We moved back to Japan when my son was one week short of turning 2 months old. At that point I was still a complete wreck breastfeeding-wise. It seemed I was constantly on the verge of mastitis and could never get rid of the clogged ducts and my nipples were so badly damaged I thought the left one would break into two halves and the outer part would fall off. I couldn't wear bras or any clothing tighter than a loose T-shirt as the feeling of chaffing was just too much to bear; and the morning engorgement was so intense and painful that it felt like I could easily break walnuts with my breasts if I wanted too.
Back in North America I visited lactation consultants and was given a lot of useful advice on how my baby should latch properly to minimize the damage for me and to increase his milk intake as at first he would only take the breast using a nipple shield which it took us about 6 weeks to transition from. Although I know that my experience is not unique and, as my nurse at the hospital where I delivered said, most of the women she sees do have some sort of issue with breastfeeding, it still feels overwhelming even remembering about it now. I believe that more information about the challenges of breastfeeding should be out there in line with the usual "breast is best" slogan to prepare future moms for the upcoming and help them feel less shocked when the experience does not progress as smooth and natural as they read it should too. In our case I think a lot of problems happened because I could not breastfeed my son right away. He was taken to the neonatal nurseries and given a bottle and I had to pump with a hospital-grade pump for 3-4 days before I could finally have him at my chest, and at that point he was already too used to the bottle to be able to take the breast straight. The pumping experience didn't go smooth either. Although it thankfully ensured the milk supply while my son couldn't yet feed, it also created the initial damage that, together with my son's improper latch later on, lead to the cracks that took too long to heal.
Our flight back to Tokyo took 12 hours and by the time we arrived to Narita Airport my husband and I were beyond exhausted. We were extremely happy that our little one seemed very fine and much less tired than both of us though - he was highly cooperative during the whole flight too. Tiredness lead to some irrational decisions. Although we sent some of our luggage - the biggest suitcase and the bassinet - straight to my husband's parents' home from the airport, we still had to carry 2 suitcases, 2 backpacks and - most importantly - the whole Britax travel system with the little one in it. However, we were desperate to get to the hotel as soon as possible, so we rushed to the Skyline express train entering the train car rather than the one where we had our seats booked, so it meant we had to walk though a few cars to get to our seats. We didn't realize though that we were back to the country where anything is at least 1.5 times smaller than back in North America so we could barely move the stroller through the aisle and - when we had to pass through the advanced class "Green Car" - we actually had to separate the car seat from the stroller and fold the latter to be able to make it to our seats - and all this in the train moving high speed. People must have been looking at us like at some crazy lunatics but that is what happens to the parents of a newborn who have had close to zero of consolidated sleep in two months and, after recovering from the initial stress of a week-long NICU, had to take care of moving from one country to another in the first weeks of the little one's life in the same time trying to manage to get his birth registration and certificate, his health insurance and passports in time.
When we finally hit Shinagawa station from where the hotel was only 10 minutes walk away, another shock was awaiting for us - the amount of busy people rushing home from work and the way nobody was caring about giving us way. Later it only took us about a month or so to get back to the idea of Tokyo's overcrowdedness, but that evening at Shinagawa we both were very close to having a panic attack - and that's only after about 2 years in North America, in a quiet, beautiful and friendly town.
By the time we arrived to our hotel and I could finally feed my son, I believe I developed the worst multiple clogged ducts that I have ever had and - though I fed him for about 40 minutes and then tried all the known tricks to relieve the blockage and pain - it just wasn't working and I literally went to bed crying. The reasons were obvious - my son wasn't feeding too well on the plane, I was too stressed out, and the bags were too heavy. Everything was to change very quickly though - and this is pretty much where my story focuses on breastfeeding practices in Japan.
Once we made it to my husband's hometown, I visited a breastfeeding division at the local maternity clinic. They immediately prescribed me a new antibiotic ointment and - most importantly - the midwife there performed a breast massage on me which lead to almost an instant relief of clogged ducts. She was surprised I had it that bad and still managed to avoid developing a fever. See, in Japan, the lactation massage is a usual practice; a midwife from the hospital where one delivers or a public health nurse would even visit your home to do one if the baby makes it difficult for you to go to the hospital yourself in the first days or weeks of his/her life. The massage seems to be a combination of lymphodrainage and milk hand-expressing and it ensures a completely new milk flow. Before having one performed I could barely pump let alone hand-express and my son would cry and become fussy at the breast often which is very common when the mother has a blockage. After this almost an hour-long massage - which itself felt like if I was being helped to get rid of all the toxins - the milk suddenly started flowing incredibly well, the little one's feedings became more efficient and thus shorter, pumping and hand-expressing became possible and the clogged ducts seemed less and less of a problem. I visited the midwife there twice in the first week and in about 2 weeks I could finally sleep in a different position rather than on my back while before that anything different was just too painful. This kind of a massage has a long-lasting effect which makes it different from a simple hand-expressing session. Back in Tokyo, I still go see a similar specialist occasionally to keep up the result. I believe that now I haven't had a single clogged duct in about 2.5 months. Also I'd like to mention that though I say a "specialist", it is in fact just a midwife with the skill who works at the labor and delivery unit and not a particular independent lactation consultant. Most local mothers I know here have received such a massage from their midwives at some point and everybody has nothing but the greatest things to say about this practice. In cases where the babies have complications during labor and the mom has to initially pump, the midwife would perform such a massage shortly after the delivery and help hand-expressing the colostrum aiding the mother in establishing her milk supply with minimal damage to the breasts.
