Breast milk and breastfeeding have many advantages over formula milk and bottle-feeding for both baby and mother. However, breastfeeding doesn’t always come easy. How often do you need to feed your baby? What is the best diet plan for a breastfeeding mum? How to cut down night-time feeds? These are just some of the concerns that you may have.

Ms Cynthia Pang, Assistant Director from Nursing Specialist Services at KK Women's and Children's Hospital, gives detailed answers to your questions.​


Question by susanksb

I have gone back to work after fully breastfeeding my baby for 6 months. However, during the daytime my baby is not drinking much of my expressed breast milk from the bottle- 30ml to 50ml each time after taking in some solid food. What can my caregiver do to ensure that my baby takes in more milk from the bottle while I am at work?

Answered by Ms Cynthia Pang, Assistant Director, Lactation Service, KK Women’s and Children’s Hospital

It is quite common for babies to take only a small amount of milk feed after they startedwith solid food. In between the solid food, your caregiver can give your baby a milk-feed of about 100 to 150mls during the morning and afternoon tea break.

It does not matter if your baby does not consume the given amount. Most breastfeeding babies will compensate by adopting reverse nursing, feeding more when you nurse him directly at night. Thus continue to nurse him as much as he wants when you are with him. Your baby’s weight gained will be a good gauge to determine if the intake is adequate. You can use the weight chart in your baby’s health booklet as your guide.


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Hi

I have expressed breastmilk my child for a year and wanting to wean her off to formula. Please advice how to wean ? And how to reduce the breastmilk naturally ? Thanks.

Regards,
Angie

Answered by Ms Cynthia Pang, Assistant Director, Lactation Service, KK Women’s and Children’s Hospital

Firstly, you will need to gradually introduce the formula milk feeds and ensure that your child is taking it well before you start weaning off your breast milk supply. Depending on your milk supply, you can first reduce the amount of breast milk expressed by about 10% at alternate expressing session. You can do this for a couple of days to avoid excessive accumulation of the milk in the breast when you reduce the amount to be emptied from the breast. You can continue this at each expressing session before further reducing the amount to be expressed. You can repeat this until your breasts feel soft and comfortable with very small amount of milk if your intention is to wean off completely.

Concurrently, you can also delay the time to express for an hour for each session for a couple of days before gradually delaying further until you reduce the number of expressing session. It may take between 1 to 3 weeks before you feel comfortable without expressing at all. However, you should consider continuing providing your child with your breast milk as long as possible, as it is still beneficial for your child beyond one year of age.


Question by chai

Hi Ms Pang,

If the diet is unhealthy and one of junk food, non nutritious one, will this affect quality of the breast milk?

Answered by Ms Cynthia Pang, Assistant Director, Lactation Service, KK Women’s and Children’s Hospital

It is advisable to maintain a balanced diet and reduce the intake of unhealthy junk food. It has been shown that the type of fats taken by the breastfeeding mother will influence the type of fats in her breast milk. Junk foods tend to be unhealthy and have more saturated and trans fats. It has been found that mothers who consumed a healthy diet with Omega-3 fatty acids have higher Omega-3 fatty acids in their breast milk.


Question by rsim

Hi,

What is the appropriate litre[ml] for each feed for 3 month old baby?

Answered by Ms Cynthia Pang, Assistant Director, Lactation Service, KK Women’s and Children’s Hospital

It has been shown that most breastfed babies take in an average of 750mls per day between the ages of 1 to 6 months. For example, for a 3 month old baby who takes about 7 feeds a day, the estimated amount per feed would be about 100mls (750 ÷ 7).

Similarly, using the weight of the baby multiply by 150mls is another way of estimating the amount needed by the baby per day. If the baby weighs about 5kg at 3 month, it would be 750mls per day (5Kg x150mls) and again the amount per feed would be this total amount divided by the number of feeds taken by the baby. Please note that this is an estimated amount and that some babies at this age may take slightly less or more at each feed according to the number of feeds needed per day. Your baby’s weight gained will be a good gauge to determine if the intake is adequate. You can use the weight chart in your baby’s health booklet as your guide.


