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  • 断奶会让我的生活更轻松吗?Would Weaning Make My Life Easier?

    断奶会让我的生活更轻松吗?Would Weaning Make My Life Easier?

    翻译:鲁鹭

    审稿:Missy, Daisy

     

    Are you thinking about weaning? Your child may be a few weeks or months old, or may be a breastfeeding toddler. Some mothers decide to continue breastfeeding until the baby outgrows the need. This is called natural weaning or child-led weaning. In modern American society, this is rather unusual. Worldwide, it is the norm. At a typical LLL meeting, you may find many mothers practice this. You can review the FAQ on the benefits of breastfeeding a toddler if this seems right to you.

    您在考虑断奶吗?也许您的孩子几周或几个月大了,也许您在哺乳学步儿。有的妈妈决定持续哺乳到宝宝不再有吃奶的需求为止,这被称作自然离乳或由宝宝主导的离乳。在现代美国社会,这种情况很不常见。从全世界范围看,自然离乳很寻常。在一个典型的国际母乳会聚会上,您可能会发现很多妈妈持续哺乳到自然离乳。如果您正好遇到这样的问题,可以回顾母乳会网站上(www.llli.org)的“常见问答”栏目中哺乳对学步儿的益处。

     

    If weaning still seems like the answer for you, ask yourself a few questions. Are you still in the early weeks, and experiencing difficulties with breastfeeding? Maybe you’d like to breastfeed longer, but feel overwhelmed or are actually experiencing discomfort. Remember that the American Academy of Pediatrics supports findings that babies do best when breastfed at least a year, and don’t hesitate to call your local La Leche League Leader if you are having problems! She can help you with any difficulties you may experience. Sometimes just talking to an experienced mother who has “been there,” who understands what you’re going through, can be so helpful. All LLL Leaders have breasted at least one baby, for at least one year.

    如果对您来说,答案仍然是希望断奶,那么再问自己一些问题。您是否才开始哺乳几周,并且在哺乳时遇到了困难?也许您打算喂得久一些,但感觉不堪重负,或者哺乳时感到不舒服。美国儿科学会研究发现,吃母乳至少一年对婴儿的发育最有益,当您遇到问题时,请毫不犹豫地联系当地的国际母乳会哺乳辅导!哺乳辅导可以帮助您去解决哺乳中遇到的各种困难。有时,仅仅是和一位“过来人”,即有经验的母乳妈妈聊天也很有帮助,因为她能理解您此刻经历的事情。国际母乳会的所有哺乳辅导都至少母乳喂养过一个孩子,而且至少母乳喂养过一年。

     

    If your child is past the newborn stage, and you want to wean him/her, again, look at your reasons. Are you feeling tied down? Is it difficult to get out of the house alone? You may find that learning to get out and do more with the baby along, will give you a change of pace, and avoid that “trapped” feeling. Try using a sling, or front or backpack, when you go for a daily walk. Getting out of the house, in the fresh air, is a great stress reducer. Make friends with the other new mothers in your LLL group. Getting together during the month, or just phoning or emailing them daily, keeps you connected to the outside world.

    如果您的孩子已经过了新生儿阶段,而您想断奶,那么,请再次回顾您希望断奶的理由。您是否感觉被束缚住了呢?很难单独从家中抽身离开?您可能会发现,尝试着带宝宝出门走走,能给自己的生活节奏带来改变,避免出现“被束缚住”的感觉。当您每天外出散步时,试试用一条背巾,或者可以将宝宝背在妈妈胸前(或背后)的婴儿背带。走出房间,呼吸新鲜空气,是很好的减压方式。在您所在的国际母乳会小组上和其他新妈妈交朋友,每个月和她们聚聚,或者只是每天通个电话、发封电子邮件,维持和外界的联系。

     

    Also, when your infant is small, you may find it’s easy to go out on dates with your husband. A breastfeeding baby is portable. You can still go to a restaurant, or the movies. Take turns holding the baby, or pop him in his infant seat, if he’s well fed and content. Many babies will breastfeed right to sleep in a dark movie theater.

    还有,当您的婴儿还很小时,您也许会发现和先生外出约会是件很容易的事。一个母乳宝宝是很容易随身携带的,您依然可以去餐厅吃饭或看电影。您可以和先生轮流抱着宝宝,如果宝宝吃饱了并且很满足,您还可以把他放到婴儿座椅里。在黑暗的影院里,很多宝宝吃着奶会睡着。

     

    Are you feeling pressure from other family members, (often one of the baby’s grandmothers) or friends to wean now? Someone who didn’t breastfeed at all, or only for a few weeks, may not understand the health benefits of breastfeeding for a longer period. Look up our FAQ on Dealing with Criticism for ideas.

    您是否从其他家庭成员(通常是宝宝的外婆或奶奶),或朋友那里感到“立刻断奶”的压力?有些人从未有过哺乳经历,或仅哺乳几周,不理解长期哺乳的对健康的益处。您可以看看我们母乳会网站(www.llli.org)“常见问答”中关于回应批评的内容。

     

    If you really feel like weaning will make your life easier, imagine the reality. You will still have a baby who needs to be fed. If he is under a year, you will be dealing with the expense and bother of several bottles of artificial milk (formula) a day. And your baby will still want to be close to you and need to be comforted from his busy, sometimes frightening and painful world. Breastfeeding can be a “magic bullet” in your parenting repertoire. It soothes a temper tantrum, sends them off to sleep, feeds a sick baby who may be refusing other foods (no need for Pedialyte!), offers security when you travel, etc. You will still be a parent when you wean, your child will still need you.

