Baptist Hospital

For those who do want to breastfeed, its a really good idea to read/learn as much as possible before the birth of your baby. As a new mother, it can be overwhelming when the hospital staff tell you your baby is hungry. Babies cry for a lot of reasons, not just hunger. Education is empowering and can help you make the right decisions for your baby. A good point to remember is although medical staff are highly trained individuals, they are often not trained in the specifics of breastfeeding. Their desire to help may actually cause you and your baby more long term problems.

Some physiology:

- Babies' stomachs are really tiny. On the day of birth their stomachs are about the size of a marble. At this age their stomachs also lack the ability to stretch. So the small amounts of colostrum (mother's first milk) are in fact in perfect harmony with this. Colostrum is rich and thick and is ALL your baby needs until your milk increases in a few days time. Some mothers get a little worried about this, wondering if their baby will starve or dehydrate. This is not the case, and introducing other liquids (formula, glucose water etc) will do more harm than good (see next paragraph). In the next week as your milk volume increases, your baby's stomach will be very slowly increasing in size and begin to be able to stretch a little.

- The junctions in a babies' intestines are quite open, meaning allergens etc can easily pass through into the bloodstream. Colostrum acts as a 'sealant' helping to seal these junctions. So it is very critical your baby only be fed this colostrum until your milk increases around 3-5 days later. During these first few days of colostrum-only, your baby will want to nurse very very regularly. This is his way of helping himself, he instinctively knows this is what he needs. Now is not the time to set a schedule or get rest, that can happen a little later. It is worth it for your baby's health.

- Breastfeeding regularly in the first few days and weeks will help your milk supply reach its full capacity. The first month or so is critical, as this is when the prolactin receptors in your breasts 'activate' and essentially tell your body how much milk you'll need in future. Infrequent breastfeeding or supplementing in the early days can permanently affect your milk supply, making hard work for you in the future. This is why the routine separation of mother and baby is so detrimental. Not to mention he only knows your voice and will probably be frightened being handled by random people he does not recognize.

- Introducing foreign substances (anything besides your colostrum and milk) into a tiny baby will have an immediate effect on your baby's digestive tract, changing the PH balance and gut flora. Even one bottle will do this, and even if after that you go back to breastfeeding, it will take a couple of weeks for the baby's gut to return to its normal state. This can have long-term effects, increasing your baby's chances of digestive illnesses and allergies in the future.

- Breast milk is the best food for your baby. Not only does it provide the perfect balance of nutrition, amongst other things it also contains anti-bacterial, anti-viral and anti-allergy properties. In developing countries, babies who do not receive human breast milk are far far more likely to die than those fed breast milk. The only reason we get away with so much formula feeding in developed countries is we have the medicine to treat the illnesses these babies are more prone to.

Of course it is a personal choice, and it is not the end of the world if you choose not to breast feed. It is, however, up to you yourself to make this decision. Don't allow hospital staff to intimidate you and make this decision for you...

If you find yourself in a situation where you don't know the answers, a quick call to La Leche League (free!) or a Lactation Consultant will help you find the answers.

:)
 
Gracey, it is really sad that you have to go with this back-up doctor you are not fully comfortable with when part of the reason for going private is to have a doctor you are comfortable with. If I got a really bad feeling from a doctor, I would try another. (or I would consider going public... why pay the high rates and deliver with someone you're not comfortable with).

Regarding breastfeeding, I don't think your ob/gyn will really have much to do with it. It's more the attitude of the hospital in general. From talking to my colleague who delivered there last year (and breastfed very succesfully for over a year), they seem to have a similar schedule at Baptist as in United Christian, the public hospital I delivered in (kind of every four hours). However, they seem to assume that mums won't want to breastfeed in the middle of the night. However, when she said she wanted to, they said she was free to come to the nursery and breastfeed whenever she wanted (which she did though she chose to skip one shift).
 
Hi Charade,

No, not in response to any particular post. It was mainly in response to the concept of routine separation and formula-feeding. If thats what a mother wants and needs, then thats absolutely her choice. But to make it standard procedure is taking the choice away from the mother, and making breastfeeding harder if thats what she is trying to do.

My point is, healthcare professionals are not always trained in the specifics of breastfeeding. A new mother is susceptible to scaremongering and guilt, and is likely to go along with the advice of the hospital staff, even if their advice is incorrect and not what the mother would choose if she had the correct information. The correct information can be found in many places, such as the World Health Organization, La Leche League, American Academy of Pediatrics and their worldwide equivalents, all of whom suggest making it possible to keep a mother and baby together.

