Spreading the breastfeeding message upwards to healthcare professionals, and the entry of Lactation Consultants.

Up to the mid-1980s, SBMG only had platforms to speak to expectant mums, and the occasional lecture to medical students by courtesy of Prof. Wong Hock Boon. The new thrust was to bring the message to nurses, and some doctors, in the government hospitals. It really came about by default. Some time in the early 1980s, Prof. Maureen Tsakok, an obstetrician and the other strong advocate of breastfeeding, invited us to give monthly talks on breastfeeding to KK Hospital mothers. Angela Lee and I gave these talks to dwindling audiences, almost all of whom were Prof. Tsakok's patients. Other doctors simply forgot, or did not bother to send their patients. In 1986 she invited me to go to Singapore General Hospital instead, as she was going to head up the O & G Department there. She wanted to introduce antenatal classes there -the first government hospital to do so. I was able to sit through many planning meetings with the staff, and was able to suggest to the doctors what was hindering breastfeeding - explaining the importance of feeding immediately after birth, among other things. What was common breastfeeding knowledge to our counsellors was clearly new information to them -even ways to manage initial lactation so as to avoid or minimize engorgement.

Before taking the antenatal classes at SGH, we requested an opportunity to address the nursing staff, so that they will give consistent support to the mothers we would prepare through antenatal classes. This was the beginning of an important series of training we called "Nurses' Contribution to Successful Breastfeeding" which SBMG conducted for SGH (1986), and all Maternal and Child Health Clinic nurses (1987). Then in 1988, Toa Payoh Hospital, National University Hospital and later Alexandra Hospital also asked for our help for their antenatal classes. In each case, we addressed the nurses before commencing our antenatal class talks. The burden of these nurses' training sessions fell to myself, Lynette Thomas, Yeo Soo Lan, and later, Bridget Goom. Toa Payoh Hospital was particularly receptive. One doctor there, Dr Noel Leong, was so impressed with the breastfeeding expertise of the Group that he invited us to give extended sessions to their nurses in 1988/89, and some of his doctors were also in attendance.

Exposure to NMAA's Lactation Conference in 1988 was significant to SBMG in a number of ways. In 1989, Yeo Soo Lan, a midwife by training, accepted a position as "Breastfeeding Advisor" in Mount Elizabeth Hospital. It was the first time a local hospital had designated a nurse to attend to the breastfeeding needs of new mothers. SBMG Counsellor Doris Fok, began to explore how she could prepare and sit for the Lactation Consultants' Exam. It was a monumental undertaking, because she did not have medical background. She had only her experience as a Counsellor for SBMG to start her off. Perseverance and determination paid off, and she qualified as a Lactation Consultant and was accredited by the International Lactation Consultants' Association (ILCA). It was a historical milestone that a non-medical SBMG Counsellor should be the first qualified Lactation Consultant for Singapore and Asia in 1992. In 1991, Doris had accepted a position as Lactation Consultant in KK Hospital, our main maternity hospital. During her seven and a half years there, she trained many nurses in KK Hospital and other hospitals, and carried out research in various areas of breastfeeding. She also lectured the medical students on breastfeeding. From this beginning, Singapore now has thirty-two accredited Lactation Consultants in our hospitals and in private practice as at November 2004.

The other important spin-off from the NMAA Conference was the inspiration it gave us to have a fixed line and an answering machine from which to operate our counselling hotline. Up to then, SBMG functioned out of the homes of Committee Members. Only official files were housed at CASE. Everything else - our Library, handbooks, teaching aids, slides and projector -were all stored in our homes. A fixed line became possible when Father Edmund Dunne, who had oversight of a Catholic welfare service, Family Life Society, read of our lack of space in a letter to the press, and offered us use of FLS's small pantry space, where we could put our phone line, and have some overhead storage, and a mailing address. This was to be our "Office" for the next ten years. We also brought back useful knowledge that cabbage leaves were efficacious for dealing with engorgement, and this has since become a standard practice in our breastfeeding management here. With the answering machine, in later years when the hotline roster was well managed, BMSG(S) answered an average of 3,500 calls annually. In 2000, counselling even expanded to include e-counselling, pioneered by Koh Geok Cheng.