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  • 你经历过产后情绪不良吗?

    点击上方“国际母乳会LLL”   “设为星标”,获取哺乳信息

    图|国际母乳会中国图片库


    1

    产后情绪不良很常见




    产后情绪不良持续超过2周需及时寻求专业帮助


    大概有30-80%的产妇可能会在产后1、2天出现情绪不稳定的情况,5-7天是情绪波动的高峰期,正常情况2周左右会自行缓解。这个时期产妇需要多休息,家人多给予关注和照顾。必要时可以寻求心理咨询或心理治疗。


    点击视频,了解详细的信息






    2

    早期情绪对孩子有深远影响



    妈妈的情绪直接影响宝宝一生的身心健康!


    早期过多的负面情绪体验会导致成年后的大脑皮层发育障碍。国外很多研究表明:促进早期母婴联结可以让妈妈情绪更稳定,有利于孩子后期的身心发育。




    点击视频,了解详细信息








    3

    如何获得积极心态




    首先切断过去失败带来的消极情绪


    消极心态出现的时候,首先不要再反复回想经过让自己不断地受伤。切断过去是重新开始的第一步。重要的是寻找自己当下的目标(以何种方式照顾新生儿),通过确定目标的意义和可行性来坚定信心。然后制定计划并不急不躁地将计划进行下去。




    点击视频,了解详细信息





    以上视频内容均出自广州市妇女儿童医疗中心妇产科主任医师伍少莹在国际母乳喂养周论坛“实现母乳喂养,为在职父母谋福利”的精彩演讲。


    伍少莹主任《积极心态的哺乳引领快乐妈妈养出健康宝宝》中提到:来自全球各地的数据显示,超过半数的生育女性出现过产后情绪不良,严重者会出现精神障碍或异常行为。


    患者症状持续时间长短及严重程度各有不同;角色的巨大变化、支持体系的明显缺失、应对技能的严重不足……不仅对女性的一生造成不可磨灭的身心伤害,还有可能对后代健康成长及社会稳定性造成巨大冲击。


    伍少莹主任通过各种实实在在的案例或活生生的社会教训为大家揭开这恶魔的面纱,指导大家如何识别它的缠绕、应对它的伤害;最终得以获得哺乳的乐趣、成就快乐妈妈、养出健康宝宝、缔造幸福家庭。


    关于国际母乳喂养周论坛的课程详细信息,可点击下方链接了解:

    本次论坛结合今年世界母乳喂养周主题“实现母乳喂养,为在职父母谋福利”涉及科学喂养的知识、哺乳期常见问题、家庭支持、心理疏导、沟通技巧和职业发展等。


    我们有幸邀请到千万粉丝级大V虾米妈咪、三位产科和乳腺科主任作为主讲嘉宾同时还有资深IBCLC、全球职业规划师为大家带来精彩分享让你收获全面且具有积极导向的哺乳知识。


    欢迎孕妈妈、母乳妈妈,母乳喂养从业者或关注母乳喂养的医护人员参加回看

    此次论坛提供含学分不含学分两种套餐。

    如果错过了直播可以在6个月有效期内无限次回听

    扫码报名享受三人成团优惠价:


    学分套餐


    选择学分套餐可获得8个IBCLC继续教育学分备考学时(6.5L,1R,0.5E)

    获取知识技能与考核分数,一举两得!


    学分套餐



    END



    视频剪辑 | 林晓星

    审阅:Victoria、笑仪

    编辑 | 沐凡






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    本篇文章来源于微信公众号: 国际母乳会LLL

  • 母乳妈妈能吃药吗?哺乳期重要的用药准则

    点击上方 国际母乳会LLL 设为星标 ,获取哺乳信息

    图|国际母乳会中国图片库




    “我刚刚做了个手术。我可以服用这种止痛药吗?”


    “我得了流感,我能吃什么药?”


    “这种感冒药会让我的乳汁变少吗?”



    我们经常收到关于哺乳期间用药安全性的问题。很多家庭不仅关心药物对婴儿的影响,还关注药物是否会影响母乳的量。幸运的是,现在有很多关于药物和母乳的信息可以提供给哺乳期的妈妈。


    ?

    常见问题

    我可以在哺乳期服用药物吗? 

    可以。

    绝大多数处方药和非处方药都与母乳喂养相容,或者可以找到与母乳喂养相容的替代药物。


    根据美国儿科学会(American Academy of Pediatrics)的说法,“母乳喂养时,只有少数药物是禁忌的(不推荐)。尽管许多药物确实会进入乳汁,但大多数药物对乳汁供应或婴儿的健康几乎没有影响。”重要的是要告知您的医疗保健提供者您正在哺乳期

    服药期间我需要“吸奶并丢弃”吗? 

    很多人经常被告知在哺乳期服药时需要“吸奶”并“丢弃”。


    这些建议往往没有证据支持,因此我们需要核对可靠的信息来源,以获取最新的基于研究的信息。


    许多医疗保健者依赖于他们所开药物的包装说明书,而包装说明书几乎总是警告“孕期或哺乳期禁用”。然而,通过许多可靠的资源,我们可以找到更准确的答案。

    有关您是否需要暂时或永久停止母乳喂养的信息,请咨询当地哺乳辅导或以下资源。



    ?

    常见问题

    国际母乳会的哺乳辅导如何提供帮助? 

    哺乳辅导是经过培训的志愿者,而不是医疗保健专业人员。


    虽然哺乳辅导不被允许告诉您药物是否安全,但他们可以提供药物信息和可能的替代方案,帮助您做出明智的决定。


    如果您确实需要暂时停止哺乳或断奶,哺乳辅导也可以帮助您制定一个吸奶方案来维持您的乳汁供应。


    药物资源和数据库有哪些?

    以下是我们发现的一些有用的资源。许多资源也被医生和药剂师用于帮助患者。


    LactMed

    LactMed(www.ncbi.nlm.nih.gov/books/NBK501922/)

    是由美国国立卫生研究院(NIH)下属的美国国家医学图书馆 (NLM) 维护的网站数据库。其在线数据库和移动应用程序都包含了有关母乳和婴儿血液中的药物含量以及对哺乳婴儿可能产生的不良影响的信息。并在适当的情况下,推荐了替代药物。所有数据均来自科学文献,有完整的参考文献。同行评审小组审查数据的科学有效性并保持及时更新。


    InfantRisk

    InfantRisk(www.infantrisk.com)

    是由注册药剂师Thomas Hale博士及其在德克萨斯理工大学健康科学中心的团队发布和维护的热线电话、网站和移动应用程序。热线电话 – 致电专家询问有关怀孕或哺乳期非处方药 (OTC) 或处方药的问题。周一至周五,上午8点至下午5点(美国东部时间),电话号码:1-806-352-2519。


    InfantRisk有2个移动应用程序(www.infantrisk.com/infantrisk-center-resources):MommyMeds是提供给母亲的免费App,InfantRisk提供给医疗保健专业人士。这些应用程序为您提供有关药物以及怀孕和母乳喂养的信息。在某些情况下,这些应用程序还会列出能安全母乳喂养的可能的替代药物。


    E-Lactancia

    E-Lactancia(https://e-lactancia.org)是一个西班牙语-英语在线数据库,由 APILAM(促进母乳喂养文化和科学研究协会)维护。这个数据库由医生和药剂师共同维护。



    译者注:

    1)本文介绍的国外资源和数据库,使用的语言都不是中文,如有需要,大家可借助翻译工具来参考阅读。

    如果希望寻找中文界面的工具,也可参考适合国内读者的一些资源(如,医学界医生站、用药助手等等)来查询哺乳期药物的安全等级。


    2)由于缺乏安全性数据,中药是查不到安全等级的。


    关于非处方药 (OTC)  


    许多家长对服用非处方药(OTC)尤其是治疗感冒和流感的药物有疑问。
    由于缺乏安全性数据,包括InfantRisk在内的许多专家普遍建议哺乳期母亲避免服用膳食补充剂和草药。

    在美国,FDA只监管膳食补充剂的标签,而不监管其含量或质量。

    Frank J. Nice博士分享道,“在很多情况下,非处方药药物含有针对不同症状的多种成分。许多非处方药的同一产品具有常规剂量和大剂量的不同规格。药物可能是短效的,也可能是长效的。

    此外,妈妈们可能会发现药品说明书很复杂,难以遵循。她们可能会服用不合适的OTC药物,或者可能从家人或朋友那里得到了不正确的建议。

    因此,服用非处方药可能并不像最初看起来那么简单。对于母乳喂养的妈妈们来说,情况可能会更加复杂。

    • 避免服用几乎没有母乳喂养信息的非处方药。药剂师应该能够协助提供更多信息。
    • 避免服用有更安全的替代产品的非处方药。同样,药剂师可以帮助确定这一点。
    • 避免服用含有多种成分的复方非处方药。母亲最好服用含有单一或两种特定成分的非处方药来治疗她的特定病症;没有必要让母亲或哺乳期婴儿接触不必要的成分。
    • 避免服用大剂量的非处方药。如果哺乳期婴儿不需要,没有必要让他接触大剂量的药物。
    • 避免服用长效非处方药。没有必要让哺乳期婴儿长时间接触药物,尤其是在婴儿可能出现不良反应的情况下。”

    关于草药或膳食补充剂


    由于缺乏安全性数据,包括InfantRisk在内的许多专家普遍建议哺乳期母亲避免服用膳食补充剂和草药。

    在美国,FDA只监管膳食补充剂的标签,而不监管其含量或质量。

    大多数草药都贴上了膳食补充剂的标签,因此必须包含免责声明,即它们“未经美国食品和药品管理局评估”,并且“不用于诊断、治疗、预防和/或治愈任何疾病”。

    膳食补充剂制造商不必为其产品声称获得FDA的批准,也不必证明该产品有效或安全。草药产品中的成分经常与标签上的不符。

    在对来自12家不同公司的44种草药产品进行的DNA研究中,研究人员发现:
    • 59%的样品含有标签上未列出的植物物种
    • 33%的样品含有标签上未列出的污染物或填料
    • 32%的样品含有不同于产品主要标签成分的植物来作为替代,但标示的成分在样品中却未检测到
    • 9%的样品仅含有小麦或大米,而不包含标签上的植物种类。

    例如,其中一个研究中标有圣约翰草的产品仅含有番泻叶——这是一种不应长期服用的泻药。在其他产品中,一些未标示的填料和污染物是过敏原,可能会导致敏感人群出现严重反应。

    如果您正在寻找有关特定膳食补充剂的信息,上面列出的药物资源中列出了一些。如果您正在寻找有关草本催乳剂的信息以帮助增加您的奶量,可查看这篇文章:催乳剂真的有效吗?真正的催乳方法是什么?

