Ning Desiyanti Soehartojo, MD, IBCLC, is a mother of four and a physician in Shah Alam, Malaysia, where she has provided primary care to families for many years. Since becoming an IBCLC in 2009 Ning has focused her practice on supporting breastfeeding women and is now eager to incorporate HUG Your Baby into the care she provides. She volunteers as a Peer Counselor Program Administrator responsible for training breastfeeding peer counselors in Malaysia. Ning shares the following story with us today.
Annie came for a lactation consult because she wanted to relactate and, if possible, learn to breastfeed her baby. Annie’s prolonged labour left her exhausted and too sedated to initiate breastfeeding immediately after birth.
Adam was a sleepy baby for the first few days, and Annie’s “flat nipples” made it difficult to get breastfeeding off to a good start in the hospital. As a result, Annie bottle-fed Adam with formula milk.
“It has been a month now, and I still can’t figure him out. He sometimes wakes up with a start and cries. When I picked him up to feed, he would either fuss and push me away or fall back to sleep.” I took the opportunity to explain a baby’s two types of sleep – active sleep and deep sleep – and how baby cycles between these two every 30-90 mins.
Adam was in Annie’s arms. I used The HUG's "See, then Share" approach. I described that Adam was in deep sleep now: his arms were floppy, his breathing deep and regular, and his eyes shut tight. Annie mentioned that it’s difficult to get Adam to wake for feeds when he’s in deep sleep. I explained that it will be easier to rouse Adam from active sleep than from deep sleep. Annie went on to undress Adam, called his name, tickled his feet, smothered him with kisses – “I do this every morning, to wake him for his bath.”
As Adam was transitioning from the Resting Zone to the Ready Zone, he showed signs of overstimulation. His limbs jerked and tremored, his face turned red, and he clearly was not happy. I pointed out this SOS, helped Annie notice how her son was entering the Rebooting Zone, and then guided Annie to decrease stimulation while increasing support. She quickly but quietly cuddled and held him close, swaying him gently.
Responding to his mother's comforting measures, Adam gradually settled. Annie sighed with relief. “I understand now. Less is more.” As the first step towards transitioning Adam to the breast, Annie plans to do lots of cuddling and skin-to-skin contact when he is in his Ready Zone.
“I wanted so much for Adam to breastfeed. But each time I put him to the breast, he fussed, cried and refused to latch. I felt he was pushing me away and didn’t need me. With the help of The Hug approach, Annie learned to pay attention to Adam’s cues and behaviours. “When I understand which Zone Adam is in, I can respond to his needs better”.
Adam transitioned from full bottle feeding to breastfeeding on demand by 3 months old. He's definitely a star, thanks to mummy Annie's patience and determination and a bit of guidance from me and The HUG!
CLICK HERE to see and hear what Malaysian Lactation Consultants think about incorporating HUG Your Baby into their work with young families.