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All you need to know about Gestational Diabetes

All you need to know about Gestational Diabetes

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Did you know that gestational diabetes mellitus, also known as GMD, is one of the most common medical complications of pregnancy?

What is GMD? Why does it happen? Can you prevent it? Keep scrolling for answers.

So, let’s start with the basics. What is gestational diabetes?

Gestational diabetes is high blood sugar that develops during pregnancy and usually disappears after giving birth. Many hormones are involved in maintaining the blood sugar level. As the hormone levels fluctuate during pregnancy, they prevent the body from using insulin effectively, leading to insulin resistance. This causes  glucose  build-up in the blood instead of being absorbed by the cells. Typically, the pancreas can make additional insulin to overcome insulin resistance, but when insulin production is not enough to overcome the effect of the placental hormones, gestational diabetes results.

A study conducted by Kai Wei Lee et., found the prevalence of GDM in Asia was 11.5%. GMD can happen at any stage of pregnancy but is more common in the second or third trimester.

But why is that?

Scientists have not been able to identify the exact hormone that causes GDM in pregnant women. But, many scientific theories suggest that as the placenta grows, more and more hormones are released, which increases risk of  insulin resistance. Thus, symptoms of GMD are seen more often in the 2nd and 3rd trimesters. 

What are the symptoms of GMD?

Many women who have GMD do not show symptoms, but the most common ones are: 

  • Increased thirst
  • Urgency to pee more often
  • Dry mouth
  • Tiredness
Gestational Diabetes Causes

These symptoms are relatively common during pregnancy and not necessarily a sign of GMD. If you are pregnant and have noticed these symptoms, you should speak to a VOG doctor or a general physician, via oDoc who will provide a prescription for a lab test. You can carry out the lab tests from the comfort of you home via oLabs too. 

Who is at risk?

GMD can affect any woman, but a list of risk factors identified by scientists increases the chances of developing GMD. 

The risk factors include

  • Being overweight before pregnancy
  • Having a family  history of diabetes 
  • Being Prediabetic (if you have a blood glucose level higher than normal but not high enough to be classed as diabetic.
  • Having PCOS 
  • Being older than 25 as they are at a greater risk for developing gestational diabetes than younger women
  • Having high blood pressure, high cholesterol, heart disease, or other medical complications
  • Having  given birth to a large baby (weighing more than 9 pounds)
  • Having had a miscarriage

How does GMD affect the mother and the baby?

More often than not, women who have GMD go on to have normal pregnancies and deliver healthy babies. However, in other circumstances, GMD can lead to:

  • Macrosomia. This is where the baby grows very large as they absorb the excess glucose in the mother’s blood and convert it into fat and are deposited. This leads to difficulties during labour, causing doctors to opt for induced labour and c-section. 
  • Too much amniotic fluid (the fluid that surrounds the baby) in the womb can cause premature labour or problems at delivery, known as polyhydramnios.
  • Premature birth
  • Low blood sugar (hypoglycemia) in the baby after delivery. This happens because the mum’s high blood sugar level also causes the baby to have a high blood sugar level, and after birth, it no longer has the high level of sugar from its mother, resulting in the newborn’s blood sugar level becoming very low.
  • Obesity and type 2 diabetes later in life for babies. Babies of mothers with gestational diabetes have a higher risk of developing obesity and type 2 diabetes later in life.
  • Stillbirth. Untreated, gestational diabetes can result in a baby’s death before or shortly after birth.
  • Future diabetes for the mother. If you have gestational diabetes, you’re more likely to get it again during a future pregnancy. You also have a higher risk of type 2 diabetes as you get older.

What are the treatment options?

The American Diabetes Association recommends screening for undiagnosed type 2 diabetes at the first prenatal visit in women with diabetes risk factors. In pregnant women not known to have diabetes, GDM testing should be performed at 24 to 28 weeks of gestation. 

