Sunday, June 5, 2011

Why low-income mums should breastfeed

Jun 5, 2011

Milk formula can be a hefty expense, while breast milk is readily available and nutritious
By Nur Dianah Suhaimi

Those who can afford milk formula complain about how milk expenses form a significant portion of their household incomes.

The reality is this: Milk formula is expensive and a recurring expense for at least the first two years of a child's life.

But why spend a fortune on milk formula when the best milk for human babies can be obtained free? Breast milk is not only readily available in new mothers, but it is also the most nutritious milk for the baby.

This is why I believe all low-income mothers should breastfeed and they should be given support by hospitals, government agencies and voluntary welfare organisations to ensure that they are able to do so successfully.

In the course of my work at this newspaper, I have come across a number of low-income mothers who feed their babies sweetened condensed milk with water because they cannot afford infant milk formula.

According to Dr Michael Latham, a professor of international nutrition from Cornell University, in the first four months of life, a baby of average weight would need about 22kg of powdered milk formula.

In Singapore, a 1kg can of infant milk formula costs about $40. When added up, this amount can be a hefty sum for a family with a monthly income of less than $1,000.

This is what drives some desperate families to feed their babies sweetened condensed milk, which costs about $2 a can. Not only does sweetened condensed milk contain very little nutritional value, but its high sugar content can also be dangerous to babies.

Unfortunately, having a successful start to breastfeeding in Singapore is easier said than done. Even before the baby is born, there are various factors determined to jeopardise its right to drink its mother's milk.

For one thing, milk formula companies market their products very aggressively.

From as early as my 11th week of pregnancy, I was given free samples of milk formula at the gynaecologist's clinic. I switched to another gynaecologist and again, I got free milk samples. The doctors, who claim to support breastfeeding, may not realise that giving new mothers milk formula samples may give the impression that milk formula is superior to breast milk.

Having obtained the contact information of expectant mothers from private hospitals, milk formula companies will proceed to send them mobile text messages and ring them up to offer free milk samples.

I also found that for many hospitals, the commitment to support breastfeeding is often mere lip service.

At most hospitals, immediately after the baby is born, instead of being put to its mother's breast to kick-start breastfeeding, it is whisked away by nursing staff to be checked, poked and probed.

Following that, the baby will be frequently taken away to the nursery so that 'Mummy can get some rest'. At the nursery, the baby will be given milk formula, water or the pacifier to stifle its cries.

Once a baby gets the milk bottle, chances are it will be reluctant to suckle on the breast because the latter requires much more effort to draw milk.

The mother's breasts produce milk on a demand and supply basis. When the baby is not brought to its mother's breast often enough, her body will not receive the signal that it needs to produce milk, even though she already has the necessary 'hardware' for lactation.

So the problem becomes twofold. First, the baby has problems latching on and second, the mother is not producing milk. When these problems arise, babies often struggle when offered the breast. The new mother will be convinced that she has failed to breastfeed her baby and turns to milk formula instead.

Many mothers I met told me they could not breastfeed because they did not have any milk in them. But when questioned further, they revealed that their babies were given milk formula regularly in the first few days at the hospital.

The problem is exacerbated by nursing staff who are not supportive of breastfeeding. A friend who gave birth a year ago shared how she was scolded by an impatient nurse when her baby struggled to latch on. The nurse also called her half-day-old baby 'naughty'. While she persevered and breastfed successfully, it is such experiences that frustrate the new mother and result in her giving up on breastfeeding.

This is perfectly fine for mothers who can afford milk formula. However, for the low-income mother, it is an added expense which she might not be able to sustain in the long term. Thus, the sweetened condensed milk with water.

So here's my suggestion: Restructured hospitals should invest some resources to ensure that low-income mothers are able to breastfeed successfully. This will have to be a holistic approach which requires the cooperation of doctors, nursing staff, lactation consultants and social workers.

The hospitals will first need to identify these low-income mothers from the time they come in for maternity checks. Hospital staff may want to speak to these mothers about the benefits of breastfeeding and stress the monetary savings it offers. The hospital may also want to link the mother up with the Breastfeeding Mothers' Support Group, which offers support and advice to breastfeeding mothers.

When the baby is born, nursing staff and lactation consultants should make a special effort to ensure that the low-income mother is able to breastfeed successfully.

At the National University Hospital where I delivered, the nursing staff encourage all mothers to nurse their babies immediately after birth. Babies room in with their mothers, instead of being kept at the nursery, so that they can nurse on demand. A lactation consultant is available for mothers who struggle to breastfeed, at no additional cost. Milk formula is not offered so readily, unless it is absolutely necessary. These small steps together help to make breastfeeding a success.

It is also important that breastfeeding support does not stop at the hospital. Once the mother and baby are home, social workers or lactation consultants should visit them regularly to ensure that the mother continues to breastfeed. While this cannot be forced on the mother, she will be more motivated to continue breastfeeding knowing that she has support from various parties.

Even if the mother chooses only to breastfeed for the first six months, she would have saved at least $1,000 in infant milk formula. More importantly, she has given her child the best nutrition there is.

Breastfeeding is only the tip of the iceberg in helping families save on baby-related expenses. Using cloth diapers is another cost-saving, environmentally friendly measure that is worth exploring. But I'll leave that for another time.

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