Monthly Meeting Minutes

taken from mother to mother peer supporter in Penang.
(thanks to sis Shida aka charantya)

Date : 5 April 2008
Time : 4.30 pm
Venue : Caring Complex Meeting Room 3

Agenda 1 - Introduction

1.1 The meeting commenced at 4.30 pm.
1.2 The chairperson Dr. Balkees chaired the meeting.
1.3 Dr. Balkees started the meeting with a welcoming speech and a brief explanation about the formation of the Mother-to-mother Peer Support (MMPS) group.
1.4 Introduction continues where core members and new mothers briefly introduced themselves.

Agenda 2 – Myth Busting

2.1 Dr. Jamie started this month topic – Myth Bustings – top 10 myths.

2.1.1 Myth #1 – Breasts will sag.
Mother’s breasts will become bigger and bigger over the 10-month pregnancy period. If the mother didn’t breastfeed the baby, the breasts size will go down rapidly and sag. If mother breastfed the baby, the breast size will go down gradually. So the mother who do not breastfeed, the breasts sag more than the mother who breastfeed.

2.1.2 Myth #2 – Baby too attached to mommy.
Mother is the first person the baby sees, and breastfeed 12 times a day, needless to say, baby will be very attached to the mother. But it’s just last for 2 years, maximum 3 years or 5 years. Think about the baby’s lifespan, 70 years? 5 years out of 70 years, just very short. And breastfed baby is more independent compared to formula-fed baby, cause breastfed baby is being held more, he feels more secure, cry less, and more independent.

2.1.3 Myth #3 – Mom’s milk not as tasty as formula.
Tasty thing doesn’t mean its good for the baby. KFC and Char Kuey Teow are tasty, but it’s not good for you. Mother’s milk has way more nutrient. The sugar in breastmilk is 6.8g whereas formula is only 4.8g. More sugar in breastmilk, but its simple sugar, easily absorb by the baby. Whereas the sugar in formula is complex sugar, would not absorb as fast as simple sugar, baby would not get the nutrient fast.

2.1.4 Myth #4 – Formula have more nutrients.
Breastmilk has 300 over nutrients. Some even scientist doesn’t know their name yet. Not only nutrients, breastmilk has antibody, enzymes and protein that cannot be duplicated by formula milk companies at all. Mother’s milk is from human, formula milk is from cow.

2.1.5 Myth #5 – Small breast = No milk.
All mothers makes enough milk for the child and all child drinks only 75% of the mother’s milk, so all mothers can keep the 25% of their milk. Bigger breast, bigger capacity, baby drinks more, and sleep longer. Smaller breast, smaller capacity, baby drink less and sleep shorter. Small breast not equals to no milk, just that the small breast mother, her child has to nurse more. Bottom line, all women have enough milk.

Fenny, the core mother, successfully breastfed her youngest daughter for 3 years, shared her experience by saying that even though her breasts are small, every time when she’s breastfeeding her youngest daughter, she kept saying ‘mommy no milk already.’ But the daughter kept saying ‘no no, still have still have, a bit a bit’ and keep suckling.

2.1.6 Myth #6 – Colostrum is dirty.
Colostrums is yellowish. All mothers have 2 weeks of colostrums. First 4 days only few droplets, and very sticky. Formula can’t copy human colostrums. There are cow’s colostrums sold in the market, but not allowed to the children. In colostrums, there is antibody which protect baby’s gut, nose and eyes to make baby stronger. Colostrum is very tasty and very healthy. It’s not dirty, don’t throw away.

2.1.7 Myth #7 – Cannot take cold drinks/food limitation.
If the mother eats healthy and balanced diet, there is no food limitation. All in moderate.

Question #1: Can drink coffee?
Coffee will pass to the baby, and make the baby very alert, cannot sleep. But 2 cups of coffees a day is OK. If the mother still has to drink coffee (more than 2 cups), the mother can feed the baby first, and then only drink the coffee. Next feed would be 2 hours later, the coffee would have diluted by then.

Question #2: How long the coffee dilution will take?
It depends on how much you drink, and the concentration of the coffee. If more concentrated, need more time to dilute.

Question #3: After taking alcohol, the next pump must throw?
If the mother is social drinker (once a week), if the alcohol level is very high, if the mother is very worry, then the next pump can throw away. Otherwise, can still breastfeed. Mother who is chronic drinker, drink everyday until hang over, the baby will get alcohol syndrome.

