Traditional/Jamu Postnatal Care - dont get short-changed

siti gina

New Member
Hi everyone

I was shocked when told by my ex-client yesterday. Being Sporean, and know how costly becoming a parent can be, I am very sad to know that some of my fellow ladies being "ripped". Esp the first time mommies, being made to fork out between S$150-$180 per session by non-Malay postnatal masseuse(s) from across the border, claiming to provide authentic jamu Malay masage. Most local Malay masseuse only charge between $80-$120 per session . With more than 16 yrs of experience, I have heard of many things but nothing beat this sort of 'high way robbery'. I have heard of cases where non-Malay masseuse used only axe-oil (camphor is bad for baby), using elastic non-traditional wrap (which is definitely less effective), claimed to push the uterus/womb back to position even for c-section (dangerous and whatever for when baby was lifted by gynae), claimed to provide special breast milk stimulation massage (hence the extra charge) when it was a mandatory feature of Malay postnatal massage!

Dear ladies, pls make wiser decision. Ask potential masseuse to name at least 2 herbs that make up the Malay massage for postnatal. Ask too how does confinement period calculated and based on what.. its not necessarily 1 month. Pls dont pay extra for baby massage cos not practical for the 1st week when the umblical chord still not drop off. I used to teach clients do do baby massage free of charge cos it does not take more than 10 minutes to learn!
btw, I have cut down on my services, more into teaching. Esp concern since my younger ladies doing the National Service for the country :) Feel free to message for advice..non obligatory, no charge..
 


Hi everyone

I was shocked when told by my ex-client yesterday. Being Sporean, and know how costly becoming a parent can be, I am very sad to know that some of my fellow ladies being "ripped". Esp the first time mommies, being made to fork out between S$150-$180 per session by non-Malay postnatal masseuse(s) from across the border, claiming to provide authentic jamu Malay masage. Most local Malay masseuse only charge between $80-$120 per session . With more than 16 yrs of experience, I have heard of many things but nothing beat this sort of 'high way robbery'. I have heard of cases where non-Malay masseuse used only axe-oil (camphor is bad for baby), using elastic non-traditional wrap (which is definitely less effective), claimed to push the uterus/womb back to position even for c-section (dangerous and whatever for when baby was lifted by gynae), claimed to provide special breast milk stimulation massage (hence the extra charge) when it was a mandatory feature of Malay postnatal massage!

Dear ladies, pls make wiser decision. Ask potential masseuse to name at least 2 herbs that make up the Malay massage for postnatal. Ask too how does confinement period calculated and based on what.. its not necessarily 1 month. Pls dont pay extra for baby massage cos not practical for the 1st week when the umblical chord still not drop off. I used to teach clients do do baby massage free of charge cos it does not take more than 10 minutes to learn!
btw, I have cut down on my services, more into teaching. Esp concern since my younger ladies doing the National Service for the country :) Feel free to message for advice..non obligatory, no charge..


Good job that you highlighted the current market price for a experienced therapist from Singapore.

For those mummies out there, do not get a therapist who is cheap (they could be inexperience or short change you with not so effective herbs and oil, some therapists or TCM doctors customized the herbs use based on individual conditions).

Do not get therapists/nanny who stay overseas , then always late due to the traffic. If anything goes wrong, their phone is unreachable (easily replaced by Pre-paid card).

You paid more for experienced people to take care of your overall well being and not giving you unnecessary stress. The journey from conceive, delivery, confinement is a beautiful and memorable experience. Enjoy it.
 
Good job that you highlighted the current market price for a experienced therapist from Singapore.

For those mummies out there, do not get a therapist who is cheap (they could be inexperience or short change you with not so effective herbs and oil, some therapists or TCM doctors customized the herbs use based on individual conditions).

Do not get therapists/nanny who stay overseas , then always late due to the traffic. If anything goes wrong, their phone is unreachable (easily replaced by Pre-paid card).

