Klinik Famili Gravidities

Breastfeeding & Lactation Medicine Services

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We Are The First Breastfeeding Doctors in Kuala Lumpur

Experience the Nurturing Expertise of Our Breastfeeding Doctors: With over two decades of clinical wisdom and a dedicated focus on breastfeeding spanning more than 7 years, our compassionate team has supported over 2000 mother-baby pairs, guiding them through a range of breastfeeding challenges. Additionally, we’ve provided gentle frenotomy (tongue-tie release) to over 500 babies, ensuring their comfort and peace of mind. Join our growing family of satisfied parents and experience the care that makes a difference.

Your Comprehensive Guide to Breastfeeding and Lactation Medicine

Breastfeeding and Lactation Medicine is becoming more recognised as one of the medical discipline. It is a specialised field that protects, supports and manages breastfeeding, lactation, and human milk feeding through science and evidence-based medicine. Klinik Famili Gravidities believes that combination of medical and lactation knowledge are important to our mission of helping families reach their own infant and child feeding goals. Here we share some of the common and special breastfeeding challenges. For those who wish to adopt a baby, breastfeeding is possible through induced lactation. For expectant couples, taking an antenatal class to prepare for the upcoming birth and breastfeeding ensures a successful and wonderful breastfeeding journey. Apart from this, we also offer tongue tie assessment and frenotomy services.

Before the appointment, the mother will be given an online breastfeeding intake form to fill up. This is to prepare the breastfeeding doctor / lactation consultant ahead for the breastfeeding consultation. During the appointment, the mother, father and/or baby will meet one-on-one with a lactation consultant or breastfeeding doctor to go over the concerns and breastfeeding goals. Breastfeeding and/or breastpumping will be observe. Troubleshooting, practical and discussion will be done. The visit generally take about one hour. Fees starts from RM130 with a breastfeeding doctor and from RM180 with a lactation consultant. Contact us for an appointment today.

One may be very far from our clinic. Yes it is possible to seek help via online consultation with our Breastfeeding Doctors or Lactation Consultants. However, there may be limitations to what can be helped through online. Education on breastfeeding may be suitable via online. nevertheless, getting help as soon as possible may prevent problems from escalating to worsening conditions. Contact us to book an online consultation today!

Ultimately, a home visit from a lactation consultant/counselor can be beneficial whenever a mother feels uncertain, overwhelmed, or is encountering challenges that are impacting her and her baby’s breastfeeding journey. Some mothers prefer the convenience of receiving breastfeeding support in their own home, especially during the early postpartum period. It’s a way to receive personalized guidance and support in the comfort of her own environment. Lactation Consultants or Lactation Counselors may come to address the concerns. Before the visit, the mother will be given an online breastfeeding intake form to fill up. This is to prepare the lactation consultant / lactation counselor ahead for the breastfeeding consultation. During the visit, the mother, father and/or baby will meet one-on-one with a lactation consultant or lactation counselor to go over the concerns and breastfeeding goals. Breastfeeding and/or breastpumping will be observed. Troubleshooting, practical, and discussion will be done. The visit generally takes about two hours. Fees start from RM350 with a lactation consultant and from RM250 with a lactation counselor. Contact us to arrange a home visit today.

Breastfeeding Medicine Doctor, Lactation Consultant, Lactation Counselor, and Breastfeeding Peer Counselor are all professionals who provide support and guidance to breastfeeding mothers, but they have different levels of training and expertise. Breastfeeding medicine doctor are those who utilised their medical training with additional advanced training or experience in breastfeeding management and lactation disorders. Most of these doctors have achieved certification with one or more of the credentials listed below:

  • A Lactation Consultant is a healthcare professional, often with a medical background (such as a nurse or a doctor), who has undergone extensive training in breastfeeding management. They possess in-depth knowledge of lactation, breastfeeding difficulties, and various medical conditions that can impact breastfeeding. Lactation Consultants are qualified to work with complex cases and provide clinical assessments, diagnosis, and treatment recommendations. Referral may be appropriate for complex problems, such as establishing supply and transitioning to feeding preterm infants, inadequate infant weight gain, and anatomic or medical issues in the mother or infant that may affect breastfeeding. These professionals are known as International Board Certified Lactation Consultants (IBCLC).
  • A Lactation Counselor (LC) can provide valuable assistance to new mothers with basic breastfeeding concerns and offer education and encouragement. They have the skills to provide breastfeeding counseling; to address normal breastfeeding in healthy, term infants; and to conduct maternal and infant assessments of anatomy, latch, and positioning while providing support to families in community settings.
  • A Breastfeeding Peer Counselor (BPC) is a person who has personal breastfeeding experience and has undergone training to offer support to other mothers within their community. They are often mothers who have successfully breastfed their own children and are trained to provide information, encouragement, and practical tips based on their own experiences.

