Cause, treatment, prevention of breast engorgement

Source: Breast engorgement: cause, treatment and prevention

Breast engorgement is a condition in which new mother’s breast is painfully overfull of breast milk. 

It happens when nursing mother's milk first “comes in”(right after birth, which usually occur in day 2 to 5 after birth delivery. Most breastfeeding mothers will experience breast fullness or slight pain during this period. New mothers do not need to panic first.

Breast engorgement can also occur when your baby suddenly breastfeeds less than usual due to various reason like poor appetite.

To prevent it from happening, nursing mothers can look for signs first.

Common signs of breast engorgement:

1. Swollen and painful breasts. 
2. Flattened nipples.
3. Slightly swollen and tender lymph nodes in your armpits. 

Treatment of breast engorgement

Before nursing, you can take a hot shower or soak in a warm bath. Heat can improve circulation and help the milk let-down. Warm compresses or a heating pad can also be used to achieve the same effect. 

Furthermore, you should use pump to express a small amount of breast milk from both breasts before you allow your baby to latch onto the breasts. This will soften the breast and makes it easy for your baby to latch on. 

Lastly, you can also massage your breasts. Gentle breast massage improve circulation. 

How to prevent breast engorgement

First and foremost, do not skip breastfeeding, especially nigh time feeding. Instead, you should try to nurse frequently and practice breastfeeding on demand which mean you may need to nurse your newborn about 8 to 12 times in a day in the first two months after birth.

During breastfeeding, you should completely empty one breast before you switch to other side. Your baby will ‘signal’ you when to switch side.

(a)    Your baby's sucking slows down a lot or stops for a minute.

(b)    You can no longer hear your baby swallowing.

Lastly, you can wear a supportive bra. But make sure it does not have under-wire and don’t bind your breasts as it can lead to plugged ducts.

Should I call doctor?

In most cases, breast engorgement can be treated at home without any medicine. Nursing mothers must take action immediately to relieve the engorgement before the situation becomes worse.

If you experience fever associated with breast engorgement, you may visit the doctor as it can be a sign of infection.

Breastfeeding

Pumping for newborn

Source: Pumping Breast Milk For Newborn

Premature babies are babies who are born before full term. Their muscle movement is still not mature enough and they may not be able to latch onto their mothers' breast.

In this case, pumping helps babies to enjoy the benefits of breast milk which include better immune system, lower risk of obesity, cancer and other diseases.

Timing of the first pump

You can use a breast pump soon after delivery, as desired. Early and regular stimulation of the breast encourages the breast milk secretion.

However, if you are feeling uncomfortable after delivery, you may want to wait for one hour or two. This will not affect success of pumping or breastfeeding. If you are going to a c-section, you may wait a bit longer.

Frequency of pumping
When your baby is under three months of age, it is recommended that you pump once in every two to three hours, or 8 to 10 times a day if you decide to pump exclusively. This is the frequency whereby most newborns will need to be fed in the first three months.

How long should I pump for?

If you are exclusively pumping, you should be pumping for about 120 minutes per day. 

How much breast milk for each pumping section?

You would probably pump small amount like 3ml or 4ml each time on the first day. This amount is sufficient to fill the tiny stomach in a day. The amount of breast milk produced will gradually increase to about 90ml each time when your baby reaches 3 months old of age.Ideally, 

How long can I store my freshly expressed milk?

This will depend on the temperature of the surrounding where your expressed milk is stored. The following is a guideline.* At room temp: 4-6 hours* In the refrigerator: up to a week*  In the freezer above or below a refrigerator: up to 3 months* In a deep freezer: 6-12 months* Once defrosted milk is thawed, it must be used within 24hrs.

Nursing room in Singapore

How often to breastfeed

First, there is no definite number for this question. In the first four months, it is recommended that nursing mothers practice breastfeeding on demand rather than scheduled breastfeeding. 

Breastfeeding on demand means you breastfeed your baby whenever she shows sign of hunger like hand sucking motion.

Breastfeeding on demand has shown to be much more beneficial than scheduled feeding as scheduled feeding has shown to be linked with poor academic performance in the future.
Another reason  that breastfeeding on demand is better is because there is growth spurt in the first year in which baby will put on more weight than usual.