    如果您确实觉得断奶会让生活更轻松,想象一下断奶后的现实情况。您仍然有一个嗷嗷待哺的宝宝。如果他不满一岁,每天您都要准备好几瓶人造代乳品(配方奶),既花钱又费事。而且您的宝宝仍然想要亲近您,需要您在他忙碌,时而惊恐或疼痛的小世界里提供安慰。母乳喂养堪称您育儿技能中的“灵丹妙药”。它可以平复怒气,哄宝宝入睡,喂饱一个拒绝其他食物的生病宝宝(不需要额外补充电解质!),当您旅行时提供安全感,等等。即便离乳,您仍然是宝宝的家长,宝宝仍然需要您。

     

    If you’re really feeling burnt out and resentful, one thing to try is a mother’s helper. Young girls, age nine or ten, and up, can often be found in your community, to entertain your baby while you are in the house, so you can rest or get some things done. The baby can be brought to you to breastfeed when needed. These young ladies can be surprisingly maternal and responsible. And babies often love them to pieces, since they’re so playful.

    如果您确实感到精疲力尽和厌烦,值得尝试的方案之一是找一位育儿帮手。小女孩,9-10岁或年龄更大,在您的社区里应该很常见,当您在家时可以请她们来陪宝宝玩,这样您可以休息,或做点其他的事。当宝宝想吃奶时,她们可以把宝宝送过来。这些小淑女们有着令人惊讶的母性和责任心。宝宝们通常也爱她们,因为小姐姐们很好玩。

     

    The benefits of breastfeeding last as long as the child is nursed and often longer. This is the greatest parenting stress reducer of all!

    母乳喂养的益处不仅在哺乳期持续存在,而且可以延续更久。母乳喂养是最棒的育儿压力减负器!

     

    A useful resource is The Nursing Mother’s Guide to Weaning, by Kathleen Huggins and Linda Ziedrich, available from the LLLI Online Store. Also see our collection of LLL Web resources on weaning.

    一个有用的资源是《哺乳妈妈的离乳指南》,作者为Kathleen Huggins 和Linda Ziedrich,国际母乳会英文网站上的在线商城中有售。同时,您可以通过国际母乳会的网页,获取更多有关离乳的资源。

     

    http://www.llli.org/faq/wean.html

  • 你的宝宝出生后期待些什么? What to expect when your baby is born

    你的宝宝出生后期待些什么? What to expect when your baby is born

    戴安·维欣吉 国际泌乳顾问 国际母乳会哺乳辅导

        刚刚成为新手妈妈的时候,我们期许自己用我们所学到的方法来当个称职的妈妈–而且是各种不同的风格。然而宝宝的期望并不是学习得来的。那是一种宝宝们活在这个世界的天性和自然反应,几千年下来都是一样不变。宝宝们并不是无助的,他们天生被赋予各种技巧来到这个他们被“预期”生下的世界。现代社会我们改变了很多,同时也为他们带来了许多生活阻力。你或许不想与你的宝宝回到古老穴居生活,但了解宝宝最初对生活的期待是有帮忙的。

        在他的出生过程中,他没有预期要跟药物打交道。那些只影响你几个小时的药物可以影响宝宝好几天,甚至几个星期,让宝宝不能有效、频繁的喝奶。如果你要做有关药物的决定,请记得您的决定会影响很多,很多,不止只是在出生时。

        当宝宝刚出生后,你的宝宝很期待和你在一起。宝宝和你有了肌肤上的直接接触后,习惯了呼吸、看和听之后,宝宝会开始想吃他的第一餐奶。他会爬或蠕动到你的胸部,找到你的乳头,含上, 喝上很久的奶,这一切只需靠一点点,甚至不需靠外界的帮忙。如果宝宝在第一时间离开你,没有喂奶而是被带去清理或测量;或者宝宝要克服麻醉药,他可能就不能把人生中第一次的活动完成得这么好,也改变了你对宝宝的天生母性反应。不管宝宝如何出生都能哺喂母乳,但是如果你们两个在一起的第一时间没有被打断,哺喂母乳将会轻松很多!

        宝宝第一次喝完奶后,他会想要在你身边或手臂上睡个长长的觉。宝宝从在你肚子里已经听惯了你的心跳、呼吸声和习惯你的体温。如果宝宝留在你身边,他的心跳和呼吸会比较平稳;如果你和宝宝保持肌肤接触,你会发现宝宝常要喝奶,这对你们来讲是好的,这样可以降低黄疸的危险、低血糖、低体温、脱水和哺喂母乳的问题。在接下来的几天,你的奶量将逐渐建立起来,马拉松式的喂奶时间会慢慢缩短,虽然宝宝还是喜欢与你的肌肤接触和很多的母乳哺喂。

        居家时,宝宝会期待在你身边。所有的哺乳类动都有自己保护自己的方法: 速度、 变色、各种安全考量。人类的宝宝保护自己的方式,就是被抱着。宝宝在你身旁时会觉得最安全平静,那里没有老虎会吃他,没有蚂蚁会爬到他身上。他预期的是设定他自己的脚步,喝完一个乳房的奶又另一个乳房,或许他不预期一次要吃两边乳房的奶。宝宝也许会频繁的吃一点零嘴,而不是不定时的大餐。他会期望你能很快地听到他的声音而对他有反应,他也希望不要等到他哭了才会得到他要的。他希望你能日夜都在他身旁,如果他睡在你旁边,他会有更好的睡眠。他指望跟你有肌肤上的接触, 尤其是刚出生的前几个星期里。

        你的宝宝期待在你的臂弯里,期待你会听他的需要而不是靠时钟或说明书。如果你能满足他的需求,你会有个较快乐、健康的宝宝,也代表你们将更快乐地生活在一起。

    戴安·维欣吉拥有美国康奈尔大学的生物和生态学以及生物进化学的本科和硕士学位。从1985年开始,她就是国际母乳会的一位哺乳辅导,1990年她获得国际泌乳顾问资格。她在纽约的伊萨卡镇有一间泌乳顾问诊所。她写了很多关于哺乳的专题知识,并且个人出资制成光盘。她还就母乳喂养的不同主题发表了很多文章和评论,也是史密斯泌乳咨询诊所和吉娜促进母乳宝宝吸吮技巧机构的捐助人。

