Bener pak Hendra, wong Gillian saya masih nenen di 14 bulan usianya.Saya sih terserah dia mau berhenti nenen usia berapa. Salam.Susan--- On Tue 08/30, Luluk Lely Soraya I < [EMAIL PROTECTED] > wrote:From: Luluk Lely Soraya I [mailto: [EMAIL PROTECTED]: [EMAIL PROTECTED]: Tue, 30 Aug 2005 20:47:49 +0700Subject: [balita-anda] Utk Pak Hendra : Sampai kapan ASI diberikan was asi 6 bulanDear 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 (sptsusu formula, MPASI, dsbnya),supply on demandnya (makin sering disusui / diperas maka makin bykdiproduksi), kondisi psikologis ibu (hormon oksitosin sgt tergantung pdpsikologis ibu), dllnya.Intinya ada di point2 tsb.Sekrg kalo boleh tahu istri bapak memberikan susu formula ke anak atas dasarapa ya ?!Maaf pak, biasanya alasan yg sering dikemukakan para ibu/ayah, terutama saatsaya siaran di Ras FM, adalah ketidaktahuan para orang tua baru atautepatnya minimnya pengetahuan para ayah/ibu.Dan jikapun mereka mengetahui, banyak dari mereka yg gak pede ataumendapatkan pressure dari lingkungan.terutama mitos2 seputar ASI yg seringkali jadi kendala. Mulai dari ASI basikalo 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 laktasijuga yg menyatakan kehebatan ASI dan manfaatnya, juga gak hanay sbginformasi. 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 3aktor tsb.Tiga aktor itu adalah ibu, anak dan ayah.Begitu besarnya peran sang ayah menjadi kenyataan yg amat sangat diyakinioleh para ahli laktasi sbg salah satu pemegang kunci sukses ataupunkegagalan ASI eksklusif.Jadi pak hendra bisa melakukan yg terbaik utk anak kok.Dg berbagai cara spt mensupport ibu, meyakinkan ibu, memijat ibu jikakelelahan 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 IchwanSering jadi pertanyaan banyak orang tua "Kapan sih usia yang tepat untukmenyapih anak dari masa menyusu pada ibunya ?"Kemudian bagaimana cara menyapih yg terbaik ?Sebetulnya apa sih yang dimaksud dg kata âmenyapihâ itu sendiri ?Menyapih adalah suatu proses berhentinya masa menyusui secaraberangsur-angsur atau sekaligus. Proses tsb dapat disebabkan olehberhentinya sang anak dari menyusu pada ibunya. Atau bisa juga berhentinyasang ibu untuk menyusui anaknya.Atau bisa juga keduanya. Jadi bisa dg berbagai alasan.Masa menyapih ini merupakan pengalaman emosional bagi sang ibu, anak jugasang ayah. Karena 3 pihak tadi (Ibu-Ayah-Anak) merupakan ikatan kesatuan yggak boleh dilupakan. Kenapa ayah juga terlibat ? Karena ayah juga berperandan memberikan pengaruh tersendiri dalam proses menyusui.Banyak yg bertanya juga kapan sebaiknya anak disapih dari ibunya, atau kapanwaktu yang tepat untuk menyapih.Sebetulnya tidak ada ketentuan khusus atau batasan khusus kapan anak harusdisapih.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 makanantambahan hingga umur 2 th atau LEBIH.Jadi tidak ada batasan di umur berapa. Ini artinya tidak ada aturan bahwapas pada umur 2 th anak harus disapih dari ibunya.Banyak orang tua menyapih anaknya pada umur 1 th-2th, ada juga yg umur 3tahun 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 umursekian si anak harus disapih tetapi sang ibu masih enjoy & sang anak jugamasih menginginkan, maka tidak perlu disapih. Intinya, pilih timing ygpaling nyaman untuk semua pihak.ASI > 1 th jelek dan tidak bergizi ?!Sering ada anggapan bahwa ASI itu sudah jelek kalo anak sudah berusia 1 thke 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 ofthe Breastfed Infant". Pediatric Clinics of North American. February2001;48(1)), bahwaASI > 1 th kaya akan nutrisi :âIn the second year (12-23 months), ASI mengandung : 43% of proteinrequirements; 36% of calcium requirements; 75% of vitamin A requirements;60% of vitamin C requirementsâ.Ini belum termasuk zat anti infeksi/anti kuman yg tetap dan selalu ada dalamASI yg manfaatnya sangat luarbiasa untuk melindungi bayi dari berbagaipenyakit.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 anaksusah disapihnya. Atau banyak juga yg menganggap anak akan jadi tidakmandiri.Benarkah hal ini ? Hingga saat ini tidak ada / belum ada penelitian khususyg membuktikan bahwa ada hubungan antara usia anak disapih dg kemandiriananak. Kenyataan yang ada sering sekali orang merancukan / mencampuradukkankedekatan orang tua dg si anak,dengan manja atau kurang mandiri. Apakahkedekatan dengan orang tua sama dengan manja? Belum tentu kan ? Bukankahsecara psikologis pada usia tsb anak justru memang membutuhkan kedekatan ygbagus dg orangtuanya. Sementara itu banyak sekali anak yang disapih di usia>1 atau 2 th tetap menjadi anak yang mandiri. Jadi kembalikan lagi kedefinisi mandiri itu bagaimana.Cara menyapih yg baik & tepat.Tidak ada cara khusus dalam menyapih.Beberapa ahli laktasi memberikan tips-tips agar proses