<![CDATA[La Leche League Asia & Middle East - Close to the Heart Articles]]>Sun, 04 Jun 2023 07:41:31 +0000Weebly<![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)

<![CDATA[After a Minor Surgery]]>Sun, 24 Apr 2022 16:00:00 GMThttps://www.lllasia.org/close-to-the-heart-articles/after-a-minor-surgery1748945
by Terry Tsang
Leader with LLL Hong Kong - Chinese Group

We just came home from my son’s minor surgery under anaesthesia. I feel thankful that I am still nursing my little boy, who is two years and eight months old.

When he was disorientated waking up from the anaesthesia, he was calmed down and comforted immediately as he latched on.
When he could only take fluid, he got my breastmilk, which was the gentlest possible nourishment for his body. Furthermore, it soothed both of us.

On the way home, I wore him and his favourite dinosaur toy in a sling, as he was too wobbly to walk. The sling hugged him close to my heart and helped us feel secure together. I comforted him with nummy (our word for breastfeeding) for the whole train ride. There were no staring eyes, no comments from strangers. A baby in a carrier, how on earth could a person complain about it?

​I walked home in a downpour wearing my 16 kg son. I had one free hand supporting his head and neck, the other hand holding an umbrella. My lovely husband helped by re-tying my shoelaces.

My son is snuggled on my chest while I am typing our story right now. He had a harsh morning; he needs mummy and “nummy”.
In case your own child needs a medical or dental procedure done under sedation or anaesthesia, you may be interested in my suggestions that follow. You might be told that the patient needs to fast (avoid food or drink) for 6 hours before the procedure. If so, you can point out that the American Society of Anesthesiologists approves a shorter fasting time for breastmilk, because it’s much more easily digestible than other types of milk.

Here is a summary of the fasting recommendations:

Ingested Substance        Minimum Fasting Period
Clear liquids                                   2 hours
Breastmilk                                      4 hours
Infant formula                                6 hours
Non-human milk                             6 hours
Light meal                                       6 hours

If you think your baby will have a tough time being unable to breastfeed for four hours before the procedure, discuss this situation with your anaesthetist; some anaesthetists may allow sucking of a recently pumped breast. Another tip is to request to be the first surgery case in the morning. This is least stressful to your baby.

Practice Guidelines for Preoperative Fasting and the Use of Pharmacologic Agents to Reduce the Risk of Pulmonary Aspiration: Application to Healthy Patients Undergoing Elective Procedures: An Updated Report by the American Society of Anesthesiologists Committee on Standards and Practice Parameters 2011.

Close to the Heart Vol. 18, No. 2 (Mid-Year 2017)
<![CDATA[Partners – do they make a difference?]]>Sun, 24 Apr 2022 15:16:31 GMThttps://www.lllasia.org/close-to-the-heart-articles/partners-do-they-make-a-differenceHow has your partner helped with your breastfeeding journey? What ways did your partner find to bond with your baby?
I am coming up to a total of five years of breastfeeding between my two sons. While nursing is an easy choice now, and often my favourite five minutes in my day, I remember a time when it was tears, anxiety and physical discomfort. The biggest contributor in having this nursing relationship work is how my husband prioritised and perceived breastfeeding in our family. ​He was 
​nursed well into toddlerhood; his mother was a La Leche League Leader in the 1980s and he believed strongly in the benefits of human milk for human babies. He believed in me. This meant, with our first child, advocating our choice at doctor’s appointments when the scales disappointed, getting lactation consultants over until we were certain the latch was effective, taking turns walking our newborn during “witching hour” to give my body a break, reading many online forums and articles about breastfeeding, and encouraging lots of outings together with the never-ending nursing in the early days. I'm so proud of myself for sticking with it and of my husband for believing in me and being there every step of the way – Kay Herb, Hong Kong
I always knew that I would breastfeed, so it really wasn't a question for my husband. During a prenatal breastfeeding class, he listened carefully; after a quick mental calculation he shocked the entire room with the conclusion, "A mother will spend about eight hours per day breastfeeding!" This is when we began 
to get a sense of the enormous life change we were about to experience. When the doctor prescribed formula on our daughter's third day of life, my husband didn't fully understand my devastation, but he absolutely supported my wishes and the extra work it took to get our baby nursing effectively: he cooked, cleaned, changed diapers, and brought the baby to me as soon as she showed the slightest interest in nursing. As I started attending LLL meetings and reading books from the LLL library, our parenting philosophies solidified and my husband became a strong advocate for breastfeeding and responding to our baby's needs rather than "training". When my husband's close friend asked, "How do you plan to go about weaning at one year old?" he was taken aback; he didn't realise anyone thought that was necessary, and he took the opportunity to share a different view with his friend. Nursing an older toddler and then a preschooler was a bigger leap for my husband than for me, but he also understood that nursing this child today is just as natural as it was yesterday. Now our third daughter is two months old and we look forward to several more years as a breastfeeding family. Kim Adams, Oman
I’ve always been a night owl whereas my husband is definitely a morning person, and we always assumed that this would somehow be useful when we became parents. Sure enough, we fell into a routine where I would handle nighttime wakings with breastfeeding, while he would be on duty if our babies woke early for the day so that I could sleep a bit longer, at least on weekends. This really helped me get through those early sleep-deprived months. Conversely, he was 
grateful to have an uninterrupted night’s sleep – once we had got the hang of breastfeeding, our babies barely made a sound during the night. Before our first child was born, he didn’t have any strong opinions about breastfeeding but was happy to support whatever choice I made. Now he tells all his male friends whose wives are expecting their first baby something like, “Make sure you encourage your wife to breastfeed! There will be bountiful breasts and you won’t have to get up in the night. If your baby bottle-feeds, she’ll have you doing the 3 am feed!”. – Jenny Buck, Hong Kong

Close to the Heart Vol. 17, No. 3 (Late-Year 2016)