You paid more for experienced people to take care of your overall well being and not giving you unnecessary stress. The journey from conceive, delivery, confinement is a beautiful and memorable experience. Enjoy it.
 
Hi SassySammi

Thanks for comments.. but not necessary therapist who is cheap is inexperience. According to my clients, I charge the cheapest in town, I have not updated my rate much since more than 10 years. Dont have the heart to charge hefty price cos most of my clients came recommended. And I know how expensive deliveries can be, and the suffering my fellow ladies went thru. And by the way, based on my experience, TCM is relatively new to traditional postnatal. In fact, as far as I know, when I first started this line, TCM practioners not many around, and definately none provide postnatal services. I started seeing more TCM agencies offering postnatal about these 2 years only. The postnatal herbs most used is from Indonesia or Msia. The brand that I recommended for clients even have ISO standard, a well known brand used for more than 30 years already.

I actually plan to give more tips on this service..more to educate while I am still doing it. As this is a Malay traditional service lots of misconception around. Maybe, I would share my personal experiences so new mothers would not need to make the same mistakes and ended paying unncessary charges and not getting what they suppose to...Do be patient, I would come around to writing those tips..:)

(btw, Siti Gina not my real name).
 
just a quick tip, I always give this advice to clients. When they are shopping for postnatal package, do ask if the package price quoted is nett price. There are many instances, the price quoted does not include transport charges, client need to pay for the traditional wrap/binder and there are therapist who charge extra if ask to come sunday or public holiday. So, the quoted price may be very low. so do ask ok
 
Hi Siti Gina,
Are u still taking in clients for pre and post massage since u said u are cutting down.. I was still thinking of getting a package at supermom babyfair this Sunday.. If you do.. Kindly pm ur price for pre and post natal massage please. I really need one soon.. I'm in 20weeks and my back is killing me
 
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This one quite cheap leh. Lower than what u quoted. What do U think??
 
yup, the basic package price is what you can get from most therapist. Most freelance therapist would factor in transport and travelling cost hence the difference in package pricing based on locality and accessiblity. Those staying in private estate, wtih no public transport access, may be charged more for transport to and fro. Agencies normally have flat-rate as they can assign therapist nearest to your location. I do advise clients to try to find therapist staying nearer their vicinity, if pricing is the main consideration.
 
by the way, I usually advise client they dont really need to go for scrub, hot-compress or ganggang (as in the poster). The scrub can only be done after you finish your confinement to minimise the necessary soaking in water. During confinement, just like when you are having your monthly menses, your body temperature is generally lower, hence the additional care or 'pantang' - no cold drink, no cold shower and proper cover-up. Theres some medical basis behind this. So, its not just old-wife tales :) Knowing what you body go thru during pregnancy, during birth and while having the lochia (bleeding after birth) is the key to taking care of your own health and not having to subject yourself to unnecssary discomfor having to go thru the "strict and rather extreme' routines most Chinese confinement prescribed.(.no shower, no plain water, no fan or aircond, ect.).

You dont really need the hot-compress cos the massage oil and the mandatory herbs are already hot and rather spicy. You can already feel the heat as the oil is being rubbed to your body.

The "ganggang" is a very old tradition of the Malay for postnatal care to get rid of the scent due to the lochia and to expediate the blood flow. Theres a special herbal oil applied on the tummy area that give the same result. And you can use your own intimate wash now, which they dont have in the past. Btw, I advise to only use after confinement and not while still having the lochia.

Ok, thats all for now. I will give more tips whenever I can find the time to write..Hope its been useful.
 
As expected, there would be some who would seize the opportunity to advertise their sevices in this thread. Agency like Baby Bellies (brochure shared by one member above) has built a good reputation though they have been around less than 10 years. They state their terms clearly (ie transport excluded, deposit for binders). Generally, a charge of $50 is for traditional normal massage at therapist's premise/shop. For postnatal, the additonal charges incurred for the loan of binder (take back on the last session), the extra herbs needed and usually extra time given esp when doing breast massage.. in my experience I have cleared breast engorgement with each breast taking up to 30-40 minutes. For the extra time given (bet 15 to 30 min) is free at therapist's discreation. So, do take note before signing up.
 
