<![CDATA[La Leche League Asia & Middle East - Close to the Heart Articles]]>Mon, 22 Apr 2024 13:11:57 +0000Weebly<![CDATA[A Designer Solution]]>Sat, 05 Aug 2023 11:31:40 GMThttps://www.lllasia.org/close-to-the-heart-articles/a-designer-solution
​​by Cher Skelling
LLL Hong Kong Island Group

I live in Hong Kong and work as a shoe designer, developing ladies’ shoes for major fashion retailers.
Before my daughter was born, I knew I wanted to breastfeed her for about a year, but I also knew I would have to return to work when she was just two months old. I wasn’t sure how it would be possible. To add to my difficulties, I worked for three to four days a week at a sample factory in mainland China.

The journey to get there from my home takes three hours, which is too long to do as a commute in one day, so I always stayed overnight. I soon realised that if I wanted to breastfeed, I would have to take my baby with me. But this seemed to pose even more problems. How to do a three-hour journey by metro, train and car? Could she stay with me in my office? Was my rather basic company accommodation suitable for a baby? Who would help look after her while I was busy doing my work?

I discussed my plans with my colleagues and although they were a bit surprised, they soon realised that it was the only way I could continue in my job. I was very relieved when they promised to support me.

Before I left for maternity leave, I started to make preparations. I bought some baby essentials for my apartment in China, I had some blinds and a comfortable chair put in my office so I could breastfeed without interruptions, and I made sure I had a sling and a car seat for travel.

What I still hadn’t sorted out was a carer to look after my daughter while I worked. I asked my Chinese colleagues for help because I didn’t know where to begin but, by the time my maternity leave started, I still hadn’t found anyone.

My daughter, Nina, arrived on her due date and, with the knowledge I had gained from La Leche League meetings, we soon got into the swing of breastfeeding. Those early weeks were tough but special; my husband took a month off work and together we learnt how to be a family. There was just one thing that was always worrying me: how would we cope when I returned to work? The dreaded date loomed closer and closer.

My first trip to China with Nina was when she was eight weeks old. There was still nobody to take care of her while I worked and I didn’t really know what I would do; I just turned up at the office and hoped for the best. That first week I didn’t get much work done, although my colleagues were more than happy to take Nina off my hands for a while. I realised how difficult it can be just to accomplish simple tasks with a small baby, and I felt torn between my work responsibilities and the needs of my daughter. The evenings alone in my apartment were really difficult too.

Then one of my co-workers hit on an idea. Our driver’s wife, A Xia, had recently given birth to a baby girl called Xuan Xuan - maybe she could look after Nina too. We asked her, and she agreed she would try. I converted one of the rooms at work into a nursery so Nina was always close at hand even if I couldn’t be with her every moment of the day. A Xia was also breastfeeding so she understood Nina’s feeding cues and would call me whenever Nina needed me. The only difficulties arose when I had client meetings and had to take a break to be with Nina. I was always honest and just told them from the start that I would need to leave the meeting for a short while to attend to my daughter. Thankfully, they were all very understanding. My colleagues were also great at covering for me while I was away. Luckily, Nina was always a fast feeder, so I could be back at my desk within 20 minutes.

Nina and Xuan Xuan fell into the same routine, and often, as I placed her sleepily into her cot, I would look up to see Xuan Xuan nursing to sleep on the sofa. As they got older they became great friends and played together in the garden or went to the park. Even when Nina stopped nursing during the day, I would still take her to the office with me so she could play and I could spend my lunch hour with her. Xuan Xuan’s dad and grandma also often helped out with looking after them both. It was lovely to see her fitting in so well with a family from a different culture.

Nina has recently started kindergarten so she doesn’t travel with me now but she often talks about China and asks about Xuan Xuan. I hope she always remembers her Chinese big sister.
I have breastfed Nina now for two and a half years, an achievement I don’t think I could have made without keeping her close to me every day. I have also since noticed a few of my Chinese colleagues bringing their babies into the office at lunchtime to nurse them. I would like to think that my experience has helped to change the culture of the company so that mothers can more easily combine work and childcare.