2.1.8 Myth #8 – Breastmilk too watery.
If the expressed milk (in the bottle) sit on the table, after awhile, you will see 3 layers, which are grey watery colour at the bottom, yellowish milk colour in the middle and a thick fat layer on top. Whereas the formula is vice versa. The watery level is on top; the very thick formula is at the bottom. It’s not the way it should be. Its watery cause 80% of the breastmilk is water. Baby drinks for thirst. Breastmilk consists of foremilk and hindmilk. Foremilk is watery. Because it has more percentage of lactose and water. The first instinct human drink is for thirst, and that’s what the mother gives the baby first. The longer the baby suck, the fat will come, which is the hindmilk, and it’s thicker.

2.1.9 Myth #9 – Need to clean breasts before feeding.
Mother’s breasts have antibacterial properties. In the studies that show a mother-and-baby first skin-to-skin contact (1st hour after delivery), experiment has shown that the breast that they clean compare to the breast that they didn’t clean, the baby will automatically choose the breast that they didn’t clean, because of the mother’s smell. After cleaning, it only smells alcohol.

Question #1: Need to use milk to clean the breast?
Don’t have to. Just normal 2 showers a day. Don’t have to clean with cotton butt, or dettol, or sterilize the breasts.

Questions #2: Need to express a bit out first before feeding, due to the bacterial content at the initial part. Is that true?
No, don’t need to. There are many little small glands that lubricate the nipple, and its antibacterial. In special cases whereby express to release engorgement, yes, it helps, so that the nipple wont be so stress, and the baby can suckle. Other than that, don’t have to express before feeding, the baby can come straight.

2.1.10 Myth #10 – Breastfeeding takes nutrients from mommy.
Yes, true. The baby gets all the nutrients from mommy. If the mother eats healthy and balanced diet, it’s ok. The risk of osteoporosis in woman who has breastfed is lower than in woman who has not breastfed.


Agenda 3 – Dicussion

3.1 Novia
• Baby gets the antibody from her milk, seldom fall sick. Only recently mix with other children in the nursery.
3.2 Shida
• Even if baby fall sick, she will recover faster than formula fed baby.
3.3 Dr. Balkees
• The risk of getting infection is lower.

3.4 Question #1: Nipple confusion, is it true?
Must start off right, no bottle feeding for the first 2 months, even if baby is jaundice and has to stay in the hospital, request for cup feeding or spoon feeding, no bottle. Because sucking milk from bottle teat is easier than the breasts. Human/baby is lazy, will opt for the easier way. But after 2 months, when mother goes back to work, swap between bottle and nipple, its totally fine as baby will still prefer mommy’s breast. 1 month prior to work, start training baby with cup or spoon-feeding. Furthermore, bottle-fed baby is very difficult to wean off bottle.

Pushpa shared a case whereby a 1-month old baby who has been bottle-fed, the mother tried to direct feed the baby again. But baby refused. Tried to let someone else to carry the baby and bottle-feed him. Within 1 week, the baby decided to go back to the mother. Don’t give the baby choice to choose between bottle and breast. If he didn’t want direct feed, the baby is not going to get near mommy. Baby would choose mommy and the breasts.

3.5 Question #2: Will the milk get less if I only express and not direct feed?
No. Must pump as much as the baby drinks. Every 3 hours, 8 times a day. Otherwise, the milk production will go down. Most importantly, must pump at night. A lot of mothers tend to extend the time of pumping; this is the root cause of why milk supply goes down.

3.6 Question #3: C-sec mothers how to breastfeed baby in the first hour?
Even knock off or still drowsy after c-sec, request the nurse to bring the baby to the mother and let the baby suckle and have skin-to-skin contact.

3.7 Question #4: Breastfeeding and medication?
Most of the medication can be taken when the mother breastfeed, especially for running nose, cough and fever. Many doctors say cannot take medication when the mother breastfeed is because even doctor don’t have much knowledge in breastfeeding. It’s not in their syllabus. If have doubts, please contact person who is more aware of breastfeeding, please don’t stop breastfeeding.

