Nursing a Dream
A pioneering advocate of breastfeeding here in Singapore, Mrs Doris Fok (Arts and Social Sciences ’78) had to overcome several challenges in her bid to promote a practice that holds physical, psychological and emotional benefits for both mothers and infants.
WHO IS SHE?
Mrs Doris Fok is the first Singaporean to become an International Board Certified Lactation Consultant (IBCLC). For more than three decades, she has spent her life blazing the trail for breastfeeding mothers, a journey that has taken her around the world.
When Mrs Doris Fok became a mother in 1984, she found herself in a position we may regard as rather odd today. “I asked the nurse for my baby to breastfeed her, and she said no!” she recalls. “Breastfeeding was a rare phenomenon. There was no support from any sector: from confinement ladies to health professionals, everyone said the default was to give newborn formula.”
It was no one’s fault, she points out. “There was just misinformation worldwide. At that time, there was a huge push towards industrialisation. I chose to stay home full-time, but many women went back to work.” Formula afforded new mothers the freedom to return to the workforce. Additionally, there was also the social stigma back then that only uneducated and lower-income women breastfed their children. For Mrs Fok and her engineer husband, the choice to breastfeed had been made even before they conceived: “We expected our parenting journey to include natural birth and breastfeeding.” Her own mother breastfed her, and Mrs Fok successfully did the same for her first child — a daughter — for a year. That daughter is now 35 and also a breastfeeding mother.
While breastfeeding was already an unusual choice, Mrs Fok then went a big step further: she began helping other new mothers to breastfeed. “I was the nosy neighbour that went around talking to everybody, and they all said they had problems breastfeeding: not enough milk, pain, etc. So a group formed in our neighbourhood around 1985 to support mothers at home, and when I had my second child, many of them also had another child so we said, ‘Let’s do it together!’” How did she teach these other mothers to breastfeed? “I went to their houses and breastfed in front of them!” she says matter-of-factly.
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I decided to champion breastfeeding as I believe it is normal to feed our babies. I also believe in giving children the best possible start and situation to thrive.
Left: Mrs Fok (seated, 5th from left) with the first batch of nurse trainees at KKH.
Right: With her baby daughter in 1984.
A Voice in The Wildnerness
That was the start of her journey as a breastfeeding advocate. She got involved as a sub-committee member with the Breastfeeding Mothers’ Support Group (BMSG), helping young mothers to breastfeed, and eventually became its President in 1995. The group had been founded in 1975 by the late Prof Wong Hock Boon (Medicine ’52), the Founding Professor of the Paediatrics Department at the then-University of Singapore. With the help of a handful of expatriate mothers, BMSG was set up as an Advisory Committee under the Consumers’ Association of Singapore (CASE). BMSG was set up to support babies who were allergic to cow’s milk and bottlefed babies with gastroenteritis. Prof Wong also ran a human milk bank with milk donated from breastfeeding mothers. “I decided to champion breastfeeding as I believe it is normal to feed our babies,” she explains. “I also believe in giving children the best possible start and situation to thrive.”
Mrs Fok has a degree from the Faculty of Arts and Social Sciences, from the then-University of Singapore, as well as a post-graduate degree in Education from the Institute of Education (now NIE). She worked as an educator for six years before she became pregnant with her first child. She decided to pursue further education in the area of lactation, after being inspired in 1988 at an International Breastfeeding Association Conference in Melbourne to become a certified lactation consultant. “I found out that to be an International Board Certified Lactation Consultant (IBCLC), I didn’t need to be a nurse or a doctor, though it would have been a huge advantage,” she says. “But what was lacking was the medical part. So I asked people to be my mentors. You must remember that this was in the 1980s: there was no Internet, and there were no books, no teachers, no curriculum.” To learn, she sought out the likes of Ms Sue Saunders, IBCLC, one of Australia’s first board-certified lactation specialists; Ms Felicity Savage King, a renowned British expert on paediatric nutrition and author of Helping Mothers To Breastfeed; Dr Ellen McIntrye from South Australia’s Flinders Medical School; and Ms Chele Marmet, IBCLC, one of the co-directors of the Lactation Institute in the US.
MILK RUN
500-600 calories are burned by the average breastfeeding mother daily; this roughly amounts to what is expended by running for an hour.
Coming Full Circle
Though Mrs Fok was not a medical professional and had been told to her face that she was not “qualified”, her persistence paid off. Her mentors gave her support, and she became the first IBLCE (International Board of Lactation Consultant Examiners)-certified lactation consultant in Singapore. “An IBCLC has to know everything there is to know about breastfeeding,” she explains. The only thing she can’t do, she says, is prescribe medication.
In 1991, KK Hospital (KKH) took “a leap of faith”, as she puts it, and engaged her to train its nurses in the maternity wards to promote breastfeeding and to help new mothers to breastfeed. “Then, in 1993, I started teaching medical students, medical officers and post-graduate students about breastfeeding. That year I also brought the IBLCE certification exams to Singapore, and served as the first country coordinator till 2003, when I had to step down to serve on the exams board for lactation consultants,” she explains.
Singapore was the first Asian country to offer the IBLCE certification. This move exponentially increased the number of lactation consultants here, across different hospitals, including KKH, National University Hospital (NUH) and Thomson Medical Centre. Today, each hospital has its own lactation team. Mrs Fok was presented a service excellence award from KKH during her time there for providing excellent lactation service to mothers. She has since been bringing the IBLCE certification to countries such as Malaysia, Brunei, Thailand, Taiwan, Hong Kong as well as China. She is also the only IBCLC in Singapore to devote herself full-time to doing research in human milk and lactation in NUS and in Singapore, and has written papers in this field.
Mrs Fok has had the privilege of meeting the babies that she has helped. “I was at a mall when a woman came running after me. It turned out that she was one of the mothers I had helped, and she had her son with her. He was now in his late 20s! We took a photo together.”
It has been 35 years since Mrs Fok embarked on this journey. In both NUS and NUH, she continues to promote breastfeeding among her colleagues and her patients. “I just wanted to help mothers to breastfeed!” she says with a laugh, noting that it has been a gradual journey of changing society’s attitude towards breastfeeding, to the point now that most mothers choose to. “I want to build a legacy for future generations. What gives me great satisfaction is that the various initiatives — the BMSG, lactation consultancy — are still ongoing, and the stay-home mothers group in my neighbourhood still exists — and we are helping our daughters to breastfeed now!”
Text by Theresa Tan. Photo by Alvin Teo.