Question by pocoyosky

Do we continue breastfeeding throughout our baby growing stage or there is a time to switch to formula milk instead?

Answered by Ms Cynthia Pang, Assistant Director, Lactation Service, KK Women’s and Children’s Hospital

During the first six months, breast milk provides all the nutrients required for optimal health and development of the baby. After six months, breastfeeding can continue with other foods until the baby is two years and beyond as desired. Unlike breast milk, formula milk does not contain antibodies to help fight against infections. As long as a mother is able to continue to provide breast milk to her child, there is no need to switch to formula milk.


Question by esim

How do to reduce night time feeds when the baby continue sleeping and feeding pattern even when we tried to change the sleeping time?

Answered by Ms Cynthia Pang, Assistant Director, Lactation Service, KK Women’s and Children’s Hospital

During the first few months, most babies will need a feed or two in the night. In a newborn baby, waking the baby regularly during the day time to feed may help to change the sleep wake pattern to enable the baby to sleep longer in the night. As babies grow older, they will usually sleep longer in the night for about 5 hrs but may still need a feed in the night. It is often difficult to actively change the sleeping time or reduce the night feeds. Giving the baby a warm bath and body massage before bedtime may help your baby sleep longer in the night.


Question by sch

Is there any 'expiry' for breast milk store in fridge? After a day, is it still okay for feeding?

Answered by Ms Cynthia Pang, Assistant Director, Lactation Service, KK Women’s and Children’s Hospital

Expressed milk can be safely stored for up to 48 hours in a fridge at 4°C. It is safe to feed the breast milk after storing for a day.


Question by simly6

Hi Ms Pang,

When the mother is unwell-having flu,cough infection, is it still advisable to do breastfeeding?

Answered by Ms Cynthia Pang, Assistant Director, Lactation Service, KK Women’s and Children’s Hospital

Yes, the antibodies in her breast milk will provide protection to her baby. However, it is recommended that the mother wear a mask during breastfeeding to minimize the direct spreading of the flu or cough to the child.


Question by dsim

Is there any difference between the milk quality for breastfeeding and bottle feeding of stored pumped breast milk?

Answered by Ms Cynthia Pang, Assistant Director, Lactation Service, KK Women’s and Children’s Hospital

Some antibodies, vitamins and protective substances in breast milk can be affected by storage duration and when breast milk is frozen. In order to maximise the benefits and value of breast milk, direct breastfeeding is the best. Otherwise, freshly expressed breast milk would be preferred. However, frozen breast milk still contains some antibodies and protective substances which are not present in formula milk.


Question by mosmos

Hi Ms Pang,

I heard that mothers need to avoid certain strongly flavored foods while breastfeeding, such as garlic or spicy foods. Are there any other food to avoid for the mother when breastfeeding?

Answered by Ms Cynthia Pang, Assistant Director, Lactation Service, KK Women’s and Children’s Hospital

Besides adopting a balanced diet, the mother should limit caffeine intake and avoid alcohol because caffeine and alcohol can pass from the mother to baby through the breast milk. Sometimes some strongly flavoured foods may cause the taste of the breast milk to change. However, not all babies are sensitive to this. The best advice is to take such strongly flavoured foods in moderation.


Question by octane

Dear Ms Pang,

Are there any medical considerations with breastfeeding? If I have a slight fever and taking Panadol, can I still breastfeed my child? Thanks.

Answered by Ms Cynthia Pang, Assistant Director, Lactation Service, KK Women’s and Children’s Hospital

Medication such as Panadol is generally considered safe during breastfeeding. However, if you are unwell, it is advisable not to self-medicate. It is advisable to seek medical advice and inform the doctor that you are breastfeeding so that appropriate medication compatible with breastfeeding can be prescribed.


