Alhamdulillah di milis ini ternyata banyak sekali pakar pakar ilmiah yang selain memahami Ayat Ayat Alloh juga memberi jawaban berdasarkan evidence base medicine. Wassalam. Sent from my BlackBerry®
powered by Sinyal Kuat INDOSAT -----Original Message----- From: "HZLC" <[email protected]> Date: Thu, 18 Mar 2010 10:50:48 To: <[email protected]> Subject: [assunnah] Re: OOT : Menyusui saat hamil Assalamu'alaikum Wr Wb, Dear dr Salamun Sastra, sungguh senang berkenalan dengan seorang Guru Besar dan Peneliti tingkat dunia. Suatu kebanggaan bagi kami, sebagai saudara muslim mengetahui keberadaan seorang saudara kami di kancah dunia. Mohon maaf sebesar-besarnya jika dr Salamun kurang berkenan dengan upaya saya untuk menanggapi pernyataan dokter mengenai larangan bagi ibu menyusui untuk melanjutkan menyusui bagi buah hatinya. Saya menekuni bidang laktasi hampir 3 tahun dan semakin saya mempelajarinya, ternyata semakin jelas maksud kebaikan yg Allah SWT dan RasulNya SAW sampaikan. Sehingga jika Ia mengatakan menyusui 2 tahun, yah lakukan 2 tahun.. Sebagai negara dg umat muslim terbesar, sungguh malu jika kita masih berargumentasi mengenai ASI. Karena (FYI), kaum Yahudi dan non muslim (BACA : KATOLIK ROMA) telah meng HARAM kan SUSU FORMULA. Sehingga beberapa negara dg umat katolik terbesar, tidak didapatkan penjualan susu formula. Dengan senang hati jika dr Salamun Sastra berkenan untuk meluangkan waktu berdiskusi di darat. Dan akan lebih menarik jika hadir pula dr Utami Roesli, SpA, IBCLC, FABM dan Prof Rulina Soeradi, SpA(K), IBCLC sebagai dua tokoh Laktasi Internasional dari Indonesia. Sehingga, kami mendapatkan pembelajaran yang luar biasa dari tokoh-tokoh di bidangnya. Alhamdulillah saya bisa bergabung di milis ini, dimana milis ini sebagai tempat diskusi dan musyawarah sebagaimana Rasul SAW mencontohkannya yaitu dengan alur komunikaksi yang santun dan lembut. Sebelumnya ijinkan saya untuk mengkoreksi, bahwa menyusui kala hamil, atau lebih dikenal dengan BREASTFEEDING WHILE PREGNANCY atau NURSE DURING PREGNANCY, BUKAN TANDEM NURSING. Sungguh berbeda pengertiannya, karena tandem nursing berarti seorang ibu menyusui pada beberapa anak, seperti anak kembar atau ibu yang memiliki 2 anak dimana sang kakak belum disapih. Breastfeeding while pregnancy / menyusui kala hamil, amankah? Mari kita baca bersama-sama uraian di bawah ini dan diskusi kan dengan tenang dan santun. Is it safe to nurse during pregnancy? Yes, in most cases. At this time no medical study has been done on the safety of breastfeeding during pregnancy so it is impossible to list any definitive contraindications. If you are having a complicated pregnancy, such as lost weight, bleeding, or signs of preterm labor, you should problem-solve your individual situation with your caregiver. Depending on your individual situation and feelings you may decide that continued breastfeeding, reduced breastfeeding, or weaning is for the best. Breastfeeding and contractions Nipple stimulation releases the hormone oxytocin into the bloodstream. Oxytocin is important for breastfeeding because it is the chemical messenger that tells breast tissue to contract and eject milk (the "milk ejection reflex"). Oxytocin also tells the uterine tissue to contract. All women experience uterine contractions during breastfeeding, although they are usually too mild to be noticed. Nipple stimulation can be used to ripen the cervix when a woman is at term, and can also augment labor after it is underway. Postpartum breastfeeding efficiently shrinks the uterus back to pre-pregnancy-size. Given these associations, it seems a short jump to guess that breastfeeding might trigger labor before it's time. This question deserves medical study, and it is important to bear in mind that at this time we do not have one. At the same time, preliminary data do suggest that breastfeeding and healthy term births are quite compatible. Sherrill Moscona's 1993 survey of 57 California mothers who breastfed during pregnancy concluded that breastfeeding resulted in no apparent adverse consequences to the mothers' pregnancies.3 There are also countless anecdotal reports of mothers who have breastfed throughout pregnancy have given birth to healthy term babies. Of course, some pregnancies are not destined to proceed as we hope, whether the mother is breastfeeding or not, and so breastfeeding mothers have suffered their share of preterm labor and miscarriage as well. Most mothers notice no contractions during breastfeeding, even during pregnancy (93% in the Moscona survey).3 Interestingly, even those who experience intense "nursing contractions" often find that the contractions cease soon after ending the breastfeeding session.3,4 Like Braxton-Hicks contractions, nursing contractions commonly occur without disrupting the pregnancy. How might that work? The scientific literature has a lot to tell us about that. The well-protected uterus The specter of breastfeeding-induced preterm labor appears to spring in large part from an