Mbak Nurul,

Dah dibantu ya ama moms yg lain.
Betul sekali yg dikatakan mbak reyna bahwa ASI > 1 th sudah jelak atau ada
isitlah asi jelek itu sama sekali tidak tepat. Its more to myth yg sama
sekali gak bener kebenarannya. Percayalah bahwa sejelek2nya ASI much much
much much much better than susu formula. Saking berharganya ASI sering
sekali dikatakan sbg cairan emas. Krn banyaaaaak sekali kandungan dalam
ASI, yg jumlahnya ratusan dan hingga saat ini belum diketahui manfaatnya,
tidak terdapat dalam susu formula. Jadi do not feel worry ya.

Dan betul juga bahwa saat ini di dunia laktasi sedang trend-nya menyusui
toddler. Karena riset menunjukkan bahwa anak2 yg mendapatkan ASI hingga
lebih dari 2 th significantly memiliki manfaat lebih. Dan ini bukan hanya
utk anak tapi jgua utk para ibu. Karena manfaat ini WHO selalu mengatakan
ASI eksklusif utk 6 bl pertama kehidupan seorg anak kemudian ASI
dilanjutkan dg MPASI hingga anak berusia 2 th atau lebih. Tidak ada
batasan khusus harus 2 th dan setelah itu harus dipaksa berhenti. Saya
posting ttg artikel ini.

Utk makanan pendampign ASI juga (MPASI) WHO mengeluarkan statement dimulai
di usia 6 bl. Jadi gak ada option spt dulu 4 atau 6 bl. Jadi 6 bl. Kenapa
? soal ini juga saya repost di milis ini.

Moga menajwab ya. Yakin aja mbak.
Luluk
--------------

Source : http://www.kellymom.com/newman/bf_toddler_01-03.html
Breastfeed a Toddler—Why on Earth?

Handout #21. Toddler nursing. January 2003
Written by Jack Newman, MD, FRCPC. © 2003

Because more and more women are now breastfeeding their babies, more and
more are also finding that they enjoy breastfeeding enough to want to
continue longer than the usual few months they initially thought they
would. UNICEF has long encouraged breastfeeding for two years and longer,
and the American Academy of Pediatrics is now on record as encouraging
mothers to nurse at least one year and as long after as both mother and
baby desire. Even the Canadian Paediatric Society, in its latest feeding
statement acknowledges that women may want to breastfeed for two years or
longer. Breastfeeding to 3 and 4 years of age has been common in much of
the world until recently, and it is still common in many societies for
toddlers to breastfeed.

Why should breastfeeding continue past six months?

Because mothers and babies often enjoy breastfeeding a lot. Why stop an
enjoyable relationship? And continued breastfeeding is even good for the
health and welfare of both the mother and child.

But it is said that breastmilk has no value after six months.

Perhaps this is said, but it is wrong. That anyone (including
paediatricians) can say such a thing only shows how ignorant so many
people in our society are about breastfeeding. Breastmilk is, after all,
milk. Even after six months, it still contains protein, fat, and other
nutritionally important and appropriate elements which babies and children
need. Breastmilk still contains immunologic factors that help protect the
baby. In fact, some immune factors in breastmilk that protect the baby
against infection are present in greater amounts in the second year of
life than in the first. This is, of course as it should be, since children
older than a year are generally exposed to more infection. Breastmilk
still contains factors that help the immune system to mature, and which
help the brain, gut, and other organs to develop and mature.
It has been well shown that children in daycare who are still
breastfeeding have far fewer and less severe infections than the children
who are not breastfeeding. The mother thus loses less work time if she
continues nursing her baby once she is back at her paid work.

It is interesting that formula company marketing pushes the use of formula
(a very poor copy of the real thing) for a year, yet implies that
breastmilk (from which the copy is made) is only worthwhile for 6 months
or even less ("the best nutrition for newborns"). Too many health
professionals have taken up this absurd refrain.

