Breastfeeding seminars

People don’t make it easy to be a nursing mother, especially in Pakistan – Commentary

From well-meaning friends and family members giving “advice” to missing work opportunities, to the lack of safe spaces, the journey is not without obstacles.

“Are you still breastfeeding your baby?

“Yes!”

Kab tak karo gi [how long will you do this for]? You’re not tired ? Laga bottle do. Asani hojae gi [give a bottle. It’ll be easier].“

Yes, I’m exhausted. I have exclusively breastfed my child for 18 months now. He’s on a weaning trip and usually I’m only supposed to give him night feedings.

Indeed, it was a long, tedious and mostly lonely journey that is physically, mentally and emotionally demanding – and exhausting too. Nonetheless, it made motherhood healthy and satisfied the urge to give and do the best for my baby.

Breastfeeding is a path I chose for me and my baby, but it wasn’t easy. Strangely, I encountered a lot of opposition, I missed many opportunities and I was constantly advised”laga dou bottle [give a bottle]”.

Full disclosure – I’m not against bottle feeding. One day, I really wanted to give him a manger. I tried too. Yet my determination, my faith and my baby’s needs dominated everything. And as they say “Agar kisi cheez ko dil se chaaho to puri kayanat usey tumse milane ki koshish mein lag jaati hai [If you truly want something, the whole world tries to make it happen.”

What to expect when you’re expecting

We always see mothers carrying baby bags, calculating the formula to water ratio and shaking the bottles aggressively before handing them to their crying infants. There were a few instances, which I remember, of women nursing their children, but not many in public spaces and if at all in public, I remember people feeling awkward about it.

In May 2020, I conceived my first child. It was a surprise conception during a pandemic; I was in uncharted territory and didn’t want the journey ahead to be unfamiliar. I went ahead, took matters into my own hands and started vigorously researching everything pertinent to pregnancy, motherhood and Covid-19.

Facebook groups, books such as What to Expect When Expecting and apps like Baby Center became my friends.

Priorities straight, I made lists of things I would need and want for my baby. Oddly, baby bottles were one of the very first items on the list because a baby needs the best nourishment to survive and mothers’ milk can only do so much, right?

I imagined I would feed him for about six months then my milk would dry up, as I often heard would happen. I invested in the right bottles; the colic type, the close-to-nature ones, the ones whose nipples resembled breasts and whatnot. I also researched the best formulas in town and every time I would go through the ingredients it would say closest to nature, as close to the mother’s milk as possible with added nutrients.

It struck me as odd at times.

We are constantly bombarded with promotions of formulas, diapers and the best baby food (even though some countries have banned such advertisements). Consequently, whether you have a kid or not, you are compelled to believe that this is the best for infants.

Being someone who tries her best to eat healthily, not have fizzy drinks or add unnatural items to my diet and avoid increasing my carbon footprint — the ingredients and assurances on these formulas weren’t inviting.

It wasn’t until I joined some breastfeeding groups on Facebook, via some mommy groups, that my world flipped and I realised that if I like to eat clean, why would I choose otherwise for my offspring? For the safest, healthiest growth of my child, nursing was the best way forward.

In Pakistan, only four in 10 babies are exclusively breastfed for the first six months. According to Unicef, Pakistan has the lowest ratio among developing countries.

The benefits of breastfeeding for children and mothers are multifaceted. They are time and again proven by science and religion. It not only improves the bond between the mother and child, but it also aids healthy brain development, protects infants against infection and decreases the risk of obesity and diseases, not to forget the reduced medical costs and protection against ovarian and breast cancer.

It can also combat new infections and diseases.

Here began the journey to understand how breastfeeding works.

Delivery plan

While shopping, I made sure we had no formula at home. Not only did it cut the budget but also “na rahega baas na bajegi bansuri [treating an issue at the source]”.

While I made sure my gynecologist and my husband knew how I wanted to give birth, I also shared my wish to have skin-to-skin contact and breastfeed at birth.

I was surprised to find that in a country that offers more 18,000 babies every day, there were no lactation specialists in the hospitals. Nurses have been “trained” to guide new mums, but breastfeeding isn’t taken seriously here. While it’s supposed to be the most natural thing, I believe that due to the lack of attention to the process, it has drastically diminished in the country.

After giving birth, I was indeed confused, yet I kept asking for my baby, for skin-to-skin contact, but he was taken away to be cleaned. A nurse came after I was stitched up to check if I was breastfeeding. I was not. They gave my baby, Kian, a bottle, even though I kept asking for it. I knew from Facebook groups that breasts are not supposed to be squeezed to let out milk, especially right after birth. Only proper latching and sucking will send signals to your body to produce milk. Also, in the early days, colostrum or golden milk is produced, which strengthens the baby’s immune system.

I was able to see my baby about two hours after birth after he was given formula. He cried a little later that night and when I tried to feed him it was easy. I thought he was clinging to me and feeding, but he was barely suckling and he was so small. He slept for quite a while and wouldn’t wake up to feed even though the nurses kept trying. After a while I was told that my child’s blood pressure was low and we needed to give him formula. Therefore, he once again received a formula.

