Like the economics, it’s all about the supply and demand theory.

The more the breast milk is used up, the more your breasts will respond to meet the demand. So, the trick is to empty your breasts. This can be done easily when you breastfeed the baby or by pumping out.

What will help during both processes is you consistently telling your self that you need more milk. And do remember that everyone is capable to supply the breast milk for that baby of hers, and it’s the nature of like. Not a miracle of such, just natural.

Most new mothers dish out the excuse for switching to bottles because they can’t produce much milk. The more you tell that to people, the more your believe it and soon your breasts will believe what you say too. So, tell it otherwise and work harder at it. Insyallah it will work out.

Increasing breast milk does not happen overnight, but surely it will.

To assist, you can try the following tips :

• Frequent and regular breastfeeding, even at night, seriously. It is recommended that baby is breastfed 8 to 12 times a day, or every 2 to 3 hours. Offer him every time he shows signs that he wants to be fed. After a while, your baby will pick up the skill of needing to breastfeed more frequently and faster too. Try too to offer the breast before baby starts to cry. Once the cries have started, he’s already in a distress mood and you have to calm him before be can comfortable to be nursed.

• Try to completely empty both breasts at every session. Some babies are small eaters and often fall asleep after the first breast. If waking him up is not working, hand express your breast milk of the other breast. The next session, offer the breast which you have expressed from. The important message you’re sending your brain is that milk is out, please make some more.

• If you are kept away from the baby, ensure regular and frequent express, either hand express or a good pump. I’ve been overseas when my baby’s just 3 months old and at this time, hand-expression is a tad too slow, so I always borrow an electric pump. If it’s not possible to store the milk, just pump and throw. What’s important if for you body to recognise that milk production must go on.

• Make sure that you have enough rest and sleep. Both give your body the chance to produce more breast milk. The best time to sleep is when the baby’s sleeping. In the beginning, seek help form relatives of friends or even get a confinement lady to assist.

• Drink plenty of water, juice or anything fluid. Maybe not coffee as it’s diuretic. Your body loses a lot of fluid during production, and you need to replenish and the lost water.

What can cause my milk supply to decrease?

• Shorter or less frequent breastfeeding or expressing sessions.
• Getting pregnant soon after having a baby.
• Not being able to latch on the baby.
• Pressure on your breasts when sleeping face down or wearing bra that is too tight.
• Stress and fatigue.
• Use of certain substances and chemicals.
• Drinking too much alcohol.
• Smoking.
• Taking certain medicines.

All babies are different and their feeding habits differ vastly too. That’s characters, I believe. However the baby’s character is, what you need to be mindful of is to be comfortable for you and the baby and here are my top three positions when I breastfeed my babies.
As with any positions, it helps to massage your breasts to stimulate letdown reflex and to help milk flow before you pick up your baby.

The Cradle Hold

A pillow would help, but not a must. I’ve never used a pillow before and have faired considerably well.

First, the baby’s head is held in the crook/elbow area of the arm on same side as breast to be used for feeding. The baby’s body will lie alongside mom’s upper waist. The mom supports the breast with the opposite hand and roll baby’s body is in toward mother’s body so they are belly-to-belly.

Using your free left hand, squirt a few drops of breast milk to entice the baby. Plus, a wet nipple can prevent sores on the nipple.

Now, place your thumb at the top of the areola (12 o’clock) and the index finger underneath (6 o’clock). This is like cupping and this helps your baby to get a better grip or mouthful of your breast. When baby opens his mouth wide enough, quickly and always gently move the baby’s head towards the nipple. Try not to force the baby, just nudge him. Forcing will only gag him and put him off.

The Football Hold.

This position frees your hand a little and is great if baby tends to nurse from one side only. For a Football hold on the left side. First, arrange some pillows on your left side under your arm. Make sure that baby’s mouth and your nipple are at the same level.

Place baby on the pillows, lying him on his side. If you find yourself twisting your breast, then chances are you will struggle to stay comfortable. Sometimes, a specially designed breastfeeding pillow can help tremendously. Use your left am to support baby’s head and body.

The Lying Down Hold

This is by far my favourite. It is easy to manoeuvre from both left or right. Let’s try right this time. Arrange a set of pillows along the left side of your body. While you lie down, make sure that the pillows provide some support for you. Place the baby at the opposite side and make sure his head and mouth are at the same level as your breast. Support you baby’s body and head with your right arm. To start, use your free left hand to form your right breast. Like the other 2 holds, wait till the baby opens up wide before you offer him the breast.

