Dear Pak Hendra,
Wah dah dibantu banyak ama mbak intan & mbak uci.
Dah komplit banget kok.
Wah saya mah bukan pakar laktasi hehehe ah jadi malu deh.
Sampai kapan Asi akan habis ? sudah dijawab oleh moms tadi ya.
Semua tergantung dari banyak faktor : spt ada substitusi pengganti ASI (spt
susu formula, MPASI, dsbnya),
supply on demandnya (makin sering disusui / diperas maka makin byk
diproduksi), kondisi psikologis ibu (hormon oksitosin sgt tergantung pd
psikologis ibu), dllnya.
Intinya ada di point2 tsb.
Sekrg kalo boleh tahu istri bapak memberikan susu formula ke anak atas dasar
apa ya ?!
Maaf pak, biasanya alasan yg sering dikemukakan para ibu/ayah, terutama saat
saya siaran di Ras FM, adalah ketidaktahuan para orang tua baru atau
tepatnya minimnya pengetahuan para ayah/ibu.
Dan jikapun mereka mengetahui, banyak dari mereka yg gak pede atau
mendapatkan pressure dari lingkungan.
terutama mitos2 seputar ASI yg seringkali jadi kendala. Mulai dari ASI basi
kalo seharian ibunya keluar rumah, ASI jelek dsbnya.
Semua pilihan utk tetap menyusui ataupun memberikan campuran (susu formula)
dsbnya adalah pilihan yg sangat personal. Berbagai penelitian ttg laktasi
juga yg menyatakan kehebatan ASI dan manfaatnya, juga gak hanay sbg
informasi. The final decision will be yours. Yours means kita, para ayah &
ibu,
Banyak ahli laktasi yg bilang bahwa ada 3 aktor utama dalam proses menyusui.
Keputusan utk meneruskan memberikan ASI, ataupun berhenti ada di tangan 3
aktor tsb.
Tiga aktor itu adalah ibu, anak dan ayah.
Begitu besarnya peran sang ayah menjadi kenyataan yg amat sangat diyakini
oleh para ahli laktasi sbg salah satu pemegang kunci sukses ataupun
kegagalan ASI eksklusif.
Jadi pak hendra bisa melakukan yg terbaik utk anak kok.
Dg berbagai cara spt mensupport ibu, meyakinkan ibu, memijat ibu jika
kelelahan menyusui, menggantikan tugas2 di luar menyusui utk membantu ibu,
dsbnya.
jadi sampai kapan ASI diberikan ? Breastfeeding is an untimely weaning.
Its up to you.
Putuskan yg terbaik utk semuanya ya pak.
Luluk
--------------------------
MENYAPIH DENGAN CINTA
(WEANING WITH LOVE)
Ditulis bebas & dirangkum dari berbagai sumber (Lalecheleague, WHO,
breastfeeding.com)
oleh Luluk Lely Soraya Ichwan
Sering jadi pertanyaan banyak orang tua "Kapan sih usia yang tepat untuk
menyapih anak dari masa menyusu pada ibunya ?"
Kemudian bagaimana cara menyapih yg terbaik ?
Sebetulnya apa sih yang dimaksud dg kata “menyapih” itu sendiri ?
Menyapih adalah suatu proses berhentinya masa menyusui secara
berangsur-angsur atau sekaligus. Proses tsb dapat disebabkan oleh
berhentinya sang anak dari menyusu pada ibunya. Atau bisa juga berhentinya
sang ibu untuk menyusui anaknya.
Atau bisa juga keduanya. Jadi bisa dg berbagai alasan.
Masa menyapih ini merupakan pengalaman emosional bagi sang ibu, anak juga
sang ayah. Karena 3 pihak tadi (Ibu-Ayah-Anak) merupakan ikatan kesatuan yg
gak boleh dilupakan. Kenapa ayah juga terlibat ? Karena ayah juga berperan
dan memberikan pengaruh tersendiri dalam proses menyusui.
Banyak yg bertanya juga kapan sebaiknya anak disapih dari ibunya, atau kapan
waktu yang tepat untuk menyapih.
Sebetulnya tidak ada ketentuan khusus atau batasan khusus kapan anak harus
disapih.
Jadi tidak ada aturan bahwa pada umur sekian anak harus disapih dari ibunya.
Menurut WHO, masa pemberian ASI diberikan secara eksklusif 6 bulan pertama,
kemudian dianjurkan tetap diberikan setelah 6 bulan berdampingan dg makanan
tambahan hingga umur 2 th atau LEBIH.