In general, in the first four months, frequency of breastfeeding is about 8 to 12 times a day. This will usually decrease as the size of tummy of baby increases.

Number of times of feeding will drop to 3 to 5 times a day when your baby is 6 to 12 months old.

For duration, there is no specific guideline, nursing mothers should look for sign that the baby is full like stop sucking for a minute.

In general, duration of breastfeeding can last from 10 minutes per session to 45 minutes per session. In the first few days after birth, the size of tummy of the baby is very small, the breastfeeding may just last 10 minutes.

One of the major concern that parents have is whether their babies have sufficient milk or not for each session of breastfeeding.

To know that, parents can monitor the weight of the baby. In the first three days, baby will lose about 7% of weight after birth and gain 35 grams daily thereafter in the first week.

In the second week to 2 months old, the baby is expected to gain weight by 170 gram every week. The increase in weight will drop to 120g to 160g per week in the 2 months to 6 months. The number will drop further to about 80 when the baby is between 6 months to 12 months old.

Please refer to how often to breastfeed for more information.

Nursing Rooms in Singapore

Singapore is becoming more and more breastfeeding-friendly – more and more building like shopping centres, government buildings, hospitals, place of interests have nursing room for the breastfeeding mothers as government is trying to raise the birth rate. 

Orchard road is a shopping parade, with many shopping centres like Ngee Ann City, Ion Orchard, Centrepoint, Tangs and 313@somerset, orchard gateway. lucky plaza, paragon, wheelock place, wisma atria, great world city.

Among them, Ngee Ann City (also known as Takashimaya as main merchant at Ngee Ann City is　Takashimaya), Ion Orchard, Centrepoint, 313@somerset and orchard gateway, Paragon, wheelock place, great world city and wisma atria have nursing room. The one at Ngee Ann City (Takashimaya) and Ion orchard has been voted as some of the best nursing rooms  in Singapore as they have good facilities like bottle warmer other than the standard facilities like hot water dispenser, cold water dispenser.

Of course, feel is an very important factor. The ones mentioned above give nursing mothers very comfortable feeling and it is one of the important reason why they are the best among many.

From what we know, some important shopping centres like Tangs does not have a nursing room. But you can find one nearby without much trouble like the one in Ion orchard and shaw building. 

Other than Orchard road, shopping centres in CBD area like Raffles City, Liang Court, Suntec City also have nursing rooms.

Office buildings in this are also have nursing room but they are usually not open to the general public.

Places of interest like Esplanade, Chinatown Point, Garden By the Bay also has nursing room for the tourists – an important feature that makes it pro-family and good destination for family.

Overall, it makes business sense to have nursing rooms in the shopping centre as it could attract family who usually need to spend a lot of money on baby related products. Of course, they not only buy baby related products, father and mother also need to purchase other things for the family.

Nursing rooms in Singapore

Nursing room in Orchard Singapore

Marina Square nursing room

313@somerset nursing room

Centrepoint nursing room

Suntec nursing room

Raffles City nursing room

Ion orchard nursing room

Takashimaya nursing room

Cost of maids in Singapore

1.Maid Agency Fee or service fee

This can range from $0 to $2000. This costs me around 600 for hire a myanmar maid through agency. It is important for you to check with your maid agency or domestic helper agency what the agent fee or service fee covers such as security bond. For my case, it covers all administrative fee, air ticket, insurance, medical examination. It is heard that you can ask for discount for this fee.

It is therefore important to ask maid agency what maid agency fee covers before engaging their service.

2.Personal Accident Insurance and security bond

As an employer, you need to purchase personal accident insurance for your foreign domestic workers, minimum sum insured will be $40,000.

All employers of foreign domestic workers need to have a security bond with the work pass division of the Ministry of Manpower (MOM). This is to avoid paying $5000 if your maid runs away for various reasons.

Some insurers like NTUC income will have a plan that combines personal accident insurance and security bond; cost of this plan may be about $256.80.

3.Performance Bond

This is only relevant if you are hiring a Filipino maid.

