博客

  • 母乳喂养婴儿正常大便? What is the normal stool like of a breastfed baby?

    母乳喂养婴儿正常大便? What is the normal stool like of a breastfed baby?

        周宗蓓:新出生的婴儿可能在四到六周内,每天至少有三到五次大便,每次有像一元硬币那么多的量。一元硬币的量就算一次,一天应该有3—5次大便。四到六周之后,如果孩子大便一天一次,来的量很多,甚至两三天,还有五天来一次的可是量相当多的孩子,不便秘的情况下,不是出来像小石头一样的就没问题,通常纯母乳喂养的孩子不会这样。

    孩子的体重:三四个月内的孩子,平均一周会长170克,如果按这个速度算的话,是从出生后大概头几天最低的体重来算,而不是出生的体重,出生体重在头几天会降下来然后再上来。最好用最低的体重来算,平均170克/周,如果低于124克/周的话,我们应该再看看母乳喂养的方法上面有没有什么问题,最好可以咨询我们或者哺乳顾问。

    如果四到六个月的孩子通常是每周增长113克—142克,孩子大了之后增长速度会慢下来。六个月到十二个月的阶段是每周增长57克—113克。每个孩子都不一样的,跟基因有关系,你跟你邻居的孩子比其实没有必要,可以根据这些标准来看就可以了。

    网友:我家宝宝1月21日出生,现在40多天,一直纯母乳喂养奶很足,长了两斤半,每次吃完母乳特别使劲想便便,特别是擦屁股时爱拉,便有稠的感觉,有的时候水便。正常吗?

    周宗蓓:孩子的状态没有什么问题吧?听起来他的成长很健康,母乳喂养孩子的大便就是比较稀。

  • 母乳喂养保护家庭,免遭污染配方奶的危害 Breastfeeding Protects Families from Risks of Tainted Formula

    母乳喂养保护家庭,免遭污染配方奶的危害 Breastfeeding Protects Families from Risks of Tainted Formula

    Contact: Melanie Ham, Emy Machida, Yuwen Ren, Ursula Weitzel, Judit Hajba
    Contact Ph# 13917124540, 13917484030 or info@lllshanghai.com

    母乳喂养保护家庭,免遭污染配方奶的危害

    (September 2008) La Leche League 国际母乳会亚洲 (Asia) 对7000多因食用被三聚氰胺污染的配方奶而致病的婴儿表示深切的悲痛。数家中国企业生产的配方奶,和其它乳制品如,牛奶,酸奶,和冰激凌中都检测出含有三聚氰胺。食用污染配方奶已导致至少4名婴儿死亡,150多名婴儿因肾脏衰竭而住院,数千个婴儿因而致病。三聚氰胺常被使用作为一种化学结合剂,也做为一种添加剂用于化肥。因为其高含氮量,人为的将其添加在牛奶中可以增加蛋白质含量检测指标,但会导致肾脏疾病。

    (September 2008) La Leche League of (Asia) was deeply saddened to read about the illness of almost 7,000 Chinese babies who were fed formula tainted by the chemical melamine. The chemical has been found in several brands of infant formula manufactured in China as well as in other dairy products, including regular milk, yogurt and ice cream. At least four babies have died,  more than 150 have been  hospitalized with kidney failure and thousands have been sickened after being fed contaminated infant formula. Melamine is a chemical which is meant to be used as a binding agent and is also an ingredient in fertilizer.  Melamine artificially increases the protein profile of milk and can cause kidney diseases.

    由于此事件已引发全球全面性召回中国 所出产的乳制产品。国际母乳会La Leche League International (LLLI) 强烈建议使用配方奶的妈妈们重新母乳喂养,避免遭到污染配方奶或者是不适当处方配方奶的影响,从而确保宝宝在这样一种灾难性的情况下获得正确的营养。

    Massive recalls of dairy products manufactured in China are being conducted world-wide.  La Leche League International (LLLI) strongly suggests that mothers with infants who are being given formula consider relactating to avoid possible exposure to tainted formula, improperly prepared formula and to protect their ability to nourish infants in case of disaster.

    即使现在奶量已很少或没有喂过母乳,也可以重新启动母乳分泌,但此过程的确需要妈妈的决心和支持的给予。相关信息有关再度泌乳信息 ,可以在以下LLLI 网站 中寻找http://www.llli.org/FAQ/relactation.html. 甚至在已经产后几个月的妈妈们和领养婴儿的妈妈们可藉由重新启动母乳分泌已达成母乳喂养。

    Although health professionals around the world advise breastfeeding as the best choice, mothers who choose to feed formula to their babies often do so believing that they are providing the best for their children. Marketing messages from formula manufacturers promote the belief that formula is equal or superior to human milk.  These marketing tactics are prevalent even in developing countries where it is often difficult to properly purchase, prepare and store human milk substitutes.  Beliefs in the superiority of human milk substitutes can become pervasive, resulting in mothers finding little or no support for their desire to breastfeed.

    尽管全世界的健康专家都认为母乳喂养是最佳选择,但选择配方奶的妈妈们经常相信她们给自己宝宝的是最好的。配方奶生产商的广告宣称配方奶等同于母乳或更好。这些营销策略甚至盛行于在母乳替代品的购买 ,准备和储藏都很困难的发展中国家。那些配方奶优越性的信念变得很有说服性,从而导致妈妈们几乎找不到支持来协助她们母乳喂养。

    According to the World Health Organization (WHO), more than one million children die every year because they are not breastfed.  WHO estimates that no more than 40% of infants worldwide are exclusively breastfed for the first six months of life. A cornerstone of WHO’s and UNICEF’s Global Strategy for Infant and Young Child Feeding (http://www.who.int/nutrition/topics/global_strategy/en/index.html) is the aim that babies be exclusively breastfed for the first six months of life. After six months, it is recommended that breastfeeding be continued along with the introduction of locally available foods.  For the first year of life and beyond, human milk provides nutrition and protects infants from disease. Research has demonstrated that the nutritional value of breastmilk, specifically the fat and energy content, continues well beyond the first year. There are many reasons that women choose not to breastfeed, including some medical conditions which are contraindications to breastfeeding.  However, in the absence of such contraindications, providing women with information and support to be able to breastfeed is important.

    根据世界卫生组织的相关数据表明,每年超过1百万的婴儿因为没有母乳喂养而死亡。该组织估计只有40%不到的婴儿在出生的头六个月完全靠母乳喂养。世界卫生组和联合国儿童基金会发布的全球婴幼儿喂养方案(http://www.who.int/nutrition/topics/global_strategy/en/index.html),提倡婴儿在出生的头六个月完全靠母乳喂养。六个月后,建议继续母乳喂养并辅以当地能获得的其它适合婴儿的食物。母乳能保护宝宝不止在第一年里抵御各种疾病。研究显示头一年后的母乳,仍继续维持着良好的营养价值与成分,尤其是脂肪和能量成分。妈妈不选择母乳喂养有很多原因,包括一些医学方面的因素以至于不能母乳喂养。然而,如果没有这方面的原因,为妈妈们提供信息和支持使得她们能够母乳喂养是十分重要的。

    Pregnant mothers need to know that while breastfeeding is natural, it is a learned behavior.  Although many mothers and babies begin breastfeeding and continue on with no problems, this is not always the case.  Mothers can find information to help them with their difficulties by contacting a La Leche League Leader or attending a La Leche League meeting.

