Motherhood: 10 Things a Breastfeeding Mother Should Do When Sick

Haven't been writing a lot lately because both QW and I are under the weather. Hence, this blog post.

If you are not feeling well, people would probably advise that you keep your distance from a baby/child so as not to spread the germs to them. That is generally advisable. But for breastfeeding mothers, it normally works a bit differently.

Here is what you should do if you are sick during your breastfeeding journey:

1. Continue to breastfeed - Yes, you are reading this correctly. Continue to breastfeed is normally the best defence/protection for babies[1][2]. If a breastfeeding mothers' is sick, her baby would have already been exposed to the same germs. When exposed to germs, our immune system spring into action and produce antibodies to fight them. So since the mothers' bodies have already mounted an attack on the germs, let the babies drink up that natural goodness to pass those antibodies contained in breast milk on to babies[3]! Having said that, there are exceptions (e.g. if a mother has chickenpox). So, do check with your pro-breastfeeding doctor if you are unsure.
2. Drink lots of fluid - Typical advice for anyone who is under the weather. Especially more so for breastfeeding mothers. Breast milk has high water content, which means it needs water to for its production. So drink it up, ladies~!
3. Eat healthily - Best way to build back your strength and help your body fight against the germs is to give it the fuel it needs. Hence, even if you do not have the appetite for anything, try to eat something and healthily. 
4. Rest well - Another typical advice even for non-breastfeeding sick ones is to ensure that he/she gets sufficient rest. 
5. Take breastfeeding friendly medicine - Give your body that extra helping hand to the road of recovery. But before you gobble those medicine down, check that it is breastfeeding friendly. If you visit your doctor, make sure you tell them that you are breastfeeding and ask them to prescribe breastfeeding friendly medicine. If you are buying your medicine over-the-counter, you can either check with the pharmacist in store, check online database or handphone app database[4].
6. Get support/help from family - So that the mother gets some rest and recover from the illness. Leave the house work to your family. Get them to help look after the baby. Just remind them to bring the baby back to you when the baby shows signs of wanting to be nursed.
7. Wear a mask - In other words, do not sneeze or cough on your baby. Germs are typically airborne or spread through secretions/contacts. Hence, minimise the chances of infecting your baby by wearing a mask.
8. Wash your hands frequently - Again, just another normal routine of minimising the chances of a sick mother passing on the germs on to her baby.
9. Limit face-to-face contact - Quote Lauren Sompayrac, author of How The Immune System Works "When a mother kisses her baby, she samples those pathogens that are on the baby's face. Those are the ones the baby is about to ingest ... B cells then migrate to the mother's breast where they produce just those antibodies that the baby needs."[5]. But when a mother is not feeling well, it is really not the time to kiss your baby. Let the breast do the job. 
10. Keep the room ventilated - So that the air quality would be good and minimise the chances of infecting your baby when he/she is being brought in for nursing.

Having said the benefits of breast milk, it is still not an elixir. It does not prevent/stop your baby from falling sick. So if your baby do fall ill, don't beat yourself up over it and/or think that there is something wrong or inadequate about your breast milk. Keep calm and latch on ;)

References:

1. Breastfeeding Basics - When a Nursing Mother Gets Sick
2. Babycenter - Is it Safe to Breastfeed if I'm Sick?
3. Ask Dr SEARS - Comparison of Human Milk and Formula
4. Kellymom - How Do I Determine if a Medication is Safe for Breastfeeding Mother?
5. Babycenter - Why Mothers Kiss Their Babies

Motherhood: 15 Things You Might Experience After Delivery

Based on my personal experience at 7th month postpartum, there are some things (intimate ones even) that I felt was different from before delivery of QW. Maybe, it is the effect of episiotomy[1]. Maybe, it is just psychological.

