When Madam Bettina Ng gave birth to her daughter almost two years ago, she was all psyched up for breastfeeding and thought it would be a breeze.
After all, she had given birth naturally, without epidural, a feat not many mothers today can lay claim to.
Her doula - a birth coach - visited her twice at the hospital and three times at home after she was discharged, and found no problems with her baby's latching on for nursing.
But during baby Alexis' one-month check-up, the doctor looked at the infant's weight gain and said she was 'not thriving', and suggested she took formula milk as a supplement.
When Madam Ng heard that, she felt stressed out and guilty, like some other mums who do not breastfeed exclusively.
The 35-year-old civil servant recalls: 'I was a total emotional wreck. Every evening I would start weeping. Initially, I didn't tell anyone about this. I felt terrible, like I had failed in my duty as a mother because I wasn't able to breastfeed her fully.'
Although she introduced formula to her daughter as advised, she soldiered on to partially breastfeed Alexis until the girl was eight months old.
Eventually, she overcame her feeling of being a failure. 'I rationalised that I did everything I could until my body almost gave up. My entire reservoir had been emptied, what else do you want me to do? My conscience as a mummy is clear,' she says.
Despite a less than successful first attempt, she intends to try to breastfeed exclusively if she has another child.
The World Health Organisation (WHO) recommends that babies be breastfed exclusively for at least six months.
But the breastfeeding rate in Singapore is low, according to doctors LifeStyle spoke to. Associate Professor Tan Hak Koon, head and senior consultant of the Obstetrics & Gynaecology department at the Singapore General Hospital, says the mean duration of breastfeeding in Singapore is 12.7 weeks.
To combat the low figure, five maternity hospitals have implemented WHO's Baby Friendly Hospital Initiative (BFHI) guidelines, in a bid to be certified by the international authority by 2014.
The hospitals - SGH, KK Women's and Children's Hospital, Mount Alvernia Hospital, National University Hospital (NUH) and Thomson Medical Centre - no longer provide formula milk as freely as before or they charge a nominal fee for infant formula.
In line with the guidelines, Mount Alvernia helps mothers initiate breastfeeding within the first half-hour of birth and NUH and Thomson practise rooming-in where baby and mother stay together 24 hours a day.
Dr Yvonne Ng, a consultant at the department of neonatology at NUH, says a newborn baby should not remain in the nursery away from the mother for long periods during the early days, so that breastfeeding can be initiated more easily.
But a mindset change is required for parents to accept this. Currently, many parents in Singapore leave their baby in the nursery so they can get more rest.
When mums do not breastfeed, it is often not for the lack of trying.
Property agent Paulynn Tan, 30, gave birth to son Elliott 10 months ago. At the time, she had prepared all the equipment needed for breastfeeding, including a nursing pillow, a breast pump and milk storage bags.
But just before she was discharged after four days, her paediatrician advised her to supplement Elliott with 15ml of formula after each feed because she was not producing enough milk for him.
'He would latch on for a few minutes but lose interest shortly and fall asleep. But when I unlatch him, he wakes up crying. My baby was just more demanding than other babies,' she says.
'At one point, I remember the nurse pushing him back into my ward telling me that my son can't wait.'
The stress she felt built up when she saw that her baby was satisfied only after a formula feed and it further dented her confidence.
After one month, she stopped breastfeeding 'with a very heavy heart'. Part of her still feels guilty for doing so, a feeling reinforced by a slew of pro- breastfeeding articles she found online when she was looking for support.
'Some articles are quite hurtful and say things such as breastmilk is the best and there is no reason why you shouldn't give breastmilk,' she says.
'But they do not understand there are mums who have tried every single thing and are not able to produce enough milk. I hope people will question less or keep their gasps to themselves when a mother does not breastfeed.'
Doctors and lactation consultants say common breastfeeding problems include poor baby positioning, perceived lack of supply and poor latching on the breast which will result in skin being torn, bleeding and painful.
The Breastfeeding Mothers' Support Group receives at least 2,000 calls and up to 800 e-mail messages a year from mothers seeking help with breastfeeding.
Vice-president Angeline Wee, 46, says its counsellors provide emotional and 'technical' support to mums, including guiding them on how to position the baby and dispensing facts on breastfeeding.
'Sometimes mothers just need a listening ear because they may be fighting with their mothers- in-law or confinement ladies, who insist on feeding formula,' she says.
The group follows the WHO guidelines on breastfeeding.
'But for mums who are struggling, the counsellors will tell them some is better than none. In extreme cases, we'll tell them it's okay to stop breastfeeding if you really don't feel happy. If you are feeling grouchy all the time, it's not good for the baby. The mum's psychological health is more important,' says Ms Wee.
Indeed, for her own mental well-being, public relations director Julie Chiang, 33, started to supplement her son Dylan's feeds with formula after two months and continued with partial breastfeeding until recently when he was six months old.
She says: 'I'm pro-breastfeeding but I stopped because my son started falling asleep at the breast whenever I was feeding him and it became very stressful having him latched on to me all the time. I was tired, irritated and, at times, resentful. At that time, I felt that breastfeeding was all I was good for.'
She was wary about telling other mothers that she used formula.
'Whenever I share this, they have that disapproving look in their eyes and whatever you say is an excuse to them. But by introducing formula, it does not mean I do not love my son or our bond is any less strong.'
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'Introducing formula does not mean I do not love my son or our bond is any less strong.'
MS JULIE CHIANG, with son Dylan and husband Terence Chan, on feeding her son formula milk
'There are mums who have tried every single thing and are not able to produce enough milk. I hope people will question less or keep their gasps to themselves when a mother does not breastfeed.'
MS PAULYNN TAN, with son Elliott and husband Roy Tan, on the strident pro-breastfeeding articles she reads online
Source: The Straits Times © Singapore Press Holdings Ltd. Reprinted with permission.