Lactation Consultants in Malaysia

Kuala Lumpur & Selangor

Christine Anne Choong

SRN,SCM,IBCLC,Grad.Dip.Childbirth Education,HBCE,CIMI

Address:  2, Jalan Taban 4, Lucky Garden, Bangsar 
Kuala Lumpur, Federal Territory, 59100 Malaysia
Tel: 03 20951206
http://www.mamalink.com.my
Practice: Private Practice
Expertise: Basic breastfeeding technique and management, Breastfeeding multiples, Low milk Supply, Inverted and Flat Nipples Latch Issues, Relactation, Adoptive Nursing, Returning to work
Languages: English
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Dr. Pearl Leong

MBB Australia, Diploma Royal Australian & New Zealand College, Obstetricians & Gyneacologist (Australia), International Board of Certified Lactation  Consultant (USA)

A-0-5, Plaza Damas, Jalan Sri Hartamas 1, Sri Hartamas, Kuala Lumpur

Tel : 03 – 6203 2837

Languages: English
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Hairan Anisa Bt Tajuddin

IBCLC

Address: Universiti Malaya, Pediatric Department, Medical Faculty,Kuala Lumpur, 50603 Malaysia
Tel: 012-7326913
Practice: Hospital,Educator/Course Provider
Expertise: Basic breastfeeding technique and management,Breastfeeding infants with anatomical challenges, Breastfeeding multiples, Breastfeeding infants with neurological disorders, Premature infants
Languages: Malay
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Nazatul Shiha Bachtiar
MD, IBCLC

Address: University Of Malaya, Lembah Pantai
Physiology Dept. Faculty of Medicine 
Kuala Lumpur, 59100 Malaysia
Tel: 03-79674304
Practice: Hospital, Educator/Course Provider
Expertise: Basic breastfeeding technique and management, Breastfeeding infants with anatomical challenges, Breastfeeding multiples, Breastfeeding infants with neurological disorders, Premature infants
Languages: English, Malay
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Rita Rahayu Omar
BSc, IBCLC

Address: 32 Jalan Bpp 4/2, Pusat Bandar Putra Permai, Seri Kembangan, Selangor, 43300 Malaysia
Tel:03 89414252 or 013-363957
http://www.momslittleones.com; www.thenurturing.com
Practice: Private Practice
Expertise: Basic breastfeeding technique and management, Breastfeeding infants with anatomical challenges, Breastfeeding multiples, Breastfeeding infants with neurological disorders, Breast Augmentation or Reduction, Low milk supply, NICU, Post-Partum Depression, Premature infants, Adoptive Nursing, Relactation, Returning to work

Languages: English, Malay
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Swee-Lee Koe
MD,IBCLC

Address: 27 Jalan Manisan, Taman Bukit Indah, Kuala Lumpur, 58200 Malaysia
Tel: 03-79830539
Expertise: Basic breastfeeding technique and management
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Nor Kamariah Mohamed Alwi
IBCLC,  SusuIbu.com

Address: 13G, Jalan Medan PB2A, Seksyen 9, Bandar Baru Bangi, Selangor, 43650 Malaysia
Tel: 03 89254614
http://susuibu.com
Practice: Private Practice
Expertise: Basic breastfeeding technique and management
Languages: Malay

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Penang

Balkees Abdul Majeed
IBCLC
Address: 4 Kampung Kolam, Georgetown, Penang, 10200 Malaysia
Tel: 04 829 9188
Practice: Private Practice
Expertise: Basic breastfeeding technique and management
Languages: Tamil

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Julianna Lim Abdullah
IBCLC, World Alliance for Breastfeeding Action (WABA)

P.O. Box 1200, Georgetown, Penang, 10850 Malaysia
Tel: 04-6584816

Practice: Community/Public Health/WIC
Expertise: Returning to work
Languages: Cantonese
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Khoo Siew Farn
MB.MCh.BAO, IBCLC
Address: 3-25-06 SRI IVORI, LENGKOK ANGSANA, Bandar Baru Farlim, Penang, 11500 Malaysia
Tel: 012-4125506
Practice: Private Practice
Expertise: Basic breastfeeding technique and management
Languages: English

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Sabah

Ho Torng Hsu
MD, IBCLC

Address: No 4b-62, Block 10, Taman Puteri Indah Jaya, Sandakan, Sabah, 9000 Malaysia
e-mail: ftvhht@yahoo.com.tw
Expertise: Basic breastfeeding technique and management

This experience can leave a mother feeling upset, frustrated and useless. You may wonder if there’s anything you can give your baby that all those nurses and doctors can’t.

