princess’ maternal grandmother commented that money can be an enabler of better healthcare.

* Another lesson here is to keep calm to be successful in many things, including drinking for survival and growth.

[9] This question was partly arisen because I am also pumping and storing frozen breastmilk for rainy days, when Little Princess will be separated from her mother – her source of drink and protective immunity.

[10]  Since the beginning of October 2016, I had pumped at least 400 ml of breast milk for freezing. I have to be careful not to do over-pumping (for each pumping session) because mothers who produce higher quantities of milk tend to have lower milk concentrations of fat and protein.

[11] “做人不能太老实,无欲无求很可能要吃亏。当然,要通过合法的手段来维护自己的合法权益和利益。”

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One comment

  1. […] [7] #pandaMnemonic: the gift of 3Ts = talent + time + treasure (money, things, blood, breastmilk) […]

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