    国际母乳会的提供


    如果这些还不能解决您的疑虑或问题
    请联系当地国际母乳会的哺乳辅导,并提出您的具体问题。如果有医疗问题和法律问题,请咨询相应的医疗保健和法律专业人士。




    Medications and Breastfeeding

    “I’ve just had surgery. Can I take this pain medication?”

    “I have the flu. What can I take?”

    “Will this cold medication make my milk dry up?


    We often receive questions about the safety of medications while breastfeeding. Families are concerned not only with how a medication might affect their baby but also how it might affect their milk supply. Fortunately, there is a great deal of information out there about medications and human milk.


    Can I take medicines while nursing? 


    Yes, the vast majority of prescription and over the counter medications are compatible with breastfeeding or have a breastfeeding-compatible alternative.


    According to the American Academy of Pediatrics(https://www.cdc.gov/breastfeeding/faq/index.htm#contraindications), Only a few medications are contraindicated (not recommended) while breastfeeding. 


    Although many medications do pass into breast milk, most have little or no effect on milk supply or on an infants well-being. It is important to share that you are nursing with your healthcare provider.


    Do I need to pump and dump while taking medications? 


    Families are frequently told to pump and dump when taking a medication. These recommendations are often not backed up by evidence, so it is important to check reliable sources for up-to-date research-based information.

    Many health care providers rely on the package insert of the medication that they are prescribing. The package insert almost always cautions against prescribing the medication to pregnant or lactating people. However, there are many reliable resources for finding more accurate answers.

    For information about whether you will need to temporarily or permanently cease breastfeeding, check with your local Leader(https://lllusa.org/locator/) or the resources below.


    How can an LLL Leader help? 

    Leaders are trained volunteers and not health care professionals. While Leaders are not permitted to tell you if a medication is safe, they are able to provide information about medications and possible alternatives to help you make an informed decision. 


    Leaders are also able to assist you in creating a pumping regimen to maintain your supply in the event that you do need to temporarily stop nursing or wean.

     

    Medication Resources and Databases 


    Here are a few resources that we have found helpful. Many are also used by medical doctors and pharmacists for assisting their patients.


    LactMed

    LactMed(https://www.ncbi.nlm.nih.gov/books/NBK501922/) is a website database maintained by the US National Library of Medicine (NLM) at the National Institutes of Health (NIH). Both the online database and mobile app include information on the levels of substances in breast milk and infant blood and the possible adverse effects in the nursing infant. Suggested therapeutic alternatives to those drugs are provided, where appropriate. All data come from scientific literature, and entries are fully referenced. A peer review panel reviews the data for scientific validity and currency.


    InfantRisk

    InfantRisk(https://www.infantrisk.com/) is a hotline, website, and mobile app that are published and maintained by Dr. Thomas Hale, a registered pharmacist, and his team at the Texas Tech University Health Sciences Center.

    Hotline- Call to ask experts your questions about over the counter (OTC) or prescription medications while pregnant or nursing. Monday Friday, 8am-5pm CT 1-806-352-2519

    InfantRisk maintains 2 mobile apps(https://www.infantrisk.com/apps): MommyMeds for Mothers (free) and InfantRisk for Health Care Providers. The apps provide you with information about medications and both pregnancy and breastfeeding. In some cases, the apps also list possible breastfeeding-safe alternative medications.


    E-Lactancia 

    E-Lactancia(http://e-lactancia.org/) is an Spanish-English online database maintained by APILAM, Association for Promotion of and Cultural and Scientific Research into Breastfeeding. It is maintained by both medical doctors and pharmacists.

     

    What about over-the-counter (OTC) medications? 


    Many parents have questions about taking over-the-counter (OTC) medications especially to treat cold and flu(https://www.infantrisk.com/content/over-counter-treatments-cough-and-cold).

    Dr. Frank J. Nice shares(https://www.llli.org/over-the-counter-otc-medications-and-breastfeeding-2/), In many cases, OTC medications consist of multiple ingredients for multiple symptoms. 


    Many OTC medicines have both regular-strength and extra-strength forms of the same product. The medication may be short-acting or long-acting. In addition, mothers may find it difficult to follow complex package directions. 


    They may take an inappropriate OTC medication or may have been given incorrect advice by family or friends. Thus, taking an OTC medication may not be as simple as it initially appears. It will probably be even more complex for consumers who are breastfeeding.


    • Avoid taking OTC medications for which little breastfeeding information is available. A pharmacist should be able to assist with additional information.

    • Avoid taking OTC medications for which safer products are available. Once again, a pharmacist can help determine this.

    • Avoid taking combination OTCs, which are those with multiple ingredients. It is better for the mother to take an OTC that has the one or two specific ingredients that will treat her specific condition; there is no need for mothers or nurslings to be exposed to unnecessary ingredients.

    • Avoid taking extra strength forms of OTC medications. There is no need for the nursling to be exposed to extra amounts of a drug when it is not needed.

    • Avoid taking long-acting OTC medications. There is no need for the nursling to be exposed to a drug for a longer period of time, especially if an adverse reaction is possible in the nursling.

     

    What about herbal medicines or dietary supplements? 


    Because of the lack of safety data, many experts including those at InfantRisk generally recommend that nursing parents avoid taking dietary supplements and herbal medicines.


    In the US, the FDA only regulates the labeling of dietary supplements, not their content or quality.

    Most herbals are labeled as dietary supplements, and so have to include the disclaimer that they have not been evaluated by the Food and Drug Administration , and are  not intended to diagnose, treat, prevent and/or cure any disease.


    The supplement manufacturer does not have to get FDA approval for its products or claims, and it does not have to prove that the product is either effective or safe.


    The ingredients in herbal products often do not match what is on the label. In a DNA study of 44 herbal products from 12 different companies(https://bmcmedicine.biomedcentral.com/articles/10.1186/1741-7015-11-222), the researchers found that:


    • 59% of the samples contained plant species not listed  on the label

    • 33% of the samples contained contaminants or fillers  not listed on the label

    • 32% of the samples contained a different plant  in place of the products main labeled ingredient, which was NOT detected within the sample

    • 9% of the samples contained only wheat or rice,  and not the plant species on the label


    For example, one of the products in the study that was labeled St. Johns Wort contained only senna, which is a laxative that should not be taken on a long-term basis. In other products, some of the unlabeled fillers and contaminants were allergens that could cause severe reactions in sensitive people.


    If you are looking for information about a specific dietary supplement, some are listed in the medication resources listed above. 


    If you are looking for information about herbal galactagogues to help increase your milk supply, check out this article .


    IS YOUR CONCERN OR QUESTION NOT COVERED HERE?


    Please contact a local LLL Leader  with your specific questions.


    Medical questions and legal questions should be directed to appropriate health care and legal professionals.

     




    参考资源


    Resources:


    https://lllusa.org/medications-and-breastfeeding/

    Breastfeeding and Surgery, LLL USA


    Over the Counter Medications and Breastfeeding, Dr. Frank Nice, RPH, DPA, CPHP for LLLI


    Medications: A Quick Guide for Parents, LLLI

    Clinical Protocol #15: Analgesia and Anesthesia for the Breastfeeding Mother Academy of Breastfeeding Medicine

    Cold and Flu Medications While Breastfeeding, InfantRisk

    Over-The-Counter Treatments for Cough and Cold, InfantRisk

    Prescription Medication Use and Breastfeeding, American Academy of Pediatrics (AAP)

    Clinical Protocol #13: Contraception During Breastfeeding— Academy of Breastfeeding Medicine

    Clinical Protocol #18: Use of Antidepressants in Breastfeeding Mothers— Academy of Breastfeeding Medicine

    Vitamin D Supplements, InfantRisk

    Vitamin D, Your Baby, and You, LLLI

    Vitamins and Other Nutritional Supplements, LLLI

    The Nursing Mother’s Herbal by Sheila Humphrey

    Nonprescription Drugs for the Breastfeeding Mother by Frank J. Nice,



    END



    译者 | Michelle

    审阅 | Victoria、笑仪、Lynn、Marien

    编辑 | 李热爱





    更多阅读资料,


    欢迎大家访问“国际母乳会LLL”官网:


    https://www.muruhui.org/




    分享

    收藏

    点赞

    在看



    本篇文章来源于微信公众号: 国际母乳会LLL

  • 可以将母乳和配方奶粉混在一起喂养吗?Should you mix human milk with formula?

    点击上方 国际母乳会LLL 设为星标 ,获取哺乳信息

    图|国际母乳会中国图片库


    世界卫生组织建议在婴儿出生后6个月内进行纯母乳喂养,在婴儿出生半年左右开始添加辅食后继续母乳喂养2或更久。


    纯母乳喂养意味着除了母乳以外什么都不喂:不喂水、不喂果汁、不喂配方奶。


    许多妈妈在得知自己的乳汁就能满足宝宝前六个月或更长时间的需求感到很高兴。


    当你母乳不足时也许会补充配方奶粉,或因为其他原因使用配方奶粉。无论是哪种情况你可能会有疑问:是否可以将母乳和配方奶粉混在一起喂养

    不建议将母乳和配方奶粉混在一起喂养,原因如下:


    建议分开喂养

       

        建议将母乳与配方奶粉分开喂养以最大限度地发挥母乳的功效。


    • 配方奶粉和母乳有不同的储存条件和允许保存的时间。
      奶瓶(或杯子)里喝剩下的配方奶必须在喂养后丢弃,而喝剩下的母乳则可以在冰箱里保存1-2小时后再丢弃。如果把母乳和配方奶粉混合在一起喂但宝宝没有一次喝完,那就必须把剩下的奶丢弃。这会造成对母乳不必要的浪费。
    • 将配方奶粉混合到母乳中会减弱母乳中的一些保护成分。
      研究发现,在喂养前将牛奶配方奶与母乳混合后,奶中的溶菌酶(一种抗菌酶)的活性会显著下降(41-74%)。因此,奶中的有害菌——大肠杆菌的生长会显著增加。
    • 配方奶粉中的成分在与母乳中的活性成分结合后使其更难被宝宝的身体吸收。
      例如,配方奶粉中添加的铁实际上会干扰母乳中铁的吸收。
    • 你可能会挤奶或使用吸奶器来增加你的奶量。
      如果你的乳汁不够每次的喂养,可根据需求多次吸奶收集到足够的母乳完成一次纯母乳喂养,其他喂养时如需要再使用配方奶。你可以选择在哺乳后补充配方奶,也可以在哺乳前给予少量配方奶,哺乳后如需要再给予剩下的配方奶。
    • 你可能因为母乳不足而经常使用配方奶粉。
      在这种情况下了解配方奶对母乳的影响可以帮助你决定何时提供配方奶,何时提供母乳。
    • 如果你有一个早产儿需要服用母乳强化剂,可以把它添加到挤出的母乳里。


    如果你对奶量或其他母乳喂养问题有疑问,请联系国际母乳会哺乳辅导以获取信息和支持。点击链接:国际母乳会哺乳辅导联系方式




    Should you mix human milk with formula?