    怀孕妇女需知道母乳喂养是自然过程,不过这也是一们学习的艺术。很多妈妈和宝宝很自然的开始并毫无任何问题的持续母乳喂养,但并非所有的妈妈都会如此顺利。需要帮助和指导的妈妈们可以联系国际母乳会的哺乳辅导 或者参加国际母乳会的聚会.

    Women in both affluent and developing countries need to have information and support to breastfeed their babies. Since 1956, LLLI  has been offering this information and support. Mother-to-mother support groups now exist in almost 70 countries. The Womanly Art of Breastfeeding, published by LLLI, has sold over two million copies. LLLI’s web site reaches millions of women a year. For more information about breastfeeding or to locate a support group in your area, visit the LLLI web site at www.llli.org.

    不管是富裕国家的妇女,还是发展中国家的妇女,都有需要母乳喂养的信息和支持。自1956年起,国际母乳会就提供相应的信息和支持。母亲对母亲的支持小组已经存在于世界70多个国家。由国际母乳会LLLI 出版的”女性的母乳喂养艺术”一书已售出超过2百万本。LLLI 的网站每年有数以百万计的访问者。如需要详细了解您所在地区的支持小组信息请上以下网址www.llli.org

    国际母乳会LLL 在上海每月有中英文聚会活动。关于母乳喂养的益处和方法将在会上讨论。如需详细信息,请写email至 info@lllshangahi.com

    联合国儿童基金会驻中国办事处和世界卫生组织驻华代表处就受污染奶粉事件联合发表声明
    北京, 2008年9月24日 –  联合国儿童基金会驻中国办事处和世界卫生组织驻华代表处就三鹿及其他奶粉公司受污染婴幼儿奶粉事件深表痛心和关注。在食品生产和销售领域对公众的欺骗行为是无法接受的,故意污染婴幼儿食品的行为更应受到谴责。
    中国食品安全主管部门正在采取迅速有力的行动对这次事件开展全面调查,我们相信此事件会得到妥善处理。同时,我们也期望在调查结束后,随着中国政府日益重视食品安全的问题,中国婴幼儿食品的监管机制将得到进一步完善。

    全球所有卫生机构一致确信,母乳是婴儿最理想的食品,没有任何一种婴儿配方奶粉可以与之相比。没有任何一种奶粉同母乳一样含有完全均衡的、可促进婴儿身心发育的蛋白质、碳水化合物和脂肪。没有任何一种奶粉同母乳一样含有可帮助婴儿抵抗疾病的抗体,没有任何一种奶粉同母乳一样安全可靠,并且对于家庭来说,没有任何一种奶粉同母乳一样经济实惠,既能为孩子提供均衡的营养又能保护其免受疾病的侵扰。
    在正常情况下,所有婴儿在出生后六个月内都应进行纯母乳喂养。在此期间无需给婴儿添加任何其他饮料或食物,甚至不用喂水。此后,在给婴儿开始添加营养丰富和安全的辅食同时,应当继续坚持母乳喂养至少到孩子满两岁。

    如果职业女性在上班时间无法用母乳喂养孩子,应该将母乳挤出并存放在干净的容器中备用,这样母亲不在身边时孩子也能喝到母乳。在室温下,母乳可以安全存放至八小时。母亲下班回家后应按正常情况哺喂孩子。这样,即使在母亲上班或临时外出后,孩子也能够持续享受母乳喂养的益处。

    所有母亲都应该在产前、分娩和产后的全程保健护理过程中了解到母乳喂养对孩子和对自己的好处,并且应该在专业人员的帮助下掌握如何开始哺乳以及持续哺乳的正确方法。父母们也应该认识到婴儿配方奶粉在其生产、加工和使用的过程中有受污染的可能性,这样的风险在此次和以往在国内外发生的类似事件中得到了充分体现。对于少数确实由于医学或其他原因不能给孩子喂母乳或者产后经过一段时间选择奶粉喂养的母亲,在决定选用母乳代用品之前,应当充分咨询专业医务工作者,并充分考虑到安全性和经济承受能力等因素。

    如需了解更多信息,请联系:
    Dale Rutstein(英文) 联合国儿童基金会驻中国办事处  电话:(86-10)65323131转1301  电邮:drutstein@unicef.org
    刘莉(中文) 联合国儿童基金会驻中国办事处 
电话:(86-10)65323131转1303  电邮:liliu@unicef.org
    Nyka Alexander(英文) 世卫组织驻华代表处 
电话:(86-10)6532-7189转81281 电邮:alexandern@wpro.who.int
    原博雍(中文) 世卫组织驻华代表处  
电话:(86-10)6532-7189转81282 电邮:yuanb@wpro.who.int

  • 挑战关于母乳喂养的传统说法 BF Myths and Facts

    挑战关于母乳喂养的传统说法 BF Myths and Facts

    作者:小巫 来源:《让孩子做主》

    (导语)从老人那里、从朋友那里,我们得到太多的关于母乳喂养的经验和观点。有些经验让我们受益匪浅,但也有观点让我们错误地丢掉了母乳喂养的机会。这里让我们来挑战那些错误的“传统”。

    传统说法1、母乳六个月以后,就没有什么营养了,应该给孩子断奶!
    事实:这个说法是毫无科学根据的。正常情况下,新生儿从出生到六个月,完全依靠母乳喂养,就能够得到成长所需全部营养,不必添加任何辅助食品,包括水。六个月以后,婴儿成长所需养分,单纯依靠母乳已经不够,需要添加辅食。而且,六个月不是绝对的底线,有些早产儿或者过敏体质的婴儿,由于身体的原因,拒绝或不能接受辅食,完全依靠母乳喂养到八、九个月甚至更长,也一样营养俱全,健壮成长。其实,直至上个世纪初,绝大多数的婴儿在一岁之前都是完全依靠母乳喂养。迄今为止,没有任何科学证据证明母乳在任何阶段会失去营养价值。