I was back home within 24 hours of delivery. That’s when I was tested. Fortunately, my in-laws and my husband were on board, and a crying child and an agitated mother did not irritate anyone. I was supported immensely as I tried to figure out what was required. It took me a week of feeding him like clockwork, locking him down properly with engorged, sore, sore breasts, a crying baby and no sleep to figure out the method. After many sleepless nights (which is common after giving birth), we have finally embarked on a healthy breastfeeding journey. Yet, I did not know that I would have to face many more obstacles.

Pumping

Babies should not be introduced to the bottle during the first six weeks to avoid nipple confusion, yet I knew I had to go back to work at some point, which meant at least eight hours without a feed. This is impossible for a baby under one year old, so he must be bottle-fed, cup-fed or spoon-fed. I started pumping and storing milk, but it wasn’t enough at first. When the baby feeds alone, the withdrawal is much greater than with the breast pump.

Fortunately or unfortunately, my baby never accepted the bottle – I had to resort to spoon or dropper feeding, which felt more like work than relief.

The lonely road

I quickly understood that Pakistan was not a mother-and-baby friendly country. Roads have no zebra crossings, no ramps for strollers, restaurants, malls and parks barely have baby chairs or changing tables and there are no mother-friendly spaces to feed the children. The lack of space for women in Pakistan has always been a topic of debate and I have seen those spaces shrink for me as a mother.

I remember standing up and feeding my two month old baby in the toilet at Nadra’s office because the stalls were disgusting and there was nowhere else to go.

My partner in crime has since become a power blanket that I bought and was my best buy ever. With great courage, a bit of shamelessness, and my husband’s support, I started breastfeeding in public—with the blanket of course. I started wearing looser, more manageable clothes in public.

Yet I left the house less – shopping, eating out and meeting people became tedious tasks. We would visit friends less often as I would have to find nooks even in private spaces to feed my child. Even in my own house, if we had guests, I would rush into the bedroom to breastfeed. He became lonely and no one could do much to help me.

The test started when I took a draft three months after giving birth. I flew to Karachi for my first concert as a mother. I was looking forward to taking the first flight alone with a newborn, but luckily skin-to-skin and breastfeeding soothe babies. Because Kian was young, he slept through the flight – and back.

The job was to write about a marginalized community in Pakistan. I had to interview people in rural areas, places far from the city or crowded places in the city. At odd hours, in the summer heat of Karachi, anything that wasn’t very baby-friendly was in play, right from the first job. Fortunately, I had family to take care of my child and travel with me while I worked. Kian was breastfed between and during the interviews and accompanied me to each location. But it wasn’t easy.

My work requires the utmost attention to detail, environment and people’s feelings to accurately convey the matter. With a baby who has her own needs and no situational awareness, things can get tricky and did I mention mom brain?

I realized that people treated me differently in different strata of society. In disadvantaged neighborhoods, I was welcomed and put at ease. They realized that I am a working mother who has to support her child, but in more affluent circles, I was always told to give her a bottle to make my life easier.

In September 2021, I enrolled in a master’s degree. My child was seven months old and had just started weaning. Fortunately, the university was welcoming and helpful. I hired a nanny who would look after him in the common room and call me between classes when he needed food. He fed once every two hours or so.

Something happened once during an exam that reminded me of how un-mom-friendly our country is. We weren’t allowed to have phones on us during exams and from the first hour I heard my son crying. I had to ask the proctor to let me feed him and I fed my child right outside the exam room that day.

Still, it gets easier as the streams spread. Soon those around me also realized that this was part of the package and if I was invited or wanted, the baby and feedings would come with me too.

When Kian was eight months old, we went to Skardu as a family. He was older, in withdrawal. This trip made me thank my stars for being a breastfeeding mom. We were hassle free, problems finding hot bottled water, sterilizing bottles and taking formula with us. I could feed him anywhere, without worrying that he would get sick. We fed near the mountains, in the lake, in jeeps, trucks – wherever it was needed.

It took me a few months of struggles, challenges and failures, but I had a healthy baby. It’s a tough journey, especially when you’re constantly being told you’re wrong. There will be days of relief, some will be hard, especially when your baby is teething and won’t let you go or move. Some days your baby may sleep through the night without nursing and you will wake up refreshed (a feeling that many miss), some days he may not need to breastfeed, just because, and you will feel unwanted.

We need to support moms who choose to breastfeed. I also realize that it was a luxury because I was stubborn enough not to give in to the pressure. I was also forced to miss opportunities and couldn’t work regularly. I wasn’t being considered for jobs because I was asking for a pump room, childcare allowance, and just the basic necessities a mother would need. We had to hire help so I could do what little I had to do.

Yet everyone is on their way. Join breastfeeding-friendly Facebook groups and let people around you know about its benefits. Contact a lactation consultant, especially if you are pregnant, and invest in learning. Educate yourself and see what works best for you, your situation and your baby.

Being a mother can never be a walk in the park, so whatever you choose, you’re doing well mom!