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Breastfeeding was hard for me too

Breastfeeding was hard for me too

Posted on 09 January 2016 by hulda

Sometimes I think back about why I managed to breastfeed my babies, despite the fact that I had nipple pain for weeks with each one of them, little milk overall and always went to work reasonably early after giving birth.  I have come to the conclusion that it was because of a few things that I was lucky to have – mainly the environment that I was in and the mindset of the people around me.

Everyone just does it, in Iceland.  In my home country, 79% of women still breastfeed at 5 months, although this number is today even higher, 35% of them exclusively do so.  Two thirds of women exclusively breastfeed for the first two months and pretty much everywhere you go, it would not be considered inappropriate to breastfeed. In hospitals, no-one ever asks you if you are going to breastfeed, it is just assumed that you will.


Breastfeeding in Iceland 2004 to 2008


It is done reasonably discretely, boobs are not just visible to everyone, but even in a meeting or a coffee break at work, a breastfeeding mother would not be inappropriate, as long as she otherwise is doing her job.  Pumping milk is not that common, women just breastfeed.  When they want to go somewhere, the milk travels with them, so planning is not all that important.  “The baby should not feed for at least another hour” – is not a sentence you would hear often in Iceland.  You just feed when the baby needs feeding.  Who wants a baby to cry when it is easy to stop it?  It is true that the maternity leave is longer there, so it is easier for that reason.  But the great emphasis on “is the baby getting enough?” is definitely not as common in Scandinavia as it is in Hong Kong.

When I started to work in Hong Kong after having my 3rd and 4th babies, I had so little breastmilk, i.e. there was exactly as much milk as they needed but not really a drop more, I could have easily have been totally discouraged by it.  I never was able to pump more than 60 ml of milk when I was trying to store milk for them in advance of working.  But I just decided to try it out.  It turned out that they adjusted to it just fine.  And then came solid food and on weekends there was catching up that was lovely for us all.  But the health clinics were certainly not very helpful in supporting this system, I must say.

The other thing that helped me, was the fact that I did in fact have very good knowledge and some skills in breastfeeding, through my work.  In Iceland, the midwives’ training includes academic study and then weeks of breastfeeding assistance on the postnatal wards and during homevisits, to be able to sit your midwife exams.  This has of course greatly contributed to the support that the mothers in Iceland are getting and the statistics reflect that.  However, it is of course different when it is your own body and baby, and we all need some form of support.  So I was lucky, that I had this, offered by the government.

Yet another part was the general mindset of not bothering with the details.

When you read about that you must cover the whole areola and that you must fully empty a breast, feed for certain amount of time etc.  -  although all of these are valid advise, you can easily get a bit hooked on this and worry that you are not doing it right.  Especially if the baby is unhappy and crying, other family members have other opinions or generally the feeling when feeding, is not good.  Areolas are greatly different between women and some women have a fast letdown reflex and plenty of milk, so their feeds take a very short time, whereas others take much longer to drain breasts to the baby’s needs.

So when you can -  take the advice and educate yourself, but then use it appropriately. For example in my case, I really had to swap between the breasts often to keep one of my babies happy.  Otherwise she would simply fall asleep and then be hungry shortly after.  But when I swapped, she was much happier.  I made sure to try and empty one of the breast at least, each time, but this again, is sometimes hard to evaluate, when you are a first time mother.  ‘Empty’ to me, was a rather difficult concept – are the breasts ever empty?  My other kids would feed more “typically” i.e. all of the standard breastfeeding advice was very appropriate and useful. But flexibility was needed.

The same goes for foremilk and hindmilk - often it seemed hard to know when it was long enough a feed to be considered to be giving hindmilk.  But when I stopped agonizing over these details, and rather focus on the baby and how she responded, gained weight and slept – then it was all a bit easier.  The information was useful, but I needed to step away from it and be able to just try and test what worked.

And one last thing – the position to feed from.  Basically, especially when I once almost had mastitis after being with another woman in labour for 20 hours, what really did the trick was to feed the baby in ALL sorts of positions.  I mean, almost nothing short of a headstand.  In the bathtub, on the sofa, in a chair, leaning over her completely, upside down on the bed – the whole lot, many times over.

Being able to extend the night by feeding lying down in bed with the baby – what a glorious thing! If someone had come and told me off for co-sleeping, I am not sure what I would have done.  But luckily, no one would have even dared to so so!

A good midwife or a lactation consultant will tell you all of this.  You can read about it too.

To actually do it, though, and release the ‘strictness’ and let go of how you ‘should’ do things, is something you must do yourself.

This is just my story, I hope it helps you.  Let’s try and make Hong Kong more like Iceland and Scandinavia, where breastfeeding is just simply no big deal, women can do it their own way, whenever and wherever they want to, based on the baby’s needs.

Hulda x


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Breastfeeding.  Why the big deal?