incomplete understanding of the interactions between nipple stimulation, oxytocin, and pregnancy. The first little-known fact is that during pregnancy less oxytocin is released in response to nipple stimulation than when a woman is not pregnant.5 But the key to understanding breastfeeding during pregnancy is the uterus itself. Contrary to popular belief, the uterus is not at the beck and call of oxytocin during the 38 weeks of the "preterm" period. Even a high dose of synthetic oxytocin (Pitocin) is unlikely to trigger labor until a woman is at term.6 Instead, the uterus must actively prepare in order for labor to commence. You could say that there are two separate states of being for the uterus: the quiescent baby-holder and the active baby-birther. These states make all the difference to how the uterus responds to oxytocin, and so, one can surmise, to breastfeeding. While the baby is growing, the uterus is geared to have a muffled response to oxytocin; at term, the body's preparations for labor transform the uterus in ways that make it respond intensely to oxytocin. Many discussions of breastfeeding during pregnancy mention "oxytocin receptor sites," the uterine cells that detect the presence of oxytocin and cause a contraction. These cells are sparse up until 38 weeks, increasing gradually after that time, and increasing 300-fold after labor has begun.6,7 The relative scarcity of oxytocin receptor sites is one of the main lines of defense for keeping the uterus quiescent throughout the entire preterm period—but it is not the only one. A closer look at the molecular biology of the pregnant uterus reveals yet more lines of defense. In order for oxytocin receptor sites to respond strongly to oxytocin they need the help of special agents called "gap junction proteins". The absence of these proteins renders the uterus "down-regulated," relatively insensitive to oxytocin even when the oxytocin receptor site density is high. And natural oxytocin-blockers, most notably progesterone, stand between oxytocin and its receptor site throughout pregnancy. 8,9,10 With the oxytocin receptor sites (1) sparse, (2) down-regulated, and (3) blocked by progesterone and other anti-oxytocin agents, oxytocin alone cannot trigger labor. The uterus is in baby-holding mode, well protected from untimely labor.4 A balanced approach Only direct research can definitively tell us whether breastfeeding can elevate the risk of preterm labor or miscarriage in any woman. But as you can see, the available research gives us valid reasons to doubt that breastfeeding could trigger labor before the body has already begun to prepare for it. With increasing first-hand experience among health professionals, many well-respected sources are asserting that breastfeeding is safe in healthy pregnancies, including Ina May Gaskin, LM,4 the American Academy of Family Physicians,11 and Ruth Lawrence, MD, in Breastfeeding: A Guide for the Medical Profession.12 Complicated pregnancies always call for more complicated decisions, but weaning can still be avoided in many cases. I have corresponded with many mothers who breastfed through high risk pregnancies, even threatened preterm labor, and have given birth to healthy term babies.4 Sometimes reduced nursing or weaning seems to be for the best; no two mothers' choices are the same. You may wish to work with your caregiver to draw up a plan for moving forward with your eyes open. As in any pregnancy, you should be on the look out for signs of preterm labor. Any mother who is experiencing contractions that concern her should end the breastfeeding session and see if the contractions stop as well. Some caregivers judge that it is helpful to observe the affects of breastfeeding on uterine contractility, fetal heart rate, or the state of the cervix. In closing, I would like to share a bit of my own story. When I became pregnant with my second child, I worried that breastfeeding might interfere with my healthy pregnancy. My midwives Anne Hirsch, LM, and CharLynn Daughtry, LM, CPM, were accustomed to supporting breastfeeding mothers. They provided me with the support I needed to hold onto my breastfeeding relationship with my two-year-old Nora Jade. What a difference it made. After I gave birth to Miles at home, my daughter rushed in to meet her brother, and she immediately wanted to nurse with him. "That `na-na' is for brother," she said. As they nursed and gazed at each other wide-eyed across my chest, I wrapped an arm around each of them, marveling at my body's powers to provide. When deciding about the health of breastfeeding during pregnancy, each mother must sort through her options, her feelings, and what her own body is telling her. Trust yourself to make the best choice for your family. A primer on the signs of preterm labor Remember to contact your caregiver immediately if you experience any of these possible warning signs: · Four or more uterine contractions in an hour—entire uterus is tight, hard, "balled up" to the touch; may