Here in Tokyo I was surprized first that I almost never see mothers breastfeeding in public (unless it is at some mom's meeting in the local Children's Hall or the like), but I very quickly understood the reason why. Almost any subway or train station or department store have excellent breastfeeding lounges that are equipped with curtain-partitioned rooms that make a breastfeeding session, especially for babies easily distracted, a bliss. I still do breastfeed using a cover here and there if looking for a lounge seems too much of a trouble, but these rooms, with a baby or a bottle mark on the signs leading to them, are in fact everywhere. A friend of mine told me that when she was a little girl though she could see mothers breast-feeding openly and without a cover outside often. One of her memories is seeing a mom openly feeding her child in a bus. While you won't see a sight like this in Tokyo anymore, the reason is the availability of breastfeeding lounges (in addition to the availability of bathrooms with the diaper-changing boards).
What I also felt here about breastfeeding is that it is taken much more naturally than in North America. No one encourages you to choose breastfeeding over formula and no one praises you for having chosen one - yet it is the choice of the majority of mothers and something deeply embedded in the culture of mothering. One of the reasons could be amazing breastfeeding support that women here get at the clinics - which includes the massage described above and which makes the experience so much more natural. Yet, if somebody cannot breastfeed, there is zero judgement or hostility towards formula bottle-feeding which is being an issue back in North America currently.
In short, when something is very natural, there is no need to feel agitated about it and protect one's interests by denying all other forms of feeding, such as formula-feeding and the like. Even the postnatal brochure issued by the municipal office has it very simple - "if you feel like you aren't producing enough milk, do not put too much pressure on yourself and feel free to supplement with formula". Yet, it is precisely the lack of "stress" around the idea of breastfeeding that helps more and more mothers here to actually breastfeed rather than formula-feed or supplement.
My journey of breastfeeding in Japan has just begun and I am excited about the opportunity to learn more about the cultural forms it takes here and to share about it in this blog.
Back in North America I visited lactation consultants and was given a lot of useful advice on how my baby should latch properly to minimize the damage for me and to increase his milk intake as at first he would only take the breast using a nipple shield which it took us about 6 weeks to transition from. Although I know that my experience is not unique and, as my nurse at the hospital where I delivered said, most of the women she sees do have some sort of issue with breastfeeding, it still feels overwhelming even remembering about it now. I believe that more information about the challenges of breastfeeding should be out there in line with the usual "breast is best" slogan to prepare future moms for the upcoming and help them feel less shocked when the experience does not progress as smooth and natural as they read it should too. In our case I think a lot of problems happened because I could not breastfeed my son right away. He was taken to the neonatal nurseries and given a bottle and I had to pump with a hospital-grade pump for 3-4 days before I could finally have him at my chest, and at that point he was already too used to the bottle to be able to take the breast straight. The pumping experience didn't go smooth either. Although it thankfully ensured the milk supply while my son couldn't yet feed, it also created the initial damage that, together with my son's improper latch later on, lead to the cracks that took too long to heal.
Our flight back to Tokyo took 12 hours and by the time we arrived to Narita Airport my husband and I were beyond exhausted. We were extremely happy that our little one seemed very fine and much less tired than both of us though - he was highly cooperative during the whole flight too. Tiredness lead to some irrational decisions. Although we sent some of our luggage - the biggest suitcase and the bassinet - straight to my husband's parents' home from the airport, we still had to carry 2 suitcases, 2 backpacks and - most importantly - the whole Britax travel system with the little one in it. However, we were desperate to get to the hotel as soon as possible, so we rushed to the Skyline express train entering the train car rather than the one where we had our seats booked, so it meant we had to walk though a few cars to get to our seats. We didn't realize though that we were back to the country where anything is at least 1.5 times smaller than back in North America so we could barely move the stroller through the aisle and - when we had to pass through the advanced class "Green Car" - we actually had to separate the car seat from the stroller and fold the latter to be able to make it to our seats - and all this in the train moving high speed. People must have been looking at us like at some crazy lunatics but that is what happens to the parents of a newborn who have had close to zero of consolidated sleep in two months and, after recovering from the initial stress of a week-long NICU, had to take care of moving from one country to another in the first weeks of the little one's life in the same time trying to manage to get his birth registration and certificate, his health insurance and passports in time.
