Breastfeeding Myths and Realities

SOURCE : http://www.promom.org/bf_info/myths.htm

By Leslie Kincaid Burby for ProMoM

This information is furnished to you by ProMoM, Inc. as a public service.
It is in no way intended as medical advice, or meant to replace the services
of a licensed medical professional.

Myth #1: Breastfeeding ruins the shape of your breasts

*Reality:* This is simply not true. As soon as a woman becomes pregnant
permanent changes occur in her breasts. Even if she doesn’t carry to term,
or chooses to abort, her breasts will never be the same as they were before
she became pregnant. Whether or not she then goes on to breastfeed will not
effect her future breast shape one way or another. Heredity plays a large
role in this matter, as does excessive weight gain or loss. It is helpful to
maintain the tone of the muscles that support your breasts, and avoid large
and sudden weight gains or losses, pregnancy-related or otherwise.

Myth #2: Small-breasted women won’t have enough milk

*Reality:* The size of your breasts, either large or small, has nothing
to do with the amount of milk they will produce. Almost all women who are
getting plenty of liquid, adequate rest and relaxation, and lots of physical
contact with their babies will produce enough milk. In fact, many women who
believe they are not producing enough milk are mistaken. It is surprising
how much milk a tiny baby can consume in a short amount of time. The number
of wet and soiled diapers being produced every day is a fairly accurate
indicator of how much milk the baby is getting. 6-8 wet cloth diapers (5-6
soaked disposables), and at least 2-5 bowel movements per day indicate that
your baby is getting plenty of milk. Once the newborn stage is over, the
number of bowel movements may decrease.

If your baby seems lethargic, seems to have poor skin tone or is not
wetting and soiling an adequate number of diapers, this is cause for
concern. If you believe you are having trouble with your milk supply,
contact a lactation consultant, or a supportive physician. It is always
better to be safe than sorry.

Remember, the more the baby nurses, the more milk your breasts will be
stimulated to produce. If you begin “supplementing” your supply with
artificial milk, your breasts will not receive adequate stimulation and your
milk supply will decrease.

Myth #3: Breastfeeding influences a baby’s future sexual orientation.

*Reality:* Not true. The misconception that breastfeeding could in some
way determine whether a child will grow up to be heterosexual or homosexual
is tied to the mistaken idea that breastfeeding is in itself a sort of
sexual activity. It is not. Breastfeeding is a nutritional and nurturing act
that helps children grow up to be healthier and more self-confident,
whatever their sexual preference turns out to be.

Myth #4: Today’s artificial breast milk is just as good as the real thing.

*Reality:* Even though modern formulas are considerably better than some
of the old fashioned ones, they can never replicate mother’s milk. In the
first place, human milk contains live cells and human hormones that are
impossible to obtain from the milk of another species. Furthermore, formula
companies admit that they don’t yet know all of the ingredients in human
breast milk. Every few months these companies come up with something
different to try to add in. If you choose to breastfeed you can be confident
that all the necessary nutrients, immunities, hormones and as yet
undiscovered beneficial elements will be present in the right amounts. On
the other hand, research shows significant risk in the use of artificial
milk.

Myth #5: Breastfeeding takes more time than bottle-feeding.

*Reality:* This statement is usually made in reference to nighttime
feedings. If a mother sleeps with or next to her baby, nighttime feedings
are much easier than they are for bottle feeders. All you have to do is open
your nightgown and roll over. Even if the breastfeeding mother does not
sleep with her baby, it is certainly less time-consuming to go pick up the
child and offer the breast, than to get up, go the kitchen, open a can of
formula (or mix up a batch from powder), turn on the stove to boil water to
heat the formula, put the formula into a bottle, warm the bottle in the hot
water, wait several minutes, then finally return to the crying child, pick
up the child and offer the bottle. Of course, at this point it is tempting
for an exhausted mother or father to prop up the bottle and leave the baby
alone to finish it. This is an extremely dangerous thing to do as the baby
can easily choke on the liquid, or spit up and choke on that. Also, it leads
to baby bottle caused tooth decay.

It is true that you may have to feed a bit more frequently if you
breastfeed because breastmilk is more easily digested than formula. Of
course that easy digestibility translates into less time dealing with colic,
diarrhea and other digestive ailments. Also, breastfed babies are far less
likely to contract colds, ear infections, and asthma. Formula feeding
mothers need to factor in extra time for trips to the store to buy supplies,
as well as possible extra trips to the doctor’s office. (See ProMoM’s “101
Reasons To Breastfeed Your
Child”,
#58).

It is also a fact that in the early months, unless you express
breastmilk, you will be the only person able to provide nutrition to your
baby. Formula feeding mothers can have other caregivers give some or most of
the feedings. However, breastfeeding offers a new mother an amazing chance
to bond with her child, as well as all the health benefits that formula and
bottles cannot provide. It may be helpful to remember that your baby will
only be completely dependent on you for a very short amount of time in the
course of your relationship together. Nursing can give you a chance for a
much needed relaxation break, and time to re-connect with your baby. Try to
savor these special moments.

Myth #6: You can’t get pregnant if you’re breastfeeding.

*Reality:* True and false! Breastfeeding is only an effective form of
birth control (98%)
during the first 6 months, and is only effective during this period if the
baby is receiving nothing but breast milk on demand. No supplements, no
solids, no water, and no pacifiers! The chance of pregnancy increases
greatly when the baby begins sleeping through the night, starts eating
solids, and/or when the mother resumes her menstrual cycle. If you truly do
not wish to become pregnant again yet, it is wise to use an additional
method of birth control.

*Myth #7: You must wean if you get pregnant.*

*Reality:* There is no particular reason why a woman who is enjoying
breastfeeding one child should wean that child when she learns that she is
expecting another, unless she has a history of preterm labor. Some women
continue to breastfeed throughout a pregnancy and then go on to
“tandem”feed. This
phrase refers to the practice of breastfeeding more than one
child simultaneously. Some children do wean themselves once their mother
becomes pregnant, possibly because her milk supply drops, or they detect a
change in the taste of the milk which does not please them. Some women
choose to wean because they find breastfeeding during pregnancy too
physically or emotionally fatiguing. Other women describe enjoying the
relaxation breaks that an ongoing breastfeeding process requires of them,
and feel it contributes to the enjoyment of their new pregnancy. See La
Leche League’s information on breastfeeding during
pregnancy.

Myth #8: You can’t breastfeed after a caesarian section birth.

*Reality:* It is entirely possible to breastfeed after a c-section. Many
women describe really enjoying being able to perform this natural act after
going through a very medically oriented birth. It is important to nurse in
way that does not put pressure on the incision sight. The “football hold”
position is
particularly helpful, as is a good nursing pillow. Ask the hospital staff
for help, and consider calling a lactation consultant or your local La Leche
League if you’re having difficulty.

Myth #9: Your milk will “come in” immediately after you give birth.

*Reality:* First of all, the substance produced by your breasts
immediately after a birth is called colostrum. It is yellowish and stickier
than mature milk, and full of nutrients and immunities for the newborn baby.
However, amounts of colostrum vary from mother to mother, and you may not
produce very much. This is normal.

After colostrum the breast then begins to produce transitional milk,
which is whitish-yellow, and more abundant. Gradually, over the next week or
two, the transitional milk begins to change to a thin, bluish-white mature
milk. Your milk production is directly linked to how often and how
effectively your baby is suckling. If your transitional milk does not come
in after 30 – 40 hours it is a good idea to contact a lactation consultant
or La Leche League, especially if the hospital staff is advising you to give
formula or water.

Myth #10: Your mate will find you less attractive if you breastfeed.

*Reality:* It is possible that your mate may have some trouble adjusting
to thinking of your breasts as sources of nourishment as well as of sexual
stimulation. On the other hand, many partners find that a woman who is
fulfilling this new part of her womanly potential is particularly exciting.
The idea of the bountiful breast filled with the milk of life can be very
powerful. If your mate does feel uncomfortable with this, however, it may be
helpful to join a support group with other couples so that he/she may become
more familiar with these new images, and begin to understand that they are
normal and healthy.

Myth #11: Breastfeeding is painful

*Reality:* Many women experience no pain or difficulty at all when they
start breastfeeding. For some, the first week or two may include some slight
discomfort and pain. However, excruciating, or ongoing pain is *not*normal.

Usually, it is caused by incorrect positioning or latch-on technique, and
can be cleared up with one or two visits from a lactation consultant. This
pain can often be avoided if the mother does some reading, and/or attends a
class about breastfeeding, and/or attends a class about breastfeeding before
giving birth.

Visiting several La Leche League meetings while you are still pregnant is
also a wonderful way to observe successfully breastfeeding mothers, as well
as to network with other new parents. La Leche
Leaguehas a peer counseling program in
which you can receive help from other
experienced mothers in the early days of your nursing relationship.

Do request any assistance you can from trained hospital staff while you
are still in recovery. Sometimes these services are not volunteered, and you
will not receive them unless you request them. Also, Ask about the
availability of a lactation consultant before you make your choice as to
which hospital or birthing center you are planning to use.

Myth #12: You can be arrested for breastfeeding in public.

*Reality:* In the United States, you *cannot* be arrested for
breastfeeding your child any place a woman would normally be. Such places
include beaches, pools, restaurants (at the table), park benches, and
parking lots, among others. You cannot be forced to remove yourself to a
bathroom, closet, or vehicle. If anyone tries to tell you otherwise, you
should feel free to refuse to comply, and inform them of your
rights.
Obviously, places like the men’s bathrooms are off limits, since it’s not a
place women are supposed to be. Who would want to breastfeed there anyway?

Myth #13: You can’t breastfeed if your plan to go back to work or school.

*Reality:* If you’re planning to return to work or school, there are
several different ways to approach the situation without weaning your child.
First of all, it may be possible to schedule your work with a lunch break
during which you may return home, or go to your child’s daycare center to
nurse. Alternatively, your caregiver might bring the child to your work
place.

If these situations are not possible to arrange, there are now wonderful
and relatively inexpensive pumps (compare them with the price of buying
formula) available to the public. Or, you may prefer to rent a
pump.
In some cases, insurance companies will even cover the cost of a pump rental
or purchase because it will save them money in the long run to have
healthier babies on their plans.

Using a good quality electric pump it is possible to pump 8-10 ounces of
milk in 15 minutes. Battery pumps are also available, and they can be used
in a vehicle or in a restroom. It may take longer for newer mothers, and you
should plan to pump at least every 4 hours. Beware of cheap low-grade
machines, some of which are manufactured by formula companies. They can
cause soreness, and probably will not pump sufficient quantities of milk.
Remember that pumping is a learned art, and may take time to get perfected.
If you do not receive the amount of milk you anticipated, try again, or try
a different pump. (See ProMoM’s “Breastfeeding and Returning to
Work”
and La Leche League’s information on working and
breastfeeding.)

If none of these possibilities work for you, you might consider nursing
when you are at home and having a caregiver provide a bottle of artificial
milk when you are at work. This method should be approached very carefully,
however, to avoid depleting the mother’s milk supply and endangering the
health of the infant.

Myth #14: Night nursing causes dental problems.

*Reality:* Generally, the worries about babies getting cavities through
nighttime milk consumption arise from the practice of leaving babies to
sleep with bottles of formula or juice. When this is done harmful bacteria
have unlimited access to these sugary mediums and will thrive in the baby’s
mouth. The acids excreted by the bacteria cause tooth decay. Such decay has
been seen occasionally in breastfed babies if these children happen to fall
into a small category of people with easily decayed teeth. For most children
night nursing will not be a problem.

One advantage that the human nipple provides over an artificial one is
that it delivers the milk further toward the back of the mouth, past the
teeth. Artificial nipples deliver the milk into the front and middle of the
mouth where it can cause decay. Also, the human nipple does not continue to
drip milk when it is not being sucked. In contrast, bottles will drip milk
all night if left in the bed with the baby. Reminder: no baby should ever be
left alone with a propped up bottle!

If you notice anything strange looking happening to your child’s teeth
consult a breastfeeding supportive dentist for help. There are many articles
on this subject available
through La Leche League.

Myth #15: Breastfeeding will ruin your sex-life.

*Reality:* Some people fear that the intimacy that a mother maintains
with her child through breastfeeding will displace her needs for intimacy
with her partner. This is partially due to our society’s viewing of the
female breast as a sex organ, rather than a source of nutrition. There is no
reason that a breast can’t perform both functions. In fact, whether a woman
chooses to breastfeed or not, she may find her libido considerably
diminished for weeks or months following a birth. It is unrealistic and
unfair to expect any new mother, breastfeeding or not, who is recovering
from a birth, who is either nursing or bottle-feeding around the clock,
getting up at night to diaper, rock and sooth the baby, cooking, cleaning,
chauffeuring, etc. to have much interest in sex! If she has an extra half
hour in the evening she will probably choose to use it to sleep! Any tasks
that her mate can assist her with will contribute to the deepening of their
relationship. If a breastfeeding mother’ partner is respectful of the
importance of the breastfeeding relationship, and able to assist with things
such as diaper changes and nighttime parenting duties, the new mother’s
sexuality will gradually resurface.

Myth #16: You have to have a good diet or your milk won’t nourish the baby
properly.