The answer is “yes.” You have a unique gift to give your preemie: your breast milk.

Breast milk offers many advantages for babies, and they are especially important if your baby was premature.

• Your milk provides antibodies that can help your baby fight off diseases and infections. Preemies are at a higher risk for infection because of their immature immune systems.
• Your milk is tailor-made for your baby’s needs. When her baby is born prematurely, a woman produces milk that is higher in protein, fat and minerals than the milk from mothers who delivered at term. These extra nutrients are highly beneficial to a preterm infant’s growth and development.
• Producing milk for your newborn triggers hormones that help you bond with your preemie.

Formulas, even ones made especially for preemies, simply cannot match these benefits. The milk you make is the very best food for your preemie.

Many women plan to breast-feed but then feel they can’t if their baby was premature. It’s true that you may not be able to start out breast-feeding your baby. At first, your baby may need to be fed through a tube or with a bottle. Still, you can pump (or express) your breast milk to be given to your preemie. In time, as your preemie grows stronger, you will be able to hold and breast-feed your baby.

6 tips for preemie breast-feeding

1. Express your milk if your baby isn’t able to breast-feed yet. This will help keep your supply strong. The hospital may provide an electric breast pump that allows you to empty both breasts at the same time, or you may be able to rent one. A nurse or lactation consultant can show you how to use the pump.

2. Get started right away. It’s best to start pumping (or breast-feeding if your baby is able) soon after birth. You’ll need to do it every three hours, or about eight times in 24 hours.

3. Once your baby is ready to nurse, feed often. Babies usually need to eat every two to three hours. As you get to know your baby, you will begin to notice the cues that he or she is hungry. In some cases, you may need to wake your baby up to feed. Try to limit crying. Crying is a late sign of hunger, and it wastes energy your baby needs to grow.

Until your baby matures, he or she may not nurse long enough at each feeding to empty your breasts. You may need to pump after feedings to keep your supply up.

4. Expect to have some problems. Preemies often have trouble sucking, swallowing or latching on to the breast. They may not develop these abilities until weeks after they were born. It’s common for preemies to fall asleep while feeding or to slip off the breast. With patience and persistence, there is usually a way to overcome the obstacles and succeed at breast-feeding.

5. If you have trouble, don’t give up. Get help. Preemies present special challenges. It’s not always easy to get a preemie to breast-feed. You may worry that your baby is not gaining enough weight or that you’re not making enough milk. If you have any concerns, talk to your doctor.

Hospital nurses and lactation consultants can be a good source of breast-feeding information and support. La Leche League International is a worldwide organization of mothers who educate and encourage women who want to breast-feed. To find a meeting or one-on-one support in your area, go to their Web site at www.llli.org.

6. Consider breast-feeding for at least the first year of your baby’s life. If that’s not possible, breast-feed as long as you can. Any amount of breast-feeding will help get your baby off to a healthier start.

(My OptumHealth.com, Jan 2010)

It’s been shown to help a baby’s later performance in school, to reduce the odds of problem behavior and to help kids cope with stress. And moms stand to benefit later on as well, studies show.

But what is it about breast-feeding that’s so helpful and healthy?

For starters, breast milk is loaded with health-promoting nutrients. “It’s not just one mechanism,” said Melinda Johnson, a spokeswoman for the American Dietetic Association, a lecturer in nutrition at Arizona State University and a dietitian in private practice in nearby Chandler, Ariz.

“The nutrition [provided by breast-feeding] is perfect for the growing child,” Johnson said. Take, for example, DHA (docosahexaenoic acid), an omega-3 fatty acid. “DHA is critical for brain development and also for nervous system development,” Johnson said.

The presence of DHA in breast milk, she said, might explain the finding that breast-fed kids do better academically.

Breast milk also contains the amino acid taurine, considered important for neurological development, said Dr. Ruth Lawrence, who chairs the American Academy of Pediatrics’ section on breast-feeding and is a professor of pediatrics and obstetrics-gynecology at the University of Rochester School of Medicine and Dentistry in New York.