menyapih berjalan dgbaik :1. Lakukan proses menyapih secara perlahan. Mis. Mengurangi secara bertahapfrekuensi menyusu.Biasanya 4 x sehari maka secara perlahan diubah 3 x sehari terus hinggaakhirnya berhenti.2. Alihkan perhatian anak / sibukkan anak dg hal lain. Bisa dg membacakanbuku ke anak, bermain, bernyanyi, dsb. Hingga anak melupakan saat menyusu.3. Kunci utama : Bina komunikasi yang baik dg anak. Ingat, seberapa kecilusia anak, anak tetap mengerti dan memiliki kemampuan utk mengerti kata2dari 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 yangmelengkapi 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 sanganak.Jangan sampai anak merasa bahwa dg manyapih sang ibu membencinya, dsb.Pemberian jamu pahit, memaksa anak utk tidak menyusu pada ibunya, dsbnyadapat merusak bonding atau ikatan batin yg terbentuk sejauh ini dalam prosesmenyusui. Amat sangat disayangkan jika hal ini terjadi. Karena ikatan indahtsb ternodai akibat proses menyapih secara mendadak tadi.Jika proses penyapihan dilakukan dg baik, maka anak2 kita akan tumbuhmenjadi anak yg cerdas, sehat dan berakhlak baik.Karena sang ibu mendidiknya melalui masa menyusui dan masa menyapih dgcinta.(Luk)--------------------------------Sumber: http://www.lact-aid.com/Relactation: One Alternative to Untimely WeaningJANICE NAU, LPNReprinted from: KEEPING ABREAST JOURNAL. 2(3): 203-207, July-September 1977When weaning is gradual and part of the normal progression of the nursingrelationship, it can be just one of the many passages mothers and theirchildren share in life, an experience filled with mutual satisfaction,development and emotional growth. Far too often, though, things happen whichinterfere with the natural progression of nursing and, as a result, manybabies wean much sooner than their mothers expect. In my work as a lactationcounselor, I have had the opportunity to learn first hand just how deeplydisappointing such "untimely weaning" is for nursing mothers.Sometimes there are situations in which the mother wants to or must wean herinfant in the early weeks or months postpartum. The need to return to workis such a situation for some mothers. But even these weaning experiences canand should be planned for and carried out gradually and lovingly, so motherand infant can make the transition without disturbing the close relationshipformed 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 poorbreastfeeding information, getting off to a bad start in the hospital,regular use of supplemental bottle feedings, starting solids early andnegative pressure from family, friends or medical professionals. Theseundermine the mother's confidence or reduce the amount of breast stimulationshe 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 doafter the weaning to help mothers feel better about it. Many lactationcounselors can tell of women who still get tears in their eyes when theyconfide 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 importantalternative for coping with untimely weaning. Very simply, "relactation" iseither rebuilding a very low milk supply or, in some cases, inducinglactation after it has completely stopped, in order to resume the nursingrelationship. Techniques used can involve self-breast stimulation by massageor breast pump and re-teaching the baby to nurse at the breast. It almostalways requires supplementing the baby until the supply is re-established.Relactation isn't for everyone. Sometimes a mother inquires about it becauseof curiosity, her own guilt feelings or even pressure from others. Before amother can decide if relactation is for her, she should consider a trueanalysis of both her and her husband's feelings about breastfeeding. In mywork as a member of the Relactation Committee of La Leche League ofColorado, my major responsibility is to help the mother make a well-informeddecision and then to support her in whatever she decides. I try to supportthe bond between the mother and her baby by helping her feel good about hermothering abilities, even if she does not resume breastfeeding.I receive many calls about relactation, and for many different kinds ofreasons. A typical call usually goes something like this:MOTHER: Hello, my name is Molly. My friend gave me your name and number andsaid 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 ofweeks 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 sheseemed to be hungry. I guess I didn't have enough milk because my doctorsaid to start supplementing after each feeding. Not long afterwards Annawouldn't take the breast at all. She is doing fine now on the bottle but Ireally miss nursing.JAN: The important thing is the mothering not the method of feeding yourbaby. You can be a good mother either way.MOTHER: I know but I really miss the closeness I felt while I wasbreastfeeding. I enjoyed nursing. It was a special experience and I wouldlike 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 herquestions 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 birthweight 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 allergymedications?)