    最近,戴安·维欣吉与戴安娜·韦斯特及特丽萨·皮特曼一起作为第八版《母乳喂养的女性艺术》的合著者将此书做了较大的更新。戴安在美国、加拿大、英国、澳大利亚、新西兰、以色列等各国做主题演讲,内容包括:母婴间的母乳喂养是如何开始的,我们使用的语言如何代表了我们对母乳喂养的无意识的看法,我们哺乳动物的本性是如何影响到人类的出生和哺乳的,当然还有从她自身作为国际母乳会的哺乳辅导的经验来讲述母亲对母亲的支持对成功母乳喂养的重要性。

    她是两个母乳男宝宝的母亲,也是两位优秀年轻女子的婆婆,还是两个漂亮的母乳宝宝的祖母。

  • 母乳喂养,绝对的优越Breastfeeding, Absolute Superiority

    母乳喂养,绝对的优越Breastfeeding, Absolute Superiority

    母乳喂养不仅仅是一种生活方式的选择,它不像选宝宝的家具或者汽车安全座椅那么简单。母乳喂养的宝宝和非母乳喂养的宝宝之间有着明显的区别。母乳喂养能增强宝宝的免疫系统,避免一些慢性疾病(包括某些癌症),为家庭和社会节约花费,通过预防疾病、减轻症状来拯救生命,甚至对婴儿猝死综合症都有预防作用。

    正如学者兼儿科专家Allan S. Cunningham在《母乳喂养:透视生命文化》中写道,“现在我们知道,尽管工业化国家的疾病和死亡率与贫穷国家的差距正在减少,然而在母乳喂养和奶瓶喂养的婴儿之间仍然存在着很大差距。我们也知道这些差距不只是简单的腹泻等问题。母乳和配方奶之间的差别会影响到人体所有器官系统的发育。现在是重新审视这些事实的时候了。”

    为人类宝宝设计

    母乳按照精确的比例提供了宝宝所需的全部养分。因为母乳是专为人类婴儿设计的,母乳比其它代乳品,如用牛奶、豆制品或其他混合物制成的配方奶,更容易消化。蛋白质—-奶水中最重要的养分之一,在各种生物中都有很大的差别。非人类的蛋白质可能引起过敏,特别是对于非常小的婴儿。母乳中的蛋白质在宝宝胃里形成小的凝乳,与由牛奶制成的配方奶中的蛋白质相比更易被吸收。人类婴儿对蛋白质的需求并不像小牛犊那么多,小牛犊两个月时体重就翻倍,能增加65磅左右。

    大脑发育与DHA

    比起身体发育来,大脑发育对婴儿才是更重要的。近期的研究表明了碳六烯酸(DHA)和花生四烯酸(AA)在眼睛和大脑发育中的重要作用。这些发现使得很多人提议在婴儿配方奶中添加DHA。然而,宝宝能从母乳中的DHA得到的益处要比从配方奶中的添加的DHA得到的要多。

    初乳(宝宝刚出生头几天产生的奶水)含有高浓度的AA和DHA。所以,在这段时间里,大量的这类脂肪酸在新生儿中枢神经系统中的积累,特别在视网膜中的积累,给宝宝带来巨大的好处。

    母乳含DHA和AA,或许是母乳宝宝能发展出更强语言能力和更高智商的原因之一。发表在美国医学会2002年五月期刊上的一篇文章证实并详述了很多前面提过的研究成果。母乳宝宝智商更高,甚至到成年后都受着“剂量反应”的影响(“剂量效应”的含义见下文)。该项研究是控制其他可能影响智力的因素,如父母受教育程度,母亲是否吸烟以及婴儿出生时的体重等,来确保所得出的剂量反应就是指母乳和智力之间的关系。

    “剂量反应”

    宝宝在纯母乳喂养阶段,母乳提供了对预防疾病最有力的保护;采用母乳喂养方式大大降低了配方奶、牛奶或固体食物等代乳品的比例。母乳喂养的时间越长,宝宝得到的好处越多。科学研究称之为“剂量反应”。

    有研究表明,一旦开始吃配方奶或其它食物,即使是少量的,母乳宝宝体内的菌群环境也变得和人工喂养的宝宝相似了,有益菌不再占优势了。

    与母乳喂养呈现剂量反应关系的情形包括:儿童白血病和淋巴瘤、耳道感染、呼吸系统感染、腹泻、嗜血杆菌流感,发育不达标,超重和母亲患乳腺癌等。

     

    抗癌斗士

    “母乳能够杀死癌细胞”——这听上去像是好莱坞电影惊悚片里的天方夜谭,但一组瑞典研究人员从母乳中分离出来了两种物质杀死了他们用于实验的所有癌细胞。其中之一为α乳清蛋白,是母乳中所含最丰富的蛋白质的一种。

    在实验室,这些物质杀死了从肺,咽喉,肾脏,结肠和膀胱分离出的癌细胞,也杀死了淋巴瘤和白血病细胞及肺炎球菌病毒。研究人员推论母乳可能在宝宝体内的癌前细胞发展成恶性肿瘤之前就杀死了它们,从而保护母乳喂养的宝宝免患癌症。尽管这个理论还未被证实,但研究结果一再表明母乳喂养能保护妈妈和宝宝远离某些癌症。其他研究人员在实验室里也得出类似结果:母乳杀死或中和了衣原体孢子、艾滋病病毒和其他一些细菌。

    母乳对癌症的预防可以一直持续到儿童时期,甚至进入成年以后。研究显示:霍奇金病、白血病、淋巴瘤甚至胃癌在母乳喂养的人群中患病几率都偏低。母乳有非常多的抗菌活性,并且能增强婴儿的免疫系统。

    “母乳喂养给了宝宝全面的营养和免疫力,让他们的生命有一个健康的开始。”

    前美国公共卫生署署长 C. Everett Koop 博士说。

     