 

In summary, while all the roles aim to support breastfeeding mothers, Breastfeeding Medicine Doctors and Lactation Consultants have the highest level of training and can address more complex issues, Lactation Counselors provide education and support, and Breastfeeding Peer Counselors offer assistance based on personal experience within a community setting.

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Having a baby is what most parents look forward to. However, sometimes, breastfeeding may not go as planned. Meeting with a breastfeeding doctor or lactation consultant can help to answer inquiries and work to solve the problems that come up. Common breastfeeding challenges include:

  1. Latching Difficulties 
    Ensuring a proper latch is crucial for effective breastfeeding. Poor latch can lead to nipple pain and insufficient milk transfer.

  2. Sore Nipples
    Tender, cracked, or bleeding nipples can occur due to incorrect latch, positioning, or friction. It may also be caused by nipple bleb or nipple thrush.

  3. Engorgement
    When breasts become overly full and firm, it can make latching difficult and lead to discomfort.

  4. Low Milk Supply
    Some mothers worry about not producing enough milk to satisfy their baby’s needs.

  5. Oversupply
    On the other hand, an oversupply of milk can lead to engorgement, fast letdown, and colic-like symptoms in babies.

  6. Blocked Milk Ducts
    A blocked milk duct can cause a painful lump in the breast.

  7. Mastitis
    An infection of the breast tissue can cause flu-like symptoms, fever, and pain.

  8. Breastfeeding Positions
    Finding comfortable positions for both the mother and baby can be a challenge.

  9. Returning to Work
    Balancing breastfeeding with work can be challenging, especially if pumping is involved. learn how to identify the best pump, fitting the right flange according to breast and nipples size, how to pump effectively, how to store the breastmilk, and how to prepare expressed breastmilk for caregivers.

  10. Teething
    Babies may start to bite during breastfeeding when they are teething.

  11. Nursing Strikes
    Sometimes babies may suddenly refuse to nurse for various reasons.

  12. Weaning
    Transitioning from breastfeeding to other forms of nutrition can be emotional and challenging. Remember that each breastfeeding journey is unique, and it’s important to seek support from lactation consultants, doctors, or support groups if you encounter challenges.

Certainly, breastfeeding comes with its unique set of hurdles, including:

  1. Premature Babies
    Premature infants might have difficulty latching and sucking due to underdeveloped muscles their small size and weaker sucking reflex. They might need specialized support to feed effectively.

  2. Multiples (Twins, Triplets) 
    Feeding multiple babies can be physically and logistically challenging, requiring careful planning and coordination.

  3. Medical Conditions 
    Both the mother’s and baby’s medical conditions can impact breastfeeding, such as babies with cleft lip/palate or mothers with certain medications. Breast Surgery: Previous breast surgeries can affect milk supply and breastfeeding positions.

  4. Breastfeeding After Surgery 
    Mothers recovering from surgeries might face challenges in breastfeeding positions and comfort.

  5. Nursing Aversions
    Some mothers experience discomfort or aversion during breastfeeding, often related to hormonal changes.

  6. Exclusively Pumping 
    Some mothers exclusively pump and bottle-feed breast milk due to latch difficulties, medical reasons, or personal preferences.

  7. Lactose Intolerance or Allergies 
    Babies with lactose intolerance or milk protein allergies might require specialized feeding plans.

  8.  HIV or Other Infections 
    Mothers with certain infections might need to take precautions while breastfeeding.

Every unique challenge brings its own intricacies and solutions. Finding guidance from dedicated healthcare professionals and expert lactation consultants, well-versed in these specific areas, can offer priceless assistance. Join our telegram group for parenting support. Click here to join.

Induced lactation refers to the process of stimulating breast milk production in a person who has not given birth to a child. This can be done for various reasons, such as adopting a baby or to provide breast milk for a baby whose biological mother may not be able to breastfeed. The process typically involves a combination of hormonal therapies, breast pumping, and regular stimulation of the nipples. It’s important to note that while induced lactation can be successful, the amount of milk produced may vary and might not be the same as that produced by a person who has given birth. Consulting a breastfeeding medicine specialist or lactation consultant is recommended for guidance and support during this process.