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 fullsupport.)While discussing these questions I am careful to avoid giving advice. I feelthe time for information and teaching can come later. If a great deal ofadvice is given at this point, it overwhelms the mother and is veryfrustrating for her.I next explain the process of relactation. I found the Lact-Aid NursingTrainer System method very helpful and most of the mothers I assist preferto use it. (See Figure 1) Relactating takes time and patienc6 and there aremany times when a mother may become discouraged. However, I assure themother I will gladly provide encouragement and help.Often questions come up about the length of time it will take for the milkto become reestablished. The milk supply cannot be predetermined. There aremany variables that can affect this, such as how the breasts react to thestimulus, how the body adjusts to the hormonal changes which occur, themother's own health and stamina, fatigue, family pressures andresponsibilities and many other factors. It is known however, that thehormone level is the highest for three months following delivery and at thatpoint it drops off sharply. The chances of reestablishing the milk supplyare considerably better during this three-month period. The mother needs tobe aware of all these factors so she will not become discouraged and wonderwhat is wrong with her or the baby if the milk supply seems to build moreslowly than expected.Figure 1Lact-Aid Nursing TrainerReducing anxiety and worry are especially important since they are wellknown to inhibit the let-down reflex. During this interval when the motheris discouraged she needs an extra amount of encouragement. She also needsreassurance that while her milk is coming in, she is establishing thecloseness of the nursing relationship, which is so important.BUILDING THE SUPPLYThe mother should nurse every two to three hours. At night, longer intervalsare acceptable to help her get much needed rest since the relactatingmother's milk supply can easily be inhibited by fatigue. Another factor thatcan slow down relactation is the tendency for the ovaries to resumeovulation when lactation is interrupted. Some mother's milk will be delayedin coming or it may reach a plateau or even decrease suddenly. The mothermay have a menstrual period, slight spotting or feelings of premenstrualtension without menses. Within two to three days after this occurs her milksupply will probably build up at an even faster rate.Often the let-down reflex is unstable at first. Remembering that thelet-down is very easily conditioned to a routine stimulus can be veryimportant in overcoming this problem. In addition to the conditioningprocess, it is important that the mother know the importance of adequaterest, a well balanced diet and good fluid intake. Warm support and help fromher husband can also relieve this problem. if she is having extremedifficulty 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 ofreestablishing an adequate milk supply. Many breastfeeding counselors havesuggested gradually diluting supplemental formula thus "starving" the babyto produce more suckling, which in turn should build the milk supply. Thismethod probably is useful when there are only a few ounces of supplement perday involved and only a moderate increase in the milk supply is needed.However, in relactation I feel the reduction of calories by diluting theformula does not stimulate milk production because the baby becomes weakerand, therefore, does not suck as effectively. This in turn does not producethe desired milk supply. By providing an adequate calorie intake, the babyremains strong and healthy with an adequate weight gain. This also puts moreemphasis on the mother-child relationship and the mother has less of atendency to become "milk oriented". She then can enjoy the baby and theirrelationship.GETTING STARTEDWhile the mother is obtaining the Lact-Aid System the baby may need agradual transition from the bottle to the breast. The mother can give thebottle next to the bare breast (NUK nipples are the best because the shapepromotes the same suckling action of mouth and jaw as the breast.) The skincontact 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 doingso can negatively condition the baby by confusing him when there is no milkand he is hungry.When the mother is ready to begin learning to use the device getting thetube situated just right can seem complicated at first. A few hints can savea 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 restedand patient, usually in the morning.2. Anticipate the baby's hunger and get ready before the baby is ready toeat. 