If you are found to have GMD, don’t worry, as it can be treated, and complications can be reduced. The doctor may ask you to monitor your blood sugar level often, exercise often, eat healthily and maybe give insulin injections if necessary. 

How is it prevented?

There are no guarantees for preventing gestational diabetes — but the more healthy habits you can adopt before pregnancy, the better.

So don’t forget to 

  • Eat healthy – Choose foods high in fibre and low in fat and calories.
  • Exercise often – Exercising before and safely during pregnancy can help protect you from developing gestational diabetes.
  • Start pregnancy at a healthy weight. If you’re planning to get pregnant, losing extra weight beforehand may help you have a healthier pregnancy.
Preventing Gestational Diabetes

If you are pregnant and experiencing any of the symptoms mentioned above or have any questions, you can speak to one of the Obstetricians, Gynaecologists or GPs on the oDoc app. Click here to download the app.

Sources 

  1. Alfadhli, E., 2015. Gestational diabetes mellitus. Saudi Medical Journal, 36(4), pp.399-406.
  2. Gestational Diabetes Mellitus (GDM). (n.d.). Johns Hopkins Medicine. Retrieved April 6, 2022, from 
  3. Gestational diabetes – Symptoms and causes. (2020, August 26). Mayo Clinic. 
  4. NHS website. (2021, November 29). Gestational diabetes. Nhs.Uk. 
  5. Lee, K.W., Ching, S.M., Ramachandran, V. et al. Prevalence and risk factors of gestational diabetes mellitus in Asia: a systematic review and meta-analysis. BMC Pregnancy Childbirth 18, 494 (2018).
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The First Trimester

The First Trimester

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Happy, anxious, nervous, scared, overjoyed and excited. These are just a few of the emotions you may experience when you first find out you are pregnant. If it is your first time you are definitely going to feel a bit confused and will resort to googling everything related to pregnancy. We have broken down everything you need to know about the first trimester of pregnancy in this blog. 

So what is the first trimester of pregnancy?

It is the earliest phase in your pregnancy. It starts on the first day of your last period and ends on the last day of the 13th week. During your first trimester of pregnancy, a lot of changes happen to you and the baby. So keep reading to find out what is in store for you

What are the changes happening in your body?. 

Due to the hormones released by the body,, many changes will occur during pregnancy. These changes help prepare you for the 9 months of pregnancy.

first trimester of pregnancy
  1. Swelling of breasts– caused by the mammary glands enlarging to prepare for lactation as a result of increased oestrogen and progesterone hormones secretion.
  2. Peeing more often – you will start peeing more often as your uterus grows and presses against your bladder.
  3. Darken and enlarged areolas – this is the pigmented area around your nipple. They may also become covered with small, white bumps called Montgomery’s tubercles (enlarged sweat glands).
  4. Mood swings – you may begin to experience severe mood swings which is caused by the surge in hormones. 
  5. Morning sickness – occurs due to increased hormone levels that is needed to sustain the pregnancy. Contrary to the name, nausea can occur at anytime of day. 
  6. Constipation – occurs as the growing uterus presses against your rectum and intestines.
  7. Heartburn and indigestion – the increased levels of progesterone can slow the muscular contractions in our intestines. 
  8. Extreme tiredness – caused as a result of the physical and emotional demands of pregnancy. 
  9. High heart rate-  caused by the increased cardiac output to supply enough blood to both you and your baby.
  10. Slight bleeding – About 25% of pregnant women have slight bleeding during their first trimester of pregnancy. Early in the pregnancy, light spotting may be a sign that the fertilized embryo has implanted in your uterus. If you have severe bleeding please seek medical advice urgently.
  11. Weight gain – this is due to a 40-50% increase in volume of blood in the body during pregnancy and storage of fat in the body which is later used for milk production. 

It is important to note that some symptoms of pregnancy continue for several weeks or months. Others are only experienced for a short time. Some women experience many symptoms, and some experience only a few or none at all. Everyone is different but that’s to be expected -you are unique! 