Breastfeeding. Why the big deal?

Posted on 29 January 2015 by hulda


I have been a mother for longer than I have been a midwife.  And before I was a midwife, when I was a nurse, I remember thinking:  What is the big deal about breastfeeding? Everyone breastfeeds, right?  But if not, then surely there is a reason.  But actually, I had no real professional knowledge about it.  Around me, everyone breastfed. For a long time.  For months and over a year.

Maternity leave makes a difference for breastfeeding.

The maternity leave in Iceland is 3 months for mums, 3 months for dads and 3 months for either mum or dad.  Total, 9 months, on 80 % salary.  When you start to work, you can usually pump or go home for lunch to breastfeed. Or bring the baby into the meeting and feed while you do what you have to do.  No one raises an eyebrow. How can you have a baby and not feed it when it is hungry?  Of course you go home from work, baby needs you.  Government pays, mostly.  This is their family friendly policy.  Not perfect, and with many other problems, but maternity leave is good.

The partner – and friends – make a difference for breastfeeding.

I cannot really remember having seen any of my friends’ breasts.  When they breastfed I mean.

I have not asked my husband but I am going to guess that he would have found it mildly uncomfortable to see my friends’ breasts when they were feeding, but probably he just looked away if there ever was a moment when he could have caught a glimpse of flesh before the baby latched on.  But it did not bother him.  He was not overly in favor of breastfeeding, as in an advocate.  But he would never have dreamed of disagreeing to it.  Breasts are for babies who are just born, and all.  Why would you even discuss this?
Or whatever.
Most partners realize that breastfeeding is also an investment in health.  They are educated and up to date.

Doctors and nurses are not experts in breastfeeding.

Bottom line is that breastfeeding was for me at the age of 24 in Iceland, no big deal.  It also was no big deal when my second baby was harder to breastfeed than the first and I gave her some formula.  Not great if you ask me actually, but I did it as I had not the information or push from people around me to do it, and not enough personal enthusiasm myself.  I was a nurse and knew quite a bit about nutrition.  But nurses, and doctors also, are not really educated about breastfeeding but for around 1 to 2 hours of all their training.  Remember, their 4 – 10 years of training.  So they are generally not very good when you need advice and help about this matter. This was good and bad for me when I had troubles; I was not helped to push through to continue, which actually I think I could have easily done.  And good that at least when I found myself at that point – needing to give formula – I did not feel awful about it.  My poor husband was so relieved when this solution was found, we had tried a lot of things but somehow could not figure it out.  But he was helpless and sad when he saw me sad.bekkabrjostagjof


Yesterday I posted a link about “mummy wars” without realizing that of course, this video was a great psychology trick created by a formula company.  I think I did not watch it to the final end so I did originally not see it, but it had already planted its message in me.

What was interesting in it was how cleverly it was done (of course with the interests of the formula company in mind), by using what many of us are thinking nowadays, that there is actually a big sandbox war out there sometimes, between groups of mums and dads.  About lifestyle, sleeping, feeding and all of the stuff I have blogged about many times.  Of course people watch this formula company video because they recognize something from this video; their friends, other parents or themselves.

And, predictably in the end, everyone is united in that we should all be friends and it is all about the babies, and it is.

But someone pointed out and this is very true, that it is this clever way of reaching out to us that has become one of the problems for new parents.

Breastfeeding is normal.

Breastfeeding is not anymore  “just” the obvious choice.  In fact, the obvious choice for people nowadays is to “choose”.  Choose between:  breastfeeding or work.  Breastfeeding and the dad is out of the question in the caregiving.  Or else, his role is to change the diapers and burp. Breastfeeding or sleep.

The truth is that there is far too much analyzing and pushing and arrogance and and and… I don’t even have a word for it, out there.

Babies are born to breastfeed.  Breasts are there and they produce milk for 99 percent of those that give birth. Breastfeeding is recommended for all babies as the main source of nutrition for babies until the age of 6 months.  Then, it can be continued for as long as the mother wishes.

There are other ways of feeding a baby but there is nothing that will fully replace the milk.  Just like nothing will fully replace an apple.  Not apple juice with “pulp” in it.

There are people who do not breastfeed, for a good reason.

For those that wish to breastfeed, in the current world we live in, unfortunately, we need breastfeeding advocates.  Pushing for it all the time, and we need education and endless support.  We need not nurses and doctors to be the main support for the new parents, but midwives and lactation consultants and health visitors and then possibly nurses and doctors if they are particularly interested in the breastfeeding and specifically educate themselves.

We also need partners, grandparents and employers and everyone else in the community to stop bitching and secretly being against breastfeeding.  Not that everyone is, but those that do, they are doing damage.  We need the world to understand that breastfeeding is and should be the norm and it should never have to be stopped until both the mother and / or the baby does not want to do it anymore.  Not because of work, exposure, grandmothers’ very generous reminders of that they “never had enough milk”, or helpful people suggesting that sleep will never return to normal until breastfeeding is stopped.