*Reality:* Surprisingly, new studies have shown this to be untrue. Even
women who are getting poor nutrition can usually produce adequate quality
milk. However, they may not be able to produce as much of milk as women who
are eating well. Needless to say, it’s best to eat right during pregnancy
and while you’re breastfeeding. Occasional lapses, however, are nothing to
worry about.

Myth #17: Breastfeeding makes you fat.

*Reality:* Breastfeeding will certainly not prevent you from getting back
to your pre-pregnancy weight. In fact, breastfeeding uses an extra 300 to
500 calories every day. It’s up to the mother how many of those calories she
chooses to obtain through eating additional food or through burning off her
available body fat. It is wise to lose weight gained during pregnancy
gradually whether or not you choose to breastfeed. It may take some women
longer than others, and it is important to remember that your body has been
through a lot, and is still working hard to provide nourishment for your
baby. You should not be losing more than a half a pound to a pound per week
or you may affect your milk supply. This is a time to be kind to yourself!

Myth #18: Breastfeeding deprives your mate and other friends and family of
their chance to bond with the baby.

*Reality:* There are lots of ways to bond with a new born. Soothing,
rocking, diapering, and burping the new baby are only a few of these
activities. Anyone can participate in them without depriving the child of
it’s optimal nutrition and nurturing. One wonderful book on this subject is
*Becoming A Father*,
by Dr. William Sears, MD.

Myth #19: Breastfed newborns need vitamin and mineral supplements.

*Reality:* Not true. No vitamin or mineral supplements should be given to
breastfed babies until at least six months. New studies are currently being
conducted as to whether or not such supplements should be given after six
months. Historically, before such supplements were invented, many breastfed
babies survived and thrived for the duration of breastfeeding, which could
last to three years or older. This is not to say that supplementation is not
a good idea after a certain age. It is simply not yet clear what that age
is. At least until your baby is 6 months old, you can be assured that your
breastmilk will provide for all of her nutritional needs.

Myth #20: You can’t take any medication while you’re breastfeeding.

*Reality:* While there are a few medications that should absolutely not
be used during the breastfeeding portion of a woman’s life, most can be
taken safely. It is important that your doctor checks actual research rather
than simply relying on the standard instructions that are issued with the
prescription. Most prescription drugs instructions automatically caution
against being taken by pregnant or breastfeeding mothers. This warning is
issued to prevent liability, and is often overly cautious. It’s also a good
idea to ask your doctor about non-prescription drugs. Some of them are not
appropriate for nursing or pregnant women. *The Nursing Mother’s
Companion* ,
by Kathleen Huggins contains a general reference section on which
medications are compatible with breastfeeding. A more up-to-date resource is
*Medications In Mother’s
Milk*,
by Dr. Tom Hale, PhD.

Myth #21: Breastfeeding ties you down.

*Reality:* It is true that breastfed babies are dependent upon their
mothers for their nutrition. This does not mean that a breastfeeding mother
must remain housebound and attached to her baby 24 hours a day. After you
have recovered from the birth, it is not only possible but usually a lot of
fun to take your baby with you on errands, visits to friends, walks in the
park and other outings. Now that it has been clearly established that women
have a right to breastfeed in all public spaces, and with the advent of
excellent breast pumps, the possibilities for nursing mothers to fully
participate in activities outside the home are almost unlimited. It is also
nice not to have the added burden of caring around all that formula
paraphernalia. If you choose to express some of your milk ahead of time you
can easily spend time apart from your baby without relying on artificial
substitutes.

Obviously, taking your baby with you on outings will probably mean you’ll
be nursing him or her in front of others, and maybe in public. Some women
“feel funny” about nursing in front of strangers, or even friends and family
members, probably because the sight of a nursing mother is not something
they themselves are used to seeing. As countless mothers will attest,
however, it’s rare that anyone will stare or say something to you while
you’re breastfeeding; more likely they’ll just look the other way, or not
even notice that you’re nursing! Breastfeeding in public can be very
discreet, especially if you wear clothes that are specially designed for
nursing mothers. In general, the more natural your attitude the less you’ll
notice the reaction of others. If you are hesitant about breastfeeding in
public, just remember – it’s what breasts are made for, and, like so many
other things, the more you do it the easier it will be.

Myth #22: After a year, breastmilk loses all it’s nutritional value.

*Reality:* I have a good friend whose mother tormented her by insisting
that if she continued to breastfeed her 9 month old daughter she would
starve the baby. This belief is a total myth, as is evidenced by the
recently released guidelines of the American Academy of Pediatricians, which
recommend breastfeeding for *at least* one year. While many people are
now aware that breastmilk is the perfect, complete source of nutrition for
babies under 6 months of age, not everyone is aware that breastmilk
continues to provide perfect nutrition as long as the mother continues to
breastfeed. Breastmilk tailors itself to the needs of a child from birth
until weaning. There is no need to worry that at some point the milk will
become worthless. It will always contain valuable nutrients, hormones, and
immunities. It will always be easier to digest than the milk of another
species. As you gradually add new foods to your child’s diet, you can be
assured that your child is getting excellent nutrition, even on those days
when she may choose not to eat much solid food at all.

Myth #23: Serious athletes can’t breastfeed.

*Reality:* A professional ballet dancer once explained to me that she had
to stop nursing after one month because she’d wanted to start taking dance
classes again. She believed that she would be unable to do jumps, and that
her milk would “go sour” from the exercise. In fact, both of these ideas are
myths. While it may be uncomfortable to run, dance, or perform strenuous
physical activity with very full breasts, it is certainly possible to nurse
or pump prior to engaging in such activities. Exercise does not “sour” your
milk. Immediately following a vigorous exercise session the lactic acid
content in you milk may increase and slightly alter the taste of your milk.
However, within an hour or two the lactic acid passes out of the milk again,
leaving it tasting just fine. Also, some researches suggest showering off
after a workout to get rid of salty tasting sweat. And remember, it’s wise
to start back to a previously established exercise regimen gradually,
whether the new mother is breastfeeding or not.

Myth #24: Adoptive mothers can’t breastfeed.

*Reality:* As surprising as this may seem, you do not have to give birth
to a child to produce milk. Many adoptive mothers have successfully
developed their ability to produce milk through pumping, putting the baby to
their breast and allowing it to suckle, and use of a supplementary feeding
system designed to give the baby artificial milk until the mother can begin
to produce her own. In some cases only a little milk will be obtained. In
others, the majority of the baby’s nutrition can be provided from the
adoptive mother’s body. The La Leche
Leaguesite has many interesting
articles on this issue.

Myth #25: After menopause you can’t breastfeed.

*Reality:* Interestingly, women can continue to produce milk after they
are no longer fertile, and have been known to do so into their 80’s! There
is no change in the quality of the milk, and many wet nurses have continued
to practice their profession well past menopause.

Myth #26: Breastfeeding clothes and pumps end up costing as much as
formula.

*Reality:* First of all, you don’t need any special clothes or
paraphernalia to breastfeed successfully. Yes, if you plan to pump you
should buy or rent a good, reputable model. Yes, you’ll need storage bags
and bottles, although you’d need even more to formula feed. Yes, it’s nice
to have a few specially designed nursing tops, bras and a nursing pillow.
Re-usable nursing pads are also helpful, and disposable nursing pads are
nice the first few weeks.

However, even with these items taken into consideration, they do not come
close to the expense of formula. Plus, there are all the added medical
expenses you may have to deal with if you formula feed. Also, when you
breastfeed you can re-use most of the items you purchase for one child with
the next. With formula, it’s just as expensive every time.

It is also possible to purchase sewing patterns and make your own nursing
clothes and baby sling if you want to, or create your own pads out of cotton
diapers. A t-shirt with a convenient slit cut in the middle can provide
extra coverage under any pull-up or button down blouse. Nursing bras are
great, but for many women a front closing cotton bra works just as well. Use
your imagination!

Compare:

*Cost of no-frills style breastfeeding*
No pump, no special clothes, etc.
*Total: $0.00*

*Optional breastfeeding expenses:*

Pump: $200*
Bras(2): $60
Pads (re-usable): $12
Tops(2): $50
Dress(1): $60
*Nursing Pillow: $35*
*Total: $417 (A one-time expense!)*

*NOTE: You save an additional $160 if you use a good manual pump like *
Isis* (increasingly popular with new mothers, especially ones that do not
have to work out of the house) rather than a professional grade one like the
*Pump-in-Style* (also very popular, especially for working mothers).

*Approximate formula expenses:*

Formula: $1,200 (Approximate average)
*Added medical expenses: $1,500* **
*Total: $2,700 (For just one year!)*

That adds up to a difference of $2,283. Wow! And remember, you can use
those nursing clothes again, then consign them or pass them on to a friend.
With formula, it’s just as expensive with every child.

These figures don’t take into account possible future orthodontic
problems, or other more serious adult disease issues associated with bottle
feeding (see ProMoM’s “101 Reasons To Breastfeed Your
Child”).
Of course, the real bottom line is that no price can be put on the special
intimacy that exists between a nursing mother and child!

*Even more myths and realities can be found
here,
here ,
here,
and yet more here .*

**(According to *Aetna employee research results*) Breastfeeding Myths and
Realities
By Leslie Kincaid Burby for ProMoM

Keuntungan Menyusui Balita

Breastfeeding benefits toddlers and young children…
nutritionally, immunilogically and psychologically.

source : http://www.kellymom.com/bf/bfextended/ebf-benefits.html

* Nursing toddlers benefit NUTRITIONALLY
* Nursing toddlers are SICK LESS OFTEN
* Nursing toddlers have FEWER ALLERGIES
* Nursing toddlers are SMART
* Nursing toddlers are WELL ADJUSTED SOCIALLY
* Nursing a toddler is NORMAL
* MOTHERS also benefit from nursing past infancy
* Additional Resources

Nursing toddlers benefit NUTRITIONALLY

* Although there has been little research done on children who breastfeed beyond the age of two, the available information indicates that breastfeeding continues to be a valuable source of nutrition and disease protection for as long as breastfeeding continues.

* “Human milk expressed by mothers who have been lactating for >1 year has significantly increased fat and energy contents, compared with milk expressed by women who have been lactating for shorter periods. During prolonged lactation, the fat energy contribution of breast milk to the infant diet might be significant.”
— Mandel 2005

* “Breast milk continues to provide substantial amounts of key nutrients well beyond the first year of life, especially protein, fat, and most vitamins.”
— Dewey 2001

* In the second year (12-23 months), 448 mL of breastmilk provides:
o 29% of energy requirements
o 43% of protein requirements
o 36% of calcium requirements
o 75% of vitamin A requirements
o 76% of folate requirements
o 94% of vitamin B12 requirements
o 60% of vitamin C requirements
— Dewey 2001

* Studies done in rural Bangladesh have shown that breastmilk continues to be an important source of vitamin A in the second and third year of life.
— Persson 1998

* It’s not uncommon for weaning to be recommended for toddlers who are eating few solids. However, this recommendation is not supported by research. According to Sally Kneidel in “Nursing Beyond One Year” (New Beginnings, Vol. 6 No. 4, July-August 1990, pp. 99-103.):

Some doctors may feel that nursing will interfere with a child’s appetite for other foods. Yet there has been no documentation that nursing children are more likely than weaned children to refuse supplementary foods. In fact, most researchers in Third World countries, where a malnourished toddler’s appetite may be of critical importance, recommend continued nursing for even the severely malnourished (Briend et al, 1988; Rhode, 1988; Shattock and Stephens, 1975; Whitehead, 1985). Most suggest helping the malnourished older nursing child not by weaning but by supplementing the mother’s diet to improve the nutritional quality of her milk (Ahn and MacLean. 1980; Jelliffe and Jelliffe, 1978) and by offering the child more varied and more palatable foods to improve his or her appetite (Rohde, 1988; Tangermann, 1988; Underwood, 1985).

References
Nursing toddlers are SICK LESS OFTEN

* The American Academy of Family Physicians notes that children weaned before two years of age are at increased risk of illness (AAFP 2001).

* Nursing toddlers between the ages of 16 and 30 months have been found to have fewer illnesses and illnesses of shorter duration than their non-nursing peers (Gulick 1986).

* “Antibodies are abundant in human milk throughout lactation” (Nutrition During Lactation 1991; p. 134). In fact, some of the immune factors in breastmilk increase in concentration during the second year and also during the weaning process. (Goldman 1983, Goldman & Goldblum 1983, Institute of Medicine 1991).

* Per the World Health Organization, “a modest increase in breastfeeding rates could prevent up to 10% of all deaths of children under five: Breastfeeding plays an essential and sometimes underestimated role in the treatment and prevention of childhood illness.” [emphasis added]

References
Nursing toddlers have FEWER ALLERGIES

* Many studies have shown that one of the best ways to prevent allergies and asthma is to breastfeed exclusively for at least 6 months and continue breastfeeding long-term after that point.

Breastfeeding can be helpful for preventing allergy by:
1. reducing exposure to potential allergens (the later baby is exposed, the less likely that there will be an allergic reaction),
2. speeding maturation of the protective intestinal barrier in baby’s gut,
3. coating the gut and providing a barrier to potentially allergenic molecules,
4. providing anti-inflammatory properties that reduce the risk of infections (which can act as allergy triggers).