    传统说法2、妈妈一开始来月经,奶就变味了,就不能再喂孩子了。
    事实:至今没有任何研究表明,来月经后的母乳在质量上有什么变化。来过月经的母亲可以继续哺乳。但是要注意,应该采取非荷尔蒙类避孕方式。含雌激素或黄体酮的荷尔蒙类避孕方式,的确会改变母乳的成分,降低乳汁分泌,因此最好避免。多年大量的研究表明,采取一定方式的纯母乳喂养,至少在宝宝出生后头6个月里,是天然而有效的避孕手段。母亲重返工作岗位而又做不到频繁挤奶、宝宝开始进食其他添加物、或者以前夜间吃奶的孩子突然开始睡整夜觉时,随着宝宝的吸吮率降低,母亲体内的荷尔蒙水平会受到影响,无论是否先行排卵,月经都有可能回来。

    传统说法3、乳房不涨、而且太小,还漏奶,肯定奶水不足。
    事实:乳房不涨并不说明奶少。在3个月左右,妈妈和孩子之间已经达成默契,身体知道该生产多少奶,不像刚刚开始喂奶时,那么慌里慌张拼命产奶了。孩子吃的奶,大部分是现吃现产的,所以涨不涨没有什么关系,和乳房的大小也没有关系。你漏出去的奶量不多,宝宝吃的时候,你还有无穷无尽的奶给他,他一边吃,你一边产,源源不断,取之不竭,用之不尽。这时没有必要给孩子添奶粉,如果你这时沉不住气加奶粉,会让你的奶越来越少。要让奶多,只有一个办法,就是让宝宝多多地吃、吃、吃!

    传统说法4、宝宝出生后头两天,奶没有完全下来,先不需要给孩子吃。
    事实:这两天极少的一点点奶,恰恰是比金子还珍贵的“初乳”(colostrum),它的脂肪和碳水化合物含量极低,却含有大量活性蛋白质、免疫球蛋白和其他对你的宝宝有益的成分,最最应该给孩子吃。母亲的乳汁是保护宝宝不受病菌病毒侵袭的天然屏障,尤其是初乳,好比给新生的宝宝打了第一道预防针。而且新生儿越早吸吮母亲的乳头,越有益于乳汁的尽早分泌。国际母乳会推荐,在没有生理和病理障碍的前提下,孩子出生后几分钟之内就应该送到母亲身上开始吸吮。即便你看不到或感觉不到有乳汁分泌,还是有涓涓滴滴的初乳进入宝宝的身体。你大量的乳汁在产后二到五天之内出现。在一个星期内,你的乳汁处于转型阶段,到了十天至十四天左右,你的乳汁稳定下来,成为成熟的奶。这个时候,不要因为觉得宝宝饿,就喂他奶粉。新生儿6个星期之内使用人工奶嘴,最容易引起乳头错觉,因为吸吮奶嘴和吸吮乳头是两种截然不同的技巧,使孩子要么拒绝乳头,要么因为衔乳姿势不正确,导致乳头皲裂,给妈妈带来痛苦。

    传统说法5、看到妈妈的乳汁是灰颜色的,很清淡,说明奶太稀,喂不饱宝宝。
    事实:我们看到的清淡的奶是“前奶”,成分大部分是水分,是给宝宝解渴的(这也是为什么母乳喂养的孩子不需要额外喝水)。宝宝越吃,母乳越浓,到最后,会分泌象奶油一样的“后奶”,是给宝宝解饿的。母乳会根据宝宝的成长情况,自动调节每一次的分泌,满足宝宝的需求。在炎热的夏季,母乳会自动变稀,供给宝宝更多的水分,所以即使在夏天,宝宝也不需要额外喝水。

    传统说法6、吃奶粉的宝宝比纯母乳喂养的孩子体重增长快,说明母乳有时不如奶粉好。
    事实:吃奶粉的孩子的确更容易胖,因为奶粉中含有数倍于母乳的脂肪和蛋白质,是宝宝不需要的,而且会造成体重过量,给将来的健康埋下高血压等定时炸弹。

    传统说法7、如果孩子长得快,个子大,光吃母乳是不够的,应该提前添辅食。
    事实:无论你的孩子的成长速度有多快,你的母乳都能够在6个月内满足她的全部需要。提前添加辅食,不仅无济于事,反而会给孩子造成过重的肾负荷,而且破坏她对母乳营养的吸收,适得其反。

  • 母乳喂养: 宝宝的第一剂疫苗 Breastfeeding – Babys First Immunization

    母乳喂养: 宝宝的第一剂疫苗 Breastfeeding – Babys First Immunization

    娄彦琦 译  高宜伶编辑

    王梅馨、陈淑娟 审稿

    「新生儿来到这遍布细菌和感染的世界里所能拥有的最强防御即来自初乳。

    初乳,母亲生产后的头几天内分泌的物质,是宝宝的第一剂疫苗。」

    (联合国儿童基金会,1992)

     

    母乳喂养给宝宝和妈妈带来众多好处,而人乳对健康的诸多裨益也已广为记录。它们包括:

    • 消化系统疾病和呼吸系统疾病的预防,例如中耳炎(Aniansson 1994)。
    • 非消化系统的疾病感染和免疫失调的预防(Cunningham et al 1991)。

    除了增进婴儿时期的健康之外,母乳喂养还能够:

    • 减少过敏的发生几率 (Chandra 1989),以及
    • 减少某些疾病在未来的发生机率,包括:乳房癌 (Newcomb 1994),骨质疏松症

    (Kritz-Silverstein 1992),糖尿病 (Gerstein 1994),溃疡性肠炎及克隆氏病(译注:局部性回肠炎)(Rigas 1993)等等。

    初乳,即最早的乳汁,是一种特别适合新生儿需要的营养浓缩液。它可以帮助新生儿增进抗感染的能力,因为它含有—系列的:

    • 免疫球蛋白,
    • 白血球,以及
    • 各种抗发炎因子 (Goldman 1993)。

    母乳中丰富的免疫球蛋白A (IgA) 已被证明能够大幅降低母乳宝宝得急性胃肠疾病的风险。美国公共卫生期刊 (American Journal of Public Health, Koopman 1985) 的一项研究指出:「吃配方奶的宝宝得急性胃肠炎的风险是母乳宝宝的六倍。」

    更神奇的发现是,母乳中的免疫球蛋白A还能够促进婴儿自身免疫系统的发育 (Cruz 1989)。所以母乳婴儿不但得到母乳中免疫球蛋白A的保护,他/她还得到自己肠胃道中所制造出来的免疫球蛋白的保护 (Koutras 1989)。 这种对宝宝自身免疫系统的早期刺激可能对宝宝在未来岁月中增强疾病抵抗方面有着深远的影响 (Davis 1988, Schwartzbaum 1991)。

    关于免疫能力的另一重大发现是,母乳宝宝疫苗注射效果更好,母乳宝宝注射的疫苗产生的抗体比配方奶宝宝明显高出许多 (Zoppi 1983, Pabst 1989, Hahn-Zoric 1990)。

    母乳所能提供给宝宝的免疫力是其它任何喂养方式所无法替代的。

    References:

    Aniansson G et al. Ped Infect Dis J,1994.