First thing first. About confinement period. Its not necessarily 30 days. It can be between 3 weeks or up to 60 days. That the general guideline. Its based on the lochia and not fix by number of days. Any period longer than 60 days, best to seek advice from gynae. If its stop less than 2 week, then thats not good either, unless for C-section delivery. I have a few clients with confinement period up to 55 days.

We are the only specie that bleed for few days but dont die. So, as long as you have blood flowing, its not normal.:)
 
Tip #2 : Still on confinement period. So long as you have blood flowing, its not normal. It mean your body still under 'stress' and proper care required. More resources will be channeled to maintain the internal balance with the constant flow of fluid (ie lochia and breast milk). With lack of sleep and milk production every few hours, less resources available for other bodily functions.

As I mentioned in my previous posting, during monthly menses and lochia, body temperature is lower. So, it is important not to bring the body temperature even lower ie drinking cold drink, taking cold shower, not wearing proper clothing, staying in aircond room with temperature < 22 degree. Since less resources available, the change in body temperature have some effects esp to the smaller capillaries, and this is one of the main reasons cited by your doting mother and mother-inlaw as the cause of rheumaticsm in later years (there are other reasons too). So best to take heed, drink warm water, take hot shower and if you shampoo your hair use hair-dryer to dry immediately. In our weather, it is rather 'extreme' not to take shower or wash your hair as the weather is hot and humid all year round. Some Chinese clients use the Chinese herbs for shower, but for other races they just shower from the water heater.
 
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Tip #3 : Still on confinement period. As your body going thru so many changes internally, less resources available, your immune system may also not be at its best. Thats the reason you are not encourage to go out unncessary esp to crowded places and places where germs and bacteria may be in abundance ie clinics, hospital, market. When your immune is in tip-top condition, your body able to detect foreign invasion of the third kind (ie germs/virus/bacteria) and combat the virus and neutralise the bacteria. However, when your immune system is not at its best, some virus or bacteria that you picked up, may still be lingering around and you become the carrier and may transmit to others including your precious baby. You know baby cant take antibiotic, so please do take precaution and exercise patience before embarking on your normal routine, for your baby's sake ( I have clients who went for pedicure and manicure, eye-brow tattoo just after 1 week giving birth..aiyoo).

The traditional confinement massage usually recommeded for 7 consecutive days, with 1 or 2 breaks in between. There is a system to the massage that divide the focus areas of the body during the 7 days, hence, experienced therapist would advise when you could take a break, if necessary. Longer period of more than 7 days (ie 10-14 days) are highly recommeded esp if your weight gained to full term is more than 15 kg, for labour more than 20 hrs, or for C-section delivery.

Confinement massage should also be considered for cases of miscarriage or termination of pregnancy, if exceeded 3 mths. Usually need only between 3-5 days, based on the period. The focus would be more to streghten the uterus (womb) and prepare it for next pregnancy. From my experience, the presence of a third person very helpful as we offer simpathetic ear or act as counselor to help them cope ( I am trained in psychology and counseling).

Usually, after the 2nd or 3rd sessions, you would see more blood clots, some rather big. Do not be alarmed. Thats normal and you are not haemorrhaging, but do check with your therapist if need be. I have cases where client's uterus not cotracting resulting in heavy flow of fresh blood, where I asked her to go hosptial immediately. There may be instances you get a sudden chill at night. Do no be alarmed cos this is a good sign. It would last for couple of hours only and just need to keep yourself warm, no need to rush to the A&E. So far, in my experience, only the few super-fit clients have this symptom. I can easily explain this.

Experience count alot in this service. Not only the massage technique, the types of herbs used, offering advise on breast feeding (how much to expect, frequency, stimulation, supplment to take, ect) - there is no one advice fit all. Your experienced therapist would assess issues and advise according, and really no need to constantly seek the service of LC. Another important aspect, experienced therapist would look out for any simptom of portpartum depression and try to help you cope with it. I usally dont tell my clients they are suffering form one.