    World Health Organization recommends exclusive breastfeeding for the first six months of life, with continued breastfeeding for two years or more after the introduction of complementary foods around the middle of the first year of life. 


    Exclusive breastfeeding means nothing but breastmilk: no water, no juice and no formula. Many mothers are happy to know that their milk is all their baby needs in the first six months or longer.


    You may be supplementing because you are not producing enough milk for your baby. Or you may be using formula for other reasons. In either case, you likely have questions about whether or not it is okay to mix formula into your milk.


    It is recommended that formula not be mixed with human milk for the following reasons:


    It is recommended that you feed human milk separate from formula to maximize the benefits of human milk.


    • Formula and human milk have different storage guidelines.

      Any formula that your baby doesn’t drink from the bottle (or cup) must be discarded after the feeding. Human milk that your baby does not drink can be kept for between 1-2 hours in the refrigerator before being discarded. If you mix your milk with formula and your baby doesn’t finish the bottle (or cup), it must be discarded. This could lead to unnecessary wastage of your milk.


    • Mixing formula into human milk decreases some of the protective components of human milk.

      Research has found that when cow milk formula is mixed with human milk prior to feeding, there is a significant (41-74%) decrease in the activity of lysozyme, an antimicrobial enzyme in the milk. As a result, there is a significant increase in the growth of the harmful bacteria, E-coli, in the milk.


    • Components in formula might bind to live components in human milk making them less absorbable by your baby’s body.

      For example, the added iron in formula can actually interfere with the absorption of the iron that is found in human milk.


    • You may be expressing milk or pumping to increase your milk supply.

      If you are not producing sufficient milk for each feeding, collect as many pumpings as necessary to make one exclusive human milk feeding and use formula at the other feedings as needed. You can give this supplement after nursing or you can give a small amount before nursing and give the remainder after nursing, as needed.


    • You may be using formula regularly because of a low milk supply.

      In this case, knowing how formula interacts with your milk, can help you decide when to offer formula and when to give your milk.


    • You may have a premature baby who requires human milk fortifiers. These can be added to your expressed milk.


    If you have concerns about your milk supply or any other breastfeeding questions, please contact a La Leche League Leader for information and support.






    参考资源


    Resources:


    Quan, R., Yang, C., Rubinstein, S., Lewiston, N. J., Stevenson, D. K., & Kerner, J. A., Jr (1994). The effect of nutritional additives on anti-infective factors in human milk. Clinical pediatrics, 33(6), 325–328.


    Mohrbacher, Nancy. (2020). Breastfeeding Answers: A Guide for Helping Families, Second Edition. Nancy Mohrbacher Solutions, Inc.

    Updated 2022

    更新于2022年


    参考资料:

    Should you mix human milk with formula? | La Leche League Canada – Breastfeeding Support and Information (lllc.ca)





    END



    译者 | Sophie

    审阅 | Victoria、笑仪、Lynn、何弢

    编辑 | 李热爱





    更多阅读资料,


    欢迎大家访问“国际母乳会LLL”官网:


    https://www.muruhui.org/




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  • 哺乳妈妈更容易渴,夏天喝水怎么喝?

    点击上方国际母乳会LLL 设为星标,获取哺乳信息

    图|国际母乳会中国图片库


    您会发现自己比生宝宝前更容易口渴。您有可能在哺乳期需要多喝水。到宝宝六周左右大的时候,他将会吃650-1000毫升的母乳,也可能 更多些。


    因此,您可能每天至少需要多喝那么多的水。但是您不需要喝得都让自己不舒服了。过多的液体摄入并不会增加母乳量


    对普通人群来说,常规建议是每天喝1.5到2升的水。如果您在哺乳期,就可以每天在这个基础上再增加1升水,总量在2.5升到3升之间


    您不需要为了产奶而喝牛奶。水是最好的饮品,但您也可以再喝些果汁、草本茶等。


    很多哺乳妈妈会继续享用适量的咖啡和红茶。这些饮料是温和的利尿剂,就是说它们可以帮助消除您体内多余的液体。然而,它们仍然有助于满足您日常对水的需求,只是不如白开水。


    吃西瓜、橙子等富含水分的水果也可以帮助您从饮食中获得更多水分。更多信息请参阅不用纠结:母乳妈妈也能喝咖啡!


    一旦有口渴的迹象就喝点东西,会让您的身体保持正常运转。这有助于清除体内的废物,并帮助调节体温。尿液呈淡黄色、没有便秘的迹象都表明您得到了足够的液体。


    在您平时喂奶的地方放一个装满水的水瓶总能触手可及,这会很有帮助。试试只要您在水龙头旁边、或一坐下来喂奶,或只觉得有点口渴时,就有意喝口水。






    Water — How Much Should I Drink?

    You may find that you are thirstier than you were before your baby arrived. You will likely need to drink more when you are breastfeeding. 


    By the time your baby is six weeks old or so, your baby will be drinking between 650 ml and 1000 ml, perhaps more. So you will likely need to drink at least that much more each day. 


    But you do not need to drink so much water that you are uncomfortable. Excess fluid intake does not improve milk supply.


    A common recommendation is to drink 1.5 to 2 L of water each day. If you are breastfeeding you could add another 1 L for a total of between 2.5 L to 3 L of water each day.


    You don’t have to drink cow’s milk to make human milk. Water is the best thing to drink but you can also add fruit juices, herbal teas, etc. Many breastfeeding parents continue to enjoy coffee and black tea in moderate amounts. 


    These beverages are mild diuretics meaning they can help to eliminate excess fluids in your body. However, they still help to meet your daily water needs, just not as much as plain water. Eating watery fruits like watermelon and oranges can also help you get more water into your diet. See 不用纠结:母乳妈妈也能喝咖啡!Caffeine and Breastfeeding for more information.


    Having something to drink at the first sign of thirst will keep your body working properly. It helps to remove waste products from your body and helps regulate your temperature. Pale yellow urine and no sign of constipation are indications that you are getting enough fluids. 


    It can be helpful to keep a filled water bottle handy in your usual nursing locations. Try to make a point of having a drink of water whenever you are near a tap, whenever you sit down to nurse, and whenever you feel even a little bit thirsty.





    参考资料


    https://www.lllc.ca/water


    参考文献:

    MyHealth.Alberta.ca (2021, September 8). Drinking Enough Water. Government of Alberta. https://myhealth.alberta.ca/Health/Pages/conditions.aspx?hwid=abk5466




    END



    译者 | Lynn

    审阅 | 传艳 & Betty

    编辑 | 李热爱



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  • 正值炎热酷暑,母乳喂养需要注意哪些?戳这里

    点击上方国际母乳会LLL 设为星标,获取哺乳信息

    图|国际母乳会中国图片库


    即使在非常炎热、潮湿的日子里,只要母乳喂养已经稳固下来,您的宝宝在出生后头六个月也只需要纯母乳喂养就够了。


    令人惊讶的是,您的母乳会自行调节,以确保宝宝获得所需的全部液体,补够水分。


    水没有任何热量和营养。您给宝宝喝多少水都会替代本应喝到肚子里的母乳量。这意味着在下次喂奶时她喝的母乳会减少。


    母乳可以给宝宝解渴,同时还提供宝贵的营养和热量。您可能会发现,宝宝在炎热的天气里吃奶可能会更频繁。请记住,宝宝喝的母乳越多,您的身体产奶就越多。给宝宝频繁地喂奶,而不给她喝任何其他液体,包括水和果汁,这样可以维持您的奶量。


    大热天里抱着暖乎乎的宝宝喂母乳会让你俩都觉得又热又汗津津的。在手臂上搭一条法兰绒婴儿毯或干毛巾,把宝宝和您的皮肤分隔开,会让你们俩都觉得更舒服。您可能想在浴缸或儿童泳池里哺乳。

    炎热的天气里,您会发现比平时需要饮用更多的水。如果您打算在大热天出门,不要忘记包里多带点水。


    当宝宝开始吃固体食物时,您可以添加少量的水。


    大热天时,宝宝可能也会喜欢吃健康的冰棒,它是用稀释的果汁、压碎的水果、酸奶或者绿色蔬菜泥(比如菠菜泥)制成的。如果有的话,您甚至可以加入挤出的母乳。一年当中任何时候,正在长牙的宝宝和学步儿,都会觉得这些东西令人舒服。






    Breastfeeding in Summer or Hot Weather


    Exclusive breastmilk is all your baby needs in the first six months, as long as breastfeeding is well-established, even on very hot, humid days. 

    Amazingly, your milk will adjust to ensure that your baby gets all the fluids needed to stay hydrated. Water does not have any calories or nutrition. Any water you give your baby takes the place of breastmilk in her tummy. This means that she will drink less of your milk at the next feeding. 

    Breastmilk quenches your baby’s thirst and provides valuable nutrition and calories at the same time. You may find that your baby might nurse a little more frequently in hot weather. 

    Remember that the more milk your baby drinks, the more milk your body makes. Nursing your baby frequently, and not giving your baby any other liquids, including water and juice, will maintain your milk supply.  

    Breastfeeding a warm baby on a hot day can leave both of you feeling hot and sweaty. A flannel receiving blanket or a dish towel draped over your arm between your skin and baby’s can help both of you feel more comfortable. 

    You may want to consider nursing in a bathtub or children’s pool. In hot weather, you’ll find that you need more water than usual. Don’t forget to pack extra water if you plan to go out on a warm day.

    When your baby begins to eat solid foods, then you can introduce small amounts of water. On hot days your baby might also enjoy healthy popsicles made of diluted juice, crushed fruit, yogurt or even pureed green vegetables like spinach. 