3.8 Question #5: Short/small/inverted nipple cannot breastfeed?
Wrong. Mother with short/small/inverted nipple can breastfeed. Baby is suckling mother’s areola, not the nipple. When baby start suckling, he will pull out the nipple. Do not use nipple shield, baby will get confused.

3.9 Question #6: Can take ginger when baby jaundice?
CAN! It’s not the ginger that causes the baby jaundice. 80% of the babies have jaundice. If baby jaundice, should continue breastfeeding.


Agenda 4 – Sharing by Pushpa – LLL Leader

4.1 Pushpa started the sharing by telling her story. Then the importance of skin-to-skin contact between mother and the baby. Example giving was when you first time fall in love with a guy, you can’t think of anything else except for the guy. Feel like being with him all the time, near him, touch him, have skin-to-skin contact with him. The baby is the same. When the baby is born, the only person baby knows is the mother. How can we deny skin-to-skin with the baby. That is essentials.

4.2 Then Pushpa talked about the role of the fathers. He can change the nappies, bath the baby, massage the baby, talk to the baby, and compliment the mother. Tell the mother “You’re very beautiful!!” The most beautiful breasts are the lactating breasts.

4.3 Breastfed babies, where we spend a lot of time with them, when they grow up, they are more independent. Because they have all the secure and all the love. As we care for them, later they will care for us.

4.4 Human is mammals, the only thing that identify human, as mammals is we nurse our baby.

Meeting adjourned at 6.00 pm.

Menstruation & Breastfeeding

I'm having my er, 1st period now and I notice a slight change in my milk supply. Googling around, and here are the outcomes.

Best remedy is always -- increasing your pumping sessions, aye..

Excerpt #1 from here

Although women do not ovulate during early lactation, the later stages of prolonged breast-feeding are frequently accompanied by menstruation. The factors influencing the onset of ovulation during breast-feeding form the main subject in the second part of this report. The reason why there is sometimes breast refusal during the menstrual cycle is unclear, but Hartmann and his colleagues (3) in Western Australia have found major, acute changes in milk composition occurring in the mid follicular and mid-luteal phases, though their exact signification awaits clarification.

Excerpt #2 from here

The return of menstruation does not mean the end of breastfeeding. The milk does not sour or "go bad" when you are having a period. The milk is no less nutritious when you are menstruating than when you are not. Some women do notice a temporary drop in milk supply in the days just prior to a period and for a few days into one. This is due to hormonal fluctuations. Once the period begins and hormone levels begin to return to normal, the milk supply will boost back up again. Most babies can compensate well for this temporary drop in supply with more frequent nursing.

Nipple tenderness occurs for some women during ovulation, during the days before a period, or at both times. Some mothers report a feeling of antisiness while nursing at these times, too. As with the drop in supply this is also hormonally influenced and therefore temporary.

Some babies may detect a slight change in the taste of the milk just before a period, again, due to hormonal changes. These same babies may nurse less often or less enthusiastically during this time as a result.

For some women, the drop in milk supply and nipple tenderness associated with menstruation becomes more of a challenge. An effective treatment for these symptoms associated with the return of periods is to add a calcium/magnesium supplement to the diet upon ovulation and continue it through the second or third day of a period. The supplement should be 1500 calcium/750 magnesium but can be as low as 500 calcium/250 magnesium (the higher the dosage the more effective and quicker the results). It should be a combination pill. This much calcium should never be taken alone. If your cycles are not regular and you do not know when you ovulate, you can take the supplement the entire month until you begin to see a pattern to your flow. This type of supplement seems to work as it prevents the drop in blood calcium levels which occurs mid-cycle and continues through the second to third day of a period. It is this drop which is associated with the nipple tenderness and drop in milk supply as well as the uterine cramping so often experienced with menstruation. You only need to take one pill a day.

The herb, Evening Primrose, is also reported to alleviate nipple soreness brought on during ovulation or before a period. The dosage is one capsule per day.

Excerpt #3 from here.

Most women can breastfeed without a decrease in milk supply when menses returns. If you notice a decrease, try to nurse more often to build up the supply. This is the best way to treat a decrease. If that does not seem to work, you may want to try a calcium/magnesium suppliment (2 to 1 ratio). You must take half the amount of magnesium with the calcium so it will be absorbed. I'm not sure why this works, but it has been proven to increase milk supply after menses has returned (I know from personal experience!) Do not take coral sources of calcium because it can cause allergic reactions in your baby. For more info on dosage, see http://www.kellymom.com/herbal/natural-treatments.html#calcium.