Now lets have a look at the changes your baby will go through. 

The most development occurs during the first trimester. During the first 13 weeks, your baby develops from a fertilized egg (embryo) into a fully-formed fetus. All major organs are formed during the first trimester of pregnancy. By the end of the first trimester of pregnancy, the fetus weighs approximately 0.5 to 1 ounce and measures, on average, 3 to 4 inches in length.

Here is what exactly happens: 

(Source: Johns Hopkins Medicine)

The fetus is most vulnerable during the first 12 weeks. During this period of time, exposure to drugs, radiation, tobacco and other toxic substances can affect the formation of the major organs and body systems. 

So what do you need to know while visiting the doctor during the first trimester?

As soon as you find out you are pregnant, make an appointment with your VOG doctor so you can start caring for the baby. You should see your doctor once a month but it is better to discuss this with your VOG doctor. 

During your first visit the doctor may: 

  • perform an ultrasound to confirm the pregnancy
  • perform a Pap test
  • take your blood pressure
  • test for sexually transmitted infections, HIV, and hepatitis
  • estimate your date of delivery or “due date,” which is around 266 days from the first day of your last period
  • screen for risk factors like anemia
  • check thyroid levels
  • check your weight

If you experience any of the following please seek medical help immediately: 

  • Severe abdominal pain
  • Heavy bleeding
  • Severe dizziness
  •  Rapid weight gain or too little weight gain

It is also recommended you start building out your birth plan early on during your pregnancy. To know more about how to create your birth plan click here. You can also consult a VOG doctor at any time and from the comfort and safety of your home via the oDoc app.

 

Source

  1. Bhargava, H. D. (2020, July 16). First trimester of pregnancy: What to expect, Baby Development. WebMD. Retrieved December 15, 2021, from https://www.webmd.com/baby/guide/first-trimester-of-pregnancy#3 
  2. Healthline Media. (2017, November 9). The first trimester of pregnancy. Healthline. Retrieved December 15, 2021, from https://www.healthline.com/health/pregnancy/first-trimester#other-considerations 
  3. The first trimester. Johns Hopkins Medicine. (n.d.). Retrieved December 15, 2021, from https://www.hopkinsmedicine.org/health/wellness-and-prevention/the-first-trimester 
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Birth Plans – what you need to know

Birth Plans – what you need to know

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Yes, Birth Plans are a thing and it is also very useful to have one. 

If you are approaching your third trimester the chances are you have already given a lot of thought to childbirth and all the options available to you. It is vital you write your preferences down and share what your preference for labour and delivery is with a loved one. This should be done well in advance because whilst you are going through labour it will be quite a task to make decisions in the middle of, you know, all the pain and hormones and stuff. Having a birth plan in advance will help you focus on the most important thing on the day – bringing your new baby into the world. We have broken down everything you need to know while creating your birth plan. 

Before we proceed, let’s go through the basics quickly. 

What is a Birth Plan?

A Birth plan is a written, typed or even drawn document which states your preferences during labour, delivery and after childbirth. It’s similar to a wish list, for example, where you can list out who you want with you in the room while you are in labour, or if you want pain meds, dimmed lights in the room, background music and other preferences. You can add anything you wish to make your delivery day as comfortable as possible. 

However, it is important to keep in mind that unexpected things can happen during labour so it might be quite difficult to follow your birth plan to the T. 

So how do you create a birth plan?

First, start with the basics. Include your

  • Name 
  • Age 
  • Brief medical history like chronic medical conditions, medicine allergies etc.

Here are a few other things you should consider when adding to your birth plan: 

Location

Where do you want to give birth? At home or at the hospital?

State your location so everyone is aware of where they need to take you when the labour pain starts.

Atmosphere

Who do you want around you when you are giving birth? Do you want a spacious room so you can walk around? Do you want a TV to help you calm down? Would you like music to be playing in the background – if so what playlist?