References
Nursing toddlers are SMART

* Extensive research on the relationship between cognitive achievement (IQ scores, grades in school) and breastfeeding has shown the greatest gains for those children breastfed the longest.

References
Nursing toddlers are WELL ADJUSTED SOCIALLY

* According to Sally Kneidel in “Nursing Beyond One Year” (New Beginnings, Vol. 6 No. 4, July-August 1990, pp. 99-103.):

“Research reports on the psychological aspects of nursing are scarce. One study that dealt specifically with babies nursed longer than a year showed a significant link between the duration of nursing and mothers’ and teachers’ ratings of social adjustment in six- to eight-year-old children (Ferguson et al, 1987). In the words of the researchers, ‘There are statistically significant tendencies for conduct disorder scores to decline with increasing duration of breastfeeding.’”

* According to Elizabeth N. Baldwin, Esq. in “Extended Breastfeeding and the Law”:
“Breastfeeding is a warm and loving way to meet the needs of toddlers and young children. It not only perks them up and energizes them; it also soothes the frustrations, bumps and bruises, and daily stresses of early childhood. In addition, nursing past infancy helps little ones make a gradual transition to childhood.”

* Baldwin continues: “Meeting a child’s dependency needs is the key to helping that child achieve independence. And children outgrow these needs according to their own unique timetable.” Children who achieve independence at their own pace are more secure in that independence then children forced into independence prematurely.

References
Nursing a toddler is NORMAL

* The American Academy of Pediatrics recommends that “Breastfeeding should be continued for at least the first year of life and beyond for as long as mutually desired by mother and child… Increased duration of breastfeeding confers significant health and developmental benefits for the child and the mother… There is no upper limit to the duration of breastfeeding and no evidence of psychologic or developmental harm from breastfeeding into the third year of life or longer.” (AAP 2005)

* The American Academy of Family Physicians recommends that breastfeeding continue throughout the first year of life and that “Breastfeeding beyond the first year offers considerable benefits to both mother and child, and should continue as long as mutually desired.” They also note that “If the child is younger than two years of age, the child is at increased risk of illness if weaned.” (AAFP 2001)

* A US Surgeon General has stated that it is a lucky baby who continues to nurse until age two. (Novello 1990)

* The World Health Organization emphasizes the importance of nursing up to two years of age or beyond (WHO 1992, WHO 2002).

* Scientific research by Katherine A. Dettwyler, PhD shows that 2.5 to 7.0 years of nursing is what our children have been designed to expect (Dettwyler 1995).

References [see also position statements supporting breastfeeding]
MOTHERS also benefit from nursing past infancy

* Extended nursing delays the return of fertility in some women by suppressing ovulation (References).

* Breastfeeding reduces the risk of breast cancer (References). Studies have found a significant inverse association between duration of lactation and breast cancer risk.

* Breastfeeding reduces the risk of ovarian cancer (References).

* Breastfeeding reduces the risk of uterine cancer (References).

* Breastfeeding reduces the risk of endometrial cancer (References).

* Breastfeeding protects against osteoporosis. During lactation a mother may experience decreases of bone mineral. A nursing mom’s bone mineral density may be reduced in the whole body by 1 to 2 percent while she is still nursing. This is gained back, and bone mineral density may actually increase, when the baby is weaned from the breast. This is not dependent on additional calcium supplementation in the mother’s diet. (References).

* Breastfeeding reduces the risk of rheumatoid arthritis. (References).

* Breastfeeding has been shown to decrease insulin requirements in diabetic women (References).

* Breastfeeding moms tend to lose weight easier (References).

Nilai Nutrisi Air Susu Ibu

sumber : http://www.idai.or.id/asi.asp

Nilai Nutrisi Air Susu Ibu

Keunggulan dan keistimewaan Air Susu Ibu (ASI) sebagai nutrisi untuk bayi sudah tidak diragukan lagi. Masyarakat luas khususnya kaum ibu telah paham benar kegunaan dan manfaat ASI, berbagai tulisan yang membahas masalah ASI telah banyak dipublikasi. Dalam makalah ini akan dibahas nilai nutrisi yang terkandung dalam ASI dan keunggulannya dibanding nutrisi lain untuk bayi, dengan demikian diharapkan para ibu akan lebih percaya diri dalam memberikan ASI kepada bayinya.

Seperti halnya nutrisi pada umumnya, ASI mengandung komponen makro dan mikro nutrien. Yang termasuk makronutrien adalah karbohidrat, protein dan lemak sedangkan mikronutrien adalah vitamin & mineral. Air susu ibu hampir 90%nya terdiri dari air. Volume dan komposisi nutrien ASI berbeda untuk setiap ibu bergantung dari kebutuhan bayi. Perbedaan volume dan komposisi di atas juga terlihat pada masa menyusui (kolostrum, ASI transisi, ASI matang dan ASI pada saat penyapihan). Kandungan zat gizi ASI awal dan akhir pada setiap ibu yang menyusui juga berbeda. Kolostrum yang diproduksi antara hari 1-5 menyusui kaya akan zat gizi terutama protein.

ASI transisi mengandung banyak lemak dan gula susu (laktosa). ASI yang berasal dari ibu yang melahirkan bayi kurang bulan (prematur) mengandung tinggi lemak dan protein, serta rendah laktosa dibanding ASI yang berasal dari ibu yang melahirkan bayi cukup bulan. Pada saat penyapihan kadar lemak dan protein meningkat seiring bertambah banyaknya kelenjar payudara. Walapun kadar protein, laktosa, dan nutrien yang larut dalam air sama pada setiap kali periode menyusui, tetapi kadar lemak meningkat.

Jumlah total produksi ASI dan asupan ke bayi bervariasi untuk setiap waktu menyusui dengan jumlah berkisar antara 450 -1200 ml dengan rerata antara 750-850 ml per hari. Banyaknya ASI yang berasal dari ibu yang mempunyai status gizi buruk dapat menurun sampai jumlah hanya 100-200 ml per hari.

Komposisi

ASI mengandung air sebanyak 87.5%, oleh karena itu bayi yang mendapat cukup ASI tidak perlu lagi mendapat tambahan air walaupun berada di tempat yang mempunyai suhu udara panas. Kekentalan ASI sesuai dengan saluran cerna bayi, sedangkan susu formula lebih kental dibandingkan ASI. Hal tersebut yang dapat menyebabkan terjadinya diare pada bayi yang mendapat susu formula.

Karbohidrat

Laktosa adalah karbohidrat utama dalam ASI dan berfungsi sebagai salah satu sumber energi untuk otak. Kadar laktosa yang terdapat dalam ASI hampir 2 kali lipat dibanding laktosa yang ditemukan pada susu sapi atau susu formula. Namun demikian angka kejadian diare yang disebabkan karena tidak dapat mencerna laktosa (intoleransi laktosa) jarang ditemukan pada bayi yang mendapat ASI. Hal ini disebabkan karena penyerapan laktosa ASI lebih baik dibanding laktosa susu sapi atau susu formula. Kadar karbohidrat dalam kolostrum tidak terlalu tinggi, tetapi jumlahnya meningkat terutama laktosa pada ASI transisi (7-14 hari setelah melahirkan). Sesudah melewati masa ini maka kadar karbohidrat ASI relatif stabil.

Protein

Kandungan protein ASI cukup tinggi dan komposisinya berbeda dengan protein yang terdapat dalam susu sapi. Protein dalam ASI dan susu sapi terdiri dari protein whey dan Casein. Protein dalam ASI lebih banyak terdiri dari protein whey yang lebih mudah diserap oleh usus bayi, sedangkan susu sapi lebih banyak mengandung protein Casein yang lebih sulit dicerna oleh usus bayi. Jumlah protein Casein yang terdapat dalam ASI hanya 30% dibanding susu sapi yang mengandung protein ini dalam jumlah tinggi (80%). Disamping itu, beta laktoglobulin yaitu fraksi dari protein whey yang banyak terdapat di protein susu sapi tidak terdapat dalam ASI. Beta laktoglobulin ini merupakan jenis protein yang potensial menyebabkan alergi.

Kualitas protein ASI juga lebih baik dibanding susu sapi yang terlihat dari profil asam amino (unit yang membentuk protein). ASI mempunyai jenis asam amino yang lebih lengkap dibandingkan susu sapi. Salah satu contohnya adalah asam amino taurin; asam amino ini hanya ditemukan dalam jumlah sedikit di dalam susu sapi. Taurin diperkirakan mempunyai peran pada perkembangan otak karena asam amino ini ditemukan dalam jumlah cukup tinggi pada jaringan otak yang sedang berkembang. Taurin ini sangat dibutuhkan oleh bayi prematur, karena kemampuan bayi prematur untuk membentuk protein ini sangat rendah.

ASI juga kaya akan nukleotida (kelompok berbagai jenis senyawa organik yang tersusun dari 3 jenis yaitu basa nitrogen, karbohidrat, dan fosfat) dibanding dengan susu sapi yang mempunyai zat gizi ini dalam jumlah sedikit. Disamping itu kualitas nukleotida ASI juga lebih baik dibanding susu sapi. Nukleotida ini mempunyai peran dalam meningkatkan pertumbuhan dan kematangan usus, merangsang pertumbuhan bakteri baik dalam usus dan meningkatkan penyerapan besi dan daya tahan tubuh.

Lemak

Kadar lemak dalam ASI lebih tinggi dibanding dengan susu sapi dan susu formula. Kadar lemak yang tinggi ini dibutuhkan untuk mendukung pertumbuhan otak yang cepat selama masa bayi. Terdapat beberapa perbedaan antara profil lemak yang ditemukan dalam ASI dan susu sapi atau susu formula. Lemak omega 3 dan omega 6 yang berperan pada perkembangan otak bayi banyak ditemukan dalam ASI. Disamping itu ASI juga mengandung banyak asam lemak rantai panjang diantaranya asam dokosaheksanoik (DHA) dan asam arakidonat (ARA) yang berperan terhadap perkembangan jaringan saraf dan retina mata.

Susu sapi tidak mengadung kedua komponen ini, oleh karena itu hampir terhadap semua susu formula ditambahkan DHA dan ARA ini. Tetapi perlu diingat bahwa sumber DHA & ARA yang ditambahkan ke dalam susu formula tentunya tidak sebaik yang terdapat dalam ASI. Jumlah lemak total di dalam kolostrum lebih sedikit dibandingkan ASI matang, tetapi mempunyai persentasi asam lemak rantai panjang yang tinggi.

ASI mengandung asam lemak jenuh dan tak jenuh yang seimbang dibanding susu sapi yang lebih banyak mengandung asam lemak jenuh. Seperti kita ketahui konsumsi asam lemah jenuh dalam jumlah banyak dan lama tidak baik untuk kesehatan jantung dan pembuluh darah.

Karnitin

Karnitin ini mempunyai peran membantu proses pembentukan energi yang diperlukan untuk mempertahankan metabolisme tubuh. ASI mengandung kadar karnitin yang tinggi terutama pada 3 minggu pertama menyusui, bahkan di dalam kolostrum kadar karnitin ini lebih tinggi lagi. Konsentrasi karnitin bayi yang mendapat ASI lebih tinggi dibandingkan bayi yang mendapat susu formula.

Vitamin

Vitamin K

Vitamin K dibutuhkan sebagai salah satu zat gizi yang berfungsi sebagai faktor pembekuan. Kadar vitamin K ASI hanya seperempatnya kadar dalam susu formula. Bayi yang hanya mendapat ASI berisiko untuk terjadi perdarahan, walapun angka kejadian perdarahan ini kecil. Oleh karena itu pada bayi baru lahir perlu diberikan vitamin K yang umumnya dalam bentuk suntikan.

Vitamin D

Seperti halnya vitamin K, ASI hanya mengandung sedikit vitamin D. Hal ini tidak perlu dikuatirkan karena dengan menjemur bayi pada pagi hari maka bayi akan mendapat tambahan vitamin D yang berasal dari sinar matahari. Sehingga pemberian ASI eksklusif ditambah dengan membiarkan bayi terpapar pada sinar matahari pagi akan mencegah bayi menderita penyakit tulang karena kekurangan vitamin D.

Vitamin E

Salah satu fungsi penting vitamin E adalah untuk ketahanan dinding sel darah merah. Kekurangan vitamin E dapat menyebabkan terjadinya kekurangan darah (anemia hemolitik). Keuntungan ASI adalah kandungan vitamin E nya tinggi terutama pada kolostrum dan ASI transisi awal.

Vitamin A

Selain berfungsi untuk kesehatan mata, vitamin A juga berfungsi untuk mendukung pembelahan sel, kekebalan tubuh, dan pertumbuhan. ASI mengandung dalam jumlah tinggi tidak saja vitamin A dan tetapi juga bahan bakunya yaitu beta karoten. Hal ini salah satu yang menerangkan mengapa bayi yang mendapat ASI mempunyai tumbuh kembang dan daya tahan tubuh yang baik.