    You can even add expressed breastmilk, if you have any. Teething babies and toddlers may find these comforting at any time of the year.





    参考资料


    https://www.lllc.ca/breastfeeding-summer-or-hot-weather




    END



    译者 | Lynn

    审阅 | 传艳 & Betty

    编辑 | 李热爱



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  • 哺乳中最容易忽视的要点(下):含乳姿势

    点击上方国际母乳会LLL 设为星标,获取哺乳信息

    图|国际母乳会中国图片库


    母乳喂养就像跳舞一样。如果你要学习跳舞,就需要先知道如何摆放自己的身体,然后再学如何移动脚步。

    刚开始会觉得很别扭。或是轻而易举,或是千辛万苦。

    不过通过练习,给婴儿哺乳就会变成你的天然习性。

    母乳喂养时首先要考虑的就是:你如何摆放好自己和婴儿的身体姿势一旦你的姿势对了,婴儿含乳就会更容易。

    好的哺乳姿势和含乳姿势对奶量的建立和维持很重要。当婴儿含乳很深时,他就能有效地吸出乳汁来。

    如果你的乳房乳汁排出通畅,身体就会收到信号去产更多的奶。若你担心自己的产奶量的话,改善哺乳和含乳姿势就是关键的第一步。


    正确、较深的含乳和有效吸吮的清单


    • 婴儿的下巴紧贴着乳房


    • 婴儿的嘴巴张得很大,上下嘴唇都外翻没有卷进去


    • 婴儿的头稍微往后仰,鼻子没有碰到、或只是轻轻碰到乳房。鼻子不应该埋到乳房里


    • 乳头不疼痛


    • 婴儿吸得很牢,不容易松口掉下来


    • 吸吮稳定,可听到吞咽声



    有关婴儿出生后立即开始第一次母乳喂养的信息,可阅读该篇文章《建立奶量》。



    如何含好乳房


    一个舒适、安全的姿势可以让婴儿利用他的本能深深地含住乳房。含乳含得好,婴儿就会含入一大口乳房组织,从而可以轻柔地将乳头伸展到他的口腔后部。


    这样的话,婴儿就能有效地吸出乳汁。较深的含乳可以确保婴儿得到足够的奶量,你的身体也得到信号要产更多的乳汁。舒适安全的姿势还可以预防乳头疼痛和损伤。


    01

    下巴紧贴乳房

    图|加拿大母乳


    如果婴儿的下巴没有碰到乳房,他就会经常转动头去寻找乳房。如果婴儿的下巴碰到了乳房,他会闻到你的乳头。这会促使他张大嘴巴,抬头去含一大口乳房。


    • 婴儿的下巴紧贴乳房时远离乳头底部会更好

    • 如果你手扶着乳房,手指要远离乳晕(即乳头周围的暗肤色区域),这样就不会妨碍婴儿含乳

    • 婴儿的下颌离乳头底部越远,他能含入的乳房组织就越多。这有助于含乳更深。

    02

    头往后仰,鼻子向上倾斜


    图|加拿大母乳会


    • 抱好婴儿,让他在寻找乳房时头能往后仰
    • 你的拇指和食指放在他的颈部、手掌放在背部上方来支撑住头部。如果你按住他的头顶,他很可能会挣脱开
    • 让婴儿的下巴紧贴乳房,乳头靠近他的鼻子
    • 当他的头向后仰、下巴紧贴着乳房时,婴儿就能把嘴巴张得大大的
    • 随着嘴张大,他可以抬头触到并吃上乳头,含入大面积的乳房组织(想想你是如何咬一大口汉堡的。开始你把汉堡的下边放在下巴上。然后抬起头、仰起上颚咬汉堡的上边。这和婴儿含一大口乳房的动作是异曲同工之妙)。
    • 轻轻地推婴儿的肩胛骨间让他含上乳。重要的是,你不把婴儿按到乳房上,而让他自己去探索

    一旦婴儿含上乳,他的鼻子可能会碰到乳房,但不应埋进去。你不该觉得必须按住乳房婴儿才能呼吸。下巴紧贴乳房、鼻子向上倾斜、头往后仰,就跟你喝水的姿势一样 (现在就试试,假装喝杯水。看看你的下巴是如何向前、头是如何往后仰的)。

    03

    两侧脸颊贴上乳房


    图|加拿大母乳会


    一旦含上乳,一侧脸颊没有挨到乳房的话,就要考虑调整婴儿的姿势,让两侧脸颊都贴上乳房。这有助于确保乳头直直地含到婴儿的口腔深处。


    根据需要调整婴儿的姿势。婴儿在哺乳时经常向上或向前爬行。

    • 如果婴儿的下巴缩到了他的胸前,嘴就不能含紧乳房。他也会发现吞咽费力(现在就试试。把你的下巴缩到胸前然后吞咽。难乎其难啊!)。

    • 哺乳期间你可能需要时不时调整婴儿的姿势,往下或往外挪一挪他的身体。

    • 你也可能需要从肩胛骨后面轻轻地推婴儿,就会让他的下巴上仰,紧贴到乳房上。还会使婴儿的头往后仰。用这个姿势,婴儿能像你一样喝得舒服。

    图|加拿大母乳会


    乳头翘起的技术


    为了让含乳更深,你可以尝试用乳头翘起技术。

    • 用手托住乳房,拇指放在上面,其余手指放在下面,拇指要离乳头底部远一些。手指的位置是和婴儿含上乳的上唇平行的。确保手指远离婴儿下巴触到的乳房部位。

    • 用大拇指按住乳房,会使乳头翘起来并离开婴儿一些。

    • 把婴儿抱向乳房,下巴紧贴着

    • 当婴儿仰头去大口含乳时,在最后一刻松开拇指让乳头垂下。这样可以使乳头滑入婴儿的口腔深处

    • 避免把乳头塞入婴儿嘴里


    喝奶 vs吸吮

    “喝奶”和“吸吮”是有区别的。婴儿吸吮可以是为了安抚或是为了喝奶。这两种情况都会看到下巴在动。重要的是要知道婴儿什么时候是在喝奶。


    吞咽是婴儿吃到乳汁的主要标志。当有嘴里有奶时,婴儿的下颌下降,“暂停”一下以便吞咽。你可能会听到“卡”的声音,这是因为婴儿吞咽后呼气。


    吃奶时他会有一个稳定的“吸吮—吞咽—呼吸”的模式。婴儿会在两次奶阵之间休息一会儿。一来奶阵,他就又开始吃奶了。


    如果吞咽或吸吮速度减慢下来,你可以用整只手轻轻挤压或按压乳房几秒钟。这样会增加乳汁流速,从而鼓励婴儿一直吃奶。


    图|加拿大母乳会


    疼痛怎么办?

    较深的含乳可预防乳头被婴儿的舌头和硬腭夹扁。较浅的含乳常常导致乳头疼痛。


    如果婴儿含乳不正确,你的乳头顶端可能会有折痕,压平或夹扁。当它被婴儿吐出来后,看起来就像是一管新口红。乳头顶端可能呈白色。


    图|加拿大母乳会


    如果你觉得婴儿没有含好,即使有人说看起来含得很好,就需要立即处理。


    疼痛是身体在提示你某地方出现问题,需要改善。疼痛的含乳往往较浅。含乳浅的话,婴儿就无法轻松吸出乳汁。所以忍受疼痛的含乳是没有用的。有效较深的含乳是让你舒服的。婴儿同时也会吃到大量乳汁。


    • 如果感觉疼痛,可以将一根手指顺着婴儿的嘴角塞入中断吸吮让他松口。然后你试着重新含乳。

    • 通常婴儿还在含着乳房的时候就可以调整含乳姿势。这样可以防止婴儿因含上、松开乳房而受挫。如果乳头已经破损,调整含乳会让你避免重复经历含乳刚开始几秒钟的疼痛。如果你听到“咔嗒”或者吧唧声,或看到婴儿的脸颊凹陷下去,试着把婴儿的下巴紧紧贴在乳房上来改善含乳。或者你可以轻轻往下按婴儿下巴让下嘴唇外翻出来。


    一小部分婴儿由于舌系带过紧或过短而舌头活动受限。因此婴儿可能无法将乳头吸入口腔深处。如果尝试改善后含乳仍然疼痛,鼓励你寻求国际认证哺乳顾问(IBCLC)的帮助。之后必要的话,你可以咨询诊断和治疗舌系带过紧的医疗专家。






    以下视频你可能觉得有帮助

    半躺式哺乳:

    Https://www.biologicalnurturing. com/sample-of-biological-nurturing/


    如何在乳房上含好乳、吃好奶(点击“阅读原文”可观看):

    https://ibconline.ca/breastfeeding-videos-english/










    Positioning and Latching


    Breastfeeding is like dancing. If you are going to learn to dance you need to know where to put your body and then how to move your feet. It may feel awkward at first. It might come easily or it may be difficult. But with practice nursing your baby can become second nature. The first thing to think about when breastfeeding or chestfeeding is how you are going to position your body and your baby’s body. Once you are in a good position, it will be easier for your baby to latch.


    Good positioning and latching is important for building and maintaining your milk supply. When your baby latches deeply onto your breast, your baby is able to remove milk effectively. When your breasts are well-drained, your body gets the message to make more milk. If you are concerned about how much milk you are making, improving positioning and latching is an important first step.


    Checklist for a good, deep latch and effective suck

    ●Baby’s chin is pressed deeply into the breast.

    ●Baby’s mouth is wide open with both lips uncurled.

    ●Baby’s head is tipped back slightly with the nose not touching, or lightly touching the breast. The nose should not be poking into the breast.

    ●No nipple pain.

    ●Good suction; baby doesn’t fall off easily.

    ●Steady sucking with audible swallows.


    For information on your baby’s very first feeding immediately after birth, please see The First Hours After Birth(https://www.lllc.ca/first-hours-after-birth-nine-instinctive-stagesand Establishing Your Milk Supply(https://www.lllc.ca/sites/default/files/Establishing%20Your%20Milk%20Supply-1.pdf).


    Getting a good latch

    A comfortable, secure position allows your baby to use her instincts to latch deeply onto the breast. With a good latch your baby takes in a large mouthful of breast tissue. This gently stretches your nipple to the back of her mouth. When this happens, your baby is able to effectively remove the milk. A deep latch ensures that your baby gets plenty of milk and your body gets the message to keep making more. It also prevents pain and damage to your nipples.