or may not feel painful · Low backache · Pelvic pressure · Cramping (like menstrual cramps) · Increased vaginal discharge, which may include mucus, blood, or water If these signs occur (or any contractions concern you) during a breastfeeding session, end the session. It is important to remember that breastfeeding can cause contractions, and, like Braxton-Hicks, these contractions do not automatically mean you are going into labor. If you have stopped nursing—or weren't nursing at that particular time—and you are still having or think you are having more than two or three contractions an hour, you should: · Begin timing how often one occurs and how long each lasts. · Empty your bladder. · Drink a large glass of water (dehydration can sometimes lead to contractions). · Lie on your left side, or recline with feet elevated, consciously relaxing.And again, if after this you find you are having four or more contractions in an hour, you should call your prenatal care provider immediately. http://www.kellymom.com/nursingtwo/articles/bfpregnancy_safety.html#uterus Dari paparan di atas bahwa menyusui kala hamil adalah aman. Stimulasi pada putting, dimana terdapat oksitosin diketahui akan menimbulkan kontraksi uterus. Hal ini sama halnya dengan cairan sperma atau kontraksi rahim yg terjadi kala berhubungan seksual. Walaupun demikian, banyak wanita yg tidak mengalami keguguran akibat rangsangan yang ditumbulkan dari hal2 tersebut. Memang tidak semua wanita memiliki ketahanan uterus yang sama, namun selama tanda-tanda yang menunjukkan berbahaya bagi kehamilan maka ibu dapat melanjutkan menyusui. Mother's health There is no evidence that a well nourished mother who nurses during pregnancy is at risk nutritionally. Breastfeeding does not increase a mother's risk for osteoporosis, even when the mother nurses during pregnancy. Breastfeeding reduces the mother's risk of breast cancer. Nursling's health Your child will benefit from breastfeeding into the second year and beyond. The milk is just as safe during pregnancy, but pregnancy can cause milk to dwindle and can also motivate mother and child to wean. Thus if pregnancy does cause a child to receive less milk, the child will receive proportionally fewer of milk's health advantages. Indeed, weaning before two years increases the risk of illness for a child, according to the American Academy of Family Physicians Bagaimana dengan kualitas ASI? ASI yang diproduksi pada kehamilan lima minggu oleh karena efek dari hormon estrogen-progesteron dan hormon prolaktin, maka kandungan tetap sama hanya tidak memiliki lemak. Sehingga anak mendapatkan ASI dlm bentuk kolostrum. (Fisiologi Kedokteran Guyton. Edisi ke 7. Hal 356). Referensi : Roger W. Harms, M.D. Mayo Clinic obstetrician and medical editor-in-chief. Breastfeeding while pregnant, Is it safe? (http://www.mayoclinic.com/health/breast-feeding-while-pregnant/AN01840) Harms RW (expert opinion). Mayo Clinic, Rochester, Minn. July 2, 2008. Murry MM (expert opinion). Mayo Clinic, Rochester, Minn. Sept. 8, 2008. LaFleur EA (expert opinion). Mayo Clinic, Rochester, Minn. Sept. 9, 2008. Riordan J. Postpartum care. In: Riordan J. Breastfeeding and Human Lactation. 3rd ed. Sudbury, Ma.: Jones and Bartlett Publishers; 2005:240-241. Hilary Flower, MA, author of Adventures in Tandem Nursing: Breastfeeding During Pregnancy and Beyond. Ruth Lawrence, MD, Professor of Pediatrics, Obstetrics and Gynecology at the University of Rochester School of Medicine and Dentistry, and author of Breastfeeding: A Guide for the Medical Profession. Nancy Mohrbacher, IBCLC and Julie Stock, MA, IBCLC, authors of LLLI's The Breastfeeding Answer Book. Jack Newman, MD, FRCPC, author of The Ultimate Breastfeeding Book of Answers. (www.drjacknewman.com) William Sears, MD, Associate Clinical Professor of Pediatrics at the University of California, Irvine, School of Medicine, and author of The Baby Book and numerous other books. Debbie Shinskie, RN, IBCLC and Judith Lauwers, BA, IBCLC, authors of Counseling the Nursing Mother. La Leche League International (www.llli.org) The American Academy of Family Physicians -- "Enjoy The Most Precious and Romantic Moments By Giving ASI to Your Baby" Salam ASI, dr Henny Zainal, CHt Konselor Laktasi HZ Lactation Care (021-99532800) Email : [email protected] YM : [email protected] Skype : drhennyzainal ------------------------------------ Website anda http://www.almanhaj.or.id Berhenti berlangganan: [email protected] Ketentuan posting : http://milis.assunnah.or.id/aturanmilis/ INFO: Saat ini domain assunnah.mine.nu telah diambil alih (direbut) oleh pihak yang tidak diketahui. Isi dan kandungannya tidak ada hubungannya dengan pengelola sebelumnya. Yahoo! Groups Links <*> To visit your group on the web, go to: http://groups.yahoo.com/group/assunnah/ <*> Your email settings: Individual Email | Traditional <*> To change settings online go to: http://groups.yahoo.com/group/assunnah/join (Yahoo! 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