Vitamin yang larut dalam air

Hampir semua vitamin yang larut dalam air seperti vitamin B, asam folat, vitamin C terdapat dalam ASI. Makanan yang dikonsumsi ibu berpengaruh terhadap kadar vitamin ini dalam ASI. Kadar vitamin B1 dan B2 cukup tinggi dalam ASI tetapi kadar vitamin B6, B12 dan asam folat mungkin rendah pada ibu dengan gizi kurang. Karena vitamin B6 dibutuhkan pada tahap awal perkembangan sistim syaraf maka pada ibu yang menyusui perlu ditambahkan vitamin ini. Sedangkan untuk vitamin B12 cukup di dapat dari makanan sehari-hari, kecuali ibu menyusui yang vegetarian.

Mineral

Tidak seperti vitamin, kadar mineral dalam ASI tidak begitu dipengaruhi oleh makanan yang dikonsumsi ibu dan tidak pula dipengaruhi oleh status gizi ibu. Mineral di dalam ASI mempunyai kualitas yang lebih baik dan lebih mudah diserap dibandingkan dengan mineral yang terdapat di dalam susu sapi.

Mineral utama yang terdapat di dalam ASI adalah kalsium yang mempunyai fungsi untuk pertumbuhan jaringan otot dan rangka, transmisi jaringan saraf dan pembekuan darah. Walaupun kadar kalsium ASI lebih rendah dari susu sapi, tapi tingkat penyerapannya lebih besar. Penyerapan kalsium ini dipengaruhi oleh kadar fosfor, magnesium, vitamin D dan lemak. Perbedaan kadar mineral dan jenis lemak diatas yang menyebabkan perbedaan tingkat penyerapan. Kekurangan kadar kalsium darah dan kejang otot lebih banyak ditemukan pada bayi yang mendapat susu formula dibandingkan bayi yang mendapat ASI.

Kandungan zat besi baik di dalam ASI maupun susu formula keduanya rendah serta bervariasi. Namun bayi yang mendapat ASI mempunyai risiko yang lebih kecil utnuk mengalami kekurangan zat besi dibanding dengan bayi yang mendapat susu formula. Hal ini disebabkan karena zat besi yang berasal dari ASI lebih mudah diserap, yaitu 20-50% dibandingkan hanya 4 -7% pada susu formula. Keadaan ini tidak perlu dikuatirkan karena dengan pemberian makanan padat yang mengandung zat besi mulai usia 6 bulan masalah kekurangan zat besi ini dapat diatasi.

Mineral zinc dibutuhkan oleh tubuh karena merupakan mineral yang banyak membantu berbagai proses metabolisme di dalam tubuh. Salah satu penyakit yang disebabkan oleh kekurangan mineral ini adalah acrodermatitis enterophatica dengan gejala kemerahan di kulit, diare kronis, gelisah dan gagal tumbuh. Kadar zincASI menurun cepat dalam waktu 3 bulan menyusui. Seperti halnya zat besi kandungan mineral zink ASI juga lebih rendah dari susu formula, tetapi tingkat penyerapan lebih baik. Penyerapan zinc terdapat di dalam ASI, susu sapi dan susu formula berturut-turut 60%, 43-50% dan 27-32%. Mineral yang juga tinggi kadarnya dalam ASI dibandingkan susu formula adalah selenium, yang sangat dibutuhkan untuk pertumbuhan cepat.

ASI dan perkembangan ketrampilan makan

Bayi mengalami pengalaman pertama tentang rasa makanan sejak masih dalam kandungan. Rasa cairan ketuban berubah-ubah bergantung jenis makanan yang dikonsumsi oleh ibu. Rasa dari makanan yang dikonsumsi oleh ibu selama kehamilan di salurkan ke cairan ketuban yang tidak hanya dirasakan oleh janin tetapi juga meningkatkan penerimaan dan kenikmatan bayi pada saat masa penyapihan ASI. Kemampuan bayi untuk mengetahui dan menerima rasa dan selera berkembang setelah lahir. Oleh karena itu pengalaman pertama terhadap rasa dan selera mempunyai dampak terhadap penerimaan rasa dan selera pada masa bayi dan anak. Telah diketahui sejak lama bahwa bayi yang terpapar dengan rasa dalam ASI akan meningkatkan penerimaan rasa tersebut sehingga mempercepat keberhasilan penyapihan. Beberapa bayi yang mendapat ASI lebih dapat menerima sayur-sayuran pada pemberian pertama dibandingkan dengan bayi yang mendapat susu formula. Anak yang diberikan ASI paling sedikit 6 bulan juga lebih jarang mengalami kesulitan makan (picky eaters), sepanjang cara pemberian ASInya benar.

Daftar Bacaan

1. Walker WA, Watkins JB, Duggan C. Nutrition in pediatrics. Basic science and clinical applications. BC Decker, London 2003.
2. Laurence RA. Breast Feeding. A guide for the medical profession. Mosby. St.Louis. 1989.
3. Hendricks KM, Duggan C, Walker AW. Manual of pediatric nutrition. BC Decker, London 2000.
4. Samour PQ, Helm KK, Lang CE. Handbook of pediatric nutrition. ASPEN, Maryland 1999.
5. Baker SS, Baker DR, Davis AM. Pediatric nutrition support. Jones & Bartlett, Boston 2007.

Penulis : Aryono Hendarto dan Keumala Pringgadini

Sumber : Buku Bedah ASI

Komponen ASI Berubah-ubah Selama 24 Jam

Sumber: http://www.erabaru.net/featured-news/48-hot-update/5664-komponen-asi-berubah-ubah-selama-24-jam

Komponen-komponen dalam air susu Ibu (ASI) berubah setiap 24 jam dalam merespon kebutuhan bayi. Sebuah penelitan baru menunjukkan bagaimana ASI bisa membantu bayi-bayi yang baru lahir untuk tidur.


Air susu ibu (ASI) berisi berbagai unsur, seperti nukleotida-nukleotida, yang melakukan sebuah peran yang sangat penting dalam mengatur bayi-bayi tidur secara teratur. Penemuan yang diterbitkan baru-baru ini dalam jurnal Nutritional Neuroscience, menyatakan bahwa komposisi ASI berubah dalam waktu-waktu tertentu sepanjang hari.

Para ilmuwan menemukan tiga nukleotida di dalam ASI (adenosine, guanosine dan uridene) yang berperan menggerakan atau mengistirahatkan sistem saraf pusat, membuat bayi tenang dan tidur.

ASI yang dikumpulkan dari 30 wanita yang tinggal di Extremadura, dinyatakan pada periode 24 jam, dengan enam sampai delapan contoh sehari. Konsentrat-konsentrat nukleotida yang paling tinggi ditemukan contoh pada malam hari (8 malam sampai 8 pagi). “Hal ini membuat kami menyadari bahwa ASI berpengaruh pada tidur bayi-bayi”, Cristina L. Sánchez, pimpinan penulis artikel dan seorang peneliti pada Chrononutrition Laboratory di Universitas Extremadura.

“Sedangkan ASI yang dihasilkan di siang hari memiliki komponen istimewa yang dapat menstimulasi aktivitas bayi, sebaliknya komponen ASI di malam hari membantu bayi untuk tidur dan beristirahat,” ujar Sánchez.

Untuk memastikan nutrisi yang tepat, bayi itu harus diberi susu pada waktu yang sama saat ASI itu dikeluarkan. Untuk full time mother, tentunya hal ini bukan masalah karena biasanya bayi menyusu langsung. Namun bagi ibu bekerja yang memerah ASI-nya di siang hari, ASI tersebut harus diberikan pada siang hari juga (keesokannya atau pada hari-hari berikutnya) karena ASI tersebut mengandung komponen untuk membuat bayi aktif (membantunya belajar kemampuan-kemampuan baru). Sedangkan ASI yang dikeluarkan di malam hari biasanya memang diminum langsung oleh bayi karena ibu bekerja sudah berada di rumah, ataupun bila Ibu memerah ASI-nya di malam hari, peruntukannya adalah untuk diberikan ke bayi pada malam hari juga, karena ASI malam mengandung komponen untuk membuat bayi tidur berisitrahat. Oleh karenanya, pencantuman tanggal disertai jam memerah ASI adalah sangat baik untuk membantu ibu mengingat ASI tersebut adalah ASI siang atau ASI malam.

Keuntungan Air Susu Ibu (ASI)


World Health Organisation (WHO) mengatakan bahwa ASI adalah makanan terbaik untuk bayi, terutama ASI mengandung semua kebutuhan penting bayi selama enam bulan setelah lahir. Tidak hanya melindungi bayi juga melawan berbagai macam penyakit seperti dingin, diare dan sindrom kematian bayi mendadak (SIDS), tetapi dapat juga mencegah penyakit-penyakit masa depan seperti asma, alergi-alergi dan kegemukan, dan juga berpengaruh pada intelektualitas anak.

Keuntungan ASI tidak hanya dinikmati bayi namun juga Ibu. Wanita yang menyusui biasanya berat badannya turun lebih cepat, pemberian ASI juga membantu mencegah anemia setelah kehilangan darah saat melahirkan, mencegah tekanan darah tinggi dan depresi pasca melahirkan. Osteoporosis dan kanker payudara juga jarang terjadi pada ibu yang menyusui bayi-bayi mereka. (Erabaru/snd)

Some Commonly Overlooked Breastfeeding Basics

Source : http://www.birthjourney.com/pdfs/breastfeeding.pdf

SOME COMMONLY OVERLOOKED BREASTFEEDING BASICS
Written by, Lois Wattis, RN, RM, IPM, FACM, IBCLC – Australia
(COPYRIGHT: Lois Wattis www.birthjourney.com)
Most women are well aware of the benefits of breastfeeding and start by offering their baby colostrum from birth. Each mother/baby combination is unique as the nurturing process unfolds developing into their personal journey. Hospital and parenting practices have changed over the years, informational resources and advice abounds, and parents often become very confused as they endeavour to provide the best for their child.
“Many of the hospital practices in the past led to mothers weaning their babies from the breast within days or weeks of going home from hospital. Your mother or grandmother will have had their babies under this system and may not understand why you are being taught different ways of caring for your baby. They may be surprised that you are able to have your baby at your bedside or in your bed in hospital. They are sure to share their experiences with you and may lament the restrictions and rules enforced when they were new mothers.” (Cox, 2004 p12)

In this article I will share a few breastfeeding basics which I believe are often overlooked in the plethora of information and advice that new parents receive. This article adressess the challenge of learning to breastfeed, feeding a newborn baby and how to know what constitutes a normal breastfeed, and some typical changes to breastfeeding patterns as baby grows.
The experience of breastfeeding
Some women have an unrealistic expectation that breastfeeding will “just happen” and may experience surprise, disappointment and frustration in the early hours and days of motherhood. Sometimes it all just seems to be too hard!
Breastfeeding is like learning to drive a car. It doesn’t matter how much you want to drive a car, or how often you sit in the passenger seat carefully watching how to steer and change gears and use the clutch and the accelerator. Everyone learning to drive will bunny hop the car, and grind the gears, and find the co-ordination of the pedals and the gears in combination with all other aspects of driving is a challenging new skill to master. Later it will all become ’second nature’ and hardly require concentration to co-ordinate the actions at all, but in the beginning it requires some effort and may involve some frustrations as co-ordination develops.
“Breastfeeding is a learned skill. You learn by observing others (which doesn’t always happen in our society) and by experience and practice. You and your baby are a unique unit, and you will very quickly become the expert, as you learn to respond to baby’s cues.” Rebecca Glover, 1997
“Breastfeeding is not simply the transfer of milk
from your breasts to your baby. It is also the transfer of smell, skin touch, warmth and feelings as you and your baby gaze at and stroke each other during this delightful interaction many times a day. Skin-to- skin contact is a basic human need.” (Cox, 2004, p12)