Although these may sound a little technical, don’t fret. Before long you’ll be an old hand at this. I’ve perfected the art of breastfeeding while lying down and some nights I could not remember if I were at the left or right side of the bed. It does come very naturally. Trust me.

We are at an age where there are literally no boundaries and viruses travel far and wide.

And we are currently in the midst of a storm of Influenze A (H1N1). Much has been said about the whys and the hows and the howtos. I cringed reading about the escalating death tolls, here in Malaysia and we’re not talking some occasional numbers here, we’re talking about 6 to 3 deaths per day.

And everytime it’s always someone from the high risk groups and babies and pregnant mothers come on top.

It’s best to take extra precaution at the moment if you are breastfeeding or have a small baby. I’m not a big fan of wearing masks, especially when this particular strain of virus is typically spread from droplets of bodily fluid of an infected person. Not entirely airborne. So, I prefer to sanitise my hands more and avoid touching my face, eyes or mouth that much.

Wear a mask if you’re sick, but more importantly practise excessive hygiene in this trying times.

A friend came to me crying about his husband demanding that she stops breastfeeding their 2.5yr old baby girl. Both ends of breastfeeding aren’t ready but the hubby is just not comfortable with the mother breastfeeding a toddler.

I hugged her and I comforted her. In Islam, a wife must obey her husband. But in this case, I advised her to seek some leeway, maybe give her about 3 months to gradually wean her off.

After all, the toddler has never had formula before and breastmilk has been her primary nutrition. And another crucial factor, the time. This is when whatever precaution you can take, to boost your immune system, you have to do. What is best for your body to be able to fend off the infection.

And taking the toddler off breastmilk is not the wisest decision. The toddler will suffer immesureable stress of being weaned abruptly, and worse, her immune system sill drop to a low because the nutristiona nd the enzymes that kept her strong all this while is suddenly been cut short.

And I thought that is the primary reason why she should let her gradually wean her off for at least 3 months.

I feel rather sad for her, but more proud that she stood her ground and she recognised what breastfeeding was to her and the baby. It’s too bad that the father had to come in between, but we all have challenges.

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One of my favourite reasons why Hand Expression Technique is preferred over any breast pumps is because it’s just so mobile.

You can do it almost anywhere and anytime because there isn’t much equipment to lug about.

Clean hands.  Check!

Wide-mouthed milk bottles.  Check!

That’s it.

That’s all the basic stuff you need. I’ve hand-express in many places and even in clean toilets too, although that’s not entirely preferable.

When I started to hand-express my 2nd daughter about 9 years ago, we have a praying room at the office.  So during peak hours at the praying room, I would be doing my 2nd session of expressing for the day.

It never failed to amuse my colleagues when they saw me expressing.  And most of their comments were how easy it was to hand-express.  They were also shocked to see that how much more milk I was able to express in that way.

Although most people are a little shy to be expressing in public, when you do hand express, it literally enriches those around you.  People suddenly are aware that you can do this and how much better this is.

Since I started this 9 years ago, I’ve had a number of friends who were already breastfeeding and expressing their breastmilk  using breast pumps, switched to hand-express and have never looked back.

I’ve taught a number of people and demonstrated how it was done and it was always very humbling to hear them say that they never thought it could work.

I’ve also had friends who have babies and regretting that they did not breastfeed their older children because they thought they could not.  And while they saw me expressing, the sound of milk spurting against the wall of the bottle, they became inspired and finally found out that they COULD breastfeed.

That only shows that it’s all in your mind.

So, just give this a try.  You’ll be suprised at how well you could do this.  If I could do it, there’re not a lot of people who could not.  Seriously.

Having understood how long EBM can last either at room temperature, refrigerator or freezer, you must also devise a plan on how best to maximise the usage of the EBM.

Over 4 kids, this is my GRAND PLAN.  *snigger*

It’s pretty simple actually.  During my 2 months confinement period, everytime I nurse, I always express from the other breast.  Need to build stock before I start work.

Once work begins, how I store the EBM depends on that day of the week.