    Chin planted on the breast.


    If your baby’s chin is not touching your breast, your baby will often turn his head searching for your breast. When your baby’s chin touches the breast, he smells your nipple. This triggers him to open his mouth wide, reaching up for a big mouthful of breast.

    ●It’s helpful if your baby plants his chin well away from the base of the nipple.

    ●If you are holding your breast, your fingers need to be far enough away from your areola (dark area around the nipple). Then they will not be in your baby’s way.

    ●The farther away your baby’s lower jaw is from the base of your nipple, the more breast tissue your baby will be able to take into his mouth. This helps to get a deeper latch.


    Head tipped back and nose tipping away.

    ●Position your baby so that her head can tip back as she approaches your breast.

    ●Support your baby’s head with your thumb and fingers at her neck and your palm at the upper back. If you touch the top of her head, she will likely pull away.

    ●Allow your baby’s chin to touch your breast with your nipple near her nose.

    ●With her head tipped back and her chin planted on your breast, your baby is able to open her mouth wide.

    ●With a wide open mouth she can reach up and over your nipple, taking in a large amount of your breast tissue. (Think about how you take a big bite of a burger. You start by placing the bottom of the burger on your lower jaw. Then you reach up and place your upper jaw up and over the top of the burger. This is the same motion your baby uses to get a big mouthful of breast.)

    ●Gently press between your baby’s shoulder blades as she reaches up to latch. It is important that you not shove your baby onto your breast. Allow her to lead the way.


    Once your baby is latched, her nose may touch the breast but it shouldn’t be poking into it. You shouldn’t feel like you have to hold your breast back so your baby can breathe. Chin in, nose tipping away, head back is the same position you take when you drink something. (Try it now, pretend to take a drink of water. See how your chin goes forward and your head tips back?)


    Both cheeks touching the breast. 

    If once latched, one cheek is not touching the breast, consider adjusting your baby so that both cheeks are touching your breast. This will help to make sure your nipple is straight and deep into your baby’s mouth.


    Adjust your baby as needed.Babies often creep upwards or forwards while feeding.

    ●If your baby’s chin is tucked into his chest, he will not be able to hold onto the breast with his mouth. He will also find it hard to swallow. (Try it now. Tuck your chin into your chest and swallow. It is very difficult.)

    ●You may need to occasionally adjust your baby during feedings by sliding him downwards or backwards towards his feet.

    ●You may also need to pull your baby in gently from behind the shoulder blades. This will push your baby’s chin forwards, deeper into your breast. And it will tip your baby’s head back. In this position your baby can drink comfortably, just like you do.


    The Nipple Tilt Technique

    To get an even deeper latch, you can try using the nipple tilt technique. This is also known as the “flipple” technique.

    ●Hold your breast with your thumb on top and your fingers on the bottom. Place your thumb well back from the base of the nipple. This is in line with where your baby’s upper lip will be once she has latched. Make sure your fingers are far away from where your baby’s chin will be.

    ●Press in with your thumb. This will tilt your nipple away from your baby.

    ●Bring your baby to your breast so that her chin is touching.

    ●When your baby reaches up for a big mouthful of breast, release your nipple at the last moment by removing your thumb. This allows your nipple to fall deeply into your baby’s mouth.

    ●Avoid pushing your nipple into your baby’s mouth.


    Drinking vs. Sucking

    There is a difference between “drinking” and “sucking”. Babies can suck for comfort or to drink. You’ll see chin movement for both. It’s important to know when your baby is drinking your milk.

    Swallowing is the main sign that your baby is getting milk. When there is a mouthful of milk, your baby’s chin will drop with a “pause” in order to swallow. You may hear a “kah” sound as the baby breathes out after a swallow. When your baby is drinking, she has a steady suck, swallow breathe pattern. Your baby will take short breaks between letdowns of milk. When another letdown of milk occurs, your baby will begin drinking again.

    If swallowing or sucking slows down, you can gently squeeze or compress your breast with your whole hand for several seconds. This will increase milk flow and encourage your baby to keep drinking.


    What if it hurts?

    A deep latch prevents the nipple from being pinched by the tongue and the hard palate of your baby’s mouth. A shallow latch often results in sore nipples. If your baby is not latched correctly, the end of your nipple may be creased, flattened or pinched. It may look like a new tube of lipstick, when it comes out of your baby’s mouth. The end of the nipple may be blanched (white).

    If you feel that your baby is not latched well, it is important to deal with it right away, even if other people tell you that the latch looks fine.Pain is your body’s way of letting you know that something is wrong and needs to be changed. A painful latch is usually a shallow one. With a shallow latch your baby is not able to remove milk easily. It is not helpful to suffer through a painful latch. A good, deep latch will be comfortable for you. And your baby will get lots of milk. 

    ●If it feels painful, you can unlatch your baby by slipping a finger in the corner of her mouth to break the suction. Then you can try latching again.

    ●Often the latch can be adjusted while your baby is still attached. This will prevent your baby from getting frustrated by being taken on and off the breast. And if your nipples are already damaged, this prevents you from continually experiencing the pain of the first few seconds of latching. If you are hearing a “clicking” or smacking sound, or see dimples in your baby’s cheeks, try improving the latch by bringing your baby’s chin deeply onto your breast. Or you could gently pull down on the baby’s chin to uncurl the lower lip.


    For more information see The Sounds of Breastfeeding(https://www.lllc.ca/skin-skin-care).


    In a small percentage of babies, the tongue is restricted because of a tight frenulum, or tongue tie. Because of this the baby may not be able to pull the nipple deeply into the mouth. If the latch is still painful even after trying to improve it, you are encouraged to seek the help of an International Board Certified Lactation Consultant (IBCLC). Then, if necessary, you may want to consult with a healthcare professional who specializes in diagnosing and treating tongue ties.


    Videos You May Find Helpful

    For the laid-back position:

    https://www.biologicalnurturing.com/sample-of-biological-nurturing/


    For latching and good feeding at breast: https://ibconline.ca/breastfeeding-videos-english/






    参考资料


    参考资源:

    www.lllc.ca/sites/default/files/Positioning%20and%20latching.pdf





    往期推荐



    哺乳中最容易忽视的要点(上):哺乳姿势

    END



    译者 | 传艳

    审阅 | Lynn & Marien

    编辑 | 李热爱




    找到我们

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    搜索关键字“国际母乳会LLL




    更多阅读资料,


    欢迎大家访问“国际母乳会LLL”官网:


    https://www.muruhui.org/




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    本篇文章来源于微信公众号: 国际母乳会LLL

  • 哺乳时长不是判定奶足的标准,真正的标准是什么?

    点击上方“国际母乳会LLL”   “设为星标”,获取哺乳信息

    图|国际母乳会中国图片库



    01

    乳汁摄入是否充足,需多方面评估




    关注宝宝的生长曲线


    很多母乳妈妈在喂奶的过程中,特别纠结一点:对宝宝来说,多长的时间间隔及哺乳时长才是正常的?真正让宝宝吃饱的安全标准是什么?作为妈妈如何能守住底线保证婴儿的奶汁摄入?

    妈妈们都知道,最适合宝宝的喂养方式就是按需喂养

    妈妈奶汁充足,但因无法评估宝宝摄入的奶量,所以顾虑:宝宝真正摄入了多少?需要多少毫升的乳汁才是吃饱?

    判断宝宝有没有吃饱母乳的标准,不仅仅是哺乳时长,更重要是宝宝的生长发育是否正常?生长曲线是否正常?是否有因乳汁摄入不足而导致的脱水现象?需要多方面评估,而不再是单纯的哺乳时长。


    点击下图了解宝宝在吃奶过程中出现的一些状况以及应对方法:



    点击视频,了解哺乳信息



    温馨提醒:关注母乳喂养的妈妈及专业人士,一定不要错过即将开展的活动~


    8月1日至7日为「世界母乳喂养周


    本次主题为:实现母乳喂养,为在职父母谋福利。


    这是由「国际母乳喂养行动联盟(WABA)」组织发起的一项全球性的活动,旨在促进社会和公众对母乳哺育重要性的正确认识和支持母乳哺育。



    本次主题主要为母乳妈妈在职场中更加便捷、顺利的进行母乳喂养;倡导改善工作场所及条件,提高母乳喂养的便利性。


    母乳喂养,不只是妈妈一个人努力的结果,需要更多人的参与、支持和理解。




    关于母乳喂养周论坛



    文中视频内容出自IBCLC范崇纯在国际母乳会“回归本能的母乳喂养”国际研讨会的演讲。


    有些学员反馈课程非常好,想多听几遍。我们日常遇到妈妈求助时,也深感有些科普课程的内容有助于她们降低焦虑,科学育儿。


    于是,我们和部分嘉宾商量,把适合普通(准)妈妈收看的科普课程放到国际母乳会知识店铺“妈妈课堂”。


    “妈妈课堂”第一期精选的5节课程已上线,之后还会不定期更新内容,敬请留意。


    欢迎进入“国际母乳会-中国“妈妈课堂,选择您喜欢的课程:

                        


    END



    视频剪辑 | 林晓星

    审阅:Victoria、笑仪

    编辑 | 李热爱、沐凡




    找到我们

    微信公众号|视频号小红书|抖音|新浪微博今日头条|哔哩哔哩|腾讯视频|优酷

    搜索关键字“国际母乳会LLL




    更多阅读资料,


    欢迎大家访问“国际母乳会LLL”官网:


    https://www.muruhui.org/




    分享

    收藏

    点赞

    在看




    本篇文章来源于微信公众号: 国际母乳会LLL

  • 哺乳中最容易忽视的要点(上):哺乳姿势

    点击上方国际母乳会LLL 设为星标,获取哺乳信息

    图|国际母乳会中国图片库


    母乳喂养就像跳舞一样。如果你要学习跳舞,就需要先知道如何摆放自己的身体,然后再学如何移动脚步。

    刚开始会觉得很别扭。或是轻而易举,或是千辛万苦。

    不过通过练习,给婴儿哺乳就会变成你的天然习性。

    母乳喂养时首先要考虑的就是:你如何摆放好自己和婴儿的身体姿势一旦你的姿势对了,婴儿含乳就会更容易。

    好的哺乳姿势和含乳姿势对奶量的建立和维持很重要。当婴儿含乳很深时,他就能有效地吸出乳汁来。

    如果你的乳房乳汁排出通畅,身体就会收到信号去产更多的奶。若你担心自己的产奶量的话,改善哺乳和含乳姿势就是关键的第一步。


    正确、较深的含乳和有效吸吮的清单


    • 婴儿的下巴紧贴着乳房


    • 婴儿的嘴巴张得很大,上下嘴唇都外翻没有卷进去


    • 婴儿的头稍微往后仰,鼻子没有碰到、或只是轻轻碰到乳房。鼻子不应该埋到乳房里


    • 乳头不疼痛


    • 婴儿吸得很牢,不容易松口掉下来


    • 吸吮稳定,可听到吞咽声



    有关婴儿出生后立即开始第一次母乳喂养的信息,可阅读该篇文章《建立奶量》。




    Positioning and Latching


    Breastfeeding is like dancing. If you are going to learn to dance you need to know where to put your body and then how to move your feet. It may feel awkward at first. It might come easily or it may be difficult. But with practice nursing your baby can become second nature. The first thing to think about when breastfeeding or chestfeeding is how you are going to position your body and your baby’s body. Once you are in a good position, it will be easier for your baby to latch.