I have heard that the immunologic factors in breastmilk prevent the baby
from developing his own immunity if I breastfeed past six months.

This is untrue; in fact, this is absurd. It is unbelievable how so many
people in our society twist around the advantages of breastfeeding and
turn them into disadvantages. We give babies immunizations so that they
are able to defend themselves against the real infection. Breastmilk also
helps the baby to fight off infections. When the baby fights off these
infections, he becomes immune. Naturally.

But I want my baby to become independent.

And breastfeeding makes the toddler dependent? Don't believe it. The child
who breastfeeds until he weans himself (usually from 2 to 4 years), is
generally more independent, and, perhaps, more importantly, more secure in
his independence. He has received comfort and security from the breast,
until he is ready to make the step himself to stop. And when he makes that
step himself, he knows he has achieved something, he knows he has moved
ahead. It is a milestone in his life.

Often we push children to become "independent" too quickly. To sleep alone
too soon, to wean from the breast too soon, to do without their parents
too soon, to do everything too soon. Don't push and the child will become
independent soon enough. What's the rush? Soon they will be leaving home.
You want them to leave home at 14? If a need is met, it goes away. If a
need is unmet (such as the need to breastfeed and be close to mom), it
remains a need well into the childhood/teenaged time.
Of course, breastfeeding can, in some situations, be used to foster an
overdependent relationship. But so can food and toilet training.

The problem is not the breastfeeding. This is another issue.
What else?

Possibly the most important aspect of nursing a toddler is not the
nutritional or immunologic benefits, important as they are. I believe the
most important aspect of nursing a toddler is the special relationship
between child and mother. Breastfeeding is a life-affirming act of love.
This continues when the baby becomes a toddler. Anyone without prejudices,
who has ever observed an older baby or toddler nursing can testify that
there is something almost magical, something special, something far beyond
food going on. A toddler will sometimes spontaneously, for no obvious
reason, break into laughter while he is nursing. His delight in the breast
goes far beyond a source of food. And if the mother allows herself,
breastfeeding becomes a source of delight for her as well, far beyond the
pleasure of providing food. Of course, it's not always great, but what is?
But when it is, it makes it all so worthwhile.

And if the child does become ill or does get hurt (and they do as they
meet other children and become more daring), what easier way to comfort
the child than breastfeeding? I remember nights in the emergency
department when mothers would walk their ill, non-nursing babies or
toddlers up and down the halls trying, often unsuccessfully, to console
them, while the nursing mothers were sitting quietly with their comforted,
if not necessarily happy, babies at the breast. The mother comforts the
sick child with breastfeeding, and the child comforts the mother by
breastfeeding.

Questions? see my book Dr. Jack Newman's Guide to Breastfeeding (called
The Ultimate Breastfeeding Book of Answers in the USA)
Handout #21. Toddler nursing. January 2003
Written by Jack Newman, MD, FRCPC. © 2003


This handout may be copied and distributed without further permission,
on the condition that it is not used in any context in which the WHO code
on the marketing of breastmilk substitutes is violated
----------------------------

Resiko pemberian MPASI terlalu dini
(Dirangkum & ditulis bebas oleh Luluk Lely Soraya I,  26 March  2005)


Banyak sekali pertanyaan dan kritik yang timbul mengenai pemberian MPASI
di usia < 6 bl.  Bahkan banyak dari kita tidak pernah tahu mengapa WHO &
IDAI mengeluarkan statement bahwa ASI eksklusif (ASI saja tanpa tambahan
apapun bahkan air putih sekalipun) diberikan pada 6 bl pertama kehidupan
seorg anak. Kemudian setelah umur 6 bulan anak baru mulai mendapatkan
MPASI berupa bubur susu, nasi tim, buah, dsb.

Alasan menunda pemberian MPASI

Mengapa harus menunda memberikan MPASI pada anak sampai ia berumur 6 bl ?!
Kalo jaman dulu (baca : sebelum diberlakukan ASI eksklusif 6 bl) umur 4 bl
aja dikasih makan bahkan ada yg umur 1 bl. Dan banyak yang berpendapat gak
ada masalah apa-apa tuh dg anaknya.