Jadi tidak ada batasan di umur berapa. Ini artinya tidak ada aturan bahwa
pas pada umur 2 th anak harus disapih dari ibunya.
Banyak orang tua menyapih anaknya pada umur 1 th-2th, ada juga yg umur 3
tahun anaknya baru disapih bahkan ada juga yg umur 4 th.
Sampai kapan proses / masa menyusui dapat dilanjutkan ?
Jawabannya : Selama ketiga pihak (ibu-anak-ayah) masih menginginkan.
Itu artinya jika sang ibu / sang anak / sang ayah sudah tidak menginginkan,
maka proses menyapih dapat dilakukan.
Misalnya, sang ibu punya deadine (batas waktu) tersendiri bahwa pada umur
sekian si anak harus disapih tetapi sang ibu masih enjoy & sang anak juga
masih menginginkan, maka tidak perlu disapih. Intinya, pilih timing yg
paling nyaman untuk semua pihak.
ASI > 1 th jelek dan tidak bergizi ?!
Sering ada anggapan bahwa ASI itu sudah jelek kalo anak sudah berusia 1 th
ke atas ? Nah apalagi jika anak berusia 2 th, betulkah ini?
Opini bahwa ASI itu jelek > 1 th ternyata sama sekali tidak benar.
ASI tetap kaya akan nutrisi. Menurut penelitian Dewey KG dalam artikel
"Nutrition, Growth, and Complementary Feeding of
the Breastfed Infant". Pediatric Clinics of North American. February
2001;48(1)), bahwa
ASI > 1 th kaya akan nutrisi :
“In the second year (12-23 months), ASI mengandung : 43% of protein
requirements; 36% of calcium requirements; 75% of vitamin A requirements;
60% of vitamin C requirements”.
Ini belum termasuk zat anti infeksi/anti kuman yg tetap dan selalu ada dalam
ASI yg manfaatnya sangat luarbiasa untuk melindungi bayi dari berbagai
penyakit.
Jadi tidak pernah ada istilah ASI jelek.
Kandungan gizi ASI itu sangat fleksibel sesuai kebutuhan sang anak.
Komposisinya tidak pernah sama dan selalu berubah bahkan tiap menit.
Ini berbeda sama sekali dg kandungan susu formula yg itu-itu saja.
Sampai saat ini banyak anggapan bahwa jika anak disusui terus nantinya anak
susah disapihnya. Atau banyak juga yg menganggap anak akan jadi tidak
mandiri.
Benarkah hal ini ? Hingga saat ini tidak ada / belum ada penelitian khusus
yg membuktikan bahwa ada hubungan antara usia anak disapih dg kemandirian
anak. Kenyataan yang ada sering sekali orang merancukan / mencampuradukkan
kedekatan orang tua dg si anak,dengan manja atau kurang mandiri. Apakah
kedekatan dengan orang tua sama dengan manja? Belum tentu kan ? Bukankah
secara psikologis pada usia tsb anak justru memang membutuhkan kedekatan yg
bagus dg orangtuanya. Sementara itu banyak sekali anak yang disapih di usia
>1 atau 2 th tetap menjadi anak yang mandiri. Jadi kembalikan lagi ke
definisi mandiri itu bagaimana.
Cara menyapih yg baik & tepat.
Tidak ada cara khusus dalam menyapih.
Beberapa ahli laktasi memberikan tips-tips agar proses menyapih berjalan dg
baik :
1. Lakukan proses menyapih secara perlahan. Mis. Mengurangi secara bertahap
frekuensi menyusu.
Biasanya 4 x sehari maka secara perlahan diubah 3 x sehari terus hingga
akhirnya berhenti.
2. Alihkan perhatian anak / sibukkan anak dg hal lain. Bisa dg membacakan
buku ke anak, bermain, bernyanyi, dsb. Hingga anak melupakan saat menyusu.
3. Kunci utama : Bina komunikasi yang baik dg anak. Ingat, seberapa kecil
usia anak, anak tetap mengerti dan memiliki kemampuan utk mengerti kata2
dari orang di lingkungannya.
4. Hindari menyapih saat anak sedang tidak sehat atau sedang sedih, kesal,
marah.
5. Hindari menyapih anak dari menyusu ke benda lain spt empeng, botol susu,
bantal, dsb. Biasanya disini peran ayah sangat dibutuhkan sbg figur yang
melengkapi sang ibu. Sekali lagi bina komunikasi yg baik dg anak.
6. Hindari menyapih secara mendadak/langsung.
Apalagi tanpa komunikasi apapun dg si anak. Ini dapat menyakitkan hati sang
anak.