When we finally hit Shinagawa station from where the hotel was only 10 minutes walk away, another shock was awaiting for us - the amount of busy people rushing home from work and the way nobody was caring about giving us way. Later it only took us about a month or so to get back to the idea of Tokyo's overcrowdedness, but that evening at Shinagawa we both were very close to having a panic attack - and that's only after about 2 years in North America, in a quiet, beautiful and friendly town.
By the time we arrived to our hotel and I could finally feed my son, I believe I developed the worst multiple clogged ducts that I have ever had and - though I fed him for about 40 minutes and then tried all the known tricks to relieve the blockage and pain - it just wasn't working and I literally went to bed crying. The reasons were obvious - my son wasn't feeding too well on the plane, I was too stressed out, and the bags were too heavy. Everything was to change very quickly though - and this is pretty much where my story focuses on breastfeeding practices in Japan.
Once we made it to my husband's hometown, I visited a breastfeeding division at the local maternity clinic. They immediately prescribed me a new antibiotic ointment and - most importantly - the midwife there performed a breast massage on me which lead to almost an instant relief of clogged ducts. She was surprised I had it that bad and still managed to avoid developing a fever. See, in Japan, the lactation massage is a usual practice; a midwife from the hospital where one delivers or a public health nurse would even visit your home to do one if the baby makes it difficult for you to go to the hospital yourself in the first days or weeks of his/her life. The massage seems to be a combination of lymphodrainage and milk hand-expressing and it ensures a completely new milk flow. Before having one performed I could barely pump let alone hand-express and my son would cry and become fussy at the breast often which is very common when the mother has a blockage. After this almost an hour-long massage - which itself felt like if I was being helped to get rid of all the toxins - the milk suddenly started flowing incredibly well, the little one's feedings became more efficient and thus shorter, pumping and hand-expressing became possible and the clogged ducts seemed less and less of a problem. I visited the midwife there twice in the first week and in about 2 weeks I could finally sleep in a different position rather than on my back while before that anything different was just too painful. This kind of a massage has a long-lasting effect which makes it different from a simple hand-expressing session. Back in Tokyo, I still go see a similar specialist occasionally to keep up the result. I believe that now I haven't had a single clogged duct in about 2.5 months. Also I'd like to mention that though I say a "specialist", it is in fact just a midwife with the skill who works at the labor and delivery unit and not a particular independent lactation consultant. Most local mothers I know here have received such a massage from their midwives at some point and everybody has nothing but the greatest things to say about this practice. In cases where the babies have complications during labor and the mom has to initially pump, the midwife would perform such a massage shortly after the delivery and help hand-expressing the colostrum aiding the mother in establishing her milk supply with minimal damage to the breasts.
Here in Tokyo I was surprized first that I almost never see mothers breastfeeding in public (unless it is at some mom's meeting in the local Children's Hall or the like), but I very quickly understood the reason why. Almost any subway or train station or department store have excellent breastfeeding lounges that are equipped with curtain-partitioned rooms that make a breastfeeding session, especially for babies easily distracted, a bliss. I still do breastfeed using a cover here and there if looking for a lounge seems too much of a trouble, but these rooms, with a baby or a bottle mark on the signs leading to them, are in fact everywhere. A friend of mine told me that when she was a little girl though she could see mothers breast-feeding openly and without a cover outside often. One of her memories is seeing a mom openly feeding her child in a bus. While you won't see a sight like this in Tokyo anymore, the reason is the availability of breastfeeding lounges (in addition to the availability of bathrooms with the diaper-changing boards).
What I also felt here about breastfeeding is that it is taken much more naturally than in North America. No one encourages you to choose breastfeeding over formula and no one praises you for having chosen one - yet it is the choice of the majority of mothers and something deeply embedded in the culture of mothering. One of the reasons could be amazing breastfeeding support that women here get at the clinics - which includes the massage described above and which makes the experience so much more natural. Yet, if somebody cannot breastfeed, there is zero judgement or hostility towards formula bottle-feeding which is being an issue back in North America currently.
In short, when something is very natural, there is no need to feel agitated about it and protect one's interests by denying all other forms of feeding, such as formula-feeding and the like. Even the postnatal brochure issued by the municipal office has it very simple - "if you feel like you aren't producing enough milk, do not put too much pressure on yourself and feel free to supplement with formula". Yet, it is precisely the lack of "stress" around the idea of breastfeeding that helps more and more mothers here to actually breastfeed rather than formula-feed or supplement.
My journey of breastfeeding in Japan has just begun and I am excited about the opportunity to learn more about the cultural forms it takes here and to share about it in this blog.