For Mondays to Thursdays, EBM is always stored in the refrigerator.  Because it will be the baby’s feeds for the next working day.  Freezing preserves the live of EBM but it does kill certain enzymes and it’s best to have the EBM as alive as possible.

Fridays, I would immediately freeze the EBM.  This is because, the Fridays’ stock will be used on Mondays and because the EBM would not survive  a whole weekend, I need to freeze it.

Sunday nights, I would bring Mondays’ stock down from the freezer to the refrigerator for a gradual thaw.

And this begins again weekly.

There would be days when you are forced to work late or overnight trips.  And since if you’re home, there’s no way to express as the baby may as well grows out of your hips, I always make it a point to wake a little early around 5:00am, when the baby is normally fast asleep, completely sated from her marathon nursing and express.

That is how I managed to cart 28 bottles of 10oz each of EBM to my mother’s place who was to watch my baby while I attend a meeting in Bangkok.  And true enough, when I came home 3 days later, my son Ariz was on his last bottle.  Timing couldn’t have been more perfect.

So there.  Not impossible my friends.  Just worth every sweat.  Seriously!

There’s a myth in Asian community that breastmilk is derived from blood and that if you leave it out long enough, it will turn into reddish blood.  *gape*

Alrighty.  It’s a myth, okay.  Breastmilk is made in milk ducts and it’s not turned into breastmilk from anything but it’s a God’s precious gift for a baby.  So, nurse that little babies, mommies.

Okay, once you’ve expressed your breastmilk (from hereon will be referred to as EBM), either through hand-expressed or using a breastpump, you can either freeze it and/or refrigerate the EBM.

What is critical is that EBM must be stored in absolute sterile container, either bottles or specific bags meant to store EBM.  I’ve seen mothers skimping on these bottles and store their precious EBM in mineral bottles.  Major NO NO.  These days Avent has produced these screw top containers for storing EBM and because it’s screw-top, it has wide necks, great for hand-expressing as you don’t need to aim the sprays that much.

It is also important to label these containers of bottles of the day they were expressed so you can t ell which is still okay and which to discard.

Storage guidelines :

1. At room temperature. In colder climates where typical room temperature does not exceed 77° Fahrenheit, or 25° Celsius, the EBM can last for 4 to 8 hours.  However, Malaysia has a hot and humid weather and typical day temperature normally hovers above 30° Celsius.  So, it’s best not to leave the EBM outside of the refrigerator.
2. In the refrigerator. EBM can stand for up to 2 to 3 days ar below 32°–39° Fahrenheit (0°–3.9° Celsius)
3. In the freezer. EBM is typically stored longer in the freezer for between 2 months to 4 months if your freezer has a internal compartment inside the freezer itself where the temperature is constantly low.   But if you are like me, who uses the freezer to store everything , then it can only last for about 2 weeks.  But be careful not to place them at the door.  If you’re freezing the EBM, be cautious not to fill the EBM up to the rim of the container or bottles, as liquids do contract when it is frozen.  Sights of broken bottles and spilled EBM is the most heart-rending sights.  Seriously!

If you’ve thawed frozen milk, it is best to place it in the refrigerator and use in the spate of 24 hours.  I know it’s liquid gold, but if you baby refuses a feed but has touched the EBM, it’s best to discard that rather than save it for later. Bacteria would’ve entered the EBM and that can only mean trouble for the little tummies.

Hand Expression Technique is just an alternative method to express your breastmilk for your baby for those hours you’re at work or away and most importantly for you to continue giving your baby your precious breastmilk, even when you’re at the Boardroom.

I firmly believe that using your own hands to express breastmilk has serious benefits over the typical and more normal breast pumps.  Benefits not a lot of mothers know or even realised.

Maybe because we see around us those fancy gadgety two-funnel breast pumps and everyone around us uses one and we quickly succumb to the herd mentality.

So, that’s why I’m doing this.  Creating awareness and making mommies around the world realise that there IS another option.

A cheaper option.

A faster option.

A far more hygienic option.

I’m not advocating that you throw away your breast pumps just yet, but do explore this option.

Although I’m a major proponent of hand expressing, I do occasionally rent our electric breast pumps if I were to be away for more than 2 nights and during these long lonely days, hand expressing would be less effective.

What I’ll try to impart to you are the benefits which are definitely the ones that I felt the most during my 9 joyful years of breastfeeding one baby after another.