Jangan sampai anak merasa bahwa dg manyapih sang ibu membencinya, dsb.
Pemberian jamu pahit, memaksa anak utk tidak menyusu pada ibunya, dsbnya
dapat merusak bonding atau ikatan batin yg terbentuk sejauh ini dalam proses
menyusui. Amat sangat disayangkan jika hal ini terjadi. Karena ikatan indah
tsb ternodai akibat proses menyapih secara mendadak tadi.
Jika proses penyapihan dilakukan dg baik, maka anak2 kita akan tumbuh
menjadi anak yg cerdas, sehat dan berakhlak baik.
Karena sang ibu mendidiknya melalui masa menyusui dan masa menyapih dg
cinta.
(Luk)
--------------------------------
Sumber: http://www.lact-aid.com/
Relactation: One Alternative to Untimely Weaning
JANICE NAU, LPN
Reprinted from: KEEPING ABREAST JOURNAL. 2(3): 203-207, July-September 1977
When weaning is gradual and part of the normal progression of the nursing
relationship, it can be just one of the many passages mothers and their
children share in life, an experience filled with mutual satisfaction,
development and emotional growth. Far too often, though, things happen which
interfere with the natural progression of nursing and, as a result, many
babies wean much sooner than their mothers expect. In my work as a lactation
counselor, I have had the opportunity to learn first hand just how deeply
disappointing such "untimely weaning" is for nursing mothers.
Sometimes there are situations in which the mother wants to or must wean her
infant in the early weeks or months postpartum. The need to return to work
is such a situation for some mothers. But even these weaning experiences can
and should be planned for and carried out gradually and lovingly, so mother
and infant can make the transition without disturbing the close relationship
formed during nursing.
Most early weaning, though, is not a happy experience for mother or baby.
Often, there are a number of factors causing untimely weaning such as poor
breastfeeding information, getting off to a bad start in the hospital,
regular use of supplemental bottle feedings, starting solids early and
negative pressure from family, friends or medical professionals. These
undermine the mother's confidence or reduce the amount of breast stimulation
she receives. As a result, her milk supply gradually diminishes and,
finally, her baby rejects the breast entirely.
The situation is common and until recently there was little one could do
after the weaning to help mothers feel better about it. Many lactation
counselors can tell of women who still get tears in their eyes when they
confide to us their disappointment about an untimely weaning experience,
even though their children are now grown.
For an increasing number of women, relactation is becoming an important
alternative for coping with untimely weaning. Very simply, "relactation" is
either rebuilding a very low milk supply or, in some cases, inducing
lactation after it has completely stopped, in order to resume the nursing
relationship. Techniques used can involve self-breast stimulation by massage
or breast pump and re-teaching the baby to nurse at the breast. It almost
always requires supplementing the baby until the supply is re-established.
Relactation isn't for everyone. Sometimes a mother inquires about it because
of curiosity, her own guilt feelings or even pressure from others. Before a
mother can decide if relactation is for her, she should consider a true
analysis of both her and her husband's feelings about breastfeeding. In my
work as a member of the Relactation Committee of La Leche League of
Colorado, my major responsibility is to help the mother make a well-informed
decision and then to support her in whatever she decides. I try to support
the bond between the mother and her baby by helping her feel good about her
mothering abilities, even if she does not resume breastfeeding.
I receive many calls about relactation, and for many different kinds of
reasons. A typical call usually goes something like this:
MOTHER: Hello, my name is Molly. My friend gave me your name and number and
said you might be able to help me bring my milk back in.
JAN: Can you tell me about it?
MOTHER: My baby, Anna, is 10 weeks old now. When she was just a couple of
weeks old I saw the doctor and he said I should only nurse every 3-4 hours.
I tried to do this but the baby was really fussy after 2 hours and she
seemed to be hungry. I guess I didn't have enough milk because my doctor
said to start supplementing after each feeding. Not long afterwards Anna
wouldn't take the breast at all. She is doing fine now on the bottle but I
really miss nursing.
JAN: The important thing is the mothering not the method of feeding your
baby. You can be a good mother either way.
MOTHER: I know but I really miss the closeness I felt while I was
breastfeeding. I enjoyed nursing. It was a special experience and I would
like to do it again.
JAN: Do you have any milk now?
MOTHER: No, not really. Do you think you can help me?
The important thing is the mothering not the method of feeding your baby.
When a mother calls to tell me she is interested in breastfeeding, I ask her
questions about several aspects of her experience, such as:
1. Name and present age of baby.
2. Baby's birth weight and present weight and, if applicable, any birth
weight loss.
