Malaysian Physician/Lactation Consultant becomes a Certified HUG Teacher

Nurhaya Yacob is a physician and lactation consultant in Penang, Malaysia. She shares her HUG Your Baby journey. 

 I am a medical doctor who is currently fully time lactation consultant serving my community. I can never thank Hug Your Baby and all the information I have learn through out. Initially, I was teaching on breastfeeding on its own. After awhile i notice there is a missing puzzle and I notice that breastfeeding can never be stand alone. Then I start digging information on early childhood education and lead me to baby behaviour. 

 I start combining these 2 big part of knowledge, and decided to proceed with Hug Your Baby. Hug Your Baby has completed my missing puzzled. I feel way more calmer now in attending my community. 

It is never easy to break the culture of many wrong doing in breastfeeding. However by acknowledging the SOS and the baby state always make the parents more confident and feeling connected to them. 

And that is breath taking for me more that the oz's they made as I vision breastfeeding more than just a gesture of serving "food" to their babies.

Malaysian Pediatrician becomes a Certified HUG Teacher!

Saw Sian Chin, a paediatrician from Malaysia, reflects on her HUG Your Baby training and certification.

I am a Paediatrician and certified lactation consultant. Jan's Hug Your Baby course simplified baby's behaviour in a simple three zones: resting, ready, and rebooting zones, which I use myself, and taught parents on learning about their new babies. Jan's tips on calming babies and interactions have helped me to interact with babies better, therefore able to perform physical examinations more efficiently, do developmental milestone assessments more meaningful, and help mothers to breastfeed in a joyful way.

Here is a description of a parent visit Saw Sian made as part of her certification process:

I met with  1-month-old Baby Q who came to the clinic because her mother noticed that she has been crying a lot in late afternoons for the past 3 days. Baby Q was born term, normal delivery. The mother is breastfeeding with occasional formula feeding. 

On arrival to clinic, Baby Q was in the “rebooting” zone- crying with jerky limbs, screwing up her face. I asked mother about baby's last feed, and checked her nappy. We established that the baby was clearly not hungry or needing nappy change. I advised mother to talk to her baby in a soft voice, swaddled her tightly, and embraced her closely in her arms. I showed mother how to hold both arms together in mid-line as shown by Jan in the teaching video. 

To mother's surprise, the child calmed when mother started to sing to and sway baby in her arms. Her face showed clear relief when the baby stopped crying. Mother obviously has been struggling for the past few days. Since the baby is now calmer, I can examine baby's abdomen in more detailed and assure mother that there is no organic cause for her crying. Perhaps practicing these calming skills will decrease baby's crying and increases mother's confidence😊.

Malaysia: Country Representative

Malaysia's HUG Your Baby Distributor: Ning Desiyanti Soehartojo, MD, IBCLC, is a physician in Shah Alam, Malaysia, where she has provided primary care to families for many years. More recently, she has become an IBCLC and is now focusing her care on supporting breastfeeding women in Malaysia. Ning is becoming a Certified HUG Teacher and wants to integrate this information into the care she provides. Contact Ning at ningds@gmail.com  Read about The HUG in Malaysia.

HUGs across Asia Pacific

As you can tell from reading HUG Blogs over the past five months, HUG Your Baby has been well received in Asia Pacific. I expected to find that parents everywhere care deeply for their baby and that those who serve these parents would want to provide up-to-date, family-friendly education and resources. But, it has been a delightful surprise that professionals from Guatemala to Sri Lanka, from Japan to Australia, and from Malaysia to Brunei are wanting a bigger, longer HUG!

HUG Your Baby's leadership (Jim Henderson [husband, editor, researcher and "Dad's Got the HUG"], Gale Touger and Barbara Hotelling [HUG Trainers]) has recently considered the growing interest and greater requests coming our way and discussed what steps forward make the most sense. We're concluding that creating a Roadmap to Breastfeeding Success online course, and then a Train-the-Trainer program, are reasonable next steps.

Presenting HUG Your Baby to over 1,500 professionals since July, I've gained insight into what HUG ideas are readily understood ("Zones" and "SOSs"), what concepts need tweaking (infant self-regulation), what baby care practices are controversial (swaddling and nighttime routines), and what additional information should be offered (a template for assessing a newborn's behavior).