    “母乳为婴儿提供配方奶不具备的特殊生物活性因子。”

    Margie Hamash博士说。

    “最新调查表明,从总体上看,在生命的最初6个月进行纯母乳喂养是最佳的婴儿喂养方式。 之后应逐步添加辅食,同时继续母乳喂养至2岁或更长。”

    世界卫生组织网站:www.who.int May 2001

    减少母亲患乳腺癌

    母乳喂养是众多减少罹患乳腺癌几率的可控因子之一。Alicia Dermer医生说:“育龄妇女母乳喂养6至24个月能降低11%至25%患乳腺癌的几率(Michels 2001)。母乳喂养也能保护妇女预防卵巢癌和子宫癌。

    对宝宝健康的好处

    基本上每个人都听说过母乳喂养的宝宝比人工喂养的宝宝更健康,但仍有一些人宣称母乳喂养的优点仅仅局限在婴儿时期,而且只对发展中国家的宝宝重要。尽管在部分发展中国家母乳喂养对宝宝来说关乎生死存亡,但研究人员仍然发现母乳喂养对工业化国家的宝宝的健康也有明显益处。无论生活在哪里,家庭的经济条件如何,母乳宝宝都更少患上呼吸和胃肠道疾病,甚至更严重的疾病,如:肺炎、败血症、肠胃炎和脑膜炎。即使生病时,母乳宝宝的症状比人工喂养的宝宝要轻。因为患病的频率和程度要更轻,所以去医院的次数也更少。

    母乳妈妈发现添加辅食的大宝宝在生病时往往拒绝辅食而只吃母乳。宝宝这样做部分是为了感情的需要,但也是由于母乳对他们生病中的肠胃更少刺激。

    研究表明分娩后头几天产生的奶水,即初乳,能保护宝宝免患肠炎和其他感染。这对早产儿来说尤为重要,因为他们更易被感染。

    几十年来的研究表明母乳宝宝较少腹泻,即使腹泻,症状也比较轻微。严重腹泻会导致婴儿死亡,甚至在发达国家也是如此。母乳宝宝比人工喂养的宝宝较少死于腹泻,而且这种保护会延续到幼儿期。

    母乳喂养也能保护宝宝的呼吸系统少受感染。人工喂养的宝宝下呼吸道感染的几率是母乳宝宝的五倍,而在前六个月第一次耳朵感染的可能性是母乳宝宝的两倍,因呼吸系统感染而住院治疗的人数也是母乳宝宝的两倍。患病宝宝的母亲产生的乳汁比健康宝宝的母亲产生的乳汁抗体含量更高。在一些家庭里,存在着其他导致呼吸系统疾病的因素,如:父母抽烟、有兄弟姐妹等。在这种情况下,母乳喂养的保护效应就更加重要。

     

    长期的健康益处

    很多研究表明了母乳喂养的长期益处,反驳了人们认为母乳喂养仅对婴儿期有益的错误观点。人们已经发现了配方奶喂养与免疫系统紊乱之间存在着联系。母乳喂养显示出能减缓乳糜泻(一种严重的慢性腹泻病)和消化紊乱的发展进程,并能避免患肠炎,如溃疡性结肠炎和克罗恩氏病(截断性回肠炎)。 婴儿期进行母乳喂养能降低以后罹患胃癌、胃炎以及胃溃疡的风险。

    母乳喂养还能预防宝宝患糖尿病,这可能是因为宝宝没有接触到牛奶蛋白的原因。出生后前两个月进行纯母乳喂养相对纯配方奶喂养能大大地减少患糖尿病的几率。即使仅母乳喂养七天也能降低宝宝儿童期和成年期患糖尿病的风险。

     

    “最让我们放心的事就是除了心脏病外,我们的宝宝非常健康强壮。护士说,这里绝大多数患心脏病的宝宝有体重增长的困难。每当医生查看了马腾的病历,然后走进来,看着我们胖胖的宝宝,都惊讶到这个患严重先天性心脏病的宝宝竟然如此的健壮!至此,我们真的相信母乳喂养会改变生活!”

    加拿大安大略省的Christine Dittmann Cookston, 摘自NEW BEGININGS2001年3~4月刊。

     

    情感的滋养

    母乳喂养的益处远不止于表现在生理上。母乳宝宝也在情感上受益。吃母乳带给宝宝巨大的舒适感和安全感。肌肤接触刺激宝宝,增强母婴感情。母乳喂养的宝宝较少哭闹,因为他们时常被抱着哺乳。母乳喂养让妈妈学会读懂和响应宝宝发出的信号,这有助于宝宝的行为发展,学会信任自己和他人。许多妈妈都认为,母乳喂养对情感的滋养更重要。

     

    花费

    母乳喂养非常经济。哺乳妈妈食用健康食品的花费远远少于为婴儿购买专门食品的花费。母乳宝宝较少生病,节省下不少看病和住院费用。我们很难精确地计算能节约多少钱。但是,我们可以从一些政府对妇女的研究项目中得出这样的结论。如美国为低收入妇女及其宝宝提供食物与卫生保健的“妇女,婴儿与儿童(WIC)”项目。一项研究估计,如果参与研究的妈妈们在前三个月都进行母乳喂养,她们总共能节省约四至七百万美元。其他研究也根据母乳喂养时间的长短,估计每个家庭能节省约200至800美元不等。

    婴儿猝死综合症和母乳喂养

    从末吃过母乳的婴儿有两到三倍的风险发生婴儿猝死综合症。母乳喂养的保护作用已被新西兰、英国和美国研究确认。母乳喂养可以预防婴儿患呼吸道和肠胃感染,这已证明可以降低发生婴儿猝死综合症的风险。母乳增强了中枢神经系统发育,并为神经绝缘鞘发育提供关键营养。宝宝更健康的大脑就可以为他的睡眠提供更好的呼吸调节。母乳宝宝要比人工喂养宝宝睡得轻,而且更愿意和母亲睡,因此一旦遇到呼吸暂停他们更容易醒来。虽然母乳宝宝也会得婴儿猝死综合症,但母乳喂养是降低此风险的有效方法。”