It is sensible to learn and make choices before the baby is born, at least that way when the baby arrives, the mother can make informed choices, not have her choices made for her.

Lali.
 
Lali, the fact is that many of us do not have a choice in the baby rooming in. Unless we have the money to shell out for a very accomodating private hospital like Mathilda, can afford a private room or are fortunate enough to be in the catchment area of the public hospitals that allow 24/7 rooming in, we have to follow hospital rules. Yes, a schedule in the early days might not be the best option, but from talking to many women who did follow that schedule (and it's generally only a couple of days) and who went on to breastfeed successfully, I'd rather not stress about something I can't really control.

Moreover, sometimes a mother really does need to rest and a nursery is helpful (or if you are at home, a relative to take over the baby for a couple of hours). If I had my baby with me rooming in at hospital, I would have been sitting up with the baby 24/7 and neither I or any of the other women in the room would have got any sleep.

I was never pressured to give my baby formula. To the contrary, I was encouraged to keep trying - my public hospital was very pro-breastfeeding. However, if a baby keeps crying after two hours (and I mean two hours non-stop) at the breast, and there seems no other reason (diaper is fine, otherwise healthy), then one has to wonder if the baby is hungry. Especially when you finally succumb, feed the baby formula (cup-fed) and the baby stops crying and goes to sleep. Again, once my milk came in, I never had this problem of baby crying after coming off the breast so I can only conclude he was indeed hungry for the first couple of days.

I had indeed read up a lot and spoke to many people on breastfeeding before I had my baby. In fact, that's why I kept sitting there - in agony because sitting on an epistiomy wound for two hours is extremely painful - trying to breastfeed my baby. What I realised though is that sometimes instinct is better than all that research. And sometimes a rested mother is better at breastfeeding than one stressing about all the statistics.

I'm not sure a 'quick call' to LLL or a lactation consultant is always the answer. I personally did not find these calls helpful. A lot of the information is like the one you pasted above - standardised. I actually found doctors more helpful, especially doctors that had breastfed. Soemtimes it really isn't a breastfeeding problem but a medical problem. This is my personal experience - other may have found lactation consultants very helpful.

I think the scaremongering and guilt happens from both sides - from those that push formula and from those that push breastfeeding. I was more susceptible to the latter. Both sides are convinced they have the "correct" answer.
 
Charade is right on one point -- most of us don't have the option of having baby room in.
Trust me -- I tried. We were even willing to shell out for a private room in a private hospital, even though it would be a financial drain and not covered by insurance. (And we make more than the typical local family)
The hospital simply has very few private rooms, and they cannot be booked in advance. If you are not in a private room, they will not bring the baby to you for breastfeeding.
If you want to breastfeed exclusively, you have to negotiate in advance with the doctor and staff, put a clear sign up on your bed, set your alarm clock for a 3-hour cycle, and then physically walk down to the nursery every time. If you cannot do so -- if you're ill, weak, just had a C-section, etc -- I don't know what the solution is.
I'm going to try my best -- but I don't think people should be judgmental against moms who can't bf exclusively, especially in situations like this.

I agree with Charade that there seem to be some extreme positions on both sides. I dislike the way private hospitals push formula, or the way some doctors try to scare moms away from the breast. But I also dislike the way some people turn their noses up at moms who genuinely have a hard time with it.
And I don't think it's true that if you don't do it 100% from the beginning, it won't happen. One of my relatives needed to use formula in the hospital (long story) but ended up breastfeeding mostly for several months after that. So every woman is different.
 
Charade and Gracey, shame on the hospital system that they still promote the kind of separation of mothers and babies (and sometimes fathers who are often left in the waiting room wondering whats going on) that was seen in the 1950s. I don't fully understand why the HK system is still like this in light of evidence and recommendations by organizations such as the World Health Organization, American Academy of Pediatrics (and their worldwide counterparts) that families should be kept together, to promote bonding and successful breastfeeding. Its no wonder breastfeeding is considered quite difficult these days, and statistics in HK reflect very low rates of exclusive breastfeeding.