In addition, I have spent time considering how best to teach the HUG ideas and what new materials to create. Because I teach best with stories and video, Jim and I discussed where we might videotape babies in this part of the world. We were delighted to have the opportunity to tape a number of babies in Malaysia. 

And, after inquires were sent and emails returned, Jim and I also arranged a return stay in Hobart, Tasmania, to work with the Royal Hobart Hospital's "Midwifery Group Practice" (MGP).

Kimmy Brooks, a friend and experienced MGP midwife, is our connection here, and she graciously spent some of her "annual leave" time gathering the support of MGP's leadership, the approval of the hospital, and the scheduling of interested pregnant patients due in November, when we were able to come back to town. In exchange I offered several complimentary HUG trainings to interested staff at The Royal and free DVDs to the parents whom we videotaped.

We've been in Tassie for three weeks now--initially staying in spectacular Woodbridge with Kimmy, her husband, Steve, and their beloved dog, Wombat--and later back at our "home away from home" ("Werndee") in North Hobart. These weeks were spent meeting young families and collecting video footage of a variety of newborn behaviors. Though I had an extensive list of behaviors I hoped to capture on film, babies are not very responsive to requests such as, "How about 'take two' on that behavior?" I've long since learned to go with whatever behaviors a baby chooses to present.

Every time I encounter a newborn I am impressed once again by how much each baby has to teach. As I review the six babies I taped in Hobart and the seven I saw in Malaysia, I realize that I have collected video of most of the behaviors I had hoped to see. Here are a few examples of the lessons these babies taught:

Baby A: This baby demonstrates her remarkable ability to transition form one Zone to another We see her using behaviors that make a smooth transition possible: She "Spaces Out," she moves into the fencing pose, and she brings her hand to her mouth. All these self-comforting measures help her regulate her Zones. As I experience Baby A, and watch her on video, she seems predictable; I can tell where she is going. I can see (and explain) why this young mother experiences her baby as easy to care for.

Baby B: This baby's first-time parents are worried about their baby's sleepiness. Though the baby's weight gain is perfect, the father can't believe "I need to spend so much time trying to wake up my sleepy baby." Identifying for and with the parents this baby's active and deep sleep cycles, and discussing the value of active sleep for brain development, proves helpful to them.

Baby C: These dedicated first-time parents are challenged by a baby who is "hard to settle." I observe that this baby moves randomly and unpredictably between Zones, demonstrates few self-soothing behaviors, and struggles with efforts to orient (to look at a toy, or my face). Helping these parents see objectively the behaviors that are at this time challenging is helpful. In addition, hearing about each baby's unique development, and showing them techniques to help this baby with Zone regulation (such as swaddling before attempts to engage visually), is reassuring for these concerned parents.


Though I have completed initial editing of these videos in order to share them with the parents who volunteered their time, I expect to spend a number more hours watching, sorting, and watching again this precious example of the complexity of a baby's behavior, and the range of parents' experiences with a baby, as I continue to plan how best to convey the most important information to the widest range of interested professionals. This will be fun!

I'm looking forward to finding time for this project both before and after our time in Thailand--where we are going tomorrow for several weeks and a number of HUG Your Baby presentations in Bangkok and Chiang Mai.

Malaysia: Mothers, Fathers and Babies Get The HUG!

Today I meet with expectant couples--and mothers and fathers with their young babies--in a packed education room at KPJ Hospital, Klang, Malaysia. All are eager to learn how to become the good parents they want to be.

I review the key components of HUG Your Baby: recognizing what "Zone" a baby is in and when a "baby sends out an SOS-Sign of Over-Stimulation". Parents hear about the "Resting, Ready and Rebooting Zones" and learn to recognize when a baby sends out body SOSs (with changes in baby's movement, breathing, and color) or behavioral SOSs: "Spacing Off" (looking into space), "Switching Off" (looking away from parents), and "Shutting Down" (getting more drowsy).

The most exciting time of the day for me is a "hands-on" HUG for babies in the audience. Parents stand in line to allow their baby to be a "Super Star and Model Baby"! (See certificate below.) One baby demonstrates a remarkable example of Deep Sleep, while another demonstrates the transition from Deep Sleep to Active/Light Sleep.