    医学博士 威廉●西尔斯,摘自NEW BEGININGS1999年5-6月刊。

    减肥与锻炼

    新妈妈经常关注产后的减肥问题。有时他们有健康方面的考虑,因为肥胖是患心血管疾病及其他疾病的风险因素之一。减肥也可能改善母亲的个人形象,使她有控制自己生活的良好感觉。

    在怀孕时,准妈妈们会增加好几镑的脂肪来保证第一年的母乳供给。研究表明在宝宝6个月时没有节食的喂母乳妈妈所减得体重比一直吃得较少的不喂乳的妈妈所减的体重还要多。另一个研究发现通常妇女储藏于大腿的脂肪在哺乳时也逐渐减少了。

    在90年代中期广泛流传着一项研究声称:妈妈运动后,宝宝会拒绝吃母乳。一听到这个研究,经常运动的母乳妈妈指出他们从未见到宝宝有过这样的反应。后来的调查表明,虽然运动确实轻微地改变了一点点母乳的成分,但是宝宝们似乎没有受影响。这一点并不奇怪,哺乳期妇女的锻炼与心理健康和心血管健康都有着重要的关系。

    人们还担心哺乳妈妈身体脂肪的快速流失可能增加母乳中蓄积环境里有害物质的浓度。当然哺乳妈妈在试着减重时仍应保持健康的饮食,令人欣慰的是,最近一项研究表明,哺乳过程中减重,母乳不会有人们担心的污染物蓄积作用。。

    “众所周知,大部分的药物对母乳喂养的婴儿几乎没有副作用。因为通过母乳传递的药物剂量几乎总是小到没有临床意义,或者说对婴儿来说,其生物利用率非常之低。”

    引自医学博士托玛斯.赫尔著《药物与母乳》, Amarillo, TX; Pharmasoft, 2oo2年

    惠及世界

    母乳喂养的益处不仅仅局限于对单个的妈妈和宝宝。母乳喂养是对生态环境最无害的婴儿喂养方式。母乳不是由工厂生产包装的,因此不会加剧空气、水和土壤污染。母乳不需要用电和气来加热,也不需要清洗容器。母乳喂养不会产生废弃的瓶子、奶嘴和包装等垃圾,比如,所以没有垃圾处理的问题。

    母乳喂养影响世界经济和全球生态。当更多母亲进行母乳喂养时,政府将节约用在人工喂养的补贴上的大量资金。预计在美国,如果领取政府补贴配方奶粉的妇女愿意母乳喂养一个月,那么每年将节省2千9百万美元。全世界的母乳妈妈都因为节约卫生保健花费和源,在对当地经济做贡献。

     

    无价的礼物

    母乳对抗疾病有神奇保护效果,但它的功效却不仅仅是生理上的。我们可能无法知道母乳保护婴儿直至成年免受疾病之苦的所有方式,但母乳喂养对每个人都有一些或大或小的意义,从听上去很神奇的健康方面的益处到母子间持续一生的亲密、温暖的感觉。大部分母亲坚持母乳喂养不仅仅因为它是喂养宝宝的最好方式,而且也是一种有效的育儿工具,是一生只有一次的经历。只有母亲能够哺乳,母乳喂养改变世界。

    “科学证明母乳喂养对婴儿健康起着重要的作用,所以现在是我们一起努力推动最佳的母乳喂养方法的时候了。无论是公共部门还是企业都有义务立即将这些建议转变成最适合我们社会需要的制度。”

    David Satcher博士, 美国卫生与公众服务部部长,于2001年在美国伊利诺伊州芝加哥的国际母乳会大会上的讲话。

    关于国际母乳会

    国际母乳会是一个非盈利性机构,成立于1956年,由七位希望帮助其他母亲学习母乳喂养知识的女士创办。今天,国际母乳会作为国际认可的母乳喂养权威机构,以母亲对母亲的形式在全球许多国家传播,母亲对母亲的人员里面包括了来自全球的哺乳辅导和支持小组。专业的顾问委员会审阅与医药有关的信息。

    母亲们通过与母乳会联系能找到关于母乳喂养问题的答案,并且能得到那些对宝宝的需求敏感并负责的父母们的支持。各地区的母乳会每月都聚会来讨论母乳喂养及其相关的话题。

    “纯母乳喂养是理想的营养来源,能最大限度的满足出生后六个月内成长的需要。建议母乳喂养至少持续到十二个月,十二个月以后根据自身情况决定母乳喂养的时间长短。

    美国儿科学会,《母乳喂养综述和母乳的效用》,1997年

    “母乳喂养,心手相传”!

  • 母乳喂养是在污染世界中的最佳选择 Breastfeeding Remains Best Choice in a Polluted World

    母乳喂养是在污染世界中的最佳选择 Breastfeeding Remains Best Choice in a Polluted World

    Missy 译 Shiuh-jane,Daisy 审校

    Schaumburg, IL (August 2003)-Breastfeeding remains the best option for feeding infants, even as attention is focused on the many chemicals that may find their way into a mother‘‘s body, according to La Leche League International, the world‘‘s foremost authority on mother-to-mother breastfeeding support.
    绍姆堡,伊利诺伊州(2003年8月)—作为世界上最权威的,由母亲帮助母亲支持母乳喂养的机构,国际母乳会表示,尽管人们越来越多地关注许多化学物质可能以不同的方式进入母亲身体,但母乳喂养仍然是母婴的最佳选择。