We also need to understand that many people have a very hard time with breastfeeding.  There are many things that can be difficult.  We don’t all cope the same and some babies are having a harder time, some sleep less and some more…..each family, baby and person has different things to cope with.

I strongly believe that everyone should, like Nike suggests, just do it.  That there should never be any suggestion of anything else.  Not even a choice.  Of course you just do it.  And have people around you who also do it.  Have an employer that understands that you actually do a better job at work when you show up happy and maintain that happiness when your 3 month old that you left at home is happy and well fed.  You may even stay longer at work as a result.  And a partner that just does not even talk about it.  Just leaves it.  Or is very helpful, if he is that type.

Then first, will those that actually cannot breastfeed, or choose not to, for whatever reason, do so without this horrible sandbox war happening, this competition of who is better than the next etc., (pretending it is all about the children), stop, and those that actually want to breastfeed properly focus on doing just that, instead of debating which is better and who is a better parent.

This is not easy.

I spend half my working hours talking to parents, mothers and fathers that are either full of guilt or worries, or both.  Mostly because of other people and their opinions.

How can you talk about all of what I have said above, to the one that has had to give up breastfeeding or give additional formula milk to their baby, without them feeling guilty?  It is the same as talking about normal childbirth to the woman who just had to have a C section, how can you remind her over and over again that a vaginal birth is probably better for both mother and child, without her feeling just awful?  Believe me, it is very very hard. I feel very sorry for them and I understand how hard this is for them.

There is enough negative in this world already and we need not to make life harder for ourselves or those around us.

Give support.  You matter.  Yes you.

Like I said in the beginning, breastfeeding is normal and everyone should be supported to feel that way. Those that run into troubles with it and feed their babies by other means should be free to do so without the finger pointing of others.  There is a reason for why we do things the way we do them and we are all adults.  I have seen people at the point of breaking and we always must weigh the options against each other.  Sometimes, simply, the formula is a better choice than continuing to breastfeed and there is no but about it.  That a dad feeds a baby expressed milk from the bottle or formula, does not make a baby’s life worse.  It may make it much better.  It may continue the breastfeeding for much longer and it may well be an educated choice.

There are mums here that have no support from their workplace to breastfeed.  And 8 weeks of maternity leave.  This is of course totally unacceptable.  If you are an employer or a co-worker, please do what you can to make it easier in the workplace for a new mother to breastfeed her baby.

We need advocacy everywhere about breastfeeding until the world gets better.  Employers, grandparents, partners, kids, mums and everyone needs to understand that breastfeeding is the right of a new baby and its mum.  The environment needs to be supportive of it.  Unfortunately those that advocate for breastfeeding have been labeled my many as “breastfeeding Nazis” or “hippies” but please… immature.

While we are out there fighting, the formula companies win.  So please stop.
Can everyone just get on with it and make it normal.   Not “natural”.   Just the norm.

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Hands on Pumping

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Hands on Pumping

Posted on 15 September 2014 by Kristrun

Although pumping or expressing is not recommended for the first 6 weeks after birth, it is sometimes necessary especially if your baby is ill, premature or unable to breastfeedingonbedbreastfeed for any reason. To get the milk production started after birth it is important to stimulate your breasts as soon as possible – preferably within two hours after the birth. To maximise the amount of colostrum produced, you may have more success hand expressing the first time since this is often more effective than using a pump.

After that initial expressing it is recommended to use a hospital-grade pump with a double pump kit about 8 times or more per 24 hours. This works out as approximately every 3 hours or whenever convenient – it doesn’t have to be always at the same time. For maximum milk production by pumping, it is important you use breast massage before and during the pumping session. This will stimulate the ‘let-down’ and the milk will flow more easily. When you’re pumping you should watch the sprays of milk and when this subsides, turn off the pump. This might take 5 minutes for some women and 25 minutes for others; you don’t pump for 20 minutes just to pump for 20 minutes. After you turn off the pump, it is recommended you try to hand express for 5-10 minutes into the pump flange since that can sometimes double your output and you can get more hindmilk which is the richest milk for your baby.

Maternal factors influence milk volume and things like stress, anxiety, fatigue and illness can decrease milk production significantly. Having an ill or premature baby can call on all these factors, so it is really important to be kind to yourself and give yourself time. It is crucial important to try to sleep and rest regularly, eat well and drink lots of fluids since your own nutritional status during lactation can affect milk volume and composition.

It is also important to know that there are experts out there who can help you so you don’t have to suffer in silence. If you’re having problems or concerns don’t hesitate to call Annerley and schedule an appointment with our breastfeeding consultant or one of our midwives. Or as a home visit.

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