“Newborns and preemies cannot manufacture taurine,” Lawrence said, although adults do. “Taurine is one of the amino acids needed for brain growth. The brain will double in size in the first year of life.” That makes it critical to have nutrients that help brain growth.

“We in the breast-feeding field have been focusing on brain growth [and its importance] for a number of years,” she said. Those who manufacture formula, Lawrence said, focus more on how much weight babies can gain with their product.

Breast milk also has been shown to jump-start a baby’s immune system, and researchers think that’s due at least in part to a protein found in breast milk. Called soluble CD14, it helps develop beta cells, a type of immune cell that helps produce antibodies, which are needed to protect against illnesses.

Breast milk also contains live and active organisms that can never be duplicated in formula, Johnson said. In one of the newer areas of research, experts have found that breast-fed babies’ guts have different bacteria than those of formula-fed babies, and that the breast-fed babies’ gut bacteria appears to be healthier, she said.

Other research has found that the intestinal bacteria present early in life play a role in whether a person will suffer from allergies, have an overactive immune system or tend to put on excess weight later in life, Johnson said.

Breast-feeding also has emotional and bonding benefits, according to Lawrence and Johnson, although they say it’s harder to explain the “why” and “how” of those.

Though a mother who bottle-feeds also holds her baby, the child has actual physical attachment while breast-feeding. “Certain hormones, feel-good hormones, are released when a woman is breast-feeding,” Johnson said, citing oxytocin and prolactin as examples. “The theory is, that’s how the moms bond.”

DHA has also been linked to mood, she said, and “if you have the right amount of DHA, you may be heading off mood disorders.” (Businessweek, Jan 2010)

Researchers found that among 700 women followed for 20 years, those who had breastfed were less likely to develop metabolic syndrome — a cluster of risk factors for type 2 diabetes and heart disease that includes abdominal obesity, elevated blood pressure and blood sugar, lower-than-desirable levels of “good” HDL cholesterol and elevated triglycerides (a type of blood fat).

What’s more, the apparent protective effect was stronger among women with a history of gestational diabetes, a form of diabetes that arises during pregnancy and goes away after childbirth.

Although it is temporary, gestational diabetes does raise a woman’s odds of eventually developing type 2 diabetes.

These latest findings suggest that breastfeeding might help diminish that excess risk, said lead investigator Dr. Erica P. Gunderson, a research scientist at Kaiser Permanente’s Division of Research in Oakland, California.

However, she told Reuters Health, while the study suggests breastfeeding has a “strong protective effect” against metabolic syndrome, more research is needed to see whether that translates into lower rates of diabetes and heart disease.

The study, published online in the journal Diabetes, included 704 women who were between the ages of 18 and 30 and free of metabolic syndrome at the outset, and who gave birth for the first time during the study period.

Over 20 years of follow-up, 120 were diagnosed with metabolic syndrome.

The researchers found that among women with no history of gestational diabetes, those who had breastfed for more than one month were anywhere from 39 percent to 56 percent less likely to develop metabolic syndrome — depending on how long they had breastfed.

Among women with a history of gestational diabetes, breastfeeding for more than one month was linked to a 44 percent to 86 percent lower risk of metabolic syndrome.

These lower risks were seen with a number of important factors taken into account — including the women’s weight, exercise levels and the presence of any metabolic syndrome components before pregnancy.

It is not yet clear why breastfeeding itself might lower a woman’s chances of developing risk factors for diabetes and heart disease.

Abdominal obesity is one of the components of metabolic syndrome, and excess weight is closely linked to type 2 diabetes. But while it’s widely thought that breastfeeding aids post-pregnancy weight loss, weight changes did not explain the benefits seen in this study, Gunderson said.

Breastfeeding may help women shed a few extra pounds in the months after giving birth, the researcher noted, but there may be other metabolic effects that explain the lower risk of metabolic syndrome.

Breastfeeding may, for example, have positive effects on blood sugar levels, body fat mass or how fat is distributed throughout the body.

Whatever the reasons for the findings, Gunderson said they do suggest that breastfeeding can have “long-term health benefits” for mothers.