“Breastfeeding is often seen as just a way to give babies milk – nutrition. It is in fact when babies receive a host of sensory input – nurture. It has been known for many years that body contact from a constant caregiver is essential to the normal development of human beings.” Cox, 2004, p27)
Breastfeeding is the culmination of the process of growing and birthing your baby. This extraordinary continuum has ensured the survival and development of our species. Modern women may doubt their own capacity to complete the nurture of their child from conception to toddlerhood and beyond, but scientific discoveries continue to confirm the wondrous properties and unique benefits of human breast milk.
“Milk, in the form of colostrum, is present from about the fourth month of pregnancy onwards. At birth, the delivery of the placenta triggers a reduction in the woman’s progesterone levels that removes the inhibition of milk production and allows the elevated levels of prolactin to function. Increased amounts of blood and lymph in the breast form the nutrients for milk production. These fluids cause the breasts to become fuller, heavier, and sometimes tender. As regular, frequent breastfeedings progress, this normal fullness diminishes. By about two weeks postpartum, when lactation is established, the breasts become comfortable soft and pliable, even when they are full with milk. Regular frequent feedings will maintain this condition.” (Lauwers & Swisher, 2005, p308)
Breastfeeding a Newborn Baby
Forget the clock
Be guided by your baby’s cues as to when he wants to feed and for how long. During the first few days when baby’s breastfeeds provide colostrum the feedings may be frequent and irregular. Colostrum is highly concentrated, and baby’s stomach capacity is small so the quantity of colostrum required to satisfy his needs is also small. Alternating sides each time the baby goes to the breast will stimulate the breasts, assisting the transition from colostrum to breast milk production (lactogenesis).
Feeding Frenzy
Around Day 2-3, baby often wants to feed more frequently, maybe 1-2 hourly. Baby has passed lots of meconium poos, emptying out his gastro-intestinal tract, and his stomach capacity is gradually increasing in size in preparation for milk feeds. He’s hungry!!! So feed him. This is nature’s way of ‘calling in the milk’ and your body will respond accordingly. Skin-to-skin contact with your baby, allowing baby to smell, hear and touch you and avoiding separations so you can respond to his feeding cues immediately will facilitate your ‘milk coming in’ – putting an end to the Day 2-3 feeding frenzy.
The milk arrives
Your breasts feel heavy, warm and may leak prior to or during feeds. Nature often overcompensates in the beginning, but it will settle down. Now it is advisable to feed your baby from one breast per feed, aiming to drain each breast a number of times during each 24 hour period. Baby will let you know when he’s had enough. As baby grows he may drain the first breast and still want more, so the feed may be completed on the second breast. In this case start the next feed on the breast with which you finished the last feed.
How do I know how long to feed my baby?
“In general, the baby’s needs should determine feeding length. When the flow of milk diminishes from one breast, the sucking rate will move from the long, drawing nutritive suck to a faster, gentler suck. The baby’s eyes will close, his fists will relax, and his hands will come away from his face. He may release the breast and let it slide out of his mouth. Allowing the baby to remove himself from the breast will ensure that he has received the high-fat hindmilk needed for optimal growth. Limiting the time spent on the breast may result in the baby’s receiving foremilk from both breasts and becoming too full to obtain a significant amount of hindmilk from either breast. This form of high volume, low fat feeding can result in poor weight gain and colic-like symptoms. Flexibility on the mothers part will allow for variations in the baby’s nursing style, hunger, and daily temperament.” (Lauwers & Swisher, 2005, p308)
Each breastfeed is usually comprised of a few instalments.
Just as an adult varies the size of meals eaten according to hunger, and meals may be comprised of several courses, babies vary their feeds too. Young babies particularly need to take each ‘meal’ in a few stages, with rest times in between each stage to allow partial digestion. This will mean baby may go to the breast two or more times PER FEED.
Consider when you go out for a meal at a nice restaurant. You order your entree, and eat is quite quickly and enthusiastically, because you were hungry! Mmmm, that feels better, and some time elapses before your main course arrives. Your initial hunger is curbed so that’s OK. Your main meal arrives and you steadily consume it, less quickly than the entree, but enjoying it just the same. You feel full. Nevertheless, you still have a look at the sweets menu. OK, lets have sweets – you’re ready for it by the time it arrives. Now you feel really satisfied and you relax into some after dinner conversation. A bit later you may want coffee and maybe after dinner mints too … but of course you don’t do that every meal – just sometimes. The whole dinner process usually takes about an hour or so – reasonable and acceptable, right?
Isn’t it reasonable and acceptable for a young baby’s feed to be consumed over a similar timeframe and in several instalments if that is what baby demonstrates by his cues that he needs? Some feeds will be completed in less time and fewer instalments according to baby’s needs. Be flexible, and respond to your baby’s early feeding cues and your baby will be contented and thrive – and sleep well between feeds.
“Your tiny baby will breastfeed eight to twelve times in 24 hours, taking from 45 to 60 minutes for each feed, including nappy changes and cuddles. Feed times will take at least eight hours each day. Small babies usually have a long wakeful time during each 24 hours. Most often this is in the evening from about five o’clock to nine or ten o’clock.” (Cox, 2004, p41)
“Generally, mothers should allow the baby to remain at the breast until he spontaneously releases the breast on his own. If the baby tends to ‘linger’ at the breast, the mother can watch for a change from nutritive to non-nutritive sucking. Non-nutritive sucking does not provide the stimulation necessary for increasing milk production. If the mother removes him from the breast at this time it should not significantly affect milk quantity. However, mothers should be encouraged to gauge their individual baby’s needs. Some babies need more comfort sucking at the breast than others need. During the first month of life, the baby establishes patterns of milk intake that will continue through the next twelve months (Mitoulas, 2002). Parents need to avoid strict schedules and allow the baby to lead his feedings. This supports the individual nature of infant needs and the importance of baby-led feedings. Each baby’s own rhythm will reflect his feeding patterns.” (Lauwers & Swisher, 2005, p308)
Just when you think you know what to expect – it changes!
Be prepared for your baby to change his pattern of feeding from time to time. This usually coincides with a growth spurt, and baby will demand feeds more frequently for a day or two. To facilitate the process of increasing your supply you may need to abandon whatever plans you had for that day and ‘just feed the baby’. If you’ve missed a lot of sleep overnight go back to bed with your baby and feed him as he demands, and your body will respond by increasing your milk supply within 24-48 hours. Giving supplementary feeds during this time will interfere with your body’s response to the process, so AVOID giving formula feeds. Rest and good nutrition are the keys to increasing your supply to meet your baby’s growing needs – so look after yourself! Typically ‘feeding frenzies’ occur at 2-3 days (“calling your milk in”); usually again around 2 or 3 weeks, sometimes again at around 6 weeks, very commonly around 3 months and around 6 months of age.
Interestingly, when breastfeeding women are having problems with insufficient breastmilk supply and they review when the problem first arose, it usually coincides with one of the typical growth spurt ages – around 3 days, 3 weeks, 6 weeks, 3 or 6 months. If mothers are prepared for growth spurt feeding behaviours they are more likely to cope with it appropriately and continue to successfully breastfeed their babies.
“GROWTH SPURTS
A mother may periodically notice an increase in the frequency with which her baby wishes to feed. All babies experience periods of sudden growth during their early months. They react to these growth spurts by feeding more frequently. Such periods of increased feeding usually last only a few days. Growth spurts can occur at any time, although there are predictable ages. Mothers who have a robust supply of milk through frequent breastfeeding in the early postpartum days easily carry through during these times of feeding frequency until the growth spurt has passed.” (Dewey, 1991 – in Lauwers & Swisher, 2005, p309)
Enjoy your unique breastfeeding experience as you nurture your special little person in the best possible way!
Lois Wattis
(RN, RM, IPM, FACM, IBCLC)
www.birthjourney.com.au

REFERENCES:
Cox, S. (2004). Breastfeeding with confidence – A do-it-yourself guide. Finch, Sydney
Glover, R. (1997). The Key to Successful Breastfeeding (brochure) Perth.
Lauwers, J & Swisher, A. (2005). Counselling the Nursing Mother – A lactation consultant’s guide.
Jones & Bartlett, London
Other good information sources include:
www.breastfeeding.asn.au – Australian Breastfeeding Association
www.lalecheleague.org – International La Leche League
www.promom.org – Promotion of Mothers Milk Inc.

Menyusui saat Puasa, Mengapa Tidak?

sumber : http://www.jawapos.co.id/halaman/index.php?act=detail&nid=88193

Oleh : Dr Widodo J. SpA

PUASA Ramadan hukumnya wajib bagi setiap muslim, termasuk ibu hamil dan ibu menyusui. Meski demikian, Islam memberikan kelonggaran bagi ibu hamil dan menyusui untuk tidak berpuasa, asal diganti berpuasa di waktu yang lain, atau membayar fidyah.

Untuk memutuskan puasa atau tidak demi kepentingan bayi, para ibu yang sedang menyusui harus mengetahui kondisi biologis dan psikologisnya. Ini agar bayi tidak menjadi korban.

Beberapa penelitian menyebutkan, sebenarnya tidak terdapat perbedaan mencolok antara saat berpuasa dan tidak berpuasa. Puasa saat Ramadan tidak memengaruhi secara drastis metabolisme lemak, karbohidrat, dan protein. Meskipun terjadi peningkatan serum uria dan asam urat, dan ini sering dialami saat dehidrasi ringan karena puasa.

Dalam sebuah penelitian juga disebutkan, saat puasa tidak berpengaruh pada sel darah manusia. Tidak terdapat perbedaan jumlah retikulosit, volume sel darah merah, rata-rata konsentrasi hemoglobin (MCH, MCHC) bila dibandingkan dengan orang yang tidak berpuasa.

Ada juga sebuah penelitian yang dilakukan di perkampungan Afrika Barat terhadap dua kelompok ibu-ibu. Pertama, ibu hamil dan ibu menyusui yang berpuasa. Kedua, ibu tidak hamil dan ibu tidak menyusui. Ternyata, dalam penelitian tersebut disimpulkan tidak terdapat perbedaan kadar glukosa serum, asam lemak bebas, trigliserol, keton, beta hidroksi butirat, alanin, insulin, glucagon, dan hormon tiroksin.

Pada penelitian hormon wanita tidak terjadi gangguan pada hormon virgisteron saat melaksanakan puasa. Tetapi, 80 persen populasi penelitian menunjukkan penurunan hormon prolaktin. Penurunan hormon prolaktin ini mungkin harus diwaspadai pada ibu yang menyusui. Tetapi, belum ada bukti penelitian yang menunjukkan kualitas dan kuantitas ASI (air susu ibu) berkurang atau berat badan bayi menurun bila ibu menyusui berpuasa.

Saat bayi menyusu, saraf-saraf di permukaan payudara memberikan rangsangan sensoris ke hipotalamus atau kelenjar pada otak untuk memproduksi hormon prolaktin dan hormon oksitosin. Hormon prolaktin memberi perintah agar sel-sel dalam payudara memproduksi ASI. Sementara hormon oksitosin menyebabkan otot-otot payudara berkontraksi, dan memompa ASI keluar dari puting. Banyaknya ASI yang diproduksi dan dikeluarkan dari payudara, sesungguhnya diatur oleh isapan bayi. Makin sering bayi mengisap, makin sering ASI dikeluarkan dan diproduksi di payudara. Melihat kondisi tersebut, ibu yang menyusui dengan kondisi tertentu harus lebih waspada, terutama saat memberikan ASI eksklusif sebelum bayi berusia 6 bulan.

Memutuskan Puasa

Melihat berbagai kondisi tersebut di atas, kecermatan ibu dalam menentukan perlu tidaknya puasa sangat diperlukan. Pada keadaan ibu yang sedang memberikan ASI eksklusif sebelum bayi berusia 6 bulan, harus dipertimbangkan secara ketat. Sebab, konsumsi ASI adalah jenis makanan tunggal yang dikonsumsi. Tidak ada salahnya kalau ibu menunda puasa. Kalaupun ibu bersikeras melakukan puasa, harus berkonsultasi lebih sering dengan dokter anak yang merawat untuk memantau kesehatan bayi. Bila dalam observasi ketat setiap minggu dokter dapat mengevaluasi bahwa jumlah ASI tidak terganggu dan bayi tidak terpengaruh pertumbuhannnya, bisa saja ibu terus berpuasa.

Keadaan lain yang perlu dicermati adalah bila ibu menyusui mempunyai aktivitas fisik tinggi, ibu dengan gizi buruk, mengalami gangguan ginjal, diabet atau penyakit kronis lain, sebaiknya juga mempertimbangkan untuk menunda puasa.

Melihat berbagai keadaan dan kondisi saat puasa yang tidak mengganggu metabolism tubuh, secara umum berpuasa saat menyusui tidak bermasalah. Untuk mencapai hasil optimal, mungkin ibu menyusui yang sedang berpuasa sangat penting tetap mempertahankan pola makan dengan kualitas dan kuantitas seperti saat tidak berpuasa. Kalau perlu, menjadwal makan tiga kali per hari. Yaitu, saat sahur, ketika berbuka puasa, dan menjelang tidur sesudah salat Tarawih. Demikian pula kebutuhan cairan, kalori, mineral, dan vitamin harus tidak berbeda dengan saat tidak puasa.

Jumlah konsumsi cairan sebaiknya didapatkan sekitar dua liter per hari. Jenis asupan cairan bisa meliputi teh manis, jus buah, air madu, kolak, air kacang hijau, susu, atau sebagian air putih. Asupan makanan yang lengkap dan seimbang harus cermat dilakukan. Pemberian asupan suplemen vitamin dan mineral tambahan terutama zat besi, bisa saja dilakukan bila disadari aktivitas meningkat, sedangkan konsumsi nutrisi dirasakan berkurang. Asupan nutrisi yang manis seperti kurma, jus buah, atau teh manis sangat diperlukan untuk dapat memperoleh energi secara cepat akibat kehilangan cadangan glukosa saat puasa. (*)

Dr Widodo J. SpA, bertugas di RS Bunda Jakarta

Kesempurnaan ASI

sumber : babywonderful.blogspot.com

Sebagai cairan ajaib ciptaan Tuhan, Air Susu Ibu (ASI) mengandung seluruh zat yang berguna untuk memenuhi kebutuhan gizi bayi, serta melindunginya dari serangan penyakit.

Seorang bayi yang baru lahir masih berada dalam proses pertumbuhan dan belum memiliki sistem kekebalan tubuh yang kuat. Oleh karena itu, zat kekebalan tubuhnya (antibodi) hanya dapat diperoleh dari makanan yang ia konsumsi, dan proses menyusui memungkinkan bayi untuk mendapat antibodi ibu, yang secara langsung turut masuk ke dalam tubuhnya.