Close to the Heart Vol. 15, No. 2 (Mid-Year 2014)
<![CDATA[Much More Than Milk]]>Sat, 05 Aug 2023 10:16:01 GMThttps://www.lllasia.org/close-to-the-heart-articles/much-more-than-milk
by Kartika Surja
LLL Hong Kong Island Group

I grew up in an ethnically Chinese family in Jakarta, Indonesia, and moved to Singapore for my university degree. I worked there for six years before I followed my husband to Hong Kong due to his job relocation. Barely three months in Hong Kong, I found myself pregnant. This joyful news quickly turned into a stressful period. 
Without friends or family, we had to navigate a complicated healthcare system. Language barriers certainly did not help our situation. Our first language is Bahasa Indonesian and the first language of most Hong Kong people is Cantonese, so we communicated with healthcare providers in English, a second language for all of us. This meant we didn’t always receive full explanations of what would happen next.

Moreover, my husband and I knew nothing about babies – neither of us had ever handled a child before, let alone an infant – and we knew even less about breastfeeding. We both grew up in formula-feeding families and had never seen anyone breastfeeding before. It’s perhaps surprising that I decided to breastfeed, but I was encouraged by a friend who was breastfeeding, plus a Bahasa Indonesian nursery rhyme stuck in my head: “I am a healthy kid because I am breastfed.”

Fortunately, my husband was fully supportive of my choice, although he also wanted to follow the advice of doctors who did not always encourage breastfeeding. My baby and I used a lot of trial and error to figure out how to make it work. It has been a tough journey and I feel very lucky that we made it.

Things seemed to start well. When Kate was born, she latched like magic. It was the most beautiful experience. I sobbed and told her I was sorry that she was not born as planned (I had undergone a prolonged induction, attached to IV drips for fluids and Syntocinon, and in the final stages forceps were used, which was all quite traumatic). But Kate was not bothered at all by my apologies. She suckled peacefully while her eyes looking deeply into mine. The nurse woke me up three hours later to feed her. Again, both of us were lost in each other’s dreamy eyes.

We continued to have our blissful moments until the second day, when she was weighed and her diaper logs were studied. Then all hell broke loose. She hadn’t passed urine for 12 hours and she had lost 3% of her birth weight. The hospital nurses and were concerned about dehydration paediatrician and told me that I was not producing enough milk. They recommended that Kate be given supplemental formula milk, to which I consented for the duration of our stay in hospital. Once we reached home, my milk “came in” on day 4 and I began to exclusively breastfeed her. She started to pick up her weight gain on day 5.

Unfortunately, that very night, she accidentally pulled her umbilical cord, causing puss to ooze from it. We took her back to hospital, where the doctor was concerned that she might catch an infection, so she was admitted to the NICU for one night and I was not permitted to stay. I only had one chance to breastfeed her while she was in the NICU. I wanted to express milk for her but they did not have any pumping facilities, and I had not brought a pump along because I had not expected her to be admitted, so she was fed formula during that night.

Looking back, I hardly knew anything about breastfeeding. All my knowledge came from a one-hour crash course in the hospital, which in retrospect did not present the most up-to-date, evidence-based information. For instance, we were told that breastfeeding while side-lying was dangerous, that feeds should be strictly scheduled, that babies should feed for 30 minutes on each breast at every feed. Nurses in the hospital repeated such advice after Kate was born, and I had no other information so I tried to follow their advice. I even used a stopwatch to time her feeding sessions – I now cringe at the memory of that. If only I had joined La Leche League earlier and read The Womanly Art of Breastfeeding before my baby was born!

So we had a shaky start with a few hurdles to overcome – lack of up-to-date information, introduction of formula at the hospital – but by the end of the fourth week, breastfeeding was going well and I had a good milk supply. I believe what helped me the most was my availability to Kate 24/7 without being disturbed by anyone. We had no visitors; we asked our families to hold off their visits until after the traditional 40-day “confinement period”. This created such a big brouhaha; our request was considered disrespectful to the grandmothers, who in our culture usually get involved (and often take over) at an early stage. After the 40th day, my parents came to visit from Indonesia for a week, but my in-laws remained upset with us.