Satu hal yg perlu diketahui bersama bahwa jaman terus berubah. Demikian
juga dengan ilmu & teknologi. Ilmu medis juga terus berkembang dan berubah
berdasarkan riset2 yg terus dilakukan oleh para peneliti. Sekitar lebih
dari 5th yg lalu, MPASI disarankan diperkenalkan pada anak saat ia berusia
4 bl. Tetapi kemudian beberapa penelitian tahun2 terakhir menghasilkan
banyak hal sehingga MPASI sebaiknya diberikan >6bl.

Mengapa umur 6 bl adalah saat terbaik anak mulai diberikan MPASI ?!

1.      Pemberian makan setelah bayi berumur 6 bulan memberikan perlindungan
besar dari berbagai penyakit.

Hal ini disebabkan sistem imun bayi < 6 bl belum sempurna. Pemberian MPASI
dini sama saja dg membuka pintu gerbang masuknay berbagai jenis kuman.
Belum lagi jika tidak disajikan higienis. Hasil riset terakhir dari
peneliti di Indonesia menunjukkan bahwa bayi yg mendapatkan MPASI sebelum
ia berumur 6 bl, lebih banyak terserang diare, sembelit, batuk-pilek, dan
panas dibandingkan bayi yg hanya mendapatkan ASI eksklusif. Belum lagi
penelitian dari badan kesehatan dunia lainnya.

2.      Saat bayi berumur 6 bl  keatas, sistem pencernaannya sudah relatif
sempurna dan siap menerima MPASI.

Beberapa enzim pemecah protein spt asam lambung, pepsin, lipase, enzim
amilase, dsb baru akan diproduksi sempurna pada saat ia berumur 6 bl.

3.      Mengurangi resiko terkena alergi akibat pada makanan
Saat bayi berumur < 6 bl, sel2 di sekitar usus belum siap utk kandungan
dari makanan. Sehingga makanan yg masuk dapat menyebabkan reaksi imun dan
terjadi alergi.

4.      Menunda pemberian MPASI hingga 6 bl melindungi bayi dari obesitas di
kemudian hari. Proses pemecahan sari2 makanan yg belum sempurna.

Pada beberapa kasus yg ekstrem ada juga yg perlu tindakan bedah akibat
pemberian MPASi terlalu dini. Dan banyak sekali alasan lainnya mengapa
MPASI baru boleh diperkenalkan pada anak setelah ia berumur 6 bl.

Masih banyak yg mengenalkan MPASI < 6 bl

Kalo begitu kenapa masih banyak orangtua yg telah memberikan MPASI ke
anaknya sebelum berumur 6 bl ?  Banyak sekali alasan kenapa ortu
memberikan MPASI < 6 bl. Umumnya banyak ibu yg  beranggapan kalo anaknya
kelaparan dan akan tidur nyenyak jika diberi makan. Meski gak ada
relevansinya banyak yg beranggapan ini benar. Kenapa ? Karena belum
sempurna, sistem pencernaannya harus bekerja lebih keras utk mengolah &
memecah makanan.  Kadang anak yg menangis terus dianggap sbg anak gak
kenyang. Padahal menangis bukan semata2 tanda ia lapar.

Belum lagi masih banyak anggapan di masyarakat kita spt ortu terdahulu
bahwa anak saya gak papa tuh dikasih makan pisang pas kita umur 2 bl. 
Malah sekrg jadi orang.

Alasan lainnya juga bisa jadi juga tekanan dari lingkungan dan gak ada
dukungan spt alasan di atas. Dan gencarnya promosi produsen makanan bayi
yg belum mengindahkan ASI eksklusif 6 bl.