Listing these preferences out will help your loved ones set the atmosphere to your liking. 

Birthing positions 

Would you like to give birth on a birthing bed or stool or ball? 

There are many positions you could try if you opt for a birthing bed. Some are listed below. 

  • Lying down: On your back, with your head flat or elevated, and your legs elevated
  • Side-lying: With one leg elevated (this is good if you’re tired or if your blood pressure levels are fluctuating)
  • Kneeling: On the lower part of the bed with your arms or upper body resting on the upper section (this posture helps ease the backache)
  • All fours: With your stomach facing down, supported by your hands and knees (helps ease backache)
  • Squatting: On your feet, with support from bed or partner (this position takes advantage of gravity and shortens the depth of the birth canal)

It is good to know the different options so you can experiment with these during childbirth easily. Please note that in Sri Lanka these positions are not practiced regularly but do talk to a VOG if you’d like to explore these positions.

Pain management 

An important component of childbirth is pain management. It is common to be confused about whether or not you should take an epidural. Please note that whatever you choose in the birth plan, you can always change your mind on the day. It is advised you discuss the pain management options available to you with your VOG doctor well before your due date. A few examples of questions you can ask are listed below: 

  • What are my choices?
  • What is the risks of taking an epidural?

 

Delivery

Expecting mums, it’s never too early to discuss this with your VOG doctors. Have a think about if you’d like a normal vaginal birth or a C-Section. Other important things to consider are: 

  • Would you like your partner to cut the umbilical cord? 
  • Would you like to opt for an episiotomy (an incision through the area between your vaginal opening and your anus to make your vaginal opening larger for childbirth) or only do it if medically required? 

Feeding after the baby is born

How do you want to feed your newborn – breastfeed or bottle-feed? It is important to let your doctors and caregivers know this beforehand. 

The above list might seem obvious, but under the pressure of labour, the raging hormones and pain, it will be difficult to communicate your choices. So we encourage you to build your birth plan well in advance and share it with your partner and most importantly your VOG doctor so they know what your preferences are when it comes to labour and delivery.   

If you would like to discuss your birth plan or would like some guidance on how to build it, you can speak to a VOG doctor via oDoc from the comfort and safety of your home.

Source

  • Dailey, K. (2012, June 8). How to Create a Birth Plan. WebMD. Retrieved November 19, 2021, from https://www.webmd.com/baby/guide/how-to-create-a-birth-plan#1

  • NHS website. (2021, November 18). How to make a birth plan. NHS UK. Retrieved November 19, 2021, from https://www.nhs.uk/pregnancy/labour-and-birth/preparing-for-the-birth/how-to-make-a-birth-plan/

  • Dorfner, M. (2018, November 7). The Importance of a Birth Plan. Mayo Clinic. Retrieved November 19, 2021, from https://newsnetwork.mayoclinic.org/discussion/the-importance-of-a-birth-plan/

  • Slide show: Labor positions. (2021, February 23). Mayo Clinic. Retrieved November 19, 2021, from https://www.mayoclinic.org/healthy-lifestyle/labor-and-delivery/multimedia/labor/sls-20077009?s=9

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Am I Just Having “Baby Blues” Or Do I Have Postpartum Depression?

postpartum depression

Am I Just Having “Baby Blues” Or Do I Have Postpartum Depression?

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You’ve just given birth. You’ve created a new life. Your body and mind have gone through a huge transformation over the last nine months. And now you have this whole other tiny human being that you need to care for and nurture. Obviously, you cannot go back to regular scheduled programming and you shouldn’t have to!

Even if you’ve been waiting so long for your baby and it is everything you’ve ever wanted and dreamed about, you are still bound to feel overwhelmed, emotional and maybe even moody. Let us shout it from the rooftops: THIS IS COMPLETELY NORMAL AND VERY COMMON FOR NEW MOTHERS.