We did have a domestic helper at home, which helped us to manage without family around. However, I began to feel jealous that our helper was able to soothe Kate better than me. Kate loved to be held and rocked, but I had a very painful episiotomy wound and pelvic pain which hurt me so much, even just from standing up, let alone when holding a 3.5 kg baby. Also, my breasts seemed prone to blocked ducts whenever there was a slight pressure on them, such as carrying her. Since I had been advised not to breastfeed Kate to sleep, I began to feel useless. I felt like a wet nurse to my baby because I was only able to breastfeed or pump milk and was unable to comfort her.
One day, when she was three months old and my husband was away, I suddenly found a determination to make Kate mine again. I courted her. I decided to trust my instincts and abandoned restraints: I breastfed her to sleep, during playtime, whenever she cried, without any time limits. Basically, I just ditched all the “rules” I had known up to then. Almost overnight we were both much happier.
I only had one friend who was breastfeeding, so I felt the need for more support. I decided to join a breastfeeding support group on Facebook. While I was encouraged to learn there were so many mothers out there in the same boat, I was quickly disappointed with their inclination towards pumping. I share their fascination with the natural wonders of breast milk: I know it is fantastic nutrition with amazing anti-infective properties, which can’t be adequately replicated by formula milk. But breastfeeding to me is more than just good nutrition. It is a great tool for me and my baby to easily feel close to each other. Bottle-feeding expressed milk could not replace the feeling that I have when she looks at me during our quiet nursing time.

Dissatisfaction with the “breastmilk-feeding group” caused me to learn more about La Leche League. I read their information more carefully and understood that LLL acknowledges the difference between breastmilk-feeding and breastfeeding. I was encouraged to discover that I’m not the only one who makes that distinction. At my first meeting, it felt wonderful to be surrounded by women who treated breastfeeding as normal.

Now my baby is nine months old and my greatest wish is to have the freedom to breastfeed my girl openly, wherever and whenever she wants. Both of us totally hate being under cover! I wish one day breastfeeding in public will be accepted as normal.

I also have a dream that Kate continues breastfeeding until she is old enough that she can remember doing it. I think breastfeeding is one of the most powerful ways to express how much I love her. I don't think any words will be able to fully express how special it has been for both of us, so I want her to be able to remember and understand.

Close to the Heart Vol. 16, No. 2 (Mid-Year 2015)
<![CDATA[Wean Me Gently]]>Thu, 05 Jan 2023 11:00:47 GMThttps://www.lllasia.org/close-to-the-heart-articles/wean-me-gently
​by Kim Adams
LLL Leader in Oman

I realised with a start this morning: I can't remember the last time my daughter nursed! This makes me a little sad, yet I am ready for this new stage (mostly).
​She has skipped days before, and this time it has probably been only two days, but I simply can't recall. I do remember one afternoon recently she crawled into my lap and asked to nurse; I said yes, but then asked her whether that was what she really wanted. To my surprise she said no and jumped down. That might have been the last request, but I am not sure.

Less than a week ago, I was feeling a little irritated and frustrated that her nursing had increased (it can be quite unpleasant and painful now, in mid- to late-pregnancy). I was also concerned about how she would cope while I would be away on a business trip two months later, if she wanted to breastfeed frequently.

Less than six weeks ago, an acquaintance stopped me to enquire how long we will breastfeed – wasn’t I worried about making her too dependent, wasn't I worried she would never stop, wasn't I making efforts to quit? (I hadn't even realised anyone outside our household knew she wasn't completely done!) I reassured her that I was worried about none of those things and that we would continue as long as we both wished.

​And now perhaps she is done.

​If she is finished, I will be very glad that it happened on her own terms. I had been less willing recently, due to nipple pain during pregnancy, but only a few times had I completely refused. It is very rewarding to watch her grow into a new stage as she is ready.

When she turned four years old, we started putting her to sleep in her own bed, and she quickly got comfortable falling asleep with my husband instead of me. When she came to our bed in the middle of the night, she often did not nurse. That was only one month ago. During the following month, she was sick and increased nursing and I wondered how long it would go on.

Suddenly, it may be over.

As I reflect on this week, I remember that she was more clingy than usual. I had attributed that to a traumatic event that has affected our entire community, but perhaps it was her need for extra snuggles as she gave up nursing. So this morning I spent a few extra minutes stroking her skin as we shared those lovely first moments of waking up together. Then I revisited one of my favourite poems (see side-bar), which made me cry as usual.

​I won't be surprised if she asks to nurse again. It may be today, or next week, or after the baby arrives. I'm not sure what I will say; it will depend on my mood and what else is going on. Just like the rest of our parenting journey, we will take it one moment at a time.