Aturan MPASI setelah 6 bulan : Karena < 6 bl mengandung resiko

Sekali lagi tidak mungkin ada saran dari WHO & IDAI jika tidak dilakukan
penelitian panjang. Lagipula tiap anak itu beda. Bisa jadi gak jadi
masalah utk kita tapi belum tentu utk yg lain.
Misalkan, ilustrasinya sama spt aturan cuci tangan sebelum makan.  Ada
anak yg dia tidak terbiasa cuci tangan sebelum makan. Padahal ia baru
bermain2 dengan tanah dsb. Tapi ia tidak apa2. Sedangkan satu waktu atau
di anak yg lain, begitu ia melakukan hal tsb ia langsung mengalami
gangguan pencernaan karena kotoran yg masuk ke makanan melalui tangannya.
Demikian juga dengan pemberian MPASI pada anak terlalu dini. Banyak yang
merasa ”anak saya gak masalah tuh saya kasih makan dari umur 3 bulan”.
Sehingga hal tsb menjadi ”excuse” atau alasan utk tidak mengikuti aturan
yg berlaku. Padahal aturan tsb dibuat karena ada resiko sendiri. Lagipula
penelitan ttg hal ini terus berlanjut. Saat ini mungkin pengetahuan dan
hasil riset yg ada masih terbatas dan ”kurang” bagi beberapa kalangan.
Tapi di kemudian hari kita tidak tahu. Ilmu terus berkembang.

Dan satu hal yg penting. Aturan agar menunda memberikan MPASi pada anak <
6 bulan bukan hanya berlaku utk bayi yg mendapatkan ASI eksklusif. Tetapi
juga bagi bayi yg tidak mendapatkan ASI (susu formula atau mixed).

Semuanya akan kembali kepada ayah & ibu. Jika kita tahu ada resiko dibalik
pemberian MPASI < 6 bl, maka mengapa tidak kita menundanya. Apalagi banyak
sekali penelitian & kasus yang mendukung hal tsb.

Apapun keputusan ibu & ayah, apakah mau memberikan MPASi < 6 bl ataupun >
6bl, alangkah baiknya dipertimbangkan dg baik untung ruginya bagi anak,
bukan bagi orang tuanya. Sehingga keputusan yg diambil adalah yg terbaik
utk sang anak.


Sumber :

•       Solid Food in Early Infancy increases risk of Eczema, from original
source : Fergusson DM et al Early solid feeding and recurrent childhood
eczema: a 10-year longitudinal study Pediatrics 1990 Oct;
86:541-546.[Medline abstract][Download citation]

•       World Health Organization (WHO). Infant Feeding Guidelines. 2003.
Information for Health Professionals on Infant Feeding.
www.who.int/health_topics/breastfeeding/en/

•       World Health Organization (WHO). 2003. Global Strategy for Infant and
Young Child Feeding. www.who.int

•       World Health Organization (WHO). Complementary feeding. Report of the
global consultation. Summary of guiding principles. Geneva, 10-13 December
2001. www.who.int

•       Artikel : Why Delay Solids?
http://www.kellymom.com/nutrition/solids/delay-solids.html

•       The introduction of solids in relation to asthma and eczema.            
    A Zutavern, E von Mutius, J Harris, P Mills, S Moffatt, C White and P
Cullinan. http://adc.bmjjournals.com/cgi/content/abstract/89/4/303

•       AAP. 1990. Early solid feeding and recurrent childhood eczema: a 10-year
longitudinal study. DM Fergusson, LJ Horwood and FT Shannon.
http://pediatrics.aappublications.org/cgi/content/abstract/86/4/541

•       NCBI. Protective nutrients and bacterial colonization in the immature
human gut. Dai D, Walker WA.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10645469&dopt=Abstract

•       Relation between early introduction of solid food to infants and their
weight and illnesses during the first two years of life. Forsyth JS,
Ogston SA, Clark A, Florey CD, Howie PW. Dept of Child Health, Ninewells
Hospital and Medical School, Dundee.

•       Artikel : Stop MPASI terlalu dini. Majalah Ayahbunda Edisi/No.01 Januari
2005












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