And more #4 from here

Let Down Reflex

I'm having a problem in getting let down reflex nowadays. While browsing, I found this article. Thought of sharing and hoping it will benefit us all.

The Let-Down Reflex (Milk Ejection Reflex)

What is the let-down reflex?

When you breast-feed, your baby's sucking stimulates nerves in your nipple. These nerves carry a message to your brain, and a hormone, called oxytocin, is released. Oxytocin flows through your bloodstream to your breasts, where it causes tiny muscle cells around your milk glands to squeeze milk out of the glands and into the milk ducts. This is known as the let-down reflex or the milk ejection reflex.

Once your let-down is working well (usually by 2 weeks after delivery), you may feel a pins-and-needles or tingling sensation in your breasts when you nurse or pump. Milk will usually drip from one breast while you are feeding on the other side. Sometimes your let-down will occur when you hear your baby cry or think about nursing your baby. A well-functioning let-down reflex helps ensure your breasts get emptied and your baby is easily getting milk.

Sometimes a woman's let-down reflex doesn't work as well as it should. This can cause breast-feeding problems. For example, you may have problems emptying milk from your breasts or your baby may not get enough milk.

What causes a poor let-down reflex?

Several situations may prevent the let-down reflex from working well.

• You may have severely sore nipples that cause you to tense up before each nursing.
• You may be stressed, anxious, or tense. For example, you may be trying to pump breast milk during a short break at work.
• You may be separated from your baby. For example, if you have to pump at home while your premature baby is still in the hospital.
• You may have had a previous breast surgery that has damaged the normal nerve pathways to the nipple, such as breast reduction or enlargement surgery. If you have altered sensation in your nipple after surgery (that is, your nipple is either somewhat numb or super-sensitive), it is possible that nerve damage from the procedure could interfere with your let-down reflex.

What can I do to improve my milk flow?

The following suggestions can help trigger the let-down reflex and improve milk flow:

• Try to nurse or pump in a place that is familiar, comfortable, and restful.
• Drink a beverage whenever you sit down to nurse or pump.
• Play soft music or do relaxation exercises before you nurse or pump.
• Gently massage your breasts before you nurse or pump.
• Have your partner give you a backrub before you nurse or pump.
• Put a warm washcloth or heating pad on your breasts, or take a warm shower before you nurse or pump.
• If you are pumping because you are separated from your baby, put a photograph of your baby by the pump.

Are there medical alternatives to improve my milk flow?

A synthetic (man-made) form of oxytocin was formerly marketed as a nasal spray known as Syntocinon. The drug was sometimes prescribed for mothers of premature infants who needed help conditioning their let-down reflex when using a breast pump. Syntocinon is no longer on the market. However, a compounding pharmacist can make the same drug with a prescription from your health care provider.

Written by Marianne Neifert, M.D., and the clinical staff of The HealthONE Alliance Lactation Program, Rose Medical Center, Denver, CO. (303) 320-7081.

Taken from here.

Why feeding your baby will NOT make your breasts sag

Breastfeeding does not make the bust sag, according to scientists.

A study has shown that smoking and ageing both affect how pert the breast remains - as does pregnancy itself.

But feeding a baby for around nine months will not add to the droop.

Experts hope the news will encourage more mothers to breastfeed and take advantage of the health benefits for their children.

Plastic surgeon Brian Rinker said he was inspired to carry out the study after hearing many of his patients blame their saggy breasts on breastfeeding.

He and his team interviewed 132 women seeking breast lifts or augmentation between 1998 and 2006 - 93 per cent of whom had experienced at least one pregnancy.

Among the mothers, 58 per cent had breastfed at least one child, for an average of nine months.

The researchers evaluated the womens' medical history, body mass index, pre-pregnancy bra cup size and whether or not they smoked.

There was no difference found in the degree of breast ptosis - sagging - between women who breastfed and those who did not.

But smoking was found to have an effect, according to Dr Rinker. He said that smoking breaks down a protein in the skin called elastin, which makes skin look young and supports the breast.

He added that pregnancy has a 'very strong contribution to breast ptosis' and that the negative effects increase with each child.

Dr Rinker, from the University of Kentucky, said: "Women may be reluctant to breastfeed because of this unfounded myth that doing so means the end of youthful breasts.