Close to the Heart Vol. 17, No. 2 (Mid-Year 2016)

<![CDATA[Breastfeeding with Type 1 Diabetes]]>Tue, 12 Jul 2022 05:13:11 GMThttps://www.lllasia.org/close-to-the-heart-articles/breastfeeding-with-type-1-diabetesby anonymous mother

I am a diabetic mother living in Pakistan. I have three sons aged between nine months and nine years. I have breastfed all of them, and the youngest is still nursing.
I was diagnosed with type 1 diabetes at the age of 12. It came as a shock to me and my family because no one we knew had been diagnosed with this kind of autoimmune disease; it definitely didn’t run in our family. I spent my childhood in England and was taught very well how to manage my diabetes there.
After moving to Pakistan, I once fell into a coma due to high sugars, but that was due to the glucometer showing incorrect results. Since that experience, I occasionally get my glucometer checked at the laboratory. I am currently injecting insulin four times a day, three times before meals and one long-acting.

It is very tough in Pakistan to find a husband if you have a life-long disease. But how God brings people together is amazing. My in- laws-to-be actually consulted with doctors before making the final decision about my suitability.

I have always adored children, and one of my fears was not being able to have any of my own. Diabetes can sometimes cause fertility problems, but I had heard of some diabetic women having three children which gave me hope. I was fortunate enough to fall pregnant only three months after getting married!

I had to manage my diabetes very carefully during my pregnancy. My endocrinologist told me to make sure my blood sugar always remains between 4 and 7 mmol/L, which was challenging and became a source of anxiety. My gynaecologist made sure that I had an ultrasound monthly to check everything was okay with the growing baby.

I was told from the beginning that the baby needed to be delivered via C-section. I’ve since heard different information, such as is stated in this website, but at the time I had complete trust in my doctor, who had handled numerous cases of type 1 diabetic mothers.

Finally, the day of the planned C-section arrived. My baby was cute and chubby, and I was relieved to hear that he was perfectly healthy and did not have diabetes.

My doctor told me that exclusively breastfeeding my baby was important for the benefit of my child and myself, and that formula milk would increase the risk of my baby developing diabetes. This advice helped me to persevere during the first few days when my baby had some difficulty nursing. Apart from some supplementation in the first week, he exclusively breastfed for six months. My doctor said to feed on demand and that I would have to wake up in the night until he was about two years old. A lot of people gave me contrary advice, but I ignored them because I completely trusted my doctor.

My eldest child weaned during my second pregnancy, at about 14 months old. The second pregnancy went smoothly, but I went into labour at 36 weeks and ended up having an emergency C-section. My baby’s blood sugar level was low and he was kept in the intensive care unit for the first day to check that his lungs were fine. In spite of this separation, nursing this baby was very smooth and I breastfed him for 18 months.

I wanted to have a third child, but my doctor had very clearly told me to have no more than two children. I don’t know why she gave that advice, which I have not been able to find corroborated by any information online – perhaps it was outdated, because modern technology allows us to control diabetes much more effectively than in the past – but she was firm about it. She sternly warned, “Patients who don’t listen to me sometimes go blind or have kidney failure.” As my doctor’s advice had served me very well up to that point, I decided to follow it again and we resolved to be content with our two little munchkins. But as the years went by, I felt a strong urge to have another baby. When the boys started school, I felt lonely and started a job teaching at a school. Other teachers were often becoming pregnant, which made me feel even more broody! It took me several months to convince my husband.

While researching, I found medical advice that multiple pregnancies are fine so long as blood sugar levels are well controlled. Eventually, my husband agreed and we got pregnant after a seven-year gap. We had a baby boy.

Breastfeeding this time has again been going well, although often it seems he wants to breastfeed all the time!

When my baby was two and half months old, I resumed my teaching job. It has daycare on site so I can go there to breastfeed whenever my baby needs it. In the early months, that meant around every two hours. Now that he is nine months old and eating a range of foods, he doesn’t need breastfeeding so often.

Breastfeeding has been a wonderful experience. It has helped to keep my blood sugar levels down because the process of manufacturing milk in my lactating body uses glucose, so I need to inject less insulin and it is easier to keep my blood sugar levels stable. But most importantly, breastfeeding reduces the risk of the baby developing diabetes.

