Penyusuan Susu Ibu dan Jaundis

Salam. Alhamdulillah, saya sudah habis melalui tempoh berpantang. Anak saya kini berusia 2 bulan 4 hari. Hari ini saya ingin berkongsi informasi tentang hubung-kait penyusuan susu ibu dan jaundis. Anak saya juga mengalami Jaundis pada 2 minggu pertama kelahiran. Saya memperoleh informasi ini dari laman sesawang http://www.ratuhati.com. 

Bagaimana Jaundis terjadi? Apa itu bilirubin?

Apabila sel darah merah dileraikan, birubilin akan dihasilkan. Kebiasaannya birubilin diproses di hati dan dikumuhkan keluar dari badan ke air kencing oleh buah pinggang. Hati bayi kadang-kala tidak dapat memproses birubilin dengan cepat berbanding penghasilannya. Birubilin ini akan wujud di dalam darah dan mula kelihatan di kulit, bahagian mata putih dan membran mukus (contohnya di bahagian dalam mulut). Apabila ini terjadi, bayi akan kelihatan kuning dan dikatakan menghidapi jaundis. Kebiasaannya jaundis hilang dalam amsa 1-2 minggu dan tidak memerlukan rawatan khas. Sedikit birubilin dalam darah adalah normal, tetapi apabila kepekatannya bertambah sehingga ke peringkat hyperbilirubinemia ia menjadi bahaya. Kadar birubilin yang sangat tinggi boleh menyebabkan kecederaan saraf yang serius seperti kerosakan otak dan kehilangan deria pendengaran.

Oleh itu, adalah dinasihatkan jika anda mendapati kelainan warna pada kulit, mata, dan sebagainya pada bayi anda atau lebih bahasa mudahnya anda syak anak kena jaundis/kuning, SILA RUJUK BAYI ANDA PADA PAKAR KANAK-KANAK/ PEDIATRICIAN untuk dapatkan rawatan dengan segera.

Kenapa dan bila jaundis perlu diambil berat dan dirawat
Paras bilirubin sebenarnya perlu diambil berat. Ini kerana jika bacaan terlalu tinggi, ianya boleh sebabkan kerosakan sel dan menyebabkan toksik bila ianya beredar di dalam darah. Walaupun kebanyakkan sel boleh tumbuh/ terhasil semula tetapi tidak bagi sel otak yang musnah disebabkan oleh bilirubin.

Bagaimana Cara dan Mengapa Penyusuan Susu Ibu Penting dalam Mencegah dan Merawat Jaundis?

Anda boleh:

1. Mulakan penyusuan susu ibu seawal mungkin selepas kelahiran.
Pastikan anda beritahu doktor atau jururawat anda, yang anda mahukan bayi anda seawal mungkin selepas kelahiran. Kalau boleh semasa dalam bilik bersalin lagi.

Susukan sekerap yang mungkin. Tidak perlu tunggu baby nangis tetapi susukan bayi anda setiap 1 ½ jam atau 2 jam sekali. Bayi yang baru lahir perlu disusukan sekurang-kurangnya 8 kali hingga 12 kali dalam tempoh 24 jam.

2. Tingkatkan proses pembuangan najis bayi.

Salah satu cara bilirubin keluar daripada badan bayi ialah melalui najis.
Oleh itu, banyakkan menyusu susu ibu, kerana susu ibu senang dihadamkan dan juga senang diproses. Bila senang diproses, maka lebih keraplah bayi anda akan membuang. Maka peluang untuk mendapat jaundis pun makin kurang.

3. Elakkan memberi air masak/ air glukosa kepada bayi.

Kenapa? Sebab kajian menunjukkan pemberian air masak/ glukosa sebenarnya akan meningkatkan lagi tahap bilirubin. Ini kerana pemberian air masak/ glukosa akan mengurangkan kadar pembuangan najis bayi berbanding jika kita menyusu susu ibu. Sebabnya susu ibu/ breast milk mempunyai kandungan lemak yang akan meningkatkan pembuangan najis bayi.

4. Fototerafi

Apa tu fototerafi? Fototerafi ialah salah satu rawatan yang biasa digunakan dalam merawat semua jenis jaundis yang berlebihan.

Bayi akan diletakkan di bawah lampu biru/ putih/ hijau. Lampu ini sebenarnya sebagai medium untuk meleraikan paras bilirubin melalui kulit. Cahaya tersebut akan diserap oleh bilirubin dan menukarkan bilirubin tadi kepada produk larut air, yang mana kemudiannya ianya boleh dikeluarkan tanpa melalui hati.