    Good positioning and latching is important for building and maintaining your milk supply. When your baby latches deeply onto your breast, your baby is able to remove milk effectively. When your breasts are well-drained, your body gets the message to make more milk. If you are concerned about how much milk you are making, improving positioning and latching is an important first step.


    Checklist for a good, deep latch and effective suck

    ●Baby’s chin is pressed deeply into the breast.

    ●Baby’s mouth is wide open with both lips uncurled.

    ●Baby’s head is tipped back slightly with the nose not touching, or lightly touching the breast. The nose should not be poking into the breast.

    ●No nipple pain.

    ●Good suction; baby doesn’t fall off easily.

    ●Steady sucking with audible swallows.


    For information on your baby’s very first feeding immediately after birth, please see The First Hours After Birth(https://www.lllc.ca/first-hours-after-birth-nine-instinctive-stagesand Establishing Your Milk Supply(https://www.lllc.ca/sites/default/files/Establishing%20Your%20Milk%20Supply-1.pdf).


    Before you begin – setting the stage for success

    Start with a calm baby. This can be tricky sometimes. If your baby is hungry or has just woken up, she may get upset very quickly. Watch for signs that your baby is hungry. Offer your breast before she starts to cry.

    Early hunger cues include:

    ●sucking on her hands.

    ●smacking her lips.

    ●turning her head toward your breast or the chest of the person holding her.

    ●fussing.


    If your baby is crying and upset, it can be tempting to rush to latch her as quickly as possible. However, it is often difficult for a little baby to latch when she is frantically upset.

    ●Take a few seconds or minutes to calm your baby. 

    ●Hold her upright on your chest and gently rock her.

    ●Place your baby in skin-to-skin contact on your chest.

    ●Offer the breast when your baby is calm.

    ●Express drops of milk so your baby can taste it.

    ●Express a little colostrum or milk onto a teaspoon. Give that to your baby to help calm her down.

    Hold your baby skin to skin. Even if your baby is already calm, skin-to-skin contact during feedings is helpful in the early weeks. It helps your baby to know where he is and what he is supposed to do at the breast. Think of your body as your baby’s “habitat” for the first several weeks. The more time your baby spends in skin-to-skin contact with you, the more opportunities your baby has to feed when he is hungry.

    For more information please see Skin-to-Skin Care(https://www.lllc.ca/skin-skin-care). 


    Sleepy babies

    Your baby may be sleepy. This may be because of birth interventions, medical conditions in the baby or because your baby was born early. Use a laid-back position with skin-to-skin contact to get your baby interested in feeding. In a laid-back position, babies often latch and feed when in light sleep. Thus, it helps to spend a lot of time with your sleepy baby against you. When your baby moves into a light period of sleep and begins to stir, move her near your breast. Get into a comfortable breastfeeding position. This can encourage your baby to latch.


    Getting into Position

    There are many different breastfeeding positions. Some can be more helpful than others in the early stages when you and your baby are learning to breastfeed. These positions include: the cradle hold, the cross-cradle hold, the football hold, side-lying position, and more. One of the best positions for the early days and weeks (and longer!) is called the laid-back position.


    Laid-Back Breastfeeding

    The laid-back breastfeeding position is a helpful first place to start if:

    ●you are having difficulty getting a comfortable latch.

    ●your baby seems stressed while nursing.

    ●your baby’s arms are getting in the way.

    ●you can’t get into a comfortable position.


    This position allows your body to rest while you feed. It encourages your baby to use her breastfeeding instincts.


    Get comfortable. Even little babies get heavy when you are holding them at the breast for hours each day. 

    ●Find a bed or couch where you can lean back and be well supported. Lean back comfortably, like you might be if you were watching television. Laying flat on your back is not helpful for this position.

    ●Use a footstool to prop up your feet. It helps to raise your lap and take pressure off of your stomach muscles. Or better yet, put your feet up on the couch or bed with a pillow under your knees.

    ●Have some pillows nearby. Once your baby is comfortably latched, you can tuck pillows under your arms or elbows. Supporting your arms allows your shoulders and neck to relax.

    ●Support your head. You can use a pillow or the back of the couch.


    Ensure full body contact. If your baby feels completely secure, he will be able to focus on feeding. If he feels insecure, he may wave his arms around or kick his feet in an attempt to hang on to you.

    ●The laid-back breastfeeding position uses gravity to hold your baby close.

    ●This position molds his body to your body. It allows your baby to feel safe and secure, knowing that he is not going to fall.

    ●It is important that the whole front of your baby’s body has full contact with the front of your body. This means that your baby’s chin, tummy, and legs should be in contact with your body.

    ●Your baby can rest on you in any direction you both like, as long as his front is next to your front. Your baby could lie with his feet down towards either one of your thighs. Or he could be across your body with his feet under your other breast.

    ●Most babies do not like their feet dangling. It is helpful to provide your baby with somewhere to plant his feet. For example, your baby’s feet could rest on your belly, legs or a pillow.

    ●When you are in position, your baby’s cheek should rest somewhere near your bare breast.


    Adjust your breast as needed. It is important for you to have your breast in a place that allows you to rest comfortably while feeding. The following may be helpful:

    ●Use your upper arm to secure your breast so the nipple does not fall to the side of your body.

    ●Hold your breast while your baby latches. 

    ●Release your breast once your baby has latched deeply and started sucking. You may need to move a little to get into a more comfortable position.

    ●Bring your baby to your breast rather than moving your breast to your baby.


    Other breastfeeding positions

    There are other breastfeeding positions you may want to use in the early days. Some are easier once you and your baby are experienced at nursing. Remember, if one position is not working for you, try another one.


    Cross-cradle hold. The cross-cradle position can be useful in the early days. It gives you more control over the position of your baby and your breast. It is a common hold used when latching a premature or small baby. Once your baby is latched it can be helpful to switch your arms to the cradle position.



    ●Hold your baby in the opposite forearm from the breast you are using.

    ●Place your baby’s bottom near the crook of your arm.

    ●Use your forearm to support your baby’s back.

    ●Support your baby’s head with your hand. Your thumb and fingers will be at the base of the neck and your palm at the upper back.

    ●Use your other hand, if you need to support your breast or want to use the exaggerated latch technique.

    ●Make sure that your baby is turned tummy to tummy with you.

    ●Give your baby a gentle push between the shoulder blades with the palm of your hand as he latches. This will bring your baby close. Continue to hold him close so he doesn’t fall off when he sucks.

    ●Lean back or use pillows to  take some pressure off of your arm. This helps your baby feel secure.

    ●Avoid holding the top of your baby’s head. This can trigger your baby to pull away from the breast. 


    Football or Clutch hold. This hold can be helpful if you have had a cesarean birth. It keeps your baby away from your incision. It can also be helpful if you have larger breasts. You can feed two babies at the same time in a double football hold.



    ●Hold your baby’s front against the side of your body.

    ●Use your forearm to support your baby’s back. Your hand is at the base of your baby’s head. Your baby’s feet are near the back of your body.

    ●Use your elbow to tuck your baby in close to you.

    ●Ensure that your baby is far enough back that she latches with her chin first and her nose tipped away (see “Getting a Good Latch” below).

    ●If needed, place a cushion between your back and the back of the chair or sofa. Otherwise your baby’s feet may push away. If your baby is too far to the front, your baby’s chin will tuck into her chest causing a shallow latch.


    Cradle hold. This position may be difficult to master in the early days and weeks but once you are experienced at breastfeeding, it will likely become a regular position for you.


    ●Cradle your baby in the forearm on the same side as the breast you are using. Use your opposite hand to lift or adjust your breast.

    ●Turn your baby toward you so that his tummy is touching your tummy.

    ●Continue to hold your baby close as he reaches up to latch. This will help make sure that he does not fall off the breast when he sucks. If you are sitting upright, it can be tiring to hold your baby close enough that he feels secure. (Think about how close he would be if he was laying on top of you. That’s how close he needs to be against your body.)

    ●Lean back to take some pressure off of your arm.

    ●Have pillows nearby to put under your arms once your baby is latched. This can help take the strain off of your arms, shoulders and neck. A nursing pillow may be helpful to support your baby’s body.


    Side-lying position. The side-lying position is helpful if you are recovering from a cesarean birth or if your bottom is sore after giving birth. It is also extremely helpful for breastfeeding in bed during the night. This position can be a little tricky to master because you have limited use of the arm you are lying on. It is worth practicing as soon as possible so you can nurse lying down. Once you get the hang of it, it makes nighttime and naptime nursing much easier.

    For more information on sleeping safely with your baby in your bed see Safe Sleep and Breastfeeding Baby.




    ●Lie on your side with your knees bent up and a pillow under your head.

    ●Place your baby on his side facing you with his head on the bed.

    ●Make sure your baby’s nose is level with your nipple. Adjust how you are lying so your nipple is as far away from the bed as your baby’s mouth.

    ●Place your arm under your baby’s head if needed to get your nipple opposite your baby’s nose.

    ●Give your baby a gentle push between the shoulder blades with the palm of your hand, as she latches. This helps bring your baby close.

    ●Remember to bring your baby in chin first, with her head tipped back and her nose off the breast.

    ●Use one hand or temporarily prop yourself up on your elbow while latching. Propping yourself allows you to also use your lower hand to latch. Once your baby is comfortably latched you can lower yourself back down onto the bed.

    ●Use a pillow between your knees for comfort.