Until next tip. Hope you can now appreciate that traditional postnatal service is a professional service requiring many different levels of skill and expertise. So, be wary of those out to profit on your health worries. :)
 
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hello everyone.. Really sorry for disappearing for so long..

by the way, about 3 days ago I asked my very educated client why she treat her baby not as 'human'..of course I wasnt chiding or criticizing her. After a week together, most of my clients become more like friends and we talk about almost anything, jokes and laugh together (after all laughter is the best medicine). I told her when I was on my fifth or sixth year of providing this service, that some mothers start feeding their baby using syringe!. In the history of human kind, only now that human babies are feed using syringe..Billion of babies have been born yet suddenly someone decided that all this while women have been feeding babies wrongly!..while quick to dump most of the past practices as 'myth' or 'old wife tales' but cant wait to embrace all the weird theories/claims/findings they read from online or book. Have your all heard about this new thig called 'medicalising society'? its being taught in our universities. Next time I talk about this 'feared' theory 'nipple confusion' and the making-life-more-difficult sterilizing techniques... btw, no offence intended, hopefully none taken :)

One of the most exasperating things I experienced after 17 years of providing postnatal services, is having to explain and explain to my Chinese clients on the importance of drinking enough water esp those who are breastfeeding. I have clients from different background, race, religion, nationalities, academic, professional, but somehow the Chinese clients are the most unique of them all. I used to tell my clients I am going blue in my face just having to correct this serious misconception.. and was desperate enough i once thought of selling bottled plain water to my client but labelled as some fancy herbal drink..

Please do note our body make up of 60-70% water. Its vital to maintain this level for all the various processes and metabolism to sustain the body. (Our lungs are 90 percent water, our brains are 70 percent water and our blood is more than 80 percent water). Simply put, we can't function without it. The body would not surrender this water easily causing dehydration as it can be life threatening. Water has a pH of about 6.6 or 7 as neutral (less means more acidic while more means alkaline). The processing time for the body to process water is very fast cos it go direct to the small intestine to be absorbed. Different for soup, red-date drink, or any other which require the water to be filted out in the large intestine, kidney, ect to return to the neutral pH to be used by the body. This process may take between 4 or more hours. ( I told my clients soup, red-date are not water but liquid food).

The problem is, if you need to produce milik every 2 or 3 hourly (esp the first 2 week), the body requires lots of water. If theres not enough water, the suppy would definitely be affected. Not only that, some clients even start getting dizzy due to heatiness, constipation, ect. Am sorry to say, compare to all my other clients, my Chinese clients complained the most as their supply is not enough, causing much stressed and some even depression. So please drink enough water, esp in our climate.

ok, next time I talk about 'what is enough' cos many clients have such unrealistic expectation with regards to their milk production capabilities esp during the first 2 week..:)

take care and enjoy your motherhood.
 
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Tip #5

breastfeeding dilemma - most common for first time mothers. Based on my experience, many clients really have such unrealistic expectation with regards to their milk production capability. Partly, lack of knowledge about the working of their own bodies. Usually, the more information they got from various sources, the more stress they become. I usually tell them, those are just general guidelines. Others factors also play a part in this special relationship between mother and baby.

I usually give these simple guidelines to address their concern.

1) For smaller babies (less than 3 kg upon birth), their feeding pattern definitely different from babies who are bigger. Average baby weight betweeen 3.3 - 3.5 upon birth differ from slightly bigger babies (ie 3.8 - 4.5 kg).. (yup, I did have client baby weigh 4.5 upon birth - thru normal delivery .. well done to the mother).

2) For the first 2 week, for smaller babies, their feeding interval should not exceed more than 2 hourly. Baby usually do not have the stamina to continue sucking longer than 15 minutes, hence, they tend to get hungry earlier. So, a schedule of between 1.5- 2hr is good for them. For average size babies, an interval of between 2.5 - 3hr is good for them. For bigger babies, usually their capacities to suck and store are better, they can stretch up to 4 hourly cos they can consume more at any one feeding.