Postpartum “baby blues” are extremely common. You’re operating on very little sleep, your hormones are on a rollercoaster, you’re adjusting to the realities of parenting a new baby so it’s no wonder you’re experiencing mood swings!

postpartum depression

But still you might be worrying about whether it is normal to feel this way. You might be wondering if this low feeling will go away in a few days or if you have something more serious, such as postpartum depression.

Symptoms of “baby blues”

  • Anxiety
  • Irritability and grumpiness
  • Exhaustion
  • Feeling joy and happiness one minute and then sadness the next
  • Unsure of your ability to take care of your baby
  • Trouble eating and taking care of your own health

How long are “blues” expected to last?

One important distinction between the “baby blues” and postpartum depression is that the “baby blues” are temporary. You are most likely going to experience “blues” for the first few days after giving birth. Symptoms that last more than two weeks might signal that you could have potentially developed postpartum depression and it is time to have a discussion with your doctor.

Symptoms of postpartum depression

  • Anger and irritability
  • Extremely low energy and wanting to sleep all the time
  • Feeling numb and disconnected from the people around you
  • Feeling you’ve failed as a mother
  • Thoughts of self-harm and thoughts of harming your baby
  • Crying excessively
  • Trouble bonding with your newborn

Postpartum depression does share many of the same moodiness as “baby blues” but symptoms are usually more intense and disturbing.

baby blues

Treatment for “baby blues”

Just because postpartum blues are very common doesn’t mean it’s easy to go through. Here’s what you can do to cope.

  • Assure yourself that what you’re feeling is completely normal and is experienced by all new mothers
  • Sleep as much as you can, which means sleeping when the baby is sleeping, or having your partner or family member look after the baby for an hour while you nap
  • Eat healthily and regularly
  • Exercise can do wonders! Even if its just a walk outside.
  • Talk about what you’re going through with loved ones or other mums
  • Don’t be hard on yourself if you don’t have the energy to do housework or other chores. You just had a baby!

Treatment for postpartum depression

If your baby “baby blues” don’t ease up after 2 weeks or if you’re experiencing symptoms of postpartum depression, don’t wait till your next check up with your doctor. Get in touch right away.

You may feel ashamed or embarrassed that you’re feeling this way, especially after this magical thing has happened in your life but you’re not alone with these feelings. 1 in 5 women experience postpartum depression after childbirth. Your doctor may recommend medication and/or therapy. You can also make healthy choices in your lifestyle such as:

  • Talk to people you trust about what you’re going through
  • Cut back on other errands. Use your energy to take care of basic needs for you and your baby
  • Build community by speaking to other mothers, joining a depression support group or just reach out to trusted friends and family. Fight isolation.
  • Rest whenever you can. Reach out to close friends and family to take the baby shift so you can sleep for a few hours. This does not mean defeat.

Causes of postpartum depression

The exact cause isn’t clear but experts say that postpartum depression may be triggered by both physical and emotional factors.

  • Hormonal changes – While you’re pregnant, your levels of estrogen and progesterone are higher than usual. After you give birth, these hormone levels drop significantly. Such a drastic change in hormones can contribute to postpartum depression.
  • Sleep deprivation
  • Not eating meals at regular hours or eating an unhealthy diet
  • Social isolation
  • Underlying medical conditions
  • Alcohol and drug abuse

Risk factors of postpartum depression

Any new mother can experience postpartum depression after childbirth, even if its not their first baby. However, your risk increases if:

  • You have a history of depression
  • You’ve had postpartum depression after a previous pregnancy
  • You’ve had family members who’ve had depression or other mood disorders
  • You’ve experienced stressful events recently
  • You have difficulty breastfeeding
  • You have a weak support system
  • The pregnancy was unplanned or unwanted

Speak to a doctor on oDoc if you think you might be having the above symptoms. This is a judgement-free zone where your doctors will NOT shame you and will only help you to feel better. Click here to download the app. 