    ●Place a pillow under the small of your back to prevent you from rolling onto your back.


    Videos You May Find Helpful

    For the laid-back position:

    https://www.biologicalnurturing.com/sample-of-biological-nurturing/


    For latching and good feeding at breast: https://ibconline.ca/breastfeeding-videos-english/






    参考资料


    www.lllc.ca/sites/default/files/Positioning%20and%20latching.pdf




    END



    译者 | 传艳

    审阅 | Lynn & Marien

    编辑 | 李热爱




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    本篇文章来源于微信公众号: 国际母乳会LLL

  • 催乳剂真的有效吗?真正的催乳方法是什么?

    点击上方“国际母乳会LLL”   “设为星标”,获取哺乳信息

    图|国际母乳会中国图片库



    01

    催乳:频繁吸吮才是有效手段




    食物药物催乳无效,刺激乳汁分泌有效:


    在母乳喂养奶量不够时,很多妈妈会考虑吃一些具有催乳效果的食物或者药物来增加奶量。

    但催乳剂真的有效果吗?

    研究表明,催乳剂对提高纯母乳喂养率的作用尚不明确;部分催乳剂可能对提高母乳产量非常有限,且研究质量不高;大部分催乳剂对母婴双方的副作用尚不明确。

    增加奶量(催乳)真正有效的原理是提高乳汁分泌量,增加吸吮频率。而非食物、药物等。


    点击视频,了解催乳的信息


    02

    妈妈的状态对奶量有重要影响




    催乳的真正方法来自妈妈自身内部

    对母乳妈妈来说最重要的是按需亲喂自己的宝宝。


    妈妈与婴儿增加肌肤接触的时间,妈妈心情好,都会增加奶量。


    妈妈快乐的心情,会分泌更多的乳汁;肌肤接触让妈妈有机会施展对婴儿全然的爱;按需喂养,频繁吸吮乳汁,提高奶量,建立供需平衡的健康哺乳模式。



    点击视频,了解更多详细信息




    上视频内容出自新西兰母乳会Leader、营养学博士生贾丽立在国际母乳会“回归本能的母乳喂养”国际研讨会的演讲。


    有些学员反馈课程非常好,想多听几遍。我们日常遇到妈妈求助时,也深感有些科普课程的内容有助于她们降低焦虑,科学育儿。


    于是,我们和部分嘉宾商量,把适合普通(准)妈妈收看的科普课程放到国际母乳会知识店铺“妈妈课堂”。


    “妈妈课堂”第一期精选的5节课程已上线,之后还会不定期更新内容,敬请留意。


    欢迎进入“国际母乳会-中国“妈妈课堂,选择您喜欢的课程:

                        


    END



    视频剪辑 | 林晓星

    审阅:Victoria、笑仪

    编辑 | 李热爱




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    更多阅读资料,


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    本篇文章来源于微信公众号: 国际母乳会LLL

  • 产后妈妈的抑郁情绪,需要并值得被重视

    点击上方“国际母乳会LLL” 设为星标,获取哺乳信息


    图|国际母乳会中国图片库


    编者按】


    表面开朗的人,内心或许并不快乐。


    一个鲜活的生命因抑郁而离去,愿逝者安息!抑郁症的危险提醒我们:关爱自己,及时求助。


    尤其是孕产期的妈妈,因激素变化更容易情绪波动,希望这篇文章对大家有帮助。




    婴儿的诞生通常被视为一段非常幸福的时光。看着臂弯里的孩子,父母们感觉到他们长久以来期待的梦想已经实现。


    初为人父母者所体验到的情绪可能与狂喜和满足相反。一些专家估计约百分之五十到八十的女人产后会被不同程度的沮丧情绪影响。(Komaroff 1999)她们可能会感到悲伤、疲劳,或者焦虑。有些情绪可能是由于产后荷尔蒙的改变引起的。


    照顾一个不能自理的婴儿,妈妈会缺少睡眠,失去对自我生活的掌控感,这些也会引起抑郁情绪。对大多数女人来说,这些“产后沮丧”只会持续一段短时间,一般出现于产后的慌乱期,而且完全可以融入于母职的工作中。


    但是,有些女人发现她们笼罩在一种无法言说的无尽的悲伤中。她们可能患上了产后抑郁症。产后抑郁症的症状包括无助感、情绪不稳定、焦虑、失眠、对生活没有兴趣。这些感觉持续不走,停留数星期,妈妈似乎无法自我改善。


    图|国际母乳会中国图片库


    产后抑郁症是一种但不是唯一一种在生产后显现的情绪障碍。情绪障碍是一个精神病学家和心理学家用来描述沮丧、焦虑和恐惧等感觉的术语。它也可以用来描述不适当的“情绪高涨”的感觉——称之为“躁狂”。


    由于科学研究已经更多地了解了大脑及其运作,心理健康专家和广大民众已经认识到抑郁和其它心理障碍,不是像以前人们所认为的那样是有性格缺陷或缺乏意志力所引起的。抑郁和其它情绪障碍是大脑中生理因素与人的生活经验交互影响造成的。


    抑郁是一种很常见的疾病。五分之一的成年人在他/她的一生中都会经历一次重大的抑郁。对易感的人来说,怀孕、生产和成为新手妈妈带来的生理和情感上的压力都可能引起抑郁和其它心理健康问题。


    在生产后的第一年,10%的新手妈妈会出现产后抑郁(ACOG 1999)。其它情绪障碍,如躁郁症(在此期间深度抑郁和极度活跃、快乐两种情绪交替出现),通常在成年早期首次出现。因此,沮丧和其它情绪障碍会影响许多妇女,在他们照顾和哺乳他们的孩子时。

    图|国际母乳会中国图片库


    情绪障碍的影响范围从对生活轻微的破坏到个体严重丧失能力。当妈妈可能经常敏感地察觉到什么事情不对时,家庭成员有时候是最先发现的。有些女人持续地悲伤、焦虑,对母亲的身份感到不开心。之后,症状严重的女人会有幻觉或妄想以及对现实的扭曲感。


    研究显示,与抑郁情绪做斗争的妈妈无法胜任好妈妈的角色。婴儿的发育依赖于一个能与之积极互动的照料者。通过母亲与婴儿之间的大量日常互动,婴儿的大脑神经和信息网络得以发展。婴儿通过与妈妈的眼神交会、妈妈生动的面部表情、口头的回应等等来学习社会行为、语言表达等一切技能。


    一个没有精力起床或没有精力与她的宝宝进行“交谈”的妈妈是不能满足这些需求的。同时,一个抑郁的妈妈已经失去了自己照顾婴儿与其他孩子所带来的日复一日的生活中的幸福感。


    这就是为什么及时治疗产后抑郁和其它情绪障碍很重要的原因。妈妈和宝宝的福祉都处于危险之中。

    图|国际母乳会中国图片库


    根据个体的需要,治疗产后抑郁和其它情绪障碍的方法也多种多样。在许多情况下“谈话”治疗很有效。一个心理治疗师能帮助一个母亲用对她自己及她的处境更实际的评价替换掉她给予自己的错误信息(如“我是世界上最差劲的妈妈”)。这种疗法称为认知行为疗法。它的目标是帮助人们了解关于自己对世界和自身的错误信念,进而学习以新的方式思考。


    专业咨询也可以帮助个体为自我建立起更好的支持系统,并且找到方法来满足自我的需求。


    有时候抑郁症也会用药物治疗,药物能在相对短的时间里很好地减轻症状。但是,只使用药物治疗产后忧郁是不明智的。药物或许能帮助一个人在数周内感觉好些,但是治疗能帮助人改变生活从而获得长期的健康。


    照顾产后情绪障碍的妈妈是对医护人员的独特的挑战,其中包含精神健康照顾者。治疗精神疾病的医护人员,有精神病学家和内科医生,他们可能会开抗抑郁药物;而心理学家、咨询师和治疗师,他们可能会提供“谈话”治疗。


    当他们治疗有新生儿的妈妈们时,他们需要考虑到有两个病人而不是通常说的一个病人。妈妈和孩子是相互依赖的,尤其是在哺乳期的时候。他们是个“二联体”,也就是说二者是一体的。对妈妈的治疗必须同时照顾到妈妈和孩子。

    图|国际母乳会中国图片库


    很多医护人员没有制定哺乳双方的治疗计划的培训经历和经验。因此,在治疗一开始妈妈们就被告知必须断奶,以便治疗她们的抑郁症,这种情况是非常普遍的。


    内科医生可能会告诉妈妈她必须停止母乳喂养,因为担心孩子会通过母亲的乳汁而受到药物的影响。治疗师也可能会建议断奶,因为他们相信如果家庭成员能用奶瓶喂养孩子,妈妈就能休息和放松。很多医护人员持有奶瓶喂养的心态,这是西方文化中的普遍观点。


    一个坚持母乳喂养作为她的“生活方式”的妈妈面临很多挑战,她常常会被认为是做了一个愚蠢的、有害的决定。那些为妈妈的病而恐慌、忧虑的家庭成员可能也无法帮助妈妈反对治疗建议,其中可能包括突然断奶。


    一个从躁狂发作中恢复过来的妈妈(她的医生坚持要她立刻断奶,因为她正在吃的药会影响到孩子)后来说:人们不能理解你和你丈夫希望获得帮助、恢复健康的愿望是如何迫切。经常三或者四个医护人员给出相互冲突的意见,我们不知道听谁的。精神病医生不会把孩子视为需要考虑的对象,儿科医生对我们又无能为力。给我的孩子断奶让我感到很伤心,尤其是现在,由于经常耳朵感染,我们正面临给孩子植入中耳通气管的手术。


    图|国际母乳会中国图片库


    但是,仔细研究断奶会发现,断奶对孩子和妈妈的潜在风险可能要高于所期待获得的任何好处。在一个妈妈有抑郁症或其它情绪障碍的情况下,有些风险与断奶密切相关。


    母亲的风险




    乳房疼痛。

    大多数女人在面临突然断奶时遭遇过乳房肿胀,包括乳房感染和脓肿的风险。一个将停止母乳喂养的妈妈需要采取几个步骤来减轻她的乳房肿胀。这些步骤当中包含获得一个适当的吸奶器或者学会手动挤奶,同时视乳房发炎和感染情况使用冰袋。有些用来治疗精神疾病的药物具有催奶效果,也就是说,他们会使乳房生产更多的奶。这会加剧涨奶的疼痛并减缓乳房停止产奶的进程。