1. Wrinkled stomach: I actually have regained my pre-pregnancy weight. But the stomach is still all wrinkled up. I guess I should be more diligent in applying the firming cream. But I must say that all the exercises (I mean carrying QW around) is sort of helping it to firm up. 
2. Linea nigra: By 2nd trimester, my linea nigra[2] showed up. Well, they did mention that it will take several months before it fade. It is still visible now (albeit lighter in shade as compared to when I just delivered). I shall update this blog when it finally fades. 
3. User manuals: Interestingly, Health Promotion Board (HPB) attempts to provide some sort of a baby user manual. In case you did not know, HPB haas manuals for pregnancy and many other child-related topics under their section on Pregnancy and Parenting[3]. While all babies are different, the manuals are still nice to have.
4. Babies' cries decoder: On TV, they usually show a bubbly or laughing baby. If you have not taken care of a baby before and your contact is only limited to birthday parties or full month celebrations, the life of a baby can be summarised as follows: cry, milk, pee, shit, sleep and of course the entertaining moments. As parents, people will turn to you whenever your baby cries (as if you are some sort of a decoder). Strangers will give you the stare, while those who know you will ask questions like "Why is the baby crying?", or even provide advices such as "Baby is hungry, must be your breast milk too thin/not enough.". Please don't beat yourself up if you cannot decode their cries. Personally, I go by elimination: first check the diaper (because this is the easiest to see!), next try to breastfeed, then rock her (in case she was feeling uncomfortable), or bring out her toys to play with her. If all else fail, keep rocking and/or nursing as it might be her wonder week or she is going through a growth spurt. (See my post on Motherhood: Articles on Infant Sleep for more information on wonder weeks and growth spurts.)
5. Life in hospital after episiotomy: Pain of course!When the effects of the local anaesthesia wear off, pain will kick in. So, do take the pain killer if it is above your pain threshold. Some gynae (like mine) will require you to pass your stools before they discharge you. But with the pain going on down there and the cleaning to be done, that is really the last thing I want to deal with. This is the time when food (such as papaya, prunes, etc) which promotes smooth stools are life savers! The only thankful thing is that the stitches will dissolve by itself.
6. Episiotomy side effects: As embarrassing as it is to admit, I did notice diminished bladder control after childbirth. So, it is definitely time to do more Kegel exercise[4]. 
7. Prolapse[5]: This is a condition where organ slips out or falls down from its place. Uterine prolapse is common among women as they age because of a weakened pelvic floor (and especially if they delivered lager babies or had excessively pushing during labour). Solution? More kegel exercise again.
8. Hunger: Perhaps because of breast feeding, I feel hungry very often (especially after nursing QW). It is definitely because your body uses energy (calories) to make breast milk. Hence, follow your hunger cues and eat healthily if you are nursing too [6]!
9. Thirst: Similarly for thirst, just follow your thirst cues. It is very normal to feel thirsty easily. After all, breast milk has water content which of course comes from the water you drink. I can easily drink up to 3 litres of water when nursing (as compared to barely even drink 8 glasses of water last time). So, drink up!
10. Cramps after delivery: After delivery, the uterus will begin to contract back to its original size. And when you have letdown from breastfeeding, it intensifies the cramp. So, you might want to give the Malay massage a try. I felt that it helps to relief the cramp because you feel more relaxed, and also helps to expel the lochia.
11. Navel belly: It may never look the same again (I am not sure about this yet). It seems more hollowed in than before.
12. Areola: Hormones of course is the cause for the darkening of areola. It is for the benefit of the baby (who has blurry vision when born) so that they will be able to locate the nipple when they breastfeed[7].
13. Hair loss: Many will experience hair loss probably when the baby is around 4 months old. It may last until baby hits 7 or 8 months old. This loss is because there is a drop in the hormones which were secreted during pregnancy that prevented hair loss. Normally, new hair will grow before baby reach 1 years old.
14. Engorgement: Nobody told me the "starting of engine/breast" was more painful than labour contractions (at least it felt that way to me)! It started around 2nd or 3rd day after birth but luckily subsided around day 5.
15. Continue to look pregnant: The stomach area still seems to suggest that, well, I am pregnant. I get that questions a couple of times when I am out. And I am still waiting for it to return to its original size.

Are there more things that you have experienced after delivery which you don't mind sharing? Do share them!

References:

1. Babycenter - Episiotomy 
2. Babycenter - Linea Nigra
3. HPB - Pregnancy & Parenting resource page
4. Babycenter - Kegel exercise
5. Wikipedia - Prolapse
6. Babycenter - Diet for healthy breastfeeding mom
7. PregnancyCorner - Darkened areola
8. Babycentre - Your body after the birth