    The four specimens often used to test levels of chemicals in the human body are urine, blood, hair and human milk. This monitoring is done to determine levels of environmental chemicals in different geographical areas. Any substances found in human milk because of this routine testing are a reflection of the exposure in all humans living in that particular area and not a statement about breastfeeding.
    经常用来测试人体中的化学物质水平的四个样本是尿液,血液,毛发和人乳。这种监测是为了确定在不同地区环境中化学物质的水平。在母乳中发现的化学物质是人们在特定生活区域中所受影响的常规测试反映,并非关于哺乳的声明。

    Scientific research shows consistently that even in a world exposed to so many chemicals, breastfeeding offers advantages which outweigh the risk of ingesting possible contaminants. Indeed, the benefits of breast milk, which includes high levels of antioxidants, may prove to be essential to compensate for and outweigh the risks of toxic effects from the environment. Today the focus of scientific concerns is being directed toward removing potentially toxic chemicals from the environment while recognizing the value of human milk, the only source of optimal nutrition for infants.
    一贯的科学研究表明,即使是在接触到这么多化学物质的世界,母乳喂养的优势超越可能摄入受污染物质的风险。事实上,母乳中含有大量的抗氧化剂,这一点至关重要,并可以证明母乳能够弥补并超越环境的毒副作用的风险。现今科学关注的焦点正集中于如何清除环境中的潜在的有毒化学物质,同时他们也认识到母乳作为婴儿最佳营养的唯一来源的宝贵价值。

    A discussion of this topic is incomplete without pointing out the well-documented nutritional inadequacies and detrimental health consequences of artificial baby milk, which may be contaminated both as products of the same environment and through manufacturing. In addition, human milk, unlike manufactured formula, does not add to the ecological burden of the planet.
    根据资料表明,在同一污染环境中制造的或是在制造过程中受到污染的人工配方奶,会造成婴儿营养不足并引发疾病。若不指出这一点,关于这个主题的讨论是不完整的。此外,母乳的产生不像生产配方奶那样,会给地球增加额外的生态负担。

    Human milk cannot be duplicated. It is a living, changing fluid which continually adapts to the needs of the developing infant. Professional research demonstrates that breastfed infants have significantly lower morbidity rates. In addition, studies show that breastfeeding offers significant immunologic, developmental and nutritional benefits.

    母乳不能被复制。它是一种根据婴儿成长的需要,会不停地调整成分的有生命力的液体。专业研究表明,母乳喂养的婴儿发病率显著较低。此外,研究也显示母乳喂养能够在婴儿的免疫力、发育水平和营养成分方面提供重大的好处。

    La Leche League International‘‘s Center for Breastfeeding Information maintains the world‘‘s largest collection of studies on breastfeeding and human milk. La Leche League International fulfills its mission of offering information and support to women who wish to breastfeed by holding monthly meetings, offering telephone counseling and on-line support, through educational meetings and by publishing books and pamphlets on breastfeeding. For further information on this or any breastfeeding topic, visit our informative Web site at www.lalecheleague.org or call 1-847-519-7730.
    国际母乳会的母乳喂养信息中心拥有世界上最全面的关于母乳喂养和母乳的研究成果。国际母乳会通过举行月度聚会、提供电话咨询和在线支持、通过教育性研讨会、出版母乳喂养书籍和手册等方式以实现它对希望进行母乳喂养的妇女提供信息和支持的使命。要了解关于国际母乳会或任何相关母乳喂养的进一步信息,可访问网站www.lalecheleague.org,或致电1-847-519-7730。

    Information on Contaminants and Minimizing Exposure
    Routine monitoring of chemicals in human urine, blood, hair and milk show that environmental contaminants are present, not just in these testing specimens, but in the fat cells of everyone living in the area tested. Their presence is a reflection of the substances that exist in a particular community. This is a reason to eliminate toxins from the environment–not a reason to eliminate breastfeeding.
    关于污染物和减少曝露于污染源的相关信息
    人类尿液、血液、毛发和乳汁中的化学物质的常规监测表明,环境污染物不只是存在于这些测试标本中,也存在于居住在测试区域内每个人体内的脂肪细胞中。这些检验结果是特定社区中化学物质存在的反映。所以人们要消除的是环境毒素,而不是取消母乳喂养。

    Virtually every infant born today already has a body burden of industrial chemicals. Indeed, evidence demonstrates that babies are more vulnerable to transmission of substances during the prenatal stage than after birth.
    如今出生的每一个婴儿身上几乎都有着工业化学物质的影响。事实上,有证据表明,与出生后相比,在怀孕期间,胎儿更容易受到母体传输物质的影响。

    While human milk has higher levels of some persistent organic pollutants than artificial baby milk, infant formula is not pollutant free and has been, among other things, associated with higher levels of heavy metals, phytoestrogens and bacteria. Many well-documented studies demonstrate the health risks of formula feeding, including life-threatening errors in the manufacturing process. Human milk will never be recalled because of manufacturer error.
    尽管人乳比人造奶地含有更多的某些持久性有机污染物,但婴儿配方奶也并非完全无污染,它含有更多的重金属、植物雌激素和细菌。许多证据确凿的研究都表明,配方奶喂养存在健康风险,其中还包括生产过程中足以致命的人为错误。人奶则永远不会因为制造商的错误而被召回。

    There is evidence that human milk with its species-specific optimal nutrition and its anti-inflammatory agents, including antioxidants, helps a child develop a stronger immune system and other potential protections against environmental pollutants and pathogens. In regard to organochlorine compounds, a recent study in Pediatrics states: “Long-term breastfeeding was found to be beneficial to neurodevelopment, potentially counterbalancing the impact of exposure to these chemicals through breast milk.”
    有证据显示,人类母乳中含着人种特有的最佳营养和消炎成分,包括抗氧化剂,可以帮助孩子发育更为强壮的免疫系统,并对孩子抵御抗环境污染物和病原体提供潜在保护。在关于有机氯化合物,儿科最新的一项研究表明:“长期母乳喂养有利于神经系统发育,有可能通过母乳制衡抵消接触到的化学物质的危害。”