    Koopman JS et al. Am J Public Health, 1985.

    Borch-Johnson K et al. Lancet, 1984.

    KoutrasAKet al.J Ped Gastro Nutr, 1989.

    Chandra RK et al. Br Med J, 1989.

    Kritz-Silverstein D et al. Am J Epidemiol, 1992.

    Cruz JR et al. Acta Pædiatr Scand, 1989.

    Newcomb P et al. N Engl J Med, 1994.

    Cunningham ASet al. J Pediatr, 1991.

    Pabst HF et al. Lancet, 1989.

    Davis MK et al. Lancet, 1988.

    Rigas A et al. Ann Epidemiol, 1993.

    Gerstein HC. Diabetes Care, 1994.

    Schwartzbaum JA et al. Med & Ped Oncol, 1991.

    Goldman AS. Ped Infect Dis J, 1993.

    UNICEF. Take the Baby Friendly Initiative, 1992.

    Hahn-Zoric M et al. Acta Pædiatr Scand, 1990.

    Zoppi G et al. Lancet, 1983.

  • 母乳喂养的准备 Preparing to Breastfeed

    母乳喂养的准备 Preparing to Breastfeed

    林佳怡译

    王梅馨、陈淑娟 审稿

    一些女性在怀孕期间不知道该为母乳喂养做些什么准备。实际上,身体上的准备几乎不需要。因为怀孕时,荷尔蒙已促使乳房发生改变。孩子一旦降生,乳房早已为泌乳做好了准备。为了有效地哺乳,大多数女性需要的是正确的哺乳资讯,需要有人给予支持及鼓励。 

    乳头的准备

    为了避免乳头疼痛,人们曾一度强调乳头的准备。现在人们意识到:正确的喂养姿势及宝宝含乳方式可避免或最大程度减少乳头疼痛。乳头准备不再是母乳喂养的必修课。

    乳头的清洁不需要使用酒精、抑菌剂、或肥皂。洗澡时光用清水冲洗就足够了。宝宝吸奶时,乳头周围的蒙哥马利氏腺会分泌一种物质,它可以滋润皮肤并抑制细菌的滋生。

    肥皂可能导致皮肤异常干燥,应避免在乳头周围区域使用。一些孕期妈妈使用保湿剂以免乳头皮肤干燥。

    乳房按摩

    轻柔地按摩乳房是较为舒适的乳房保健方式。日后需要挤奶时,乳房按摩也很管用。其中一种方法就是用你的指尖轻压乳房某个区域并画圈圈。几秒钟后再换个位置。先从乳房上方开始按摩,绕着乳房朝乳晕方向按摩。按摩完一侧乳房后再换到另一侧乳房。

    孕期初乳

    怀孕期间,乳房开始制造初乳,这是为宝宝的母乳喂养做好准备。怀孕最后几周,你可能注意到乳头会有些许渗漏,或在按摩乳房时可能会有一些渗出。

    曾经有专家建议,每天从你的乳房挤出几滴初乳,但没有证据表明这样做能预防胀奶和乳头疼痛。

    扁平乳头或凹陷乳头的检查

    宝宝必须将乳头深深地含入嘴里才能有效地吸吮到母乳。假如你的乳头是扁平的,宝宝要正确地含乳可能会有困难。

    将拇指和食指靠近乳头底部朝中间轻压。如果乳头未能突出足以用手捏住,那么你的乳头可能就是扁平或凹陷的。

    帮助扁平乳头外突的一个方法是:双手拇指分放乳头两侧,直接作用在乳头的底部,而不是乳晕的周围。两拇指冲着乳房组织用劲下压,同时外拉。这样做可以让乳头伸出来,同时也放松乳头底部的肌肉。绕着乳头的底部重复上述拉伸动作数次。

    凹陷的乳头

    如果上述运动根本无助于乳头的外突,说明你的乳头可能是凹陷的。凹陷的乳头在乳晕受到挤压时,反而缩回乳房内。

    凹陷的乳头有些需要治疗,有些不需要。一些哺乳专家认为,含乳正确时,宝宝可以将凹陷的乳头深深吸入口中;另一些人则建议使用特别为使乳头突出而设计的乳头保护罩。乳头保护罩戴起来舒适、轻盈、穿在胸罩内也不显。你在怀孕时就可以一天戴上几个小时,随后逐渐加长使用时间。

    假如是在产后才发现自己的乳头是凹陷的,你也可以持续几天在两次喂养中间戴上乳头保护罩。

    乳头保护罩可从国际母乳会的直销目录上求购或从各地母乳会组织中购得。这些产品都附有完整的使用说明。

    哺乳胸罩

    大部分的妈妈们都是在怀孕期间就购买专为哺乳设计的,方便宝宝吃奶的哺乳胸罩。在怀孕最后数周购买胸罩时,罩杯及胸围应留有富余。试胸罩时,要记住:乳房会在产后及乳汁开始分泌时涨大。罩杯或胸围过紧的哺乳胸罩会导致输乳管堵塞或乳房感染。

    哺乳 着装

    上下分身式的外装—半身裙、仔裤、宽松的裤子、短裤配上宽松的上衣或毛背心是最理想的。哺乳时上衣或毛衣自腰际掀起来,宝宝的身体可遮盖住裸露的部分。若你穿带钮扣的前开式上衣,钮扣应自下而上解开。若你穿的是三件套的服装,有外套或披肩之类,你就可以更为隐蔽地哺乳。很多时髦与舒适的衣服都设计有特殊开口以方便喂奶。在一些妈妈用品专卖店与特用品直销目录上,通常会有一些哺乳用的时装款式。

    鼓励与支持

    最可以提供你这方面的信息与支持,让你以愉快的心情哺喂母乳的地方就是国际母乳会。正确资讯可以帮助妈妈们避免一些常见问题。若有任何疑问或担心,都可以请教当地国际母乳会的哺乳辅导。在怀孕期间参加母乳会聚会是母乳喂养的最好准备。

  • 什么是初乳?初乳对宝宝有什么好处? What is colostrum? How does it benefit my baby?

    什么是初乳?初乳对宝宝有什么好处? What is colostrum? How does it benefit my baby?

    Your breasts produce colostrum beginning during pregnancy and continuing through the early days of breastfeeding. This special milk is yellow to orange in color and thick and sticky. It is low in fat, and high in carbohydrates, protein, and antibodies to help keep your baby healthy. Colostrum is extremely easy to digest, and is therefore the perfect first food for your baby. It is low in volume (measurable in teaspoons rather than ounces), but high in concentrated nutrition for the newborn. Colostrum has a laxative effect on the baby, helping him pass his early stools, which aids in the excretion of excess bilirubin and helps prevent jaundice.