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.) Whenthe baby is "latched on" the tube should extend down the center of the roofof his mouth toward the soft palate.4. The baby should take four ounces of supplement in about 30-40 minutes. Ifit takes longer, test the Lact-Aid System by filling it with water andholding it upside down. There should be a steady, rapid dripping if thedevice is working properly. Refer to the instruction booklet for details oncleaning.5. Some babies tend to tire more easily and need shorter, more frequentnursings.6. Weak babies having difficulty sucking may be given slightly dilutedsupplement with physician's approval (to make the supplement flow easier oneto two tablespoons of distilled water per four ounces of formula.)ENCOURAGEMENTAfter the excitement of finally getting the baby to nurse some mothers getthe "one week blues." It seems to the mother that she has been nursing forages and nothing has happened. The mother may be experiencing some feelingsof fullness in her breasts. This is real encouragement indeed! Usually a fewdays later the mother will be able to express thick, sticky drops followedby milk several days later.WEANING FROM THE LACT-AID SYSTEMThis is a very natural process if the mother is aware of the signs to watchfor:1. The baby may spit up after each feeding.2. The baby will want to nurse less often; i.e., instead of every two tothree hours he may want to go four hours between feedings.3. The baby may leave supplement in the bag after each feeding because thebreast 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 thatlactation is becoming well established and she can begin careful weaningfrom the Lact-Aid System.1. Slightly reduce the amount of supplement offered by how much is left inthe bag. (See Instruction Book)2. Encourage the baby to empty both breasts before following with theLact-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 persistentin wanting the Lact-Aid System, introducing solids can be extremely helpfulin 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 tooffer some of the supplement by cup, if any is needed.There might bean occasional mother who may not be able to establish a fullyadequate milk supply. However, with warm support, respect and kindness, sheand her baby can certainly share many of the pleasures and rewards ofnursing.The return to breastfeeding can be a beautiful experience. As well asproviding the best source of nutrition for the baby, nursing can be anexpression of love and the nurturing of a strong bond between mother andbaby.BIBLIOGRAPHYï· Amsel P: The need to wean; as much for mother as for baby. RN 52-64 May1976.ï· Auerbach KG, et al: Breastfeeding the premature infant. Keep Abreast J2(2): 98-121 Apr-June 1977.ï· Avery, JL: Induced Lactation: A Guide for Counseling and Management.Denver, J J Avery, Inc. 1972.ï· Brown RE: Breastfeeding in modern times. Am J Clin Nutr 26:556-562 May1973.ï· Jelliffe DB: Discussion (p. 68). In: CIBA: Breastfeeding and the Mother.Ciba Foundation Symp #45 (New series). Amsterdam, Elsevier 1976.ï· Klaus MH, Kennell JH: Maternal-Infant Bonding. St. Louis, C V Mosby 1976.ï· LLLI: The Womanly Art of Breastfeeding. Franklin Park IL, La Leche League1958.ï· Pasteels JL, Robyn C (Eds): Human Prolactin. New York, American Elsevier1973.ï· Pryor K: Nursing Your Baby. Revised Ed. New York, Harper & Row 1973.ï· Raphael D: The Tender Gift: Breastfeeding. Englewood Cliffs NJ,Prentice-Hall 1973.ï· Rees D: Sore nipples are a pain! Keep Abreast J 1(2): 137-144 April-June1976.ï· Schneour E: The Malnourished Mind. New York, Anchor Press/Doubleday 1974.ï· Waletsky LR, Herman E: Relactation. AFP 14(2): Aug 1976.At the time this article was published, Janice Nau, L.P.N., was a counselorfor the Denver/Metro Area Relactation Committee of Colorado La Leche League.She frequently conducted workshops for La Leche League Leaders, childbirtheducators and student nurses on relactation counseling. She currentlyresides in Texas..AYO GALANG SOLIDARITAS UNTUK MEMBANTU KORBAN MUSIBAH DI ACEH & DAN SUMATERA UTARA !!!================Kirim bunga, http://www.indokado.comInfo balita: http://www.balita-anda.comStop berlangganan/unsubscribe dari milis ini, e-mail ke: [EMAIL PROTECTED] milis, email ke: [EMAIL PROTECTED]
_______________________________________________ No banners. No pop-ups. No kidding. Make My Way your home on the Web - http://www.myway.com