References:

  • Is It Postpartum Depression or ‘Baby Blues’?, 2021, WebMD
  • Do I have Postpartum Blues or Postpartum Depression, 2020, VeryWell Family
  • Everything You Need To Know About Postpartum Depression, 2016, Healthline
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We Need To Stop Saying Breastfeeding Is “Easy”

breastfeeding is hard

We Need To Stop Saying Breastfeeding Is “Easy”

And focus on supporting mothers instead

Nicole Parakrama | BSc Hons Molecular Cell Biology, UCL (UK) | 14th August 2021 |
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Just recently, we all tuned in to watch the Olympic Games held in Tokyo. We admired the beautiful performances of the athletes, and we acknowledged and celebrated all the sacrifices, hard work and preparation that led up to that day.
breastfeeding

What if we viewed breastfeeding the same way?

What if instead of glorifying only the ‘highlights reel’ of breastfeeding, we all agree that breastfeeding needs education, preparation and hard work to get through the first few weeks. What if we supported and empowered mothers on this journey filled with sacrifices and challenges and collectively took responsibility for it? What if we celebrated them loudly and genuinely when they achieved their goals?

The recently concluded ‘World Breastfeeding Week’ was triggering for a lot of mothers. For many women, any mention of breastfeeding brings back feelings of pain, anxiety and a lack of support. It serves as a reminder of the guilt and shame that they felt for stopping breastfeeding, the feeling that their bodies weren’t doing what they were meant to do.

Changing the Messaging

A Sri Lankan mum recently told me:

“Breastfeeding is hard… everyone tells you how painful labour is and how difficult pregnancy is, but no one tells you how hard breastfeeding is! All you see are images of moms with babies on their breasts and they make it look like it’s the easiest thing!”

Amy Brown, Professor of Child Public Health, Swansea University says: “When we gloss over the realities of breastfeeding, women feel unprepared for what it’s really like. If we tell women to expect easy, and they hit a hurdle, they may think they’re doing something wrong. . Women then end up depressed, blaming themselves, thinking they didn’t try hard enough because after all, isn’t breastfeeding easy?”

Without swinging towards ONLY the positive or the negative, perhaps the good, the bad and the ugly all need to be portrayed together. We need to find a balance.

So what are the benefits of breastfeeding?

  • We sometimes refer to breastmilk as “liquid gold”! Mums often joke that breastmilk is the cure for nearly everything:baby acne, sore eyes, heat rash,eczema and healing our cracked and sore nipples.
  • The composition of breastmilk is biochemically and nutritionally complete, giving numerous long term and immunological advantages.. It protects from infections, diarrhoea, UTIs, and chronic diseases like diabetes, childhood cancers, obesity, inflammatory bowel disease, asthma and allergies. In preterm babies, it reduces the risk of sepsis and necrotising enterocolitis (NEC).
  • For mothers, it has been proven to reduce the risk of hypercholesterolaemia, diabetes, hypertension, cardiovascular disease, as well as reduce the incidence of breast and ovarian cancer and osteoporosis. It stabilises endometriosis and confers partial contraception.
  • The process of breastfeeding stimulates the release of oxytocin, the bonding chemical. Babies don’t only breastfeed to eat, but also to help themselves settle: it provides them comfort and helps them regulate their emotions.
  • From a practical standpoint, breastfeeding is free and convenient! No stumbling around in the dark to boil water and prepare a bottle! Your baby has access to fresh milk straight from the source.

OK, I’m convinced of the benefits. Now hit me with the challenges of breastfeeding!

Here in Sri Lanka, we are seeing a rise of an ‘Instagram mum brigade’ who raise awareness on issues surrounding motherhood whilst sharing experiences and building community. They are finding their voices and being the support that they wished they had as new mums.