    乳房在怀孕期间就开始产生初乳并在产后前几天内持续分泌初乳。初乳这一特殊乳汁颜色呈黄色或桔色,性质粘稠。初乳含脂肪量少,但富含有助于宝宝健康的碳水化合物、蛋白质及抗体。初乳非常容易被消化,因此是您宝宝最完美的第一道食物。初乳量不多(也就几茶匙量)但为新生儿提供了丰富的浓缩营养。初乳有通便的作用,促进宝宝排胎粪,带出过量胆红素,从而预防黄疸的发生)。

    When your baby is breastfed early and often, your breasts will begin producing mature milk around the third or fourth day after birth. Your milk will then increase in volume and will generally begin to appear thinner and whiter (more opaque) in color. In those first few days it is extremely important to breastfeed your newborn at least 8-12 times each 24 hours, and more often is even better. This allows your baby to get all the benefits of the colostrum and also stimulates production of a plentiful supply of mature milk. Frequent breastfeeding also helps prevent engorgement.

    如果您产后给您的宝宝早哺乳,常哺乳的话,您的乳房就能在3或4天开始分泌成熟乳。那时,您的产乳量将会增加,乳汁变稀变白(更不透明)。在产后最初的几天里,很重要的一点就是每24小时内要给新生儿哺乳至少8至12次,能超过12次当然更好。这有助于宝宝完全利用初乳的营养,并刺激乳房生产充足的成熟乳。频繁喂养还可预防涨奶。

    Your colostrum provides not only perfect nutrition tailored to the needs of your newborn, but also large amounts of living cells which will defend your baby against many harmful agents. The concentration of immune factors is much higher in colostrum than in mature milk.

    您的初乳不仅仅为您的新生儿提供了符合他/她个体需求的完美营养,还提供大量活细胞帮助宝宝抵抗各种有害病原。初乳中免疫成分含量要远远高于成熟乳。

    Colostrum actually works as a natural and 100% safe vaccine. It contains large quantities of an antibody called secretory immunoglobulin A (IgA) which is a new substance to the newborn. Before your baby was born, he received the benefit of another antibody, called IgG, through your placenta. IgG worked through the baby‘‘s circulatory system, but IgA protects the baby in the places most likely to come under attack from germs, namely the mucous membranes in the throat, lungs, and intestines.

    初乳实际上相当于天然的、百分百安全的一剂疫苗。它含有大量免疫球蛋白A(IgA)抗体-这是新生儿体内所没有的。宝宝出生前得益的抗体叫免疫球蛋白G(IgG),来自胎盘。免疫球蛋白G(IgG)主要作用于宝宝的循环系统,免疫球蛋白A(IgA)主要保护宝宝最易遭细菌侵袭的部位如咽喉黏膜,肺黏膜和肠黏膜。

    Colostrum has an especially important role to play in the baby‘‘s gastrointestinal tract. A newborn‘‘s intestines are very permeable. Colostrum seals the holes by “painting” the gastrointestinal tract with a barrier which mostly prevents foreign substances from penetrating and possibly sensitizing a baby to foods the mother has eaten.

    初乳对宝宝的胃肠道发挥着极其重要的作用。新生儿的肠道具有很大渗透性,初乳象是给胃肠道加涂了一层膜,封堵了肠壁上的孔隙,从而防止外来物质侵入、防止宝宝对妈妈摄入的食物而有可能产生的过敏。

    Colostrum also contains high concentrations of leukocytes, protective white cells which can destroy disease-causing bacteria and viruses.

    初乳还含有高浓度白血球,这一具有保护作用的白血球可消灭致病的细菌和病毒。

    The colostrum gradually changes to mature milk during the first two weeks after birth. During this transition, the concentrations of the antibodies in your milk decrease, but your milk volume greatly increases. The disease-fighting properties of human milk do not disappear with the colostrum. In fact, as long as your baby receives your milk, he will receive immunological protection against many different viruses and bacteria.

    产后两周内,初乳逐渐变成熟乳。在这一转变过程中,母乳中抗体浓度减少了,但乳量急剧增加了。不过,母乳中的抗疾病成分不会随初乳的消失而消失。事实上,只要宝宝在吃母乳,他/她就能持续获得抗病毒和细菌的免疫性保护。

  • 非母乳喂养的风险 Risk of Not Breastfeeding

    非母乳喂养的风险 Risk of Not Breastfeeding

    Mary Kay Linge
    Staten Island  NY USA
    Report from the 2005 LLLI Conference

    2005年国际母乳会会议报告
    From: NEW BEGINNINGS, Vol. 22 No. 5, September-October 2005, p. 208

    Michal A. Young, a neonatologist at Howard University College of Medicine, took an active role in the recent controversy over the breastfeeding public service ads that were modified at the behest of the formula industry. She offered an inside perspective on the ideas behind the ad campaign and a way to move forward during her session, “Risks of Not Breastfeeding and Strategies to Promote Exclusive Breastfeeding for the First Six Months.”

    Michal A. 杨, 霍华德大学医学院新生儿科学家,在最近的关于母乳喂养公益广告被按配方奶行业要求修改的争论中发挥了其积极作用。她在会议上提出了公益广告活动背后的意图并指明了前进方向,即 “婴儿最初六个月不进行母乳喂养的风险和促进前六个月纯母乳喂养的策略” 。

    Dr. Young observed that too many pediatricians “give lip service” to the American Academy of Pediatrics‘‘ standards, which recommend exclusive breastfeeding for the first six months of life. The original ad campaign would have pointed out more of the health risks of formula feeding, including an increased risk of diabetes and increased rates of childhood cancer. “We need to be able to say without hesitation that artificial baby milk is inferior to human milk,” she said emphatically. “This thought should just roll off our tongues. Why breastfeed? To keep your child from getting sick and dying.”

    杨博士指出,太多的儿科医生对美国儿科医师学会的标准只是“口头上说说而不执行”,标准建议最初六个月进行纯母乳喂养。原来的公益广告内容道出了更多的配方奶喂养引发的健康风险,包括患糖尿病的危险增加及儿童患癌症几率增加。 “我们必须毫不迟疑地说出人造婴儿奶粉绝对不如天然母乳好,” 她强调说,“我们应该脱口而出,为什么母乳喂养?就是为了使您的宝宝远离病痛和夭折” 。

    Focus groups found that mothers-to-be are more likely to consider breastfeeding when they hear about the risks of formula, Young said. Researchers concluded that the proposed ad campaign didn‘‘t make women who had chosen to formula-feed their babies feel guilty; rather, it made them feel angry that their doctors had never told them about the risks of that choice. Looking on the bright side, Young said that the ad campaign fight forced breastfeeding advocates to pull all their research together. It‘‘s clearer now than ever before that, “It is criminal to not inform mothers of the risks,” she said.