Relactation is the process of re-establishing breastfeeding after a period of not breastfeeding or minimal breastfeeding. This can be due to various reasons, such as medical conditions, separation, or personal choice. The journey of relactation involves a combination of techniques, including frequent and effective breast pumping, skin-to-skin contact with the baby, offering the breast whenever possible, and seeking guidance from a lactation consultant. While relactation can be challenging, it is often a rewarding experience for both the mother and the baby. It requires patience, commitment, and support, as milk supply can take time to rebuild. With the right approach and determination, relactation can provide valuable nourishment and bonding for the baby and mother alike.

Induced Lactation is possible for any women, from premenopausal to menopausal women. The act of breastfeeding by a women helps her to bond with her adopted baby. For Muslim women, induced lactation helps to create the breastmilk needed to achieve the mahram status in the adopted baby before 2 years of age.

Induced Lactation Package by Dr Nurzarina Abdul Rahman, Lactation Consultant – RM600. Consists of Consultation (3 times), Physical Examination, Blood test and ECG. What adoptive parents get from the consultations :

  1. Understanding how breastmilk is made
  2. Undergoing physical and mental preparation for the adoptive parents
  3. Knowing the effective way of pumping the breastmilk
  4. Knowing how to use nursing aid to breastfeed an adopted baby
  5. Choosing the best protocol for induced lactation.

The package price does not include medications if needed.

WHAT IS A TONGUE TIE?

During pregnancy, the developing tongue separates from the floor of the mouth. Sometimes this process is incomplete and some of the tissue remains – this is called a frenulum. If the frenulum interferes with the normal movement or function of the tongue, it is called “ankyloglossia”, or “tongue tie”.

HOW CAN A TONGUE TIE AFFECT BREASTFEEDING?

For a painless and effective breastfeeding, the baby must latch on deeply onto the breast with the mouth wide open and the tongue forward. The tongue then moves in a wave-like motion which stimulates the breast to release its milk and for milk to flow to the baby. A tongue tie can make it hard for the baby to do these things and may contribute to:

  •  Compressed or pinched nipples, nipple damage, soreness, and vasospasm pain.
  • Slow flow of milk from mother to baby.
  • Long and/or frequent feedings, decreased milk production and slow weight gain.
  • Nipple blebs, blocked ducts and mastitis.
  • Difficulty latching or maintaining the latch, clicking sounds, or loss of suction.
  • Difficulty coping with fast flow, pulling off, choking, sputtering.

How is a tongue tie assessed?

We assess all babies for tongue-tie as it relates to breastfeeding. We do this by:

  •  Asking the mother which breastfeeding problems is she experiencing.
  • Observing the mother and baby breastfeed.
  • Looking at the tongue frenulum and evaluating the movement (using a Hazelbaker Assessment Tool).

WHAT IS A TONGUE-TIE RELEASE?

If we believe that a tongue-tie is contributing to the breastfeeding issues, we will offer to release it. The procedure is called a “frenotomy”. Frenotomy takes only a few seconds and is done in the clinic during the appointment. Our Lactation Consultant will go over all the details of the procedure, answer any questions parents may have, and ask parents to sign a consent form. Releasing a tongue-tie often helps resolve breastfeeding problems but may need to be followed by post-frenotomy tongue and mouth exercises for at least 1 month.

The earlier a tongue tie is released, the more likely breastfeeding problems are likely to resolve. It should be released immediately once it is diagnosed.

The procedure can be done during any of your appointments at the clinic. Baby will be held securely by a clinic assistant. The doctor will lift your baby’s tongue firmly, exposing the frenulum and allowing for a precise incision. Using sterile scissors, the doctor will make a small cut into the frenulum followed by a quick push with her finger to release it completely.

Babies generally cry as soon as they are restrained and crying continues for varying amounts of time after the procedure is complete. Immediately after, the baby is offered the breast, with assistance as needed. Many babies latch and calm quickly while others take a little longer to settle. There is usually some insignificant bleeding, gauze and pressure are used if blood pools under the tongue or bleeding continues for longer than usual. Bleeding usually stops as the baby calms, especially if s/he calms at the breast.

The baby’s latch may feel different immediately or it may take a few days or longer for the baby to use his/her tongue differently and for the breastfeeding situation to improve.

Fees for assessment and frenotomy (only for babies below 6 months) – from RM250 onwards.

We recommend Breastfeeding Consultation for mothers with tongue tie babies as we may need to alleviate the breastfeeding problem after the frenotomy has been done. Consultation with our breastfeeding doctors starts from RM130.