4. Placement Fee

This may not be necessary if you are hiring Indonesian maid.

5. Settling-in Program

This may cost you $75 if your foreign domestic worker is working in Singapore for the first time.

6. Employers'orientation program

If you are hiring maid for the first time, you may need to attend the orientation program unless you have valid reason. This can cost you $20 or $30. This sometimes is included in the service fee or agent fee.

7.Others Upfront Cost

You may also need to purchase bed, mattress, bed sheet, pillow and blanket if you do not have these items for your maid. As an employer, you have to provide these items to the maid.

8. Cost of Hiring Maid - Monthly Salary

1. Indonesian maid: $450 and above
2. Filipino maid: $500 and above
3. Myanmar maid: $430 and above

9. Foreign Domestic Worker Levy

You need a pay a monthly foreign domestic worker levy of $265 through arrangement of GIRO.

If you meet condition for concession of foreign domestic worker levy, you only need to pay $65 monthly. You can read this under the common question below for the conditions for the foreign domestic worker levy concession.

10.Food and toiletry

As an employer, you are supposed to provide food for the foreign domestic worker. If you do not cook, you have to give maid some cash to buy her own meals. It may be recommended that you pay for the basic toiletry such as shampoo, toothpaste and tooth brush for the maid, but this is not compulsory unless you and your maid agree to it in the contract.

11. Medical expenses

As an employer, you have to pay all medical expenses of your maid. This is the reason why it is important for you to have the personal accident insurance plan.

12. Air Ticket

You need to pay the transportation fee for the repatriation of the maid upon cancellation of the work permit.

Please refer to cost of maid in Singapore for details of cost and maids in Singapore

Pediatrician Woodlands

Woodlands is the regional centre for Northern part of Singapore. Many commercial buildings will be built in this area in the next few years and more transport like MRT station will be built in this area to make it even more accessible. All these new development will be built around the current Woodlands MRT Station. 

But this town is very far from city centre where there are a lot of healthcare facilities. Despite being a regional centre, there is no public hospital in this area. The nearest hospital can be found in Yishun which is 3 MRT station away. 

There are only 2 pediatrician in this area. They are Dr. Tan Yean Swee Angelin of Angelin's Baby & Child Clinic and Dr. Wong Chun Ping of The Gynae Link.

Dr. Tan Yean Swee Angelin has 26 years of experience in the field while Dr. Wong Chun Ping has 20 year of experience.

If you are looking for Pediatrician in Woodlands or surrounding area. Please refer to Pediatrician in Woodlands for more information. You will be able to find map, address, contact number, qualification of all these pediatrician. 

Pediatrician in Singapore

Pediatrician in Clementi

In Singapore, Clementi is a town where there are many education institutes such as National University of Singapore, Singapore polytechnic, Ngee Ann polytechnic and many more. There are a lot of development happening in this area also.

It is a town which is home to National University Hospital which has a dedicate department for children. This is also the reason why there are many pediatrician working in this area.

Other than about fifty pediatricians that works for National University Hospital, there are 7 pediatricians working in private clinics in this town.

These seven pediatricians working in two different baby and children clinics in Clementi. These two clinics are Kinder Clinic @ Pandan Valley and Chia Baby & Child Clinic.

Working at Chia Baby & Child Clinic is Dr. Chia Foong Lin who has 31 years of experience and has the following qualification: MBBS , M Med (Paed) , FAMS - Fellowship of the Academy Medicined.

Working at Kinder Clinic @ Pandan Valley  are Dr. Darryl Lim who has 22 years of experience, Dr. Ravin Selvadurai with 27 years of experience, Dr. Gong Wei Kin who has 24 years of experience.

It is not necessary cheap to visit pediatrician in public hospital like National University Hospital. Some of these pediatrician can actually charge more those in private sector, especially if you are foreigner.

If you are looking for a pediatrician in Clementi or National University Hospital or the surrounding area in Singapore. You can refer to pediatrician in Clementi for more details such as contact address, contact number, qualification of pediatrician, years of experience and so on as well as map.  

Source: Pediatricians in Singapore