Namun begitu penyusuan susu ibu / breastfeeding perlu diteruskan semasa rawatan fototerafi dengan tujuan untuk menambahkan pengambilan cecair. Ini kerana fototerafi mempunyai kesan di mana bayi boleh menjadi dehidrasi kerana pembuangan air melalui najis dan kulit bayi.

Low Milk Supply

Source: http://www.babycenter.com

What is it?

Almost all mothers go through a period of questioning whether their milk supply is adequate, especially when they begin breastfeeding. In some cases a mother isn't able to produce enough milk to meet the needs of her baby. But according to many experts, true milk insufficiencies are rare.

Many women think their milk supply is low when it isn't. This can happen if you lose the feeling of fullness in your breasts, or if milk stops leaking from your nipples — but these are actually natural, common signs that your body has adjusted to your baby's feeding requirements. A baby going through a growth spurt may also want more milk than usual, and his more frequent feedings may leave your breasts less full than usual.

Others, however, including Marianne Neifert, a pediatrician, lactation specialist, and author of Dr. Mom's Guide to Breastfeeding, believe that low milk supply is a real phenomenon for some women and that to ignore it may put babies at risk for malnutrition. For the vast majority of these women, better breastfeeding management can correct the problem, but 2 to 5 percent are physically incapable of producing enough milk.

What causes it?

A mother's milk supply may diminish temporarily if she's not feeding her baby often enough because of nipple pain, a lethargic nurser, or a poor latch-on technique. Estrogen-containing birth control pills or an illness can also affect milk production. For a few women, a biological or physical condition such as a hormonal disorder or breast surgery causes their milk supply to be low.

For most women, though, the real problem is delivery, not production. They produce plenty of milk, but for some reason, such as an incorrect latch-on technique, their baby isn't getting enough.

What should I do?

First, rule out false alarms about your milk supply. Here's how to tell whether your baby's getting enough — and therefore you're producing enough — breast milk:
Your baby gains an ounce a day in the first three months of life and half an ounce a day from age 3 to 6 months. (Newborns will typically lose between 5 and 10 percent of their birth weight in the first few days before gaining it back.) Your baby should be back to his birth weight by ten to 14 days after birth. Weight gain is the best way to make sure your baby's getting enough milk.

In the first month, your baby has at least three stools a day and they lighten to a yellowy-mustard color by the fifth day after birth. After the first month, the stools become less frequent. Some babies will even go a day or two between stools.

He nurses frequently — every two to three hours, for a total of at least eight to 12 feedings a day.

You hear him swallow and you sometimes notice milk in the corners of his mouth.

He appears healthy and active.

He wets seven or eight cloth diapers a day, or five to six disposables. Disposable diapers are more absorbent, making it hard to tell when one is wet. If you're not sure, take one off and compare its weight to a dry disposable. A wet one should feel slightly heavier. (Note: Wet diapers alone are not enough to determine whether your baby's getting enough milk: A dehydrated baby can still wet a diaper. Stools and weight gain are the best ways to tell how your baby's doing.)

If you're not producing as much milk as you (and your baby) would like, try the following:

• See a lactation professional. She can weigh your baby and give you tips on how to boost your milk supply.
• Feed your baby often. Frequent nursing sessions stimulate your body to produce more milk.
• Get the best latch-on possible. Check for proper positioning at the breast.
• When your baby's sucking and swallowing pattern slows down, use breast compression to increase milk flow to your baby and to completely drain the breast.
• When your milk flow with compression seems to be slowing, switch sides and repeat. Keep switching back and forth between breasts until your baby is satisfied or stops swallowing. A more effective measure may be to nurse your baby for ten to 15 minutes per breast, then use a fully automatic electric breast pump with a double collection kit to completely drain your breasts and increase milk production. To make sure your baby's getting enough, you may have to supplement the milk you've collected with formula.
• A sleepy baby may need to be awakened and encouraged to nurse more vigorously (thus stimulating your glands to produce more milk). To arouse him, try switching sides frequently, alternating positions, or even undressing him. Some mothers play with their baby's feet during feedings to keep him awake.
• Mothers who determine that their milk output is actually low may want to have their thyroid level checked. A low thyroid level is known to reduce milk supply.
•  If you're not sure your baby is sucking well, or are still concerned about your milk supply, don't hesitate to call on a lactation consultant for help.

Will it affect my baby?

Yes, if your baby regularly needs more milk than he gets, he could fail to thrive, a condition that can inhibit physical and mental development. Call your doctor and schedule a checkup right away if he's not gaining weight, or is losing weight. Improved breastfeeding techniques often help, but in some cases slow weight gain indicates a serious health concern.

Can I still nurse?

Yes, especially if you're suffering from a temporary decrease in milk supply, nursing frequently is the key to boosting milk production.