    杨博士说,调查发现准妈妈在听到配方奶的风险后会更倾向母乳喂养。研究人员得出结论认为,原有的公益广告内容并没有让那些选择了配方奶粉喂养宝宝的妇女感到内疚;她们的感受是愤怒,因为医生从来没有告诉过她们配方奶喂养的风险。从积极的一面说,她认为这次公益广告内容的争议迫使母乳喂养维权人士把各项相关研究做了个整理。现在比以往任何时候都更清晰了,“不告知妈妈相关风险就是犯罪, ”她说。

    “Changing society‘‘s attitudes toward breastfeeding is a challenge,” Young commented. It calls for education, practical instruction, and emotional support for new mothers. When she talks with women about breastfeeding, Young said she is sure to bring up such benefits as quicker postpartum weight loss and the sense of pride that comes from nourishing baby with mother‘‘s milk. “You have to walk it with them,” she said of the counseling process. “You never know what will encourage a mother to breastfeed.”

    杨博士说: “改变社会对母乳喂养的态度是个挑战”。它需要对新手妈妈进行教育,务实指导,以及情感上的支持。当她与妇女谈论母乳喂养时,杨博士说她肯定会提到母乳喂养的诸多好处,比如加快产后减重,另外能用自己的乳汁滋养宝宝会给你带来自豪感。关于母乳喂养顾问服务,她说,“你必须自己实践,不然你永远不知道什么能鼓励妈妈进行母乳喂养” 。

    Young said that negative attitudes from other women discourage many young mothers from breastfeeding. “Keep at it,” Dr. Young advised breastfeeding counselors. “I always say, ‘‘This is your baby. You want less than the best for your baby? Your choice.‘‘” Big business may have undone the ad campaign, but nothing can stop committed advocates from spreading the word about the risks of not breastfeeding.

    杨博士说其他妇女的负面态度会劝阻许多年轻妈妈进行母乳喂养。 “坚持进行,”杨博士对母乳喂养辅导员建议说“我总是说,‘‘这是您的宝宝。您不想给宝宝最好的吗?您自己选择。” 有实力的企业可以对我们的公益广告内容进行删节篡改,但没有什么可以阻止母乳喂养维权人士传播非母乳喂养的风险。

  • 母乳喂养对早产儿重要吗? Is Breastfeeding Important for My Premature Baby?

    母乳喂养对早产儿重要吗? Is Breastfeeding Important for My Premature Baby?

    The simple answer is YES! Babies that are born pre-term have a special need for their mother‘‘s milk. If your baby was born earlier than expected, you are probably awash in a storm of feelings. Feelings of protectiveness come over you when you see your baby‘‘s tiny body. You may be feeling afraid, angry or guilty. The busy, bustling medical team may be making you feel out of place and question your role as a vital partner in your child‘‘s care.

    答案很简单:是的!早产儿对母乳有特别需求。如果您的宝宝比预期要早出生,您可能一时会有”百感交集”的感觉。当看到宝宝幼小的身体时,您会有保护她/他的欲望。您也可能感觉害怕、生气或愧疚。而且身旁来来往往忙碌的医生护士们会让您觉得自己是个多余的人,怀疑自己作为照顾宝宝最重要人物的角色。

    You are needed, and have a unique gift to provide: your milk. The milk from your breasts is something you alone can provide for your baby. It contains invaluable nutrients and immunities that can make a big difference in the health of your baby and in his development.

    宝宝需要您,您可以给它一份特殊的礼物:母乳。您乳房流淌出的乳汁是只有您自己才能够给予宝宝的。它含有对宝宝健康和成长非常重要的珍贵养份和免疫物质。

    The milk produced by the mother of a pre-term infant is higher in protein and other nutrients than the milk produced by the mother of a term infant. Human milk also contains lipase, an enzyme that allows the baby to digest fat more efficiently. Your breastfed preemie is less likely to develop infections that are common to babies fed breastmilk substitutes. He will be protected by the immunities in your milk while his own immature immune system is developing.

    早产儿妈妈的母乳中含有的蛋白质和其他营养成分要比足月儿妈妈乳汁中含有的成分高。人乳中还含有脂肪酶(一种让宝宝更有效消化脂肪的酶)。母乳喂养的早产儿感染几率低,而这种感染在用母乳替代品喂养的宝宝中很常见。当宝宝在发育其尚不成熟的免疫系统的过程中,您的乳汁将为宝宝提供免疫保护。

    Your fresh milk is best for your baby. Donor milk must be pasteurized, which kills the infection-fighting live cells (though it is certainly the best alternative when a mother is unable to provide her own milk).

    您的新鲜母乳对宝宝来说是最好的。别人捐赠的母乳必须用巴氏消毒法,但这种方法也会杀死抗感染的活细胞(妈妈自己不能提供母乳的情况下,巴氏灭菌后的捐赠母乳仍是最好的选择)。

    Research has found that breastfeeding is less stressful than bottle feeding for babies, so let your doctor know you prefer to put the baby to the breast when he is ready, instead of using a bottle. To encourage a reluctant baby, you may want to try a special tube feeding system on your nipple or finger. An LLL Leader or lactation consultant will be able to help you obtain one and learn to use it.

    研究表明,对宝宝来说,母乳喂养的宝宝跟奶瓶喂养的宝宝相比,压力水平更低,所以让您的医生知道您倾向于用乳房喂养宝宝而不是用奶瓶。为鼓励不情愿吃奶的宝宝,您可以尝试一种特殊的叫饲管的方法,把细管粘在你的乳头或手指上。一位国际母乳会哺乳辅导或者其它哺乳顾问可以帮您获取或者教您如何用。

    Providing your milk, either directly at the breast or by pumping, benefits you and your baby in other ways. The loving bond you feel as the milk flows is good for your relationship. When you pump milk for your baby or breastfeed him, you secrete hormones that enhance the bonding process. It helps you to think of your baby as a person first, your very own beloved child, and not just the doctor‘‘s medical case. This bond will sustain both of you through any difficulties that lie ahead.

