Got a breastfeeding/ lactation question?

Write to: LC Doris Fok c/o Q&A Lactation, MotherNeeds, 141 Lentor Street, Singapore 786838, or fax us at 6456-0031, or email info@motherneeds.com with "Ask LC Doris" as your subject heading.
Please limit your queries/questions to a maximum of 150 words.

Doris will select 2 letters to be answered every month. Selected letters published here win a S$12 gift certificate for purchases at our MotherNeeds online store.

Visit our Archives for breastfeeding topics previously addressed.

Question 1:
Dear Doris,

I am currently breastfeeding my 7-week-old daughter exclusively. I recently caught the flu, and was prescribed some antibiotics (amoxycillin), decongestant (fedac) and cough syrup (dhasedyl). During the 5 days I was on medication, I was advised to express my breastmilk and dispose of it. Aside from feeling the tremendous waste of breastmilk and hard work (expressing), I heard that I can and probably should be breastfeeding my baby anyway throughout my flu (provided I wear a mask while I nurse her).

Is there any truth to this advice? If I am to dispose my breastmilk, is there any way to overcome the wastage (e.g. perhaps if I nurse right before I take my medication, she may not receive as much traces of the medication)? To better prepare myself when I do catch a cold/ flu again, is there any over-the-counter medicine that are "safe" for breastfeeding?

Thanks and best regards,

Jocelyn Ng

Answer 1:
Dear Joceyln,

It's great that you have been breastfeeding your baby for 7 weeks. It's such a pity to throw away your breastmilk. According to the WHO recommendations, there are very few instances when we are discouraged from giving breastmilk to our babies. These instances will include medical conditions like when a mother needs to take cancer drugs and undergo radiotherapy or chemotherapy. There are very few instances where a mother is encouraged to stop giving her baby breastmilk. In the instance that you have just described and with the medications that you have been given, the recommendations from the experts in WHO, American Academy of Paediatrics and Academy of Breastfeeding Medicine, is to continue breastfeeding. You should observe normal hygiene and also breastfeed first before taking any medication to reduce the side effects on the baby.

Wishing you all the best in your breastfeeding adventure!

Regards,
Doris Fok

Question 2:
Dear Doris,

I am currently 7 months pregnant with a pair of twin boys. I would like to breastfeed exclusively, but am concerned I may not have enough for the two, particularly when I am now pre-eclamptic and may end up with an early delivery. If my babies are born early or premature (by more than 4 weeks), would my body be "in tune" fast enough to catch up on breastmilk production for the twins, since my pregnancy would most likely not be full term? Would I need to supplement them with formula in the interim while my milk supply catches up? Is it a good idea to take Domperidone to help speed up the process?

Thanks.

Regards,
Shi Yan

Answer 2:
Dear Shi Yan,

Congratulations on conceiving twins. It's both a double joy and a double challenge. Your body will know how much milk to produce based on how much signals you give it. As far as we know, it is theoretically possible for a mother to produce enough milk for up to 4 babies at a time. So, if you have twins, it is possible to produce enough, provided you ensure that:

(a) you breastfeed properly with no pain;
(b) you breastfeed frequently, according to the babies' cues;
(c) you have a lot of breastfeeding support from your significant others.

It is possible for a mother to breastfeed twins. Please contact the Breastfeeding Mothers' Support Group if you need any more local support. We have counsellors who have breastfed twins before, successfully!

You can do it if you want to! You just need the know-how and get the support from everyone around you! Supplementing formula will signal to the brain that you do not need the milk volumes, so work on getting your breast milk supply up by breastfeeding as much as possible. Express your milk if you find that it is difficult to co-ordinate the breastfeeds with your babies. Please have a word with your lactation consultant first to determine whether you need Domperidone.

Best wishes and congratulations on wanting to give your twins the very best that a mother can feed her babies!

Doris Fok

*We regret that only 2 letters will be answered by Doris every month.

Neither the information nor any opinion expressed constitutes a medical consultation or prescription or treatment of a medical or health condition. This column is prepared for general viewing and is published for general information only. It does not have regard to the specific medical or health condition, and the particular needs of any specific person who may receive this information. Persons needing medical attention should seek advice from his/her healthcare practitioner regarding the appropriateness of information discussed or recommended in this column. Should you have a pressing question or issue concerning your medical or health condition, please consult your healthcare practitioner.

Copyright © 2009 MotherNeeds, All rights reserved. This page may not be copied, photocopied, reproduced, translated, or converted to any electronic or machine-readable form in whole or in part without prior written approval of MotherNeeds.