    The World Health Organization, the American Academy of Pediatrics, and other major health associations, overwhelmingly support the importance of breastfeeding even in a contaminated world. Documented benefits of breastfeeding include reduced incidences of the following: insulin dependent diabetes, some childhood cancers, ear infections, upper respiratory infections, obesity and other health problems. In addition, studies suggest that breastfeeding may have a positive influence upon the development of verbal and general intelligence.
    世界卫生组织,美国儿科学会,和其他主要的健康组织,极力支持在受污染的世界进行母乳喂养的重要性。研究证明母乳喂养有利于降低以下疾病发病率:胰岛素依赖型糖尿病,一些儿童期癌症,耳部感染,上呼吸道感染,肥胖和其他健康问题。此外,研究表明,母乳喂养还可能对语言和智力发育产生积极的影响。

    It is impossible to reduce exposure to all chemical elements. However, for those who would like to reduce contact with chemicals especially before pregnancy, and during pregnancy and lactation, the following suggestions may be helpful.
    我们无法避免使自己减少暴露在所有的化学物质环境中。然而,对于那些在孕前,孕中和哺乳期间希望减少与化学物质接触的人们,以下的建议可能会有帮助。

    10 Simple Steps to Help Reduce the Level of Chemicals in Your Body
    10个简单的步骤来帮助减少你身体中的化学物质
    Avoid smoking cigarettes and drinking alcohol since levels of contaminants have been found to be higher in those who smoke and drink alcoholic beverages.
    避免吸烟和饮酒,因为那些吸烟和饮用含酒精饮料的人体内污染物水平更高。
    Be aware in purchasing homes and buildings that have been treated with pesticides for termites and/or older homes that might have lead-based paints.
    在购买房屋和建筑物时,请注意该物业是否已被白蚁杀虫剂处理,或老房子是否有铅基油漆。
    In general, eat a variety of foods low in animal fats, remove skin and excess fat from meats and poultry. Avoiding high-fat dairy products may reduce the potential burden of fat-soluble contaminants.
    通常来说,多吃各种动物脂肪含量低的食物,肉类和家禽应去除皮及多余的脂肪。避免吃高脂乳制品, 这可以减少脂溶性污染物质给身体带来的潜在负担。
    Increase consumption of grains, fruits and vegetables. Thoroughly wash and peel fruits and vegetables to help eliminate the hazard of pesticide residues on the skin. When available, eat food grown without fertilizer or pesticide application.
    多吃谷物、水果和蔬菜。水果和蔬菜应彻底清洗和去皮以清除残留农药。如有可能,食用未使用化肥或农药的食物。
    Avoid fish such as swordfish and shark or freshwater fish from waters reported as contaminated by local health agencies.
    避免食用诸如剑鱼和鲨鱼的鱼类,或当地卫生机构报告为污染水域的淡水鱼。
    Limit exposure to chemicals such as solvents found in paints, non-water based glues, furniture strippers, nail polish, and gasoline fumes.
    避免暴露在某些化学溶剂中,如油漆,非水基胶水,家具除漆剂,指甲油,汽油烟气等。
    Remove the plastic cover of dry cleaned clothing, and air out the garments in a room with open windows for 12-24 hours.
    去掉干洗服装的塑料包装,在开窗房间里让衣服通风12-24小时。
    Try to avoid contact with incinerator discharge, preserved wood, or produce grown near incinerators.
    尽量避免接触垃圾焚烧厂排放物、涂有防腐剂的木材、或在焚烧厂附近种植食用植物。
    For those in the workforce, attempt to avoid occupational exposure to chemical contaminants and seek improved workplace chemical safety standards for all employees, especially pregnant and lactating women.
    请职工试图避开职业性暴露于化学污染物中,并为所有员工,特别是怀孕和哺乳的妇女,寻求更高的职场化学物质安全标准。
    Encourage other family members to be sensitive to contaminant residue they may inadvertently bring into the home.
    鼓励其他家庭成员对他们可能会在无意中带入家的污染物残留保持敏感。

  • 有关母乳的科学 The Science of Mother’s Milk

    有关母乳的科学 The Science of Mother’s Milk

    Ayala Ochert     晓琳 译    Shiuh-jane, Daisy 审校

    Most mothers are aware that breastfeeding boosts a baby‘‘s immune system, but few of us could say how. “It‘‘s something to do with antibodies,” we might answer vaguely. Now there‘‘s a brand of formula on the market claiming to “naturally strengthen your baby‘‘s immune system;” it also says it is “inspired by breastmilk” and “supported by science.” To understand these claims we need to delve a bit deeper into the real science of breastmilk and find out how it actually supports a baby‘‘s developing immune system.
    大多数妈妈知道母乳有助于增强宝宝的免疫系统,但很少有人能道出个中缘由,只能以一句“是抗体在起作用”模糊作答。现在市场上出现了这样一款婴儿配方奶,号称“受母乳启发”,且“有科学依据”,能够“自然地增强宝宝的免疫系统”。要想真正弄懂这种说法,我们需要更深入地挖掘正确的母乳科学知识,找出其有助于宝宝免疫系统建立的确凿证据。

    It turns out that there is much more to the story than just antibodies, important though they are. Breastmilk contains literally thousands of different components that support the immune system in some way. Some of these components are very specific, defending against a particular pathogen (bacteria, virus, parasite), while others have a broader function, protecting the baby in many different ways. Often these various components act together, providing even more protection than each would alone.
    尽管抗体意义重大,但事实表明还有更多值得一提的内涵。母乳确实含有数以千计的不同成分,以各自的方式帮助建立免疫系统。其中的一些成分作用明确,用于抵御特定的细菌、病毒和寄生菌,而另一些成分则具有更广泛的功能,以多种不同方式为宝宝提供保护。通常这些不同成分联合起来协同作用,保护能力远胜单一成分孤军作战。