Editor’s note: For further reading about breastfeeding with type 1 diabetes, check out this article from LLL in the UK:

Close to the Heart Vol. 20, No. 1 (Early-Year 2019)

<![CDATA[Moving Mountains]]>Tue, 03 May 2022 15:19:35 GMThttps://www.lllasia.org/close-to-the-heart-articles/moving-mountains
by Ariel Sapp
Yokosuka, Japan

Have you ever passed on an opportunity to do something because you were breastfeeding? What if it could have been a once-in-a-lifetime experience? That’s what my climb of Mount Fuji in August this year turned out to be!
Have you ever passed on an opportunity to do something because you were breastfeeding? What if it could have been a once-in-a-lifetime experience? That’s what my climb of Mount Fuji in August this year turned out to be!

Mount Fuji is located a few hours outside of Tokyo, Japan. At 12,389 feet (3,776 meters), it is the tallest mountain and volcano in Japan and has a very narrow hiking season due to extreme weather conditions. There were so many reasons for me not to do a climb like this. As a military spouse, I have been managing the household and caring for my four children single-handedly during my husband's many deployments. The youngest of my children are 10-month-old twins who are nursing around the clock.

I was inspired to hike Mount Fuji because I love the outdoors, hiking and a challenge. But I was very hesitant about doing the hike. I hadn't been able to do much hiking in the past few years due to a lack of childcare when we first arrived and then being pregnant with twins last year. I had not left the babies for a long period of time and they don't always take the bottle well, so it was very nerve- wracking. I did find comfort in knowing the babies were being cared for by my visiting mother-in-law and my husband. Ultimately, my turning point in deciding to do this challenging climb was fear of not having the opportunity again, because I knew we would be leaving Japan soon.
I didn't have a set schedule for pumping. I don't pump regularly for the babies, so during the two weeks leading up to the hike I added an early morning pumping session to stock up for them while I was away. I planned to leave one ounce per baby per hour that I was gone, and I estimated I would be gone about 16 hours between the drive, the climb and the decent (4 hours driving and 12 hours hiking). I managed to store up 22 ounces, so I was nervous about not having left them quite enough.

I successfully did the climb on August 14, 2017. I think leaving behind the babies was equally as mentally challenging as climbing the mountain was physically challenging. As I started the ascent, the thought crossed my mind that I was hiking a active volcano, and worst-case scenarios played through my mind!

Earlier that day, I nursed my babies when they woke at around 4am and then headed out with my visiting cousin. I drove two hours to the parking lot where we would take the bus to Mount Fuji 5th station, and I used an electric pump in the car for 20 minutes. I left the electric pump and milk in the car cooler. In my hiking pack I carried a cooler with ice packs, six milk bags and a hand pump. Then we set off, ascending the Fujinomiya trail and would return by descending the Gotemba trail. We hiked about five hours before I felt engorgement, so I pumped at the 9th station. Thankfully I am not shy, after nursing for almost five years straight, and was comfortable enough to pump in the open; there was no seclusion to be found. I went about another five hours until I pumped again on our decent. My final pumping session of the trip was when we returned to the car, after about another five hours. It felt nice to use the electric pump again, as it drains the breast much better than the hand pump for me and I was feeling some tenderness and discomfort after about 10 hours of only hand pumping. I drove home and woke the sleeping babies to nurse for full relief.

Because they eat solids quite well, my babies had been perfectly content with the 22 ounces I had left them, until bedtime when they were a bit fussy because they normally nurse to sleep. The following day, they nursed a bit more than usual, probably trying to catch me up from the previous day’s adventure.

Climbing Mount Fuji was one of the most challenging things I have ever done! I worried about the babies the whole time, but I was distracted by the beautiful views and by pushing my body when I didn't think I could push any more. It was definitely worth it and very rewarding. Arriving at the summit was exhilarating; the last 200m were very difficult, between exhaustion, altitude shock and shortness of breath. When I saw the Tori gate at the top, suddenly I was filled with energy again and just felt so accomplished! The best part of the hike was the view above the clouds; I felt like a bird up there, there seeing the view I’ve only seen through airplane windows.

My advice to other women who might be hesitant to take on a challenge due to nursing would be to ask themselves if they would regret NOT doing it. That is the question I asked myself. I felt selfish, possibly sacrificing a day of unhappy kiddos for a day of happy mommy, but I knew I would always regret not attempting to climb Mount Fuji. I had trusted family to care for the babies and a willing cousin to climb with me, so it all fell into place for me. Thankfully, my babies weren't unhappy for that time I was away, even though I stressed about it the whole hike. It was incredible and I wouldn't change my decision.

Close to the Heart Vol. 18, No. 3 (Late-Year 2017)