 

Colic

Colic is a term used to describe excessive, often inconsolable crying and fussiness in infants, typically occurring in the late afternoon or evening. While the exact cause of colic is not fully understood, it’s believed to be related to a combination of factors, including immature digestive systems, gas, and sensitivity to stimuli. Colic usually begins around a few weeks of age and tends to resolve on its own by the time the baby is around three to four months old. It can be distressing for both parents and baby, but it’s important to know that colic is a temporary phase. Comforting techniques like gentle rocking, swaddling, and offering a pacifier can sometimes provide relief, but if you’re concerned, it’s always a good idea to consult a doctor to rule out any underlying issues.

Crying and Sleep Problem

Crying and sleep problems are common challenges parents face with their babies. Newborns communicate through crying, and it’s their way of expressing needs like hunger, discomfort, or fatigue. As they develop, their sleep patterns evolve, but disruptions can still occur due to growth spurts, teething, or changes in routine. Establishing a consistent sleep routine, creating a soothing sleep environment, and responding promptly to their cues can help improve sleep. However, occasional sleep disturbances are normal, and seeking guidance from doctors or infant sleep experts can provide valuable strategies to navigate these issues while ensuring both baby and parents get the rest they need. Learn about Dunstan Baby Language and HUG Your Baby methods.

Using babywearing to calm baby

Learn how to use babywearing, in particular a pocket-wrap to carry a newborn. The act of babywearing imitates the Kangaroo Mother Care approach which is used to expedite healing of premature babies. Babywearing has many benefits including bonding, calming baby, a great way to put baby to sleep, easing a colicky baby and helps mom to be hands-free while at home. It is also one of the useful steps towards bring baby back to breast in cases of nipple confusion and breast refusal. Pocketwrap consultation starts from RM35.

Bottle strike (refusing bottle feeding)

For parents who plan to put their baby with a caretaker before going back to work, they may face difficulties feeding baby using bottles and other alternative methods. Come and learn the Responsive Bottle Feeding method to help transition baby to bottle feeding with Expressed Breastmilk (EBM). This may help to alleviate mother’s concern about baby drinking their EBM with ease while mother is at work.

Parentcraft education, also known as prenatal or antenatal education, is a form of education and support provided to expectant parents to help them prepare for childbirth, newborn care, and the early stages of parenthood. It aims to empower parents with the knowledge and skills needed to navigate pregnancy, childbirth, and the postpartum period more confidently and effectively.

Gravidities has been conducting classes for expectant parents and breastfeeding families since 2015. Parentcraft classes are often conducted by our doctors who are specialised in childbirth education, emergency and many other certifications. These classes can be offered in various formats, such as group sessions, one-on-one consultations, or online courses. Attending parentcraft education can help parents feel more informed and empowered as they approach the journey of parenthood, leading to more confident decision-making and smoother transitions during the perinatal period.

Calm Birth Class : Special 4-hour Childbirth Preparation Class

Who should come?
First time expectant couples, mothers going for VBAC (Vaginal Birth After Caesarean), anyone who has fear of birth.

When is the best time to learn?
After entering 2nd trimester or after 20 weeks of pregnancy.

What do you learn?

  1. Prepare a positive mind about birth.
  2. Knowing how the body works in labor.
  3. Identifying signs of labor.
  4. Practicing special breathing techniques.
  5. Tips to manage contractions without painkillers.
  6. Learning about Mother-friendly care and preparing birth plans.
  7. Staying fit during pregnancy.

 

Bonus
Live childbirth video, How to start BF after birth, and practical on labor positions.

Fees
RM250 / couple

Speakers
Dr Nurzarina Abdul Rahman (CBE & IBCLC) and other invited speakers.

Babies and Breastfeeding Class : A 4-hour class for pregnant couples or anyone who wants to learn about basics of breastfeeding and baby care.

When should you learn?
After the 2nd trimester or anytime during breastfeeding.

What do you learn?

  1. The benefits of breastfeeding.
  2. Understanding how breastmilk is made and how BF happens
  3. Tips to ensure baby gets enough milk
  4. Techniques of breastfeeding
  5. Common challenges and how to overcome it.

 

Bonus

  1. Understanding baby’s cry .
  2. Introduction to HUG Your Baby.
  3. Immunisation for baby.

 

Fees
RM250/couple

Speakers
Dr Nurzarina Abdul Rahman (IBCLC) and other invited speakers.

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