3. Difficulties she is having.
4. Solids or supplements and how much.
5. Lactating now ... if so, how much?
6. How long has it been since she last nursed?
7. Are there any other children and did she nurse them?
8. Is she on any medications (especially contraceptives or allergy
medications?)
9. What are her social activities and is she working outside the home?
10. How does her husband feel about her relactating?
11. How does her physician feel about her relactating? (She needs his full
support.)
While discussing these questions I am careful to avoid giving advice. I feel
the time for information and teaching can come later. If a great deal of
advice is given at this point, it overwhelms the mother and is very
frustrating for her.
I next explain the process of relactation. I found the Lact-Aid Nursing
Trainer System method very helpful and most of the mothers I assist prefer
to use it. (See Figure 1) Relactating takes time and patienc6 and there are
many times when a mother may become discouraged. However, I assure the
mother I will gladly provide encouragement and help.
Often questions come up about the length of time it will take for the milk
to become reestablished. The milk supply cannot be predetermined. There are
many variables that can affect this, such as how the breasts react to the
stimulus, how the body adjusts to the hormonal changes which occur, the
mother's own health and stamina, fatigue, family pressures and
responsibilities and many other factors. It is known however, that the
hormone level is the highest for three months following delivery and at that
point it drops off sharply. The chances of reestablishing the milk supply
are considerably better during this three-month period. The mother needs to
be aware of all these factors so she will not become discouraged and wonder
what is wrong with her or the baby if the milk supply seems to build more
slowly than expected.
Figure 1
Lact-Aid Nursing Trainer
Reducing anxiety and worry are especially important since they are well
known to inhibit the let-down reflex. During this interval when the mother
is discouraged she needs an extra amount of encouragement. She also needs
reassurance that while her milk is coming in, she is establishing the
closeness of the nursing relationship, which is so important.
BUILDING THE SUPPLY
The mother should nurse every two to three hours. At night, longer intervals
are acceptable to help her get much needed rest since the relactating
mother's milk supply can easily be inhibited by fatigue. Another factor that
can slow down relactation is the tendency for the ovaries to resume
ovulation when lactation is interrupted. Some mother's milk will be delayed
in coming or it may reach a plateau or even decrease suddenly. The mother
may have a menstrual period, slight spotting or feelings of premenstrual
tension without menses. Within two to three days after this occurs her milk
supply will probably build up at an even faster rate.
Often the let-down reflex is unstable at first. Remembering that the
let-down is very easily conditioned to a routine stimulus can be very
important in overcoming this problem. In addition to the conditioning
process, it is important that the mother know the importance of adequate
rest, a well balanced diet and good fluid intake. Warm support and help from
her husband can also relieve this problem. if she is having extreme
difficulty she may consult her physician about the use of oxytocin.
(Available in a nasal spray, oxytocin stimulates the milk let-down reflex.)
[Added note 1998. This is no longer available.]
In the past there has been some controversy over the methods of
reestablishing an adequate milk supply. Many breastfeeding counselors have
suggested gradually diluting supplemental formula thus "starving" the baby
to produce more suckling, which in turn should build the milk supply. This
method probably is useful when there are only a few ounces of supplement per
day involved and only a moderate increase in the milk supply is needed.
However, in relactation I feel the reduction of calories by diluting the
formula does not stimulate milk production because the baby becomes weaker
and, therefore, does not suck as effectively. This in turn does not produce
the desired milk supply. By providing an adequate calorie intake, the baby
remains strong and healthy with an adequate weight gain. This also puts more
emphasis on the mother-child relationship and the mother has less of a
tendency to become "milk oriented". She then can enjoy the baby and their
relationship.
GETTING STARTED
While the mother is obtaining the Lact-Aid System the baby may need a
gradual transition from the bottle to the breast. The mother can give the
bottle next to the bare breast (NUK nipples are the best because the shape
promotes the same suckling action of mouth and jaw as the breast.) The skin
contact and the baby's head turning restore the natural rooting behavior.
Also she should not try to nurse the baby at the empty breast because doing
so can negatively condition the baby by confusing him when there is no milk
and he is hungry.
When the mother is ready to begin learning to use the device getting the
tube situated just right can seem complicated at first. A few hints can save
a lot of frustration. Here are some I have found helpful:
1. The best time to start is when the mother and baby feel the most rested
and patient, usually in the morning.
2. Anticipate the baby's hunger and get ready before the baby is ready to
eat. It is difficult to work with a frantic, hungry baby.