"A lot of times, if a woman comes in for a breast lift or a breast augmentation, she'll say 'I want to fix what breastfeeding did to my breasts'".

"Now, expectant mothers can relax knowing that breastfeeding does not sacrifice the appearance of their breasts."

The results of the study were presented at a conference of the American Society of Plastic Surgeons.

They follow research showing that breastfeeding makes babies brainier.

British researchers discovered that mother's milk in the first few months of life can boost a child's IQ by seven points.

This applies in nine cases out of ten, where the youngster inherits a common but newlyidentified 'brain-boosting' gene.

Britain has one of the lowest rates of breastfeeding in Europe.

Around a fifth of women choose not to, while a third of those who do try will give up within six months.

Breast-feeding is best for a brainy baby

says study..

By DAVID DERBYSHIRE - More by this author » Last updated at 11:13am on 6th November 2007

Breast-feeding really does make babies brainier, a major study suggests.

British researchers have found that mother's milk in the first few months of life can boost children's IQ by seven points.

This applies in nine cases out of ten, where the youngster inherits a common but newly-identified "brain boosting" gene.

The finding adds to the mounting evidence that breast-fed babies are happier, healthier and brighter than those raised on formula milk.

It also helps resolve a long-running dispute about the benefits of breast milk on intelligence - and the role of nature and nurture in IQ.

The findings were welcomed by health campaigners, who say that Britain has one of the lowest rates of breastfeeding in Europe and that too little is done to support and encourage new mothers.

Around a fifth of women choose not to breast feed their babies, while a third of those who do have given up within six months.

The link between breast milk and intelligence was first discovered in 1929 and is often used as an incentive to encourage mothers to feed naturally.

However, a major study by the Medical Research Council last year suggested that the link was a myth.

It found that past research had failed to take into account the mother's background.

Not only were those who breastfeed usually brighter, they were more highly educated, older, better off and provided a more stimulating home environment, it found.

Now two studies suggest that breast milk helps babies whatever their family background.

In one, carried out on 1,037 children in New Zealand, IQ was tested at ages seven, nine, 11 and 13.

DNA samples were gathered from the participants when they reached 18.

The other study looked at 2,232 British twins, whose IQ was measured at five.

Both sets of research found that the IQs of breastfed children were seven points higher, even after their social background was taken into account - so long as they had inherited a particular gene from their parents.

The gene, FADS2, is involved in the way the body processes fatty acids in the diet.

Breastfeeding made no difference to the one in ten children who did not carry the gene variant, according to a team from King's College, London.

Previous research has shown that longchain polyunsaturated fatty acids (Pufas) accumulate in the brain during the months after birth.

They are present in human breast milk, but not cow's milk, and have recently been added to infant formulas.

Pufas are thought to be important to childhood brain development because they are essential for the efficient transmission of nerve messages and help to promote the growth of nerve fibres.

The findings appear in the journal Proceedings of the National Academy of Sciences. Professor Terrie Moffitt, based at the Institute of Psychiatry in London, said: "The argument about intelligence has been about nature versus nurture for at least a century. We're finding that nature and nurture work together.

"Our findings support the idea that the nutritional content of breast milk accounts for the differences seen in human IQ. But it's not a simple allornone connection: it depends to some extent on the genetic makeup of each infant."

In the last decade, many infant formula makers have started adding two Pufas - docosahexaenoic acid (DHA) and arachidonic acid (AA) to their products.

But the children taking part in the gene study were born in 1972-73 in New Zealand and 1994-95 in England, before fatty acid supplementation of infant formula began.

The jury is still out on whether Pufa supplementation has made a difference. However, in laboratory tests, animals given fatty acid supplements have performed better at learning, memory and problem-solving tests.

Past studies have shown that breast-fed babies are less likely to suffer from asthma, eczema, heart disease and obesity later in life.

Rosie Doddes, a breastfeeding adviser for the National Childbirth Trust, said the benefits of breastfeeding to mothers and children were well established.

"In the early months, breastfeeding protects against respiratory and gastrointestinal problems.

"It's up to women to choose whether to breast feed or bottle feed, but we are very concerned that women are not getting the right support and information.

"Rates are relatively low in Britain compared to Europe, and very low compared with the rest of the world."