ASI dihasilkan dari suatu emulsi lemak dalam larutan protein, laktosa dan garam-garam anorganik yang dihasilkan oleh kelenjar payudara melalui proses laktasi. Keseimbangan zat-zat gizi dalam ASI berada pada tingkat terbaik bagi tubuh bayi, karena sifat lain dari ASI adalah penyediaan lingkungan yang ramah bagi bakteri menguntungkan yang disebut flora normal dalam tubuh bayi. Sementara pada saat yang sama, ASI juga sangat kaya akan sari-sari makanan yang dapat mempercepat pertumbuhan sel-sel otak dan perkembangan sistem saraf.

Selain mengandung zat-zat makanan, ASI juga mengandung enzim penyerap. Bila dibandingkan dengan susu sapi yang tidak diberi enzim, penyerapan susu sapi tergantung pada enzim yang ada di usus bayi. Dengan kata lain, karena ASI sudah mengandung enzim, sistem pencernaan bayi tidak perlu lagi menggunakan enzim dalam usus, sehingga ASI merupakan asupan yang mudah diserap dan dicerna, serta sangat ramah bagi usus bayi.

Karena ASI merupakan makanan yang mudah dicerna dan diserap, bayi mengeluarkan sedikit energi untuk mencerna makanan, sehingga ia dapat menggunakan energi selebihnya untuk pertumbuhan dan perkembangan organ lainnya.

Beberapa fakta tentang manfaat dan keajaiban ASI, yaitu:

*
ASI bebas penyakit, kecuali bila payudara terkena radang
*
ASI dikonsumsi secara segar, sehingga semua zat yang terkandung di dalamnya tetap memiliki kuaitas yang baik
*
ASI mengandung semua zat yang dibutuhkan bayi dalam perbandingan yang tepat sehingga mudah dicerna dan diserap oleh usus
*
ASI mengandung semua zat penambah antibodi terhadap serangan penyakit
*
Tidak ada zat dalam ASI yang memberikan dampak negatif pada bayi, walaupun diberikan sebanyak apapun
*
Dengan memahami proses produksi ASI dalam tubuh ibu, ASI dapat diperoleh kapan saja dan tanpa mengeluarkan biaya
*
Suhu ASI sesuai dengan kebutuhan bayi, tidak perlu dipanaskan lagi
*
ASI, yang selalu siap setiap saat dan selalu berada pada suhu yang paling sesuai, memainkan peran utama dalam perkembangan otak, karena gula dan lemak yang dikandungnya
*
Unsur-unsur seperti kalsium yang dimilikinya juga berperan besar dalam perkembangan tulang-tulang bayi
*
Proses menyusui dapat menguatkan ikatan antara ibu dan bayi
*
Proses menyusui dapat membantu alat-alat kandungan ibu kembali pada kondisi sebelum melahirkan
*
Menyusui mengurangi ibu dari serangan kanker payudara
*
Menyusui dapat membantu menjarangkan kehamilan pada ibu.
*
Bila bayi mengalami sakit, misalnya ketika disuntik, hal terbaik adalah memberinya ASI. Secara alami ASI memiliki efek mengurangi rasa sakit karena terasa manis dan mengandung banyak bahan kimia yang dapat menjadi penahan rasa sakit alami
*
ASI berpengaruh pada sifat bayi yang lebih tenang, karena ketika sedang menyusu, bayi yang dekat dengan ibunya akan merasa lebih nyaman dan aman. Perasaan ini akhirnya berpengaruh pada psikologi dan sifatnya kelak.

Fakta tentang keajaiban ASI tidak berhenti sampai di sini. Perannya yang penting terhadap kesehatan bayi selalu berubah seiring dengan fase kehidupan bayi. Selain itu, kandungan ASI juga dapat berubah guna memenuhi kebutuhan khusus bayi di setiap fase kehidupannya.

Bila dibandingkan dengan susu sapi, keunggulan ASI diantaranya:

*
Kadar ASI bisa berubah sesuai dengan fase pertumbuhan, perkembangan, usia, dan kebutuhan bayi.
*
Jumlah kalori dan zat gizi berubah berdasarkan keadaan bayi saat lahir, apakah ia lahir prematur ataukah tepat waktu. Bila bayi lahir prematur, kadar lemak dan protein ASI lebih tinggi daripada kebutuhan bayi umumnya, karena bayi prematur membutuhkan kalori lebih banyak.

Kedua keunggulan tersebut sangat tidak bisa ditemui pada susu sapi. Lagipula bakteri pada susu sapi, dapat tumbuh bila susu disimpan pada suhu kamar selama enam jam. Namun, tidak ada bakteri yang muncul dalam ASI yang disimpan dalam suhu dan jangka waktu yang sama.

Apakah kandungan asi ibu yang melahirkan bayi laki2 lebih banyak dari kandungan asi ibu yang melahirkan bayi Perempuan?

sumber : http://www.opensubscriber.com/message/zamanku@yahoogroups.com/6971478.html

Apakah kandungan asi ibu yang melahirkan bayi laki2
lebih banyak dari kandungan asi ibu
yang melahirkan bayi Perempuan?

ASI DAN MENYUSUI.

Menyusui adalah proses pemberian susu kepada bayi atau anak kecil
dengan air susu ibu (ASI) dari payudara ibu. Bayi menggunakan refleks
menghisap untuk mendapatkan dan menelan susu.

Bukti eksperimental menyimpulkan bahwa air susu ibu adalah gizi
terbaik untuk bayi. Para pakar masih memperdebatkan seberapa lama
periode menyusui yg paling baik dan seberapa jauh risiko penggunaan
susu formula.

Seorang bayi dapat disusui oleh ibunya sendiri atau oleh wanita
lain. ASI juga dapat diperah dan diberikan melalui alat menyusui lain
seperti botol susu, cangkir, sendok, atau pipet. Susu formula juga
tersedia untuk para ibu yang tidak bisa atau memilih untuk tidak
menyusui, namun para ahli sepakat bahwa kualitas susu formula
tidaklah sebaik ASI. Di banyak negara, pemberian susu formula terkait
dengan tingkat kematian bayi akibat diare, tetapi apabila
pembuatannya dilakukan dengan hati-hati menggunakan air bersih,
pemberian susu formula cukup aman.

Pemerintah dan organisasi internasional sepakat untuk mempromosikan
menyusui sebagai metode terbaik untuk pemberian gizi bayi setidaknya
tahun pertama dan bahkan lebih lama lagi, antara lain WHO, Akademi
Dokter Anak Amerika (American Academy of Pediatrics}, dan Departemen
Kesehatan.
Saat melahirkan, keluarnya plasenta menyebabkan turunnya tingkat
hormon progesteron, estrogen, dan HPL secara tiba-tiba, namun hormon
prolaktin tetap tinggi. Hal ini menyebabkan produksi ASI besar-
besaran yang dikenal dengan fase Laktogenesis II.

Apabila payudara dirangsang, level prolaktin dalam darah meningkat,
memuncak dalam periode 45 menit, dan kemudian kembali ke level
sebelum rangsangan tiga jam kemudian. Keluarnya hormon prolaktin
menstimulasi sel di dalam alveoli untuk memproduksi ASI, dan hormon
ini juga keluar dalam ASI itu sendiri. Penelitian mengindikasikan
bahwa level prolaktin dalam susu lebih tinggi apabila produksi ASI
lebih banyak, yaitu sekitar pukul 2 pagi hingga 6 pagi, namun level
prolaktin rendah saat payudara terasa penuh.

Hormon lainnya, seperti insulin, tiroksin, dan kortisol, juga
terdapat dalam proses ini, namun peran hormon tersebut belum
diketahui. Penanda biokimiawi mengindikasikan bahwa proses
laktogenesis II dimulai sekitar 30-40 jam setelah melahirkan, tetapi
biasanya para ibu baru merasakan payudara penuh sekitar 50-73 jam (2-
3 hari) setelah melahirkan. Artinya, memang produksi ASI sebenarnya
tidak langsung setelah melahirkan.

Kolostrum dikonsumsi bayi sebelum ASI sebenarnya. Kolostrum
mengandung sel darah putih dan antibodi yang tinggi daripada ASI
sebenarnya, khususnya tinggi dalam level immunoglobulin A (IgA), yang
membantu melapisi usus bayi yang masih rentan dan mencegah kuman
memasuki bayi. IgA ini juga mencegah alergi makanan. Dalam dua minggu
pertama setelah melahirkan, kolostrum pelan pelan hilang dan
tergantikan oleh ASI sebenarnya.

KENAPA KANDUNGAN ASI IBU BAYI LAKI-LAKI LEBIH BANYAK?

Menurut seorang Guru Biologi sebuah Sekolah Menengah Atas (SMA) di
Kuningan, bahwa Bayi laki-laki itu cenderung lebih Agresif. Kenapa
demikian? karena banyak faktor yang mempengaruhi bayi laki-laki
cenderung agresif, diantaranya adalah faktor Genetik pembawa sifat
secara fenotif (bentuk tubuh) dan genotif (sifat dalam) yang berbeda
dengan perempuan.

Prinsipnya Kalau seorang bayi lebih agresif menyusu pada ibunya,
otomatis hormon prolaktin yang memproduksi asi, itu akan terangsang
untuk menghasilkan asi lebih banyak. Jadi kalau asinya sudah banyak,
maka kandungan gizinya pun akan banyak pula.

Proses Produksi ASI

sumber : http://babywonderful.blogspot.com/2009/03/proses-produksi-asi.html

Menyusui adalah proses pemberian susu kepada bayi dengan air susu ibu (ASI) dari payudara ibu. Bayi menggunakan refleks menghisap untuk mendapatkan dan menelan susu. Seorang bayi dapat disusui oleh ibunya sendiri atau oleh wanita lain. ASI juga dapat diperah dan diberikan melalui alat menyusui lain seperti botol susu, cangkir, sendok, atau pipet.

ASI terdiri dari berbagai komponen gizi dan non gizi. Komposisi ASI tidak sama selama periode menyusui, pada akhir menyusui kadar lemak 4-5 kali dan kadar protein 1,5 kali lebih tinggi daripada awal menyusui. Juga terjadi variasi dari hari ke hari selama periode laktasi.

Proses produksi, sekresi, dan pengeluaran ASI dinamakan laktasi. Keberhasilan laktasi dipengaruhi oleh kondisi hormonal setelah dan saat kehamilan. Sementara kondisi sebelum kehamilan ditentukan oleh perkembangan payudara saat lahir dan saat pubertas.

Pengaruh Hormonal
Sejak bulan ketiga kehamilan, tubuh wanita mulai memproduksi hormon yang menstimulasi munculnya ASI dalam sistem payudara. Hingga akhirnya pada bulan kelima dan keenam kehamilan, payudara telah siap memproduksi ASI.

Adapun hormon-hormon tersebut adalah:
Ø Prolaktin: berperan dalam membesarnya alveoli selama kehamilan.
Ø Oksitosin: mengencangkan otot halus dalam rahim pada saat melahirkan dan setelahnya. Setelah melahirkan, oksitosin juga mengencangkan otot halus di sekitar alveoli untuk memeras ASI menuju saluran susu. Oksitosin berperan dalam proses turunnya susu (let-down / milk ejection reflex)
Ø Progesteron: mempengaruhi pertumbuhan dan ukuran alveoli. Tingkat progesteron dan estrogen menurun sesaat setelah melahirkan. Hal ini menstimulasi produksi secara besar-besaran
Ø Estrogen: menstimulasi sistem saluran ASI untuk membesar. Tingkat estrogen menurun saat melahirkan dan tetap rendah untuk beberapa bulan selama tetap menyusui. Karena itu, sebaiknya ibu yang menyusui menghindari KB hormonal berbasis hormon estrogen, karena dapat mengurangi jumlah produksi ASI.
Ø Follicle stimulating hormone (FSH)
Ø Luteinizing hormone (LH)
Ø Human placental lactogen (HPL): sejak bulan kedua kehamilan, plasenta mengeluarkan banyak HPL, yang berperan dalam pertumbuhan payudara, puting, dan areola sebelum melahirkan.

Dalam proses produksi ASI atau Laktogenesis terdapat tiga fase yaitu:
Laktogenesis I
Selama masa kehamilan, payudara biasanya menjadi lebih besar seiring dengan meningkatnya jumlah dan ukuran kelenjar alveoli sebagai hasil dari peningkatan hormon estrogen. Pada saat pembesaran payudara ini hormon prolaktin dan HPL, yang berperan dalam produksi ASI, aktif bekerja. Hal ini terjadi sampai seorang bayi telah disusui untuk beberapa hari dimana produksi susu yang sebenarnya dimulai.

Pada fase terakhir kehamilan, payudara memasuki fase Laktogenesis I. Saat itu payudara memproduksi kolostrum, yaitu berupa cairan kental yang kekuningan. Pada saat itu, tingkat progesteron yang tinggi mencegah produksi ASI sebenarnya. Tetapi bukan merupakan masalah medis apabila ibu hamil mengeluarkan (bocor) kolostrum sebelum lahirnya bayi, dan hal ini juga bukan indikasi sedikit atau banyaknya produksi ASI sebenarnya nanti.