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Dear Ms. Cynthia,

I am an exclusive pumping mum for the past 7 month. I had a scared last week while half way pumping, i realised that there is a blood clot coming out , blood clot is the size of a 50 cent coin. There is no pain at all. I did not suffer from engorgement or mastitis. Should I be worried and see a breast specialist to check it out ? Thanks!

Mummy D

Answered by Ms Cynthia Pang, Assistant Director, Lactation Service, KK Women’s and Children’s Hospital

This occurrence could be due to a bleed in the fine capillaries or a blood blister form at the nipple surface with prolonged pumping. Usually, it will resolve spontaneously. However, if the bleeding persists, it is advisable for you to see a breast specialist for further evaluation.


Question by camen

Hi, I had cesarean delivery for my baby and he is still in NICU. I am breastfeeding him now. Though he is drinking little milk now, may I know what food diet should I avoid since I am breastfeeding him. Furthermore, he will be undergo one heart surgery (PDA) this week. Just worried what I eat if will affect him or make him better (For example, eggs..) Please advise. Thank you

Answered by Ms Cynthia Pang, Assistant Director, Lactation Service, KK Women’s and Children’s Hospital

It is advisable to adopt a well- balanced diet and limit your intake of caffeine and alcohol. Otherwise, it is not necessary avoid any other food. I would suggest that you seek the advice of your baby’s neonatologist to further address your concern.


Reposted by administrator

My baby weaned himself on 3months. Now I don't have milk and I really want to breast feed. He still presses against my breast asif he wants to feed,but I don't have milk. How do I get milk again for breastfeeding?

Answered by Ms Cynthia Pang, Assistant Director, Lactation Service, KK Women’s and Children’s Hospital

It is important to understand that it requires commitment and perseverance for you to restart your lactation. You can latch your baby to breastfeed if your baby is still willing to suckle at the breast. If not, you can use a breast pump to stimulate the milk supply by pumping regularly. It may take a while before your milk supply start to produce and increase.

In order to encourage your baby to suckle at the breast, using a tube feeding device at the breast to supplement the milk feeds may encourage your baby to suckle at the breast and stimulate your milk supply. Medication to boost your milk supply may be necessary. It is recommended that you seek the assistance of a lactation consultant to help you in this relactation process.


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My wife encounter the following 2 problems:

  1. She occasionally experience pain on either side of her breasts even after she feeds the baby. But the pain goes away after a few hours or the following day. Any need for concern?
  2. There are small black round marks like black moles around her breasts. Any need for concern? Before she started breast feeding there is no sign of such small black round marks.

Three questions:

  1. Please confirm it is normal for my wife to feel pain when the breasts are full of milk.
  2. As she is studying full-time, will her milk extraction for the baby to drink from the bottle daily affect her production of milk?
  3. Whenever our baby wants to drink milk especially in the night, my wife will just feed him. Any concerns for both baby and mother?

Samuel Lee

Answered by Ms Cynthia Pang, Assistant Director, Lactation Service, KK Women’s and Children’s Hospital

It is normal for your wife to feel painful when the breasts are full of milk. It is advisable not to allow the breast to get over distended with milk. Excessive accumulation may lead to blocked milk ducts and increase in pain. Regular expressing at about every 3 hours interval will minimize the risk of blockage and pain. Performing breast massage before expressing will also help to clear any blockages and enhance the flow of the milk.

Expressing of milk regularly will not affect her supply as it drains the milk from the breasts to help to maintain her milk supply when she is unable to breastfeed directly. It is advisable for the mother to breastfeed directly whenever she is with her baby.

Breastfeeding the baby at night is the ideal way to enhance the bonding for both mother and child and it also helps to maintain and boost the milk supply. As for the small black round marks around her breasts, consult her doctor to determine if it is due to the pigmentations caused by the hormonal changes during pregnancy.


Ref: S13​