Of course there are genuine needs for formula, but on a much rarer scale than seen here. And there are plenty of cases where a rough start ends in successful breastfeeding, but it is a fact that there are some practices which do make it harder, whilst other practices which make it easier. I feel sad for the mothers here who really gave it a good go but it didn't work due to separation and incorrect advice.

I still feel the best thing to do is have a good understanding and a good plan, and try to have the hospital staff respect the plan. I am grateful that we had our baby in Australia in a hospital which is a signatory to the Baby-Friednly-Hospital-Initiative, an initiative put forth by UNICEF (see below). So far as I know there are no hospitals in HK who adhere to this policy:

UNICEF Baby-Friendly Initiative:

- Have a written breastfeeding policy that is routinely communicated to all health care staff.

- Train all health care staff in skills necessary to implement this policy.

- Inform all pregnant women about the benefits and management of breastfeeding.

- Help mothers initiate breastfeeding within one half-hour of birth.

- Show mothers how to breastfeed and maintain lactation,even if they should be separated from their infants.

- Give newborn infants no food or drink other than breastmilk, unless medically indicated.

- Practice rooming in - that is, allow mothers and infants to remain together 24 hours a day.

- Encourage breastfeeding on demand.

- Give no artificial teats or pacifiers (also called dummies or soothers) to breastfeeding infants.

- Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital or clinic.
 
Lali,

I have to agree with Charade on this one. My son was born in Sanaotrium (private hospital) and we had a semi private room which meant no rooming in. Effectively that meant we could keep the baby with us for most of the day. But during night time I would go to nursery to feed him. Letting baby go to the nursery for some time, specially in the night helped me a LOT. I was exhausted, my milk supply was settling in and sitting up with an infant suckiling and then bawling for a couple of hours was very trying. The nursing staff were very supportive towards BF - brining the bay or ringing me up every time as per schedule or if the baby was crying. Asking me before giving even glucose water. But an expereinced old lactation expert summed it up the best - At 3:30 AM on the third night she said - "you have done your best. now just take a break for couple of hours. go back and try to sleep. if you are not tense, the baby would be relaxed and milk would flow in much sooner". She was right. A couple of formula feeds during those early days did no harm and I exclusively BF my baby for a year. After that he moved to cow's milk.

Another advantage of a nursery was that there were a number of lactation experts on duty at different times. So instead of having someone specific assigned to me forever, I did get additional tips from whoever was on duty. Breast feeding is hardly an exact sceince to be done by the book - each tip helped settle us in.

WHO needs to put up a strict guideline because they have to be followed accross cultures and geographies. They cant be saying might / may be / could - or their advice would get washed down completely. But IMHO the advice needs to be adapted to our particular circumstances. BF Nazis in the end do more harm than good for new moms - they almost scared me away. It was the moderates that made it possible for me atleast.
 
Lali,

Just wanted to add... a lot of my freinds have exclusively breast fed or mostly (barring one night top feed) breast fed theirs bubs in the first few months. Most of them wean before they want because of the stress, lack of family support, work-family balance, or sheer society pressure. The problem is much bigger and blaming the first 3 or 5 days in the hospital is naive.

I would go with a good hospital and a good doctor irrespective of their rooming in regualtions. As long as they are not outright pro-formula and agains bf.
 
i gave birth at st teresa (private) and they were totally pro-formula. they kept trying to convert me (i was pro-breastfeeding) and kept telling me things like 'you have no milk' etc. thankfully i had maggie@llleche on my speed dial so was calling her for advice which helped me through those first few days.

my 'chinese' baby did become jaundice but we ended up at margaret (meifoo) for the 'sunning machine' (no idea what they call this professionally) where the nurses were completely opposites to st teresa, and definitely more pro-breastfeeding and helpful with tips and advices.
 
There's even a big difference between doctors at the same hospital.
My lovely doctor is very open and supportive to breast-feeding, as are the maternity nurses at Baptist, despite their (lack of) rooming in policy.
But I had a check-up with another "back-up" doctor last week, who was not so breast-feeding. She told me that Chinese babies were more likely to have jaundice, that formula helped that, and that exclusive breast-feeding was a "gweilo" thing.
So.... I probably won't listen to her unless I have some real breastfeeding issues.
The irony is that none of my Chinese family have had jaundice, but my Western husband did when he was a baby!
 
Gracey, did you give birth yet? How was your experience? I hope your little one is healthy and well.

Your backup doctor sounds a lot like Dr Grace Wong
 
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