Laktogenesis II
Saat melahirkan, keluarnya plasenta menyebabkan turunnya tingkat hormon progesteron, estrogen, dan HPL secara tiba-tiba, namun hormon prolaktin tetap tinggi. Hal ini menyebabkan terjadinya produksi ASI besar-besaran yang dikenal dengan fase Laktogenesis II.

Apabila payudara dirangsang, level prolaktin dalam darah meningkat, memuncak dalam periode 45 menit, dan kemudian kembali ke level sebelum rangsangan tiga jam kemudian. Keluarnya hormon prolaktin menstimulasi sel di dalam alveoli untuk memproduksi ASI, dan hormon ini juga keluar dalam ASI itu sendiri. Penelitian mengindikasikan bahwa level prolaktin dalam susu lebih tinggi apabila produksi ASI lebih banyak, yaitu sekitar pukul 2 pagi hingga 6 pagi, namun level prolaktin rendah saat payudara terasa penuh.

Hormon lainnya, seperti insulin, tiroksin, dan kortisol, juga terdapat dalam proses ini, namun peran hormon tersebut belum diketahui. Penanda biokimiawi mengindikasikan bahwa proses laktogenesis II dimulai sekitar 30-40 jam setelah melahirkan, tetapi biasanya para ibu baru merasakan payudara penuh sekitar 50-73 jam (2-3 hari) setelah melahirkan. Artinya, memang produksi ASI yang sebenarnya tidak langsung terjadi setelah melahirkan, jadi yang dikonsumsi bayi sebelum ASI adalah kolostrum.

Kolostrum mengandung sel darah putih dan antibodi yang tinggi daripada ASI sebenarnya, khususnya tinggi dalam level immunoglobulin A (IgA), yang membantu melapisi usus bayi yang masih rentan dan mencegah kuman memasuki bayi. IgA ini juga mencegah terjadinya alergi makanan. Dalam dua minggu pertama setelah melahirkan, kolostrum pelan pelan hilang dan tergantikan oleh ASI sebenarnya.

Laktogenesis III
Sistem kontrol hormon endokrin mengatur produksi ASI selama kehamilan dan beberapa hari pertama setelah melahirkan. Ketika produksi ASI mulai stabil, sistem kontrol autokrin dimulai. Fase ini dinamakan Laktogenesis III.

Pada tahap ini, apabila ASI banyak dikeluarkan, payudara akan memproduksi ASI dengan banyak pula. Penelitian berkesimpulan bahwa apabila payudara dikosongkan secara menyeluruh juga akan meningkatkan taraf produksi ASI. Dengan demikian, produksi ASI sangat dipengaruhi seberapa sering dan seberapa baik bayi menghisap, dan juga seberapa sering payudara dikosongkan

Hormon Pengatur Produksi ASI
Ketika seorang bayi mulai menyusu pada puting seorang wanita, hasil perangsangan fisik menyebabkan impuls. Impuls pada ujung saraf ini dikirim ke kelenjar hipotalamus di otak, dimana secara bergantian kelenjar ini memberitahu kelenjar pituitari yang juga berada di otak untuk menghasilkan dua hormon yang disebut oksitosin dan prolaktin. Kedua hormon ini memiliki peranan penting untuk mengatur produksi dan sekresi ASI.

a. Hormon Prolaktin
Dalam proses menyusui, payudara mengirimkan rangsangan ke otak. Otak kemudian bereaksi mengeluarkan hormon prolaktin yang masuk ke dalam aliran darah menuju kembali ke payudara. Hormon prolaktin merangsang sel-sel pembuat susu untuk bekerja memproduksi susu.

Sel-sel pembuat susu sesungguhnya tidak langsung bekerja ketika bayi menyusu. Sebagian besar hormon prolaktin berada dalam darah selama kurang lebih 30 menit setelah proses menyusui. Jadi setelah proses menyusui selesai, barulah sebagian besar hormon prolaktin sampai di payudara dan merangsang sel-sel pembuat susu untuk bekerja. Jadi, hormon prolaktin bekerja untuk produksi susu berikutnya. Sementara susu yang dihisap bayi sudah tersedia dalam payudara pada muara saluran ASI.

Saat menyusui, foremilk disimpan dalam alveoli dan lactiferous sinuses, akan tetapi kebanyakan dari susu hindmilk diproduksi berdasarkan permintaan. Payudara tidak menyimpan susu, tetapi memproduksinya berdasarkan permintaan. Semakin besar permintaan, semakin banyak susu yang diproduksi.

Yang sering dikeluhkan ibu-ibu adalah suplai ASI yang kurang, padahal ASI diproduksi berdasarkan kebutuhan. Jika diambil banyak akan diberikan banyak. Sederhananya, prinsip mekanisme produksi susu dalam payudara mirip dengan tanaman teh. Jika kita memetik pucuk teh, maka akan tumbuh dari bawah ketiak daun, dua buah cabang baru. Jadi semakin sering dipetik, semakin banyak pucuk mudanya. Jika tidak dipetik, tidak akan ada cabang baru.
Begitu pula dengan ASI, semakin sering disedot bayi, semakin banyak ASI yang diproduksi. Semakin jarang bayi menyusu, semakin sedikit ASI yang diproduksi. Jika bayi berhenti menyusu, maka payudara juga akan berhenti memproduksi ASI.

b. Hormon Oksitosin
Setelah menerima rangsangan dari payudara, otak juga mengeluarkan hormon oksitosin selain hormon prolaktin. Hormon oksitosin diproduksi lebih cepat daripada prolaktin. Hormon ini juga masuk ke dalam aliran darah menuju payudara.

Di payudara, hormon oksitosin merangsang sel-sel otot untuk berkontraksi. Kontraksi ini menyebabkan ASI hasil produksi sel-sel pembuat susu terdorong mengalir melalui pembuluh menuju muara saluran ASI. Kadang-kadang, bahkan ASI mengalir hingga keluar payudara ketika bayi sedang tidak menyusu. Mengalirnya ASI ini disebut refleks pelepasan ASI atau milk ejection reflex atau let down reflex.

Produksi hormon oksitosin bukan hanya dipengaruhi oleh rangsangan dari payudara, tetapi juga dipengaruhi oleh pikiran dan perasaan ibu. Suara tangisan bayi juga dapat memicu aliran, yang memperlihatkan bagaimana produksi susu dapat dipengaruhi secara psikologi dan kondisi lingkungan. Jadi ketika ibu mendengar suara bayi, meskipun mungkin bukan bayinya, ASI dapat menetes keluar. Suara tangis bayi, sentuhan bayi, atau ketika ibu berpikir akan menyusui bayinya, atau bahkan ketika ibu memikirkan betapa sayangnya kepada sang bayi, ASI dapat menetes keluar.

Sebaliknya refleks pelepasan ASI dapat dihambat oleh kecemasan, ketakutan, perasaan tidak aman, atau ketegangan. Faktor-faktor ini diperkirakan dapat meningkatkan kadar epinefrin dan neroinefrin, dan selanjutnya akan menghambat transportasi oksitosin ke dalam payudara. Begitu pula bila ibu merasa tidak ingin memberikan ASI lagi (menyapih), kadang kala produksi susu juga akan berhenti dengan sendirinya.

Jika refleks pelepasan ASI ibu tidak bekerja dengan baik, bayi akan mengalami kesulitan memperoleh ASI karena harus mengandalkan hanya pada kekuatan sedotan menyusunya. Akibatnya, bayi akan kelelahan dan memperoleh sedikit ASI. Hal ini terkadang membuatnya frustasi, dan kemudian menangis.

Peristiwa ini tampak seolah-olah payudara berhenti memproduksi ASI, padahal tidak demikian, karena yang terjadi adalah payudara tetap memproduksi ASI, tetapi ASI tidak mengalir keluar. Oleh karena itu refleks pelepasan ASI yang bekerja dengan baik merupakan hal yang sangat penting bagi bayi.

Refleks Turunnya atau Pelepasan ASI
Keluarnya hormon oksitosin menstimulasi turunnya susu (milk ejection / let-down reflex). Oksitosin menstimulasi otot di sekitar payudara untuk memeras ASI keluar. Para ibu mendeskripsikan sensasi turunnya susu dengan berbeda-beda, beberapa merasakan geli di payudara dan ada juga yang merasakan sakit sedikit, tetapi ada juga yang tidak merasakan apa-apa.

Refleks turunnya susu tidak selalu konsisten khususnya pada masa-masa awal. Tetapi refleks ini bisa juga distimulasi dengan hanya memikirkan tentang bayi, atau mendengar suara bayi, sehingga terjadi kebocoran. Sering pula terjadi, payudara yang tidak menyusui bayi mengeluarkan ASI pada saat bayi menghisap payudara yang satunya lagi. Lama kelamaan, biasanya setelah dua minggu, refleks turunnya susu menjadi lebih stabil.

Refleks turunnya susu ini penting dalam menjaga kestabilan produksi ASI, tetapi dapat terhalangi apabila ibu mengalami stres. Oleh karena itu sebaiknya ibu tidak mengalami stres.Refleks turunnya susu yang kurang baik adalah akibat dari puting lecet, terpisah dari bayi, pembedahan payudara sebelum melahirkan, atau kerusakan jaringan payudara. Apabila ibu mengalami kesulitan dalam menyusui akibat kurangnya refleks ini, dapat dibantu dengan pemijatan payudara, penghangatan payudara dengan mandi air hangat, atau menyusui dalam situasi yang tenang

Tips for Pumping, Working and Nursing Successfully

source : http://www.drjaygordon.com/development/bf/worknursetips.asp

By Cheryl Taylor, CBE
If breastfeeding is going to be combined with working, there are some things to consider that will give you greater success. A working mom can provide breastmilk for her baby without having to resort to the use of ABM (artificial baby milk). She has many balls in the air and every trick that makes any aspect of pumping a bit easier is worth consideration. Whether you’re planning on returning to work, or you’ve hit a bump in the road, I hope you’ll find a tip here that will make life easier and the milk flow.

Pumping Routine
Establishing a routine schedule for pumping is one of the best ways to consistently get an excellent MER or milk ejection reflex (letdown). Think of it as teaching your body a pattern that you would naturally fall into if you were with your baby all day. One of the favorite tricks of many working moms is to rise prior to baby waking and pump with a plentiful morning supply. Your breasts will kick into action and continue producing milk so that your baby will achieve plentiful MER’s on his own during the first nursing. Another good trick is to pump on one side during that first morning nursing while nursing the baby on the other. This takes advantage of the baby establishing MER for you and is often the best way to get maximum ounces in a brief period of time.

Pumps
Your choice of pump will be crucial to your success as a working mom. There are many options available that are excellent. For a fulltime working mom, a double electric pump that has adjustments available both for the strength of the suction, as well as the speed of the cycle, is a must. Take a look at what is out there, talk to other successful nursing working moms, and don’t be afraid to spend a little money to get a good model. You will be spending many months using it and a quality pump will make your life much easier. There are pumps available for rent if you’d like to have an opportunity to use a certain brand before purchasing it. Your local LC (Lactation Consultant) or IBCLC (Internationally Board Certified Lactation Consultant) should be able to assist you with renting one if you so desire.

It’s a good plan to have a few extra pump parts stashed at work, in case a small but crucial piece gets lost in the shuffle. File this under something else that a working mom does not need to have to deal with, and prepare for it so it never happens to you. Another little tidbit is to be careful where you put your parts in the dishwasher. Dishwashers are great for “eating” pump parts. It would be a good idea to get a basket designed for small pieces for your dishwasher if you plan on using it regularly to wash your pump parts.

Pumping on Days Off
The last thing that a working mom wants to see on her day off is her pump. There’s a distinct love/hate relationship with the pump. The love comes from this machine that allows you to provide your wonderful breastmilk for your baby even though you are separated while you are at work. The hate comes from the pump being a poor substitute for your precious baby at the breast. It may be necessary, in order to maintain a good supply for your work days, to pump even on your days off. Some mothers have no trouble maintaining a supply while only nursing on their days off. Some mothers at least pump the early morning session while home.

Supply Dips
I often receive the panicked contact from a nursing mom whose freezer supply is running low and fresh supply isn’t meeting the baby’s needs. The assumption is often made that there is a dip in the milk supply. I propose that the supply itself may not be a problem at all, but rather the reaction to the pump. Using a pump instead of the baby is already a matter of “fooling” your body. Sometimes the pump calls your bluff and you have to find a new trick.

Some tricks that may work when your reaction to the pump isn’t:

* Massage your breasts prior to beginning a pumping session
* Massage toward the nipple while pumping
* Lean forward and “shake” your breasts to encourage MER
* Look at a favorite photo of your baby that provides warm fuzzies
* Smell an item of clothing that your baby wore the previous day
* Bring a bottle of shampoo or lotion that you use on your baby to smell while pumping
* Breathe deeply and imagine that every breath flows into your lungs and out your nipple as milk. Another one that works well is to have a glass of water and take a swallow of it and imagine it flows right down and out your nipples. I know that imagery can sound strange, but just try it. They are merely relaxation techniques and using the imagery to help your body relax and work with you.
* Rock your shoulders gently forward and back. Then stretch your head forward and gently roll to relax the muscles in your upper back.
* Hand express for a couple of minutes prior to pumping
* Find some soothing music or nature sounds that relax you
* Read and take your mind off of the task at hand
* Twiddle your nipples between your forefinger and thumb until you achieve letdown and then begin pumping. Use imagery to assist you by closing your eyes and imagining your baby is nursing.