    荷尔蒙的改变。

    突然断奶给母性的雌激素、黄体酮和催乳素带来巨大的改变。这样的变化可能导致情绪波动,也可能使母亲的抑郁症加剧。每当母亲哺乳宝宝时,她的心情就会正向地受到释放于血液中的催产素所影响;突然断奶剥夺了一个沮丧的妈妈的这种情绪促进荷尔蒙。


    长期照看孩子的额外压力。

    家人和朋友团结起来帮助处于危机中的妈妈,他们准备并且乐于用奶瓶喂养孩子,这样妈妈就能稍微休息一下。但是这种帮助是短暂的,因为生活需要帮助者们把注意力放到其它地方。当没有帮助者的时候,这个妈妈发现她有了额外的压力:清洗、准备奶瓶和其它相关用具,而在以前母乳喂养的时候她只需要舒服地坐下来,轻松地把孩子抱到她胸前。


    图|国际母乳会中国图片库


    额外的开支。

    断奶的代价不仅仅是购买婴儿配方奶的额外费用,还有孩子更频繁地生病的花费。奶瓶和其它喂养相关用具需要购买。这些经济负担会降临到年轻的夫妇身上,他们可能负担不起这些。


    生育能力恢复。

    对一个已经疲于应对的家庭来说又一次怀孕的可能性是一个重要的要关注的问题。给孩子断奶会导致妈妈的生育能力恢复,因此她必须考虑避孕。这也会增加花费。在选择不避孕的家庭里,哺乳期闭经提供了一种重要的控制生育间隔的途径。


    亲子连接的破坏。

    抑郁的妈妈们发现她们不能尽力与她们的孩子玩耍、拥抱她们的孩子等等。哺乳的时候,能确保孩子与她们的妈妈每天有数次充满爱意的接触。


    与母乳喂养相关的“母性荷尔蒙”促进妈妈与她的孩子的连接。如果奶瓶喂养成为养育孩子的一个选项,妈妈可能就不会花那么多的一样高质量时间给她的婴儿。


    无助感。

    一般而言,有情绪障碍的妈妈们感觉失控、无力、没有希望。母乳喂养可能是能帮助这些妈妈们对她自己以及履行母职感觉好一些的一件事。让她停止母乳喂养给了她又一个能力不足的信息。如果其他人接手照顾宝宝,她的不足和无力便被确定了。甚至在被强行断奶数十年后,妈妈们还会有巨大的悲痛和对医护人员的敌意。


    图|国际母乳会中国图片库


    婴儿的风险




    婴儿越小,过敏和其它营养问题的风险越大。

    对婴儿来说,替代母乳的配方奶有很大的健康风险,包括过敏风险增大,得I型糖尿病、肥胖、克罗恩氏病等的风险会增大。


    更频繁、更严重地生病。

    母乳喂养保护婴儿避免感染流行病。配方奶喂养的婴儿更频繁地感冒,耳部感染,腹泻以及胃肠不适。


    断奶不仅会给婴儿的健康带来风险,也会给婴儿的养育带来挑战。生病的婴儿一整天都需要并且要求更多的关心。


    依恋创伤。

    一个不许靠近乳房来取食和获取安慰的婴儿可能会极度悲伤。妈妈和婴儿的长时间的分离可能会带来持续的影响。


    研究清晰地表明,妈妈和婴儿极需彼此在一起,以便让婴儿能正常生长和发育。证据说明当他们不能互动的时候,终身的沮丧可能在婴儿时期就开始形成了。


    一个对新生老鼠的研究表明,在新生儿时期断奶并且与鼠妈妈隔离24小时后,帮助调节情绪的应激激素升高,下丘脑-垂体-肾上腺的系统被破坏。(Schmidt 2002)婴儿经历的由于突然断奶带来的悲痛是真实的,医护人员或是替代看护人不应忽略或看轻这一点。


    图|国际母乳会中国图片库


    由于妈妈的情绪障碍而挣扎的母乳喂养二联体可能尤其容易受到突然断奶的伤害。如果荷尔蒙的改变和负面信息导致妈妈的情绪螺旋式下降,她会变得不那么能有效地照顾她的孩子。


    如果婴儿由于消化不良或是过敏导致更虚弱,就对妈妈的养育能力提出了更大的挑战。一个更难满足的婴儿会使妈妈觉得自己更不足和无助。同时,由于很多专家相信精神疾病有遗传因素的影响,突然断奶带来的依恋的破坏将使孩子未来产生情绪障碍的可能性增加,得出这样的推论看起来就合乎情理。


    应该如何处理产后抑郁




    很多情况下,当妈妈由于产后抑郁或是其它类型的情绪障碍接受治疗时继续母乳喂养是可能的。为了继续照顾她的孩子和自我恢复,她需要医护人员和家人、朋友的支持。让每个支持她的人认识到并且尊重她和孩子的需求,这一点非常重要。


    亲朋的支持和实际的帮助对于产生积极的结果至关重要。很多抑郁的妈妈都有无力感和边缘化的感受。另外,那些照顾她的人可能会控制或者强迫她同意治疗计划,那些治疗计划没有考虑母乳喂养和亲自照顾她的婴儿对她来说是重要的。


    这也许是那些关心妈妈的人自身的恐惧感带来的结果,因为看到妈妈如此艰难会令人担心。事实是,虽然她有病,但是通常她完全有能力做决定。


    图|国际母乳会中国图片库


    妈妈们完全能在任何形式的危机来临前与家庭成员讨论母乳喂养的重要性。妈妈们可以分享她们对于亲子关系的感受,实行母乳喂养的目标与愿望,以及未来对她的伴侣与关心的人的希望。


    当家人和朋友理解了妈妈眼中母乳喂养的重要性,或许他们就不会把断奶的建议当作第一选择。有了这点认识也会使这些人准备好在发生危机时支持母乳妈妈和孩子。分享国际母乳会哺乳辅导的电话和国际母乳会朋友的名字可以帮助她的家人了解母乳喂养。


    找到一个理解母乳喂养共生体观点的精神健康照顾者对于妈妈的治疗也很重要。妈妈会经常看精神病医生和心理治疗师,因为他们在治疗中扮演着不同角色。如果可能的话她需要两者的帮助。


    精神病医生应该要愿意探索能让妈妈继续母乳喂养的治疗方案。包括寻找各种药物对母乳喂养和婴儿的影响的信息。了解很多用来治疗这些问题的药物与母乳喂养是不矛盾的是很重要的。


    另一方面,一种安全、有效的替代药物可能会用来治疗这个妈妈的情绪障碍。详细的药物信息可以通过多种渠道获得,包括国际母乳会专业联络部门和书面材料如Dr. Thomas Hale‘s的书籍《药物与母乳喂养》。这些信息在适当时可以与医护人员分享。


    图|国际母乳会中国图片库


    当医生决定开药时,除了药物会在妈妈乳汁里外还有几个因素要考虑。药物是否有害取决于进入到乳汁中的药物的含量和婴儿的年龄以及婴儿摄入的奶量。婴儿从妈妈乳汁中汲取少量药物的风险要与婴儿配方奶带来的风险做比较。当使用某些药物时,监测孩子的血中药物浓度、观察不良反应是明智的做法。在监测婴儿可能发生的药物反应上,妈妈的医生可以向婴儿的医生咨询。


    一个好的治疗师应该是乐于倾听和了解家庭特殊需要的,包括妈妈在母乳喂养关系上所赋予的价值。这位照料者可能乐于与其它医护人员交谈(经妈妈的同意)。与其劝妈妈断奶,治疗师不如倾听妈妈关于她对母乳喂养关系的感受,只要可能,不仅仅支持,而且向其它医护人员倡导。


    在一个妈妈有抑郁症的时候立即面临的问题之一就是她是否还能照顾她的婴儿和家里的其它孩子。如果这个妈妈被认为自己能照顾她的婴儿,那么母乳喂养肯定能让她轻松一些。如果她需要帮助,她的帮助者们能帮她做家务,或者帮她照顾大一点的孩子,以便她能集中精力照顾她的新生儿。


    有严重情绪障碍的女人(她们的症状或者对现实的扭曲妨碍到了婴儿甚至是她自己的安全)可能需要朋友和家人轮流在身边陪伴她和她的婴儿。这允许妈妈和宝宝之间的连接持续,同时也确保他们的安全。这位妈妈可以继续母乳喂养,即使她的帮助者必须帮助她把孩子抱到她的胸前。


    图|国际母乳会中国图片库


    如果必须住院,家里人要考虑定期把婴儿带给妈妈,同时准备吸奶器以及帮助她使用吸奶器。多数情况下,很可能是这样的:支持继续母乳喂养的想法是新鲜的,因此很可能会被怀疑甚至是被讥讽。如果妈妈无法面对这些麻烦,关爱她的人的支持再次变得非常重要。


    幸运的是,产后抑郁及其他情绪障碍已经有了有效的疗法。这些疾病不会带着过去的污名,而治疗也不需要中断任何妈妈和宝宝的连接。当妈妈和她的配偶、朋友以及其它家庭成员和医护人员一起努力,可以找到使妈妈能够在复原过程中继续母乳喂养又能治疗她的情绪障碍的办法,妈妈和她的婴儿都将获益。



    参考资料


    • American College of Obstetricians and Gynecologists (ACOG). Answers to Common Questions about Postpartum Depression. Washington DC: ACOG, 2002.

    • Hale, T.R. Medications and Mothers’Milk, Eleventh Edition. Amarillo, Texas: Pharmasoft Publishing, 2004.

    • Kendall-Tackett, K.A. The Hidden Feelings of Motherhood. Oakland, California: New Harbinger Publications, 2001.

    • Komaroff, A.L., ed. Harvard Medical School Family Health Guide. New York: Simon and Schuster, 1999.

    • Mohrbacher, N. and Stock, J. THE BREASTFEEDING ANSWER BOOK. Schaumburg, Illinois: La Leche League International, 2003.

    • Schmidt, M. et al. Maternal regulation of the hypothalamic-pituitary-adrenal axis in the 20 day-old rat: consequences of laboratory weaning. Journal of Neuroendocrinology 2002; 14(6):450-57.

    • Taj, R. and Sikander, K.S. Effects of maternal depression on breast-feeding. Journal of Pak Med Assoc 2003; 53(1):8-11.



    END



    译者 | Season Yang

    审阅 | Shiuh-jane & Daisy

    编辑 | 李热爱




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