3. Position the tube so it extends slightly past the tip of the nipple.
(Hair styling tape next to the areola helps to hold the tube in place.) When
the baby is "latched on" the tube should extend down the center of the roof
of his mouth toward the soft palate.
4. The baby should take four ounces of supplement in about 30-40 minutes. If
it takes longer, test the Lact-Aid System by filling it with water and
holding it upside down. There should be a steady, rapid dripping if the
device is working properly. Refer to the instruction booklet for details on
cleaning.
5. Some babies tend to tire more easily and need shorter, more frequent
nursings.
6. Weak babies having difficulty sucking may be given slightly diluted
supplement with physician's approval (to make the supplement flow easier one
to two tablespoons of distilled water per four ounces of formula.)
ENCOURAGEMENT
After the excitement of finally getting the baby to nurse some mothers get
the "one week blues." It seems to the mother that she has been nursing for
ages and nothing has happened. The mother may be experiencing some feelings
of fullness in her breasts. This is real encouragement indeed! Usually a few
days later the mother will be able to express thick, sticky drops followed
by milk several days later.
WEANING FROM THE LACT-AID SYSTEM
This is a very natural process if the mother is aware of the signs to watch
for:
1. The baby may spit up after each feeding.
2. The baby will want to nurse less often; i.e., instead of every two to
three hours he may want to go four hours between feedings.
3. The baby may leave supplement in the bag after each feeding because the
breast flows faster than the Lact-Aid System.
4. The baby will have VERY wet diapers.
5. The baby will have soft stools, more typical of breastfed infants.
6. He will be gaining and thriving.
When these signs are occurring consistently, the mother can be assured that
lactation is becoming well established and she can begin careful weaning
from the Lact-Aid System.
1. Slightly reduce the amount of supplement offered by how much is left in
the bag. (See Instruction Book)
2. Encourage the baby to empty both breasts before following with the
Lact-Aid System.
3. Offer the cooperative baby the breast between feedings as a pacifier.
4. For the baby taking only an ounce per feeding, but who seems persistent
in wanting the Lact-Aid System, introducing solids can be extremely helpful
in establishing total breastfeeding with solids.
5. Morning supplements are usually eliminated first.
6. By the time the baby is five to six months old, mothers should be able to
offer some of the supplement by cup, if any is needed.
There might bean occasional mother who may not be able to establish a fully
adequate milk supply. However, with warm support, respect and kindness, she
and her baby can certainly share many of the pleasures and rewards of
nursing.
The return to breastfeeding can be a beautiful experience. As well as
providing the best source of nutrition for the baby, nursing can be an
expression of love and the nurturing of a strong bond between mother and
baby.
BIBLIOGRAPHY
Amsel P: The need to wean; as much for mother as for baby. RN 52-64 May
1976.
Auerbach KG, et al: Breastfeeding the premature infant. Keep Abreast J
2(2): 98-121 Apr-June 1977.
Avery, JL: Induced Lactation: A Guide for Counseling and Management.
Denver, J J Avery, Inc. 1972.
Brown RE: Breastfeeding in modern times. Am J Clin Nutr 26:556-562 May
1973.
Jelliffe DB: Discussion (p. 68). In: CIBA: Breastfeeding and the Mother.
Ciba Foundation Symp #45 (New series). Amsterdam, Elsevier 1976.
Klaus MH, Kennell JH: Maternal-Infant Bonding. St. Louis, C V Mosby 1976.
LLLI: The Womanly Art of Breastfeeding. Franklin Park IL, La Leche League
1958.
Pasteels JL, Robyn C (Eds): Human Prolactin. New York, American Elsevier
1973.
Pryor K: Nursing Your Baby. Revised Ed. New York, Harper & Row 1973.
Raphael D: The Tender Gift: Breastfeeding. Englewood Cliffs NJ,
Prentice-Hall 1973.
Rees D: Sore nipples are a pain! Keep Abreast J 1(2): 137-144 April-June
1976.
Schneour E: The Malnourished Mind. New York, Anchor Press/Doubleday 1974.
Waletsky LR, Herman E: Relactation. AFP 14(2): Aug 1976.
At the time this article was published, Janice Nau, L.P.N., was a counselor
for the Denver/Metro Area Relactation Committee of Colorado La Leche League.
She frequently conducted workshops for La Leche League Leaders, childbirth
educators and student nurses on relactation counseling. She currently
resides in Texas..
AYO GALANG SOLIDARITAS UNTUK MEMBANTU KORBAN MUSIBAH DI ACEH & DAN SUMATERA
UTARA !!!
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