    The brand of formula in question says it contains a “unique patented mix of special prebiotics” — sugars that are naturally found in milk and which are a source of food for so-called friendly bacteria (probiotics). Having a healthy mix of friendly bacteria in the gut is important for overall health because 80 percent of the immune system is located here, and the “good” bacteria can help to push out the “bad” bacteria that can cause disease.
    上文提到的那种婴儿配方奶宣称其含有“特殊益生元专利技术”的糖类物质。益生元天然产自于母乳,同时也是所谓的有益菌的食物来源。肠道中含有大量有益菌群对身体的整体健康至关重要,因为80%的免疫系统位于肠道内,“好”细菌帮助把致病“坏”细菌排出体外。

    But prebiotics are more than just food for bacteria. There are hundreds of different types of these special sugars — properly known as “oligosaccharides” — and the milk of each animal species contains a distinctive mix. (In fact, the precise mix varies from individual to individual, so each woman has her own unique blend — though not patented, of course!) After fat and lactose, oligosaccharides form the third largest solid component in human milk (the proportion in colostrum is even higher), but they used to be dismissed by scientists as just a useless indigestible by-product of milk production. Now it is clear that they actually have a very important function.
    但是益生元的功用并非仅仅作为细菌的食物这么简单。这些特殊的糖类,有数百种不同的型态,像已被熟知的低聚糖,均以不同比例存在于所有动物的乳汁当中。(实际上,由于个体差异,这一比例并不固定,因此每一位妈妈具有自己的一套协调配比方案,当然就不存在什么专利之说。)位居脂肪和乳糖之后,低聚糖是构成人类乳汁的第三大固体成分(初乳中低聚糖的含量甚至更高)。然而在过去,低聚糖甚至被科学家们误解为是一种无用的难消化的母乳副产品。如今,它的重要作用终于得到了清晰明确的认识。

    Human milk has been found to contain 90 different oligosaccharides forming over 900 different chemical structures, each of which can block infection by preventing a particular strain of bacteria from sticking to the gut wall. (I don‘‘t know how many oligosaccharides are found in this formula with the “patented mix,” but we can safely assume it does not contain 90 different types, in 900 different forms.) Unlike antibodies, they are able to protect a baby from bacteria or viruses that a mother has never been exposed to. What is more, oligosaccharides are just one in a class of human milk components — there are others called glycoproteins and glycolipids — that work by blocking the attachment of microbes to the cells of the gut, so preventing infection.
    人奶已知含有90多种低聚糖,以900多种化学结构存在,通过阻碍特定细菌粘附于肠道壁的方式防止感染。(我不清楚上面那个专利配方的婴儿食品中含有几种低聚糖成分,但我们可以确定,它不会像母乳这样含有这么多种类的低聚糖。)与抗体不同,即便是妈妈以前没有感染过的细菌或病毒,低聚糖也能为宝宝提供保护。低聚糖仅仅是人奶所含诸多成分中的一类物质,此外,还有一些被称为糖蛋白和糖脂的物质以阻断微生物附着于肠道细胞的方式进行抗感染保护。

    Human milk is relatively low in protein compared to the milk of other species, yet the primary function of two of the major proteins in milk — antibodies and lactoferrin — is not nutrition but defense against infection. Most milk antibodies are made of a special form of protein called SIgA, which is particularly resistant to digestion. A mother‘‘s milk contains antibodies to pathogens that she‘‘s recently been exposed to. Chances are the baby has been exposed to the same pathogens. These SIgA antibodies stick to microbes and stop them from attaching to and infecting cells in the gut. They also make their way into the nose and mouth, where they can defend against airborne diseases.
    相较于其他物种而言,人奶蛋白质含量较低。其中含有的两种重要蛋白质──抗体和乳铁蛋白──主要作用是提供抗感染保护而非营养功效。大部分人奶中的抗体是SIgA。SIgA是一种结构特殊的蛋白质,不能被消化吸收。母乳中所含的抗体由妈妈近期接触过的抗原刺激产生,宝宝可能也已暴露于相同的抗原中。这些SIgA抗体粘附在微生物上,阻止它们依附和感染肠道细胞。抗体在鼻腔和口腔中发挥同样作用,防止经空气传播途径致病菌的侵袭。

    While each antibody is specifically designed to target one particular pathogen, the major milk protein lactoferrin acts more broadly. It can directly kill bacteria, viruses, and fungi, and it also has an anti-inflammatory effect, which helps reduce the pain, swelling, and high temperature associated with infection. Because lactoferrin is quite resistant to digestion, it passes into the urine relatively unchanged and so helps prevent urinary tract infections. Lactoferrin also helps to encourage the growth of friendly bacteria in the infant‘‘s gut. Human milk contains particularly high levels of lactoferrin and, significantly, human lactoferrin is distinct from that found in the milk of other species.
    虽然一种抗体只针对某一特定病菌发挥作用,具有特异性,但母乳里的主要蛋白质──乳铁蛋白的作用却更为宽广。它能直接杀死细菌、病毒和真菌,并兼具抗炎效果,能够帮助缓解由感染引起的疼痛、红肿和高热症状。乳铁蛋白不能被消化分解,因此进入小便后能帮助预防尿路感染。乳铁蛋白还能促进婴幼儿肠道内有益菌的生长繁殖。人奶中具有高含量乳铁蛋白,且与其他物种乳汁中的乳铁蛋白有显着区别,这点意义重大。

    In addition to these there are many other components that are known to play a role in supporting the immune system. The list includes alpha-lactalbumin, lysozyme, lipids, milk fat globules, nucleotides, defensins, cytokines, hormones, growth factors, anti-secretory factor, leucocytes, neutrophils, macrophages, lymphocytes, and more. The more you find out about these remarkable substances, the more apparent it becomes that mother‘‘s milk is important for babies. As the research scientist David Newburg puts it: “My thinking on milk has changed totally. I used to think of it as the best source of nutrition. Now, it‘‘s looking like milk is really designed to be protective.”
    除上述内容以外,已知还有许多其