Today I’ll elaborate on my first and foremost motivation to hand express my breastmilk.

ENCOURAGE BETTER MILK FLOW

Most conventional breastpumps, use the vacuum method to coax breastmilk from its milk ducts.  Which is okay, logically.  Except that babies do not rely on pure vacuum power while they nurse.

If you observe a suckling baby, first he would massage the areola and he uses his jaws to suck, never the tongue alone.  And it’s like coaxing breastmilk from the ducts down to the nipple.

That’s what you do when you hand express.  You massage your breasts first.  And you when you express, try to rub your thumb from the flshy part of the breast towards the nipple and before you know it, the sprays will get stronger and a minute later, you could just relax while the letdown reflex works its magic.  You control the flow.

I’m not making this up, seriously.

My son Ariz needed a total of 30 oz of breast milk for the 8 hours I was at work.  Breast pumps would never get me that much with me cringing in pain.  But hand expressing did it for me.

I hand express my supply at 11ish in the morning and get 10 oz from each breast and at 3pm, another round and 5 ox per breast.  Tara! 30 oz.  And I was able to keep this up for 17 months.  Alhamdulillah.

So, there.

Now, we’re on to the real deal now.  We’re talking equipment. 

This is one of the many benefits of using the Hand Expression Technique to express your breastmilk instead of relying on a breast pump.

YOU DON’T NEED MUCH EQUIPMENT !

Well, maybe you need to have :

1. Both hands.  Clean, please?
2. Wide-mouth milk bottles.  I love the ones from Avent.
3. Some towels to wipe sprays (especially when you’re chatting with friends while you’re at it)
4. Pictures of your baby, to stimulate milk production.
5. Medela breast shells or breast pads, if you are have great let-down reflexes for the otehr breast.
6. Fridges or coolboxes to store the expressed breast milk bottles.  This is a cheat, I guess, cos you do’t really lug these around, would’ya?

Let’s dwell a little bit more now.

Your hands are all you need.  That’s the pump, that’s the engine and that’s God-given gifts to you.   They’re pretty much portable, easy to clean and ard to lose (unless you’re at a war somewhere, Transformers maybe?)

Wide-mouthed milk bottles.  The first pictures of hand expression I saw was a woman leaning about 1 foot away from a bowl.  Now, that looks a little hard.  So, I improvised.

I learned that effective expressing works when you target the nipple straight into the bottle.  Take care not to touch the bottle though.  You don’t want to introduce germs into your stock of EBM.

Towels are essentials.  If you’re like me, who are able to sprays dead a fly, a foot away, you need extra towels.  It’s easy to get distracted.  And if you’re distracted the milk still gets sprayed, all over the place.  That’s why you need the towel.

Plus, once you’re done, the only clean-up you need is to wipe your hands and breasts clean and that’s it.

Pictures of your baby is the easy way to stimulate letdown reflexes and milk production.  Think about your baby.  Usually, that’s enough to get me squirting away.

Breast pads or the Medela breast shells are extremely useful items to me, throughout my breastfeeding months.  I believe you need to have this on standby, because using hand expression gets the most milk out, at the fastest rate, and your other breast would be leaking milk too.  So, you might as well collect those.  Afterall, it’s hard work producing the milk, I ain’t letting it go to waste.

And of course to store the bottles of the expressed breast milk (EBM).

So,  there, you’re all set to go.

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Breastfeeding is one of the most magical experience I’ve had in my life and no one baby is the same as the next .  I have four and I think, I do have a tiny wee bit of authority to admit just that.

Anyhow.

Because I work full time and I am obligated to start work 2 months after the childbirth.   It’s a constantly stressful time.  But that needs a new post altogether.

You see, mu husband had athma when he was younger and being genetically hereditary, I became overly obsessed over breastfeeding.  I figure that, if I can’t avoid it, at least, I hope that I could at least lessen its onslaught.

So I was determined to exclusively breastfeed my baby.

Like most working young mother, I could not afford those fancy Medela or Avent breastpumps and I could just afford the manual breast pump, the one where it comes in many parts and funnels and you’re supposed to pump up and down, creating vacuum so breastmilk would collect in the bottle.

My first pump was attached to a bulb.  I later learned that that was meant to relieve engorgement and not meant to store expressed breastmilk.

Anyhow.