3) For the same period, baby with jaundice, reading above 160, usually tend to be lethargic, sleepy, less alert. Most of the body systems mobilize to overcome the jaundice, hence, not much resources for other activities including staying awake. Mothers need to be extra alert and observe feeding time properly, if needed, wake the baby up for feeding and not let baby continue to sleep past their feeding time. As babies need to preserve as much strength as possible, baby tend to be rather weak to even suck the breast. It is advisable to express the breastmilk and use bottle instead, so as not to exert more stress on the baby.

4) As for first time mothers, the first 5 days after delivery, the milk production can range from 10ml to 50 ml. This is average for most mothers. Depending on the baby weight and frequency of feeding, may not be sufficient to cater to baby needs. Hence, supplementing with formula may be needed. At the same time, mothers should continue to work at the breast ie direct feed and pump. This routine is important to be observed for the first 2 week, as the body "program" the extra activity ie milk production- allocating resources, scheduling, ect. The body usually requires between 10 days to 14 days to respond to new changes (eg when taking new supplements ie vitamins, minerals,) before the result can been seen. Consistency is important as this give the required signal to the brain to take into account. Mothers need to continue latching, pumping, even when there is very little milk, clearing every drop, if possible. And its good to use warm towel to compress and do gentle massage each time.
(for my clients, I usually teach them to do some breast massage 2 week before EDD. Mainly to get them acquianted with the different parts of the breast eg the lymp nodes, the technique. Usually this help ease the tension, and improve readiness for the breast to start supply ealier.)

5) The milk production would slowly increase in supply in the 2nd week, can even reach up to 90 ml. This is sufficient for most babies. By 3rd week, the milk supply can reach more than 100 ml and continue to full production by 4th week. I am referring to the interval of 2.5 to 3 hourly. By end of the month, most babies feeding interval can be stretched to 4 hourly.

6) Factors that can affect milk supply - not drinking enough fluid. As I explained in the previous post, ph for water is 6.6 neutral. This is what the body recognize and consume directly for the various metabolism and maintaining the body critical balance. Any other fluids, eg soup, red-dates, have different Ph reading and thus need to go thru "filtering process" would require time before can be used by the body. Mothers need to stay hydrated as much as possible so as not to affect the milk supply. Mothers need to drink plenty of plain water (neutral ph) .

As milk is produce from the nutrition in the body (eg fats ), mothers need to have sufficient food to spare for the milk production. The body would not surrender any nutritions needed for maintaining critical processes, hence, would only utilize "excess" for non-critical funtion like milk production

Another factor, enough sleep (esp the first two week). Each night, the body go thru "maintenance process" while we sleep. This process is important for repairs, topping-up, cleansing, detoxing, ect involving the various organs. It lasts between 4-5 hour. So, its important for the body to have totally control in order to carry out the various processes. A deep sleep of 4 hours is sufficient for the body to complete the process. I usually advise my clients to try to get at least 3-4 hrs sleep after baby last feeding, eg 11pm or 12midnight, possibly asking someone esle to help with the baby. Most mothers say its tough even to do that.

7) Some mothers do have blocked breast ducts. Breast stimulation massage to clear ducts need to be done first 5 days to ease flow. The ducts distribution and apertures vary between women. At times, I would joke with my clients their "pattern" - eg shower head (with many distributed openings) or running tap water (with centralise, large opening).

8) Lastly, most first time mother tend to make the mistake of assuming their breasts as "engorged" just the first few days. Actually, this is not the case as the milk production is not full swing as yet to cause engorgement. What really happen, is the muscles in the breast are being stretched out to create the space for milk storage. I usually use the analogy of someone who has never run before, not doing any warm-up exercise and start running a sprint, resulting in every inch of the muscles aching.

Ok, I hope these help. Feel free to ask any question if you have any. I be happy to help, if I can
 

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