    不论是直接喂还是吸出来再喂,母乳喂养对您和宝宝还有其他方面的好处:随着奶的流动,您会感觉到爱的涌动,这有助于增进亲子关系。当您为宝宝吸奶或直接哺乳时,您分泌的荷尔蒙能增强您与宝宝的亲密感。这有助于您将宝宝看成一个人,一个属于您的深爱的孩子,而不仅仅是医生的病例。这种紧密感将有助于您和宝宝克服日后的困难。

  • 非母乳喂养的宝宝存在各种健康方面的风险 Babies who *aren’t* breastfed are at a higher risk of a range of problems

    非母乳喂养的宝宝存在各种健康方面的风险 Babies who *aren’t* breastfed are at a higher risk of a range of problems

    在一个大众认为配方奶喂养很正常和很安全的社会文化下,母乳喂养很容易被归结为各种问题的原因。但事实却是,非母乳喂养的宝宝存在各种健康方面的风险,从轻微的婴儿腹泻到严重的癌症、婴儿猝死综合症、糖尿病等,上升的婴儿死亡率也与此相关。脑瘫源于大脑损伤,而不可能是因为增重不理想。低于标准的10%绝不会引起脑部损伤。实际上,从婴幼儿的生理发展来看,大脑的营养是首先就会保证的。在前6个月低于平均标准的10%是绝不应该判断为营养不良。实际上,一半的宝宝是低于平均体重的,而另一半高于平均体重。标准的宝宝体重不是所有宝宝应该达到的目标。它只是所有健康宝宝包括偏重的和偏轻的一个平均值。没有任何研究显示脑瘫和母乳喂养之间存在必然联系。但是却有无数的研究显示很多短期或长期的婴儿健康问题来源于配方奶喂养。纯母乳喂养6个月,继续母乳喂养至2岁甚至更长时间才是我们人类生物学的规范,这是衡量所有婴儿健康问题的标准。

    戴安·维欣吉国际泌乳顾问国际母乳会哺乳辅导

    A Message from Diane Wiessinger, February 14, 2012

    In a culture in which formula-feeding is believed to be normal and safe, it’s easy to suspect breastfeeding of causing all sorts of problems.  The reality is that babies who *aren’t* breastfed are at a higher risk of a range of problems from simple diarrhea to serious illness and increased mortality  in infancy and beyond, including higher rates of certain cancers, SIDS, and diabetes. Cerebral palsy results from brain damage, and it is not reversed by weight gain.  Being 10 percent underweight is not a source of brain damage.   Indeed, infant and young child physiology is designed to protect the brain from nutritional shortfalls.  Being ten percent below average in weight at 6 months would not in any way be considered malnutrition.  Indeed, half of all babies weigh less than the average weight for their age, just as half weigh more.  Average baby size is not a goal to be met by all babies; it’s simply an average of all healthy babies large and small.   There is no research to support a connection between cerebral palsy and breastfeeding; there are literally thousands of studies documenting short-term and long-term problems resulting from formula-feeding.  Exclusive breastfeeding for about the first half-year, with continued breastfeeding to the age of two or beyond is our biological norm – the standard by which all other infant health should be measured.

  • 母乳喂养和内疚 Breastfeeding and Guilt

    母乳喂养和内疚 Breastfeeding and Guilt

    Written by Jack Newman, MD, FRCPC

    作者: 杰克•纽曼医生(Jack Newman, MD, FRCPC), 国际母乳会健康顾问委员会成员。

    (revised January 2000)

    2000年1月修订

    One of the most powerful arguments many health professionals, government agencies and formula company manufacturers make for not promoting and supporting breastfeeding is that we should “not make the mother feel guilty for not breastfeeding”. Even some strong breastfeeding advocates are disarmed by this “not making mothers feel guilty” ploy.

    很多健康专家、政府机构和奶粉制造公司为他们不宣传和支持母乳喂养所找到的最有力的理由之一是,我们“不应该让妈妈们因为不进行母乳喂养而感到内疚”。甚至连一些坚定的母乳喂养倡导者都对“不能让人因为不母乳喂养而内疚”这个似是而非的说法无计可施。

    It is, in fact, nothing more than a ploy. It is an argument that deflects attention from the lack of knowledge and understanding of too many health professionals about breastfeeding. This allows them not to feel guilty for their ignorance of how to help women overcome difficulties with breastfeeding,which could have been overcome and usually could have been prevented in the first place if mothers were not so undermined in their attempts to breastfeed. This argument also seems to allow formula companies and health professionals to pass out formula company literature and free samples of formula to pregnant women and new mothers without pangs of guilt, despite the fact that it has been well demonstrated that this literature and the free samples decrease the rate and duration of breastfeeding.

    但事实上,这种说辞仅仅只是一个混淆视听的障眼法而已。这个障眼法将人们的注意力从太多的医务人员缺乏母乳喂养知识和理解这一事实上转移开来。在其掩盖下,他们就算对如何帮助克服母乳喂养困难很无知,也可以逃避因此引发的内疚感。纵使这些困难通常是可以克服的,或者从一开始就可以避免,如果妈妈们的母乳喂养努力没有遭到如此大的破坏的话。这个借口还使奶粉公司和一些医务人员可以毫不内疚地向孕妇和新妈妈分发奶粉宣传资料和免费奶粉样品,尽管事实已经证明,这些奶粉宣传资料和免费样品降低了母乳喂养率和持续时间。

    Let‘s look at real life. If a pregnant woman went to her physician and admitted she smoked a pack of cigarettes, is there not a strong chance that she would leave the office feeling guilty for endangering her developing baby? If she admitted to drinking a couple of beers every so often, is there not a strong chance that she would leave the office feeling guilty? If a mother admitted to sleeping in the same bed with her baby, would most physicians not make her feel guilty for this even though it is, in fact, the best thing for her and the baby? If she went to the office with her one week old baby and told the physician that she was feeding her baby homogenized milk, what would be the reaction of her physician? Most would practically collapse and have a fit. And they would have no problem at all making that mother feel guilty for feeding her baby cow‘s milk, and then pressuring her to feed the baby formula. (Not pressuring her to breastfeed, it should be noted, because “you wouldn‘t want to make a woman feel guilty for not breastfeeding”.)

    让我们看看真实的生活吧。如果一个孕妇到医生那里,承认抽了一包烟,当她离开诊所时,是不是很可能会因为使自己正在发育的宝宝遭受危险而感到内疚?如果她承认经常会喝一些啤酒,在离开诊所时,是不是极有可能会因此感到内疚?如果一个妈妈承认她和宝宝睡在一张床上,是不是大多数的医生都会让她觉得内疚,虽然事实上,这是对她和她的宝宝都最好不过的事情。如果她带着一周的宝宝来到医生办公室,告诉医生,她在给宝宝喝市场上出售的液体均质牛奶(鲜奶),医生的反应会是什么?大多数医生会惊讶到崩溃以至于失控。他们一定会让这个妈妈感到内疚,因为她正在用牛奶喂养她的宝宝,然后,会强制这个妈妈用奶粉喂养宝宝。(大家注意,不是强制她进行母乳喂养,因为“你不想让妇女因为不进行母乳喂养而感到内疚”。)

    Why such indulgence for formula? The reason of course, is that the formula companies have succeeded so brilliantly with their advertising to convince most of the world that formula feeding is just about as good as breastfeeding,and therefore there is no need to make such a big deal about women not breastfeeding. As a vice-president of Nestle here in Toronto was quoted as saying “Obviously, advertising works”. It is also a balm for the consciences of many health professionals who, themselves, did not breastfeed, or their wives did not breastfeed. “I will not make women feel guilty for not breastfeeding,because I don‘‘t want to feel guilty for my child not being breastfed”.