Freezer Supply
Providing your baby with fresh breastmilk should be your ultimate goal. Fresh breastmilk maintains nutrients at optimal level. Cooling milk will reduce those and freezing will further reduce them. Regardless of the manner in which your breastmilk will be stored, it is definitely a far superior choice over formula. I consider a freezer stash to be a matter of “insurance” and a bit of a stress reducer for mom in knowing that there is an “extra” stash in case it is needed. If your caregiver is not in your own home, consider leaving a small stash in their freezer for emergencies. The last thing that a mom needs to be worried about at work is whether the EBM (expressed breastmilk) she left is going to be enough. Alleviate this concern with a small freezer stash. Once you’ve returned to work, a good way to create a freezer stash is to pump on your days off during baby’s naps.

Storage
Consider storing your breastmilk in a variety of increments, some in two ounces and some in four or more. The caregiver can then become accustomed to approximately how much your baby takes at different times of the day. It is never a problem to warm an extra two ounces of EBM, but it is a true shame to waste the same amount. Mom has worked too hard to pump it to risk not using it. It’s important that the caregiver is on your team with this concept.

If it’s possible to have a standing freezer unit, EBM is stored for longer periods than when in a freezer unit attached to a refrigerator. EBM is good for two weeks in a freezer compartment located inside a refrigerator, for 3 to 4 months in a separate door refrigerator/freezer and for 6 months or longer in separate deep freeze at a constant temperature of 19 C (0 F). When storing your EBM in the freezer compartment attached to a refrigerator, you have to bear in mind that many new units have a frost-free cycle that periodically turns the freezer off. To help identify if your unit goes through such a cycle, put an ice cube in a small dish and allow it to sit in your freezer compartment for several days and observe any changes. Many frost-free units use a periodic heating of the walls of the freezer to defrost. In that case, do not store EBM against the walls of the freezer, but stack them in a container kept in the center. It’s also a good idea to keep an ice cube in a small ziplock bag in the freezer to identify, in the event of a power outage, if defrosting has occurred.

For further tips on storing EBM, see Common Concerns When Storing Human Milk.

The Flavor of EBM
A crucial element to using expressed breastmilk for your baby is to take the time to do a taste test. This may seem strange to you, if you’ve never heard that upon expression some women’s milk takes on different flavors. Some women notice that their EBM has an unpleasant smell or flavor. This can be caused by vitamin or mineral supplements, or some medications including strong antibiotics or nasal sprays, but typically they do not cause this effect. However, there is a situation involving the lipase in a mother’s milk that does alter the flavor. Lipase is what breaks down the fat in breastmilk, and the presence of high lipase content can cause the milk to take on a soapy flavor. It can be noticed not long after expression, after cooling or after freezing. It is for this reason that I recommend a taste test prior to returning to work. If you happened to be one of these women with high lipase content, you wouldn’t want to find out after having accumulated a large freezer stash.

Setting up a simple taste test will let you know if lipase content is an issue for you and your baby. Experiment by expressing some milk and letting it set at room temperature for thirty minutes. Express some fresh EBM and compare the taste. If there is no difference in taste, refrigerate the EBM. After the EBM is cooled, repeat the taste comparison with fresh EBM. Continue in this manner through the process of freezing and thawing. The predominance of women will find that the milk may taste slightly different, but does not take on an unpleasant flavor. Much in the way that a vegetable cooked fresh has more in depth flavors than the same vegetable after having been frozen.

If you find that your milk takes on a very soapy flavor at any step along the process, there are a couple things you can further experiment with. It may be as simple as cooling the milk before placing it into the freezer, or allowing the EBM to thaw in the refrigerator prior to warming it in a cup or bowl of hot water. Alter the process in these simple ways to see if it will bring about the change needed. If the milk still has a strong soapy flavor, you may need to give your EBM a very, quick scald prior to cooling. Be careful not to bring it to a boil. Heat it quickly to just this side of boiling and take it off the stove immediately, pouring it out of the pan into a heat safe glass container to cool. When the EBM is cooled, you may place it in the storage container of your choice and put it into the refrigerator to cool further, before transferring it to the freezer if needed.

Lunch Breaks
If it is at all possible to leave work and be with your baby during your lunch break, it will make life much easier for you. Not only will you not have to provide milk for that session, but the stimulation of even one nursing during the long day you’re at work will make a big difference in your supply. When making arrangements for care for your baby, this is something to keep in mind. The closer to home you can be employed, the easier this will be to accomplish. Think outside the box and see what you can arrange. If it cannot be set up for your family, you will still be able to maintain a supply regardless. It is truly a matter of effort and commitment and can be accomplished even in less than perfect circumstances.

Caregivers
It is crucial that whomever is the caregiver for your baby while you are at work understands that feeding should not be used as the first option when baby seems fussy. Sit down and have a serious discussion with them about how hard it can be to pump and provide the EBM for your baby. Encourage them first to hold, rock, sing, dance, walk or play with the baby. If baby is merely bored or in need of loving arms, one of these will fit the bill. If baby is truly hungry, they will not. In this way, there is never a precious drop of breastmilk wasted. Make sure they understand that you are not asking them to schedule your baby, but rather to learn to recognize baby’s needs rather than presume each cue is one of hunger.

Bottles or Cups
The most difficult initial decision to make as the time draws near for your return to work is what to use to feed your baby when you are not there to nurse. If a bottle can be avoided by using a sippy cup, soft-feeder or other feeding methods that do not utilize an artificial nipple, it will eliminate the risk of nipple confusion/preference. Even very young infants can learn to use a sippy cup with some patience both in experimenting with different kinds and in teaching the caregiver how to tip it back and forth to assist the baby. If a bottle is used, it is best to consistently use a newborn or slow flow nipple regardless of the age of the infant. This will help to reduce the risk of nipple confusion by keeping the flow of the EBM from the bottle at a slow pace. Graduating up to older infant nipples will provide a very fast flow which runs the risk of baby choosing the faster flow over nursing and exhibiting a full blown strike to go along with it. When you are with your baby, always nurse. You need the stimulation for your supply that a baby at the breast provides.

Nurse Often at Home
Remember on your days off that you are maintaining and stimulating your supply. Take it one step further than you would normally and nurse more often than if you were with your baby fulltime. You need the opportunity not only to provide stimulation for the sake of your supply, but also to love, snuggle and cuddle with your baby while nursing. It helps to balance out the time spent at the pump during work days. Resist the temptation of over scheduling your days off. You need to make nursing a priority on those days, particularly in the early months, to ensure that you have a long and continued nursing relationship.

Watch What You Drink
We all know that water is very important to our overall health. It is even more vital to the fulltime working and pumping mom. It may be from merely providing the adequate and excellent hydration that sixty-four ounces provides any adult. There is controversy on the impact of water consumption on milk supply amongst lactation professionals. I may not stand with the popular opinion on this issue, but I’ve seen the negative effect of too little water consumption on the ounces at the pump and an almost immediate increase with a minimum of sixty-four ounces of water consumed daily by the pumping mom too often to not admit to the correlation. I also caution against drinking too many dehydrating drinks, both due to sodium content and caffeine. Any that are consumed need to be counteracted with at least that much water to make up for their dehydrating effect. I realize that a morning cup of coffee is the mainstay of many working moms, but it does need to countered with an equal amount of water. Other liquids, such as juice or herbal teas, may not be a dehydrating problem, but should be consumed in addition to your sixty-four ounces of water a day, not as part of them. Water alone serves the ultimate purpose of keeping your system flushing toxins and well hydrated. Staying well hydrated assists greatly in keeping your body in optimal functioning order, and optimal functioning order is definitely required for a fulltime working nursing mom!

Rest
It is very important that any nursing mom stay well rested, because her bodies is not only maintaining her own health, but spending 500 – 800 calories a day in the production of milk. That’s a lot for one body to do on less than optimal sleep. Make rest a priority. Consider naps on your days off. Schedule one day a week with a completely lazy morning. Make this a priority from the beginning. It’s crucial.

Your Diet
Maintaining a good, healthy diet is another important factor for everyone, but particularly working moms. Candles are burning at both ends and meals often suffer for it. Plan ahead. Cook large meals on the weekend and freeze leftovers to use when you’re in a hurry. You need the good foods for energy to accomplish the many tasks required of you.

Galactagogues
Should your reaction to the pump decrease and all the above methods have been tried without success, there are galactagogues (herbs or medications that stimulate milk production) that will assist with increasing supply. There are many herbs that have a history of success, however, you must use herbs carefully. They can cause reactions that range from mild to strong and should be used under the advice of a professional that is familiar with them. I would recommend checking with an IBCLC (Internationally Board Certified Lactation Consultant), a certified herbalist or doctor of homeopathic medicines for guidance in selecting which herb is right for you and in what form. There are also medications that a physician can prescribe to increase milk supply. Again, there are side effects, and every other tip should be tried before resorting to an herb or medicine to increase supply.

For more information, see: Increasing Milk Supply

Handling Managers and Coworkers
Your commitment to pumping may be met with a variety of reactions. You need to remember that you have made an excellent choice by providing EBM for your baby and it is a choice that does not need defending. Do not feel the need to educate your peers on breastfeeding and why you pump. The best approach is to succinctly tell them that you will be using your breaks to pump. Period. You aren’t asking permission. You’re informing nicely. It is your right to use your breaks in this manner, so there should be no argument. The logistics of exactly where you will pump will have to be worked out. Find the most relaxing environment for you that is available. Whether it be in a private locked office, the break room or in your car, the important thing is that you are comfortable with the location. The more relaxed you are, the easier your task of pumping will be.

Some mothers meet with resistance in the workplace. La Leche League International website has information on it pertaining to legislation regarding the workplace. Many states offer incentives to employers for providing a breastfeeding friendly environment. Should you receive pressure regarding pumping, don’t panic. Find the information you need for your state and present yourself as a positive role model for other mothers and your employer. Stand up for your rights in the workplace in the gentlest way possible to get the job done. You may be paving the way for many mothers behind you.

When it’s time to take the leap and return to work, consider starting on a Thursday. That will give you an opportunity for a dry run that only lasts two days as opposed to what may look like a very long week stretching before you if you start on a Monday.

You may also consider speaking with your supervisor about rearranging your schedule to work four days a week. Working on Monday and Tuesday and then again on Thursday and Friday would allow a much friendlier schedule for a mom of a young nursing infant. It is not possible in all work situations, but is certainly worth considering if there’s a possibility of a modified schedule as an option for you. Function on the “it never hurts to ask” policy with this. The worst thing that could happen is that you would be told “no”.

It will be much calmer for your return to work if you take the time to make all pumping arrangements regarding where you will pump prior to returning to work. Take the time to have a brief meeting with any superiors if this is needed and get this solved ahead of time. The last thing a mom needs when she is making the transition to returning to work is to spend a moment worrying about exactly how pumping is going to play out for her. Step back into work with the confidence that these plans are set.

Growth Spurts

source : http://www.drjaygordon.com/development/bf/growspu.asp

By Cheryl Taylor, CBE
If there is a rule that would help moms survive growth spurts with a smile, it would have to be, “Don’t Watch The Clock!” Don’t watch the clock for how long baby has been nursing. Don’t watch the clock for how long it’s been since baby last wanted to nurse. Don’t watch the clock for how many times you’ve been awakened that night to nurse.

Growth spurts happen. They happen with all nursing dyads. Some babies protest more about them and others seem to sail through them with the greatest of ease. Some books will tell you they happen at so many weeks or months. They may tend to, but the truth is, they can happen anytime.

Signs of a Growth Spurt

* Baby is nursing often or almost nonstop
* A baby who was previously sleeping through the night is now waking to nurse several times
* Baby will latch and unlatch, fussing in between

These signs are all signals to the mom’s body to “MAKE MORE MILK NOW!” Our bodies listen very well if we will merely respond to the baby’s needs. The extra suckling will stimulate your body to make more milk.

Often Observed After a Growth Spurt

* Baby sleeps extra for a day or two
* Mom is a bit fuller than usual for a day or so
* Baby calms down at the breast
* You may see an increase in wettings with the increased supply baby is drinking

Growth spurts seem to throw new moms for a loop. Just when they thought they were beginning to understand their baby’s signals, they abruptly changed. The frequent requests to nurse can be confusing as well as the frequency with which growth spurts happen within the first few months. The key is purely and simply to go with the flow (pun intended!) If you respond to your baby’s signals to nurse during a growth spurt and do not interfere with them in any manner, your body will quickly respond and increase supply. Typically it happens within 24 to 48 hours. Sometimes growth spurts seem to drag on for a week. This would be a good time to make sure you’re drinking plenty water.

Don’t allow a growth spurt to rob you of your confidence in nursing. Instead, allow it to instill confidence in your ability to read your baby’s cues. Your confidence will be further rewarded as your supply increases and your baby settles back down into a happy breastfeeding baby again, with a smart mommy who knew that sometimes baby really does know best and our job is to listen.