One baby enters the Rebooting Zone, only then to show us how he can begin to calm down by hearing my sing-song voice.

A two-week-old baby demonstrates her ability to to turn her head toward my voice before "Switching Off" (by turning away from my talking face).

A father observes the "Deep Sleep" Zone while hearing about the special skills babies can learn from an engaged father.

A baby who is two months old demonstrates his developing motor skills as he tucks in his chin so that he can hold his head midline and gaze at me.

"Babies can be our greatest teachers," I say, as I once again discuss the remarkable capabilities of a newborn. Parents in Klang, Malaysia, today not only enjoy the satisfaction of sharing their adorable babies with an appreciative audience. They also see how ready babies are to communicate with their loving and attentive families.

Malaysia: HUG Your Baby Reaches New Lands

It was not easy to say goodbye to my old friend Elizabeth (who headed back to Princeton) and our new friend/teacher/driver, Ida, and to leave beautiful Bali. But Malaysia is our next stop and promises another set of memorable and moving experiences.

Though eating is not ALL we do in Malaysia, we can't help but start every conversation with a description of what we JUST ate! The multicultural heritage of Malaysia is evident the moment we step into the airport, at restaurants where Malay, Chinese and Indian food cohabit, and on the bus where we continue to hear the "One Malaysia" song celebrating what people of diverse
backgrounds share as a nation.

We love hearing the Muslim call to prayer as we drive past a colorful Hindu temple, a sparkling gold Buddha, or a subdued Catholic church. Each faith is awe-inspiring, but seeing them all practiced in harmony is all the more uplifting.

We learn to order dishes like dim sum, bak-kut-teh, or asam laksa; to dodge fast cars and motorbikes on well-paved roads; and to shake hands followed by a touch to the heart (Malay style). Today a toddler reaches out to grasp my hand, bringing it to his mouth for a kiss. Mother explains that this is how young children are taught to meet and greet. I loved this, of course!

I am finally able to meet Siti Norjinah Moin (photo), who has been my Skype buddy for 6 months. She founded the Malaysian Breastfeeding Association and has worked tirelessly for decades to make EVERY public hospital in Malaysia Baby-Friendly in 1998. She set up two HUG Your Baby trainings is Shah Alam (outside of Kuala Lumpur) and helped me confirm a keynote presentation at The 9th Perinatal Symposium in Brunei next week. Norjinah makes things happen!

The KPJ Hospital in Klang hosts HUG Your Baby's first Malaysian trainings. Well prepared for the 50 registered professionals, workshop event planners Danny, Belle and Janet move at lightning speed to set up extra chairs and print out more handouts and certificates for the crowd of 80 nurses, breastfeeding consultants and peer counselors, physicians and childbirth educators who arrive!

Feeling quite welcomed by hospital leadership (Dr. Sivamohan, Medical Director; Jaliah Mat Jani, Chief Nursing Officer; and Zaharah Osman, RN, General Manager) as well as by a local (pregnant) "Reality Show" celebrity, Betty Nanafe, I am surprised and delighted by the ceremonial "launching" of the workshop with the drop-down "release" of a HUG Your Baby banner and an explosion of festive confetti.  I am fired up and ready to roll!

I am usually struck by what is similar about most international HUG trainings: a desire to help parents better understand their babies and the surprise that HUG concepts are so relevant and easily explained to expectant and new parents. 

Because this training focuses closely on how HUG strategies and techniques support breastfeeding, I am especially delighted to have extended conversations with local lactation specialists. (CLICK HERE to watch a two-minute interview with them). Though excited by The HUG, they, like some other lactation professionals, worry that my teaching about infant sleep cycles might cause mothers to inadequately breastfeed their infants because of confusion about "early feeding cues" versus "active sleep." We share our varied points of view and promise to stay in touch as they think through how to give parents accurate information to meet the sleep needs of young mothers AND the nutritional needs of their babies.

Tomorrow we host a community-wide workshop and prepare to welcome expectant and new parents who want to give their baby a HUG! But first, we need to EAT AGAIN! ( Photo of event planners Janet, Danny and Belle who share with us the "FAMOUS" Klang dish, Bak Kut Teh ["Pork, ribs, tea"]).