    为什么对奶粉如此纵容?原因当然是,奶粉公司用他们的广告,出色地成功说服了世界上的大多数人——奶粉喂养差不多和母乳喂养一样好,因此,不进行母乳喂养也没什么大不了的。引用多伦多雀巢公司副总裁的话:“显然,广告起作用了。”这也是许多自己不进行母乳喂养,或者他们的妻子不进行母乳喂养的医务人员的用以弥合心灵创伤的一贴良药。“我不会让女人因为不母乳喂养而感到内疚,因为我不想因为我的孩子没有得到母乳喂养而感到内疚”。

    Let‘s look at this a little more closely. Formula is certainly theoretically more appropriate for babies than cow‘s milk. But, in fact, there are no clinical studies that show that there is any difference between babies fed cow‘s milk and those fed formula. Not one. Breastmilk, and breastfeeding, which is not the same as breastmilk feeding, has many many more theoretical advantages over formula than formula has over cow‘s milk (or other animal milk). And we are just learning about many of these advantages. Almost every day there are more studies telling us about these theoretical advantages. But there is also a wealth of clinical data showing that, even in affluent societies, breastfed babies, and their mothers, incidentally, are much better off than formula fed babies. They have fewer ear infections, fewer gut infections, a lesser chance of developing juvenile diabetes and many other illnesses. The mother has a lesser chance of developing breast and ovarian cancer, and is probably protected against osteoporosis. And these are just a few examples.

    让我们更仔细的看看这件事情。奶粉从理论上说当然比牛奶更适合婴儿。但事实上,并没有临床研究表明牛奶喂养的婴儿和奶粉喂养的婴儿之间有差异。一个也没有。母乳和母乳喂养而不是母乳瓶喂,比之奶粉,和奶粉比之牛奶(或者其他动物奶)相比,有着更多的优势。我们还在不断地发现很多新的优势。几乎每天,都有研究告诉我们新的东西。有众多的临床数据显示,即使在发达国家,母乳喂养的婴儿和他们的妈妈比奶粉喂养的婴儿和妈妈享受更多的优势。母乳宝宝更少发生耳部感染,更少肠道感染,患青少年糖尿病和其他疾病的几率更小。母乳妈妈患乳房和卵巢癌症的比例更低,并且不太可能患上骨质疏松症。这些还仅仅是少数例子而已。

    So how should we approach support for breastfeeding? All pregnant women and their families need to know the risks of artificial feeding. All should be encouraged to breastfeed, and all should get the best support available for starting breastfeeding once the baby is born. Because all the good intentions in the world will not help a mother who has developed terribly sore nipples because of the baby‘‘s poor latch at the breast. Or a mother who has been told, almost always inappropriately, that she must stop breastfeeding because of some medication or illness in her or her baby. Or a mother whose supply has not built up properly because she was given wrong information. Make no mistake about it — health professionals‘‘ advice is often the single most significant reason for mothers‘‘ failing at breastfeeding! Not the only one, and other factors are important, but health professionals often have influence and authority far beyond their knowledge and experience.

    我们如何提供关于母乳喂养支持呢?所有的孕妇和他们的家人都需要知道人工喂养的风险。应该鼓励他们都进行母乳喂养,宝宝出生后,所有母亲都应该在第一时间获得开始母乳喂养最好的支持。因为,世界上一切善意都不能帮助因为宝宝含乳不当而经历可怕乳头疼痛的妈妈,也不能帮助在她们自己和她们的宝宝生病用药时总是被错误告知必须要停止母乳喂养的妈妈,或者因为错误信息而没有建立奶量的妈妈。没错,医务人员的意见常常是妈妈们母乳喂养失败的最主要原因。当然这不是唯一的原因,还有其他重要因素,但医务人员的影响和权威,往往超出他们的知识和经验。

    If mothers get the information about the risks of formula feeding and decide to formula feed, they will have made an informed decision. This information must not come from the formula companies themselves, as it often does. Their pamphlets give some advantages of breastfeeding and then go on to imply that their formula is almost, well, between us, actually, just as good. If mothers get the best help possible with breastfeeding, and find breastfeeding is not for them, they will get no grief from me. It is important to know that a woman can easily switch from breastfeeding to bottle feeding. In the first days or weeks – no big problem. But the same is not true for switching from bottle feeding to breastfeeding. It is often very difficult or impossible, though not always.

    如果妈妈们知道奶粉喂养的风险,她们还是决定奶粉喂养,那么她们是在被告知风险下做出的决定。这些信息不应由奶粉公司来提供,虽然通常这些信息就是由奶粉公司提供的。奶粉公司的小册子会列出一些母乳喂养的优点,然后用隐晦的语气暗示他们的奶粉其实差不多和母乳一样好。如果有的妈妈已经得到可能得到的最好的母乳喂养帮助而仍选择不母乳喂养,那么她们不会得到我的同情。须知,在最初的几天或几周内从母乳喂养转向奶瓶喂养很简单。但是,由奶瓶喂养转向母乳喂养却不是这样,通常会非常困难或几乎不可能,当然也有例外。

    Finally, who does feel guilty about breastfeeding? Not the women who make an informed choice to bottle feed. It is the woman who wanted to  breastfeed,who tried, but was unable to breastfeed who feels guilty. In order to prevent women feeling guilty about not breastfeeding what is required is not avoiding promotion of breastfeeding, but promotion of breastfeeding coupled with good, knowledgeable and skillful support. This is not happening in most North American or European societies.

    最后,谁会为母乳喂养而感到内疚呢?不是那些被告知风险后做出奶粉喂养决定的女人,而是那些想要母乳喂养、尝试过母乳喂养,但不能实现母乳喂养的女人,她们才感到内疚。为了防止女人因不母乳喂养而内疚,需要的不是阻止推广母乳喂养,而是在推广母乳喂养的同时,提供良好的、知识性的、有技巧的母乳喂养支持。而这一点,在大多数北美和欧洲国家都还没实现。

    杰克•纽曼医生 (Jack Newman, MD, FRCPC), 国际母乳会健康顾问委员会成员。

    (revised January 2000)

    杰克•纽曼医生 (Dr. Jack Newman)于1970年毕业于多伦多大学的医学院,并在温哥华总医院实习。1977~1981年期间他在魁北克省的儿科和多伦多儿童医院接受了培训,1981年成为加拿大皇家医师学院的一名成员,并在同年获得美国儿科协会的认证。他于1984年在加拿大成立了第一所医院里的哺乳诊所。他是联合国儿童基金会爱婴医院倡议活动的顾问,评估了在加蓬、科特迪瓦和加拿大的第一所爱婴医院。

    纽曼医生在1983年至1992年期间是儿童医院急诊室的一名儿科医生,期间也是急救站的代理主任。但是,哺乳门诊开业后,占用了他越来越多的时间,最后他就全职工作来帮助母亲和婴儿实现成功母乳喂养。现在他在多伦多市里的几家诊所工作。