One of these Instagram mothers, Ameena (IG handle @raisingimaan) – expresses the challenges of breastfeeding so beautifully in a recent post. She said:

“Breastfeeding isn’t simply putting a breast into a baby’s mouth and transferring milk. It is SO MUCH more than that. And women pay for it with a unique currency of time, commitment, energy, mental and physical health, as well as bodily autonomy. That’s a massive price to pay. And to tell women that it’s all on themselves alone to manage. Frankly, it’s quite a raw deal”.

sore nipples
  • The first few weeks of breastfeeding, in particular, require a considerable investment of time. It IS time consuming, and new mothers can feel that all they do in the early days is feed!
  • In addition, the breastfeeding technique can take a bit of practice to get right. Mums need to experiment with different holds and find solutions for attachment and positioning issues.
  • There are potential physiological challenges, such as sore/cracked nipples, breast engorgement, blocked ducts, and mastitis/abscess which mums may have to navigate.
  • Feeling like there is not enough milk can be a significant challenge for many mothers in their breastfeeding journeys. However, as I have written about in a previous article, this is mostly a perception issue. In as many as 95% of cases, it is easily surmountable with the proper support.

How important is it to have a supportive community?

I cannot stress enough the huge role a supportive community plays in successful outcomes for breastfeeding. In “the fourth trimester”, women adjust to being mothers just as much as their babies adapt to life outside the womb. This postnatal period seems to be universally defined as 40 days.

Kimberly Ann Johnson, author of the book “The Fourth Trimester” says:
“Everything that a new baby needs, a new mom needs. So you know a new baby needs swaddling, you know a new baby needs a constant food source, you know a new baby needs eye contact, you know a new baby needs soothing. That’s everything a new mom needs.”

But the best way of caring for a breastfed baby is to care for their mother. Feed her, love her, support her by taking care of other stuff. Do housework, run errands, look after older children. The same goes for supporting women who are bottle feeding.

How can we as a society make breastfeeding easier for mothers?

As a society we can further encourage breastfeeding mothers when it comes to feeding in public. Public bathrooms are not acceptable places to feed infants! Establishments can train their staff on how to respond compassionately to a mother whose infant needs to feed, and to take a step further to provide a private space in which to do this, if required. Far too often this is left to the discretion of the staff, and so mothers have mixed experiences. Just one negative experience can be a huge setback to a mother’s breastfeeding journey, making her feel that she has to stop breastfeeding in order to leave the house and ‘have a life’.

Alongside all of this, the government MUST step up and make things easier for new families. In 2018, a significant amendment to the Shop and Office Act was passed in Sri Lanka which mandated the “provision of nursing intervals for nursing mothers” (previously only mandated in the state sector, although sometimes practiced informally in the private sector). This means that working mothers are now entitled to 2 paid feeding breaks of 1 hour per working day until their child is 1 year old.

This is a significant step forward – however longer, better paid leave for both mothers and fathers, as per the Swedish model, would do wonders for the well-being of the whole family, and in increasing breastfeeding figures.

If you are a new mum and are having trouble breastfeeding, you can speak to a doctor on oDoc. You can video call them from your home, baby in hand, even while breastfeeding! You can download the app here.

HOW I BECAME ‘THE MILK COACH’

When my first child was born, I was quite unprepared for what lay ahead. Particularly when it came to breastfeeding… I was naïvely expectant that I could just place him onto my chest, and let nature take its course. What a surprise I was in for! Cracked nipples from sub-optimal positioning, and my milk taking its own sweet time to come in, led to terrible pain. This pain became excruciating when my son developed oral thrush which travelled into my milk ducts. Fortunately, thanks to a lot of research and some wise mummy friends, I was able to power through the awful first few months. Most crucially, I was able to advocate for myself with health professionals, when the ‘system’ didn’t really support me.

This birthed a passion to counsel, support and advocate for my fellow Sri Lankan mums. To this end I am working to add to a science background (in Molecular Cell Biology) with an accreditation by La Leche League International (LLLI). My heart is to help YOU to achieve your breastfeeding goals – whether that is one week, one month, six months, or even a year and beyond.

Join the conversation, follow @themilkcoach on Instagram or Facebook.

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