By week 1, I was not a hammpy camper, having to lug in the pump and pump away to not much milk collected and I especially hated having to carry the whole gangbang to wash those tricky funnels and tubes and whatnots.

There’s got to be something better, something easier and in my Dorling Kindersley Mother and Baby Book, I found it.  There was a picture of a woman, leaning over a wide-mouth bowl espressing milk.

And I was sold.

To me, the Hand Expression Technique to express my bountiful breast milk was the most natural thing to do, next to breastfeeding itself.

So, read up my next posts on how you can make it happen too.

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Okay. Now we get to the hard details.

It’s a new territory, this breastfeeding business.  And with anything at all, it serves you well, if you research the subject first.  And of course, there are thousands and thousands of websites telling you how to breastfeed, why you should breastfeed and where, who and everything in between.

I think I spent my pregnant days and months reading up on every single article I could find on it.

I decided then that BREASTFEEDING is the way to go for me.  And I set my mind.  That’s all is needed.  Not maternal instinct.  But pure awareness and determination.

And, that’s all you need.

A set mind.  Go to La Leche League (I love their articles) and read your pregnant self away.

Ciao!

You know, some people say that to breastfeed is a MATERNAL INSTINCT.

I dunno.

I seem to have to think about it months or years before I actually am in a situation that warrants the action.

So, this is my take.

When I became pregnant, no one I know breastfed their babies.  Okay, okay.  This was in 1998 and we’re living in a developed country where infant formula were the in think if you have babies.  This was not the States or the UK where the recognition of benefits of breastfeeding were shouted about.  This was where the huge market of those infant formula end.  The society has been brandished by years of advertisement that infant formula is far superior than the plain, basic mother’s milk.

And the worse is, our mothers, our grandmothers raised us all consuming the same thing and look at us.  All well and jolly. So, what’s wrong with the infant formula?

Let me scream this out!

It’s wrong!  It’s wrong!  It’s wrong!

The only problem is that I can’t be screaming this at my mom, or my grandmother.  So, most people just succumbed to this.

Luckily the times have changed and mothers, old and new are rediscovering the joy of breastfeeding.  But it has to be seen.  The habit has to be acceptably considered a norm before it can catch on.

And alhamdulillah, I believe that mothers here in Malaysia have grasped the idealogy that breastfeeding is far far superior than any man-made formula.

Part 2.  Next.

You know the feeling.

When all the huffing and the puffing is over and the pushing is done and you have that little bundle of joy in your arms.  He coos and he looks longingly in your eyes.  He wriggles and he stretches in your arms.  All wet and slippery.

And then he opens up and he yells.

Yikes!

Welcome to motherhood, mommies and daddies.

It never failed to bring soppy tears to my eyes, that first moments when Aliya, Ayisha, Adani and Ariz came into my world and blaring their sirens away.  Haha.

While the first 3 of my babies were presented to me, all cleaned up and screaming bloody murder, hungry.  My youngest son was handed over to me in his freshest form, slippery and wet and needing comfort.

And instinctively, I knew to put him on the breast.  That moment defined it.  Although I must it was kinda hard because you’re half-lying down, with a whole room of busy people milling around you and not to mention, the doctor would be sticting you up.

So, let me tell you this.

Forget them.  Look deep into your baby and feel the connection.  It doesn’t matter if you’re shy, but what matters at the moment was your baby needing you to comfort him, to hold him with your arms this time, instead of the womb.

Ahhh .. I feel like crying now.

By the way, it doesn’t have to be a full latch and a half hour marathon of nursing just yet.  Just to comfort him.  Just for a few minutes before the nurses will need to take the baby to check on him and clean him up.

Your world has just changed, my peers.  Changed forever.

*tsk tsk tsk*

Finally!

I know I miss breastfeeding. But seriously, after Ariz was born who is my 4th child and he has 3 other older sisters, I think I’m ready to call it quits where pregnancy and babies are concerned.

But, I figured that my 9 years of playing mummy-cow must count for something. So, the blog is meant to do just that.

I want to share with you, mommies and mommies-to-be, fathers, fathers-to-be and sisters and husbands and brothers and wives of what a joy it has been for me to be able to breastfeed and what more, I was able to very very efficiently manually hand expressed my breastmilk.

So, this is a chronicle of my journey and I hope you will start yours too, soon.