(The Gazette, December 2009)

During feeds, babies tend to swallow air. This is especially true if your baby does not latch on properly to your breast during feeds, causing him to take in mouthfuls of air. Burping your baby will help him get rid of some of the air swallowed. If babies aren’t burped frequently, it will lead to spitting up or vomiting, crankiness and gassiness in some babies. A colicky baby can also develop gas by swallowing too much air during crying spells, making your baby even more uncomfortable.

How to Burp Your Baby
There is no need to pound hard on your baby’s back, instead repeated gentle patting on your baby’s back should do the trick. Place a towel or a bib under your baby’s chin to prevent messy cleanups when your baby spits up or has a “wet burp”.

You may also want to experiment with different positions for burping that are comfortable for you and your baby. Many parents prefer to use one of these three methods:

Sit upright and hold your baby against your chest. Your baby’s chin should rest on your shoulder as you support his or her head and back with one hand. With the other hand, gently pat your baby’s back. Sitting in a rocking chair and gently rocking with your baby while you do this may also help.

Hold your baby sitting up, in your lap or across your knee. Support your baby’s chest and head with one hand by cradling your baby’s chin in the palm of your hand and resting the heel of your hand on your baby’s chest (but be careful to grip your baby’s chin – not throat). Use the other hand to pat your baby’s back gently.

Lay your baby on your lap on his or her belly. Support your baby’s head and make sure it’s higher than his or her chest. Gently pat your baby’s back.

If your baby seems fussy while feeding, stop the session, burp your baby, and then begin feeding again. Try burping your baby every 2 to 3 ounces (60 to 90 milliliters) if you bottle-feed and each time you switch breasts if you breastfeed. If your baby doesn’t burp after a few minutes, change the baby’s position and try burping for another few minutes before feeding again. Always burp your baby when feeding time is over.

For the first 6 months or so, keep your baby in an upright position for 10 to 15 minutes (or longer if your baby has gastroesophageal reflux) after feeding to help prevent the milk from coming back up. But don’t worry if your baby spits up a few times. It’s probably more unpleasant for you than it is for your baby.

Sometimes your baby may awaken because of gas – simply picking your little one up to burp might put him or her back to sleep. As your baby gets older, you shouldn’t worry if your child doesn’t burp during or after every feeding. Usually, it just means that your baby has learned to eat without swallowing excess air.

Also watch “How to Burp a Baby” on video.

Source: The Ministry of Health Malaysia

When to start expressing your breast milk

• Start to practice expressing your breast milk 1 or 2 weeks before resuming your work. You can do this at any convenient time.
• After feeding, any excess milk can be expressed and stored in a clean container or bottle.
• You can also express and store milk between feeds if you find that your breasts are full or if they are leaking.
• With practice, you will get an idea of how much milk you will have to leave behind.
• It is important for you to express your milk every 3-4 hours once you are back to work. The expressed milk should be kept and brought home to be given to your baby on the next day.

By the end of the 2 weeks’ practice, you may find that you can collect about 4 bottles of expressed milk with 70-90ml of milk per bottle daily.

How to store expressed breast milk

• Immediately after expressing breast milk into a clean container, store it in a refrigerator or ice box. This milk should be used within 24-48 hours.
• If no refrigerator is available, you can store your expressed milk in a cool place for up to 8 hours.
• Never add freshly expressed milk to previously stored milk.

How to use stored breast milk

• Before use, let the breast milk return to room temperature. If necessary, place the container with the breast milk in a bowl of warm water.
• Never boil breast milk.
• In case your work takes you away from home for a few days, you can freeze your expressed milk in small quantities. To thaw this milk, hold the container under running water. Then, gradually warm the milk in a bowl of hot water until it reaches room temperature. Never refreeze or refrigerate thawed milk.
• Allow the person who will be looking after your baby to practice feeding your baby your expressed breast milk.

Remember! In order to maintain your milk supply, you must either breast feed or express milk at least every 3 hours. Therefore, continue to breast feed your baby after office, at night and the days that you are not working and remember to express milk when you are at the office.

Follow this general principle: if you do not have to take medication, don’t. if you have to take medication, make sure your doctor knows that you are breast feeding and ask him or her to explain the possible effects on the baby. Many drugs are compatible with breast feeding. For example, if you are diabetic and take insulin every day, you can certainly continue to breast feed. But make sure your doctor knows you are breast feeding and helps you adjust your insulin dose accordingly.

1. Breast engorgement

Reasons:
If you do not position you baby properly and put your baby often enough to the breast, the breast will engorge. Your breast will become swollen, hard, heavy and painful. This can happen especially during the fist week after delivery.

Solutions:
Before feeding, gently express some of the milk to soften the breast. This makes it easier for your baby to grasp the nipple and areola. Also, feeding will be less painful for you. After feeding, if your breast is still hard, express the remaining milk and apply a cold compress for comfort. Wearing a supporting nursing bra is sensible.

2. Sore nipples

   Reasons:
   If the baby sucks only the nipple and does not take the areola or does not take part of it, this may cause sore or cracked nipples.

   Solutions:

   • Choose a position in which you feel relaxed and comfortable. Bring the baby towards your breast and not the breast towards the baby.
   • Make sure your baby takes the nipple with as much as possible of the areola into his or her mouth. The mouth should, therefore, be wide open and his chin should be touching your breast.
   • It is very important to keep on feeding in the correct position.
   • Let the baby suck the least affected or unaffected breast first. When the milk flows readily, change to the sore breast.
   • After feeding your baby, put the tip of your finger into the corner of the baby’s mouth. Then move your baby gently away from the breast.
   • Express some milk and apply it on the sore nipple to help it to heal. Avoid using soap, cream or lotion on the nipple.
   • Expose your nipple to air as much as possible. Avoid using a bra until the soreness has healed.
   • If the nipples are very sore, seek the advice of your doctor. In the meanwhile, keep on expressing your milk so that the milk production is maintained and your baby is continued to be fed.
3. Lack of breast milk

   Reasons:
   Your milk flow will diminish because of lack of stimulation due to the following:

   • If you do not let your baby suck as frequently as he or she wants to
   • If you start giving supplementary feeding too early or if you bottle feed
   • If you breast feed from only one breast

   Other reasons may be that you have a lack of confidence in your ability to breast feed or that you are emotionally stressed.

   Solutions:

   • Feed your baby as frequently as you can and as he or she wants to.
   • Try not to let more than 2 hours lapse between feeds.
   • Breast feed from both breasts.
   • Improve your diet. Eat more body building foods (like fish, chicken, meat, eggs, milk, nuts, peas and beans) and protective foods (like fruits and vegetables).
   • Have confidence in yourself!
   • Try to relax!

You need to get your positioning right. These are your posture, how you hold your baby and how your baby takes your breast.

1. Your posture
   • Make yourself comfortable: Your baby needs to be well supported. You may want to consider sitting up in bed, back well supported with baby’s head resting in the crook of your arm or sitting on a chair with your back supported.
   • Make sure you are not leaning back so that your breasts are not pulled away from your baby and out of his mouth while he tries to feed. Don’t hunch over either.
   • Use props for support. Have as many pillows, cushions, soft or firm supports (such as folded rugs or blankets as well as whatever you may want to support your feet) as you need, to support both you and your baby.
2. How to hold your baby
   • Is held close to you
   • Is well supported
   • Is facing you
   • Has his or her mouth just below your nipple as you prepare to feed
   • Has his head, neck and back all in a straight line

In summary, the important points to remember about how you hold your baby are that your baby:

Also make sure that the arms and hands do not get in the way as your baby goes to feed.

3. How your baby takes your breast
   • Gapes his or her mouth wide open
   • Takes as much as possible of the dark skin area around the nipple (the areola)
   • Your baby’s chin is against your breast
   • The mouth is open wide and the lower lip is pressed down and back against the chin
   • The nose lies right against your breast. Notice that the nose lies on the surface of your breast and he or she is free to breathe. You do not need to hold your breast away from the nose.

Make sure your baby takes your breast; do not try to give it to your baby or push your breast into the mouth. As your baby goes on your breast, check that he or she:

Once your baby is feeding well, this is what you should see:

When breast feeding is going well, your nipple will not be damaged, because it is so far back in the baby’s mouth that there is no friction against it. It is the friction that causes both soreness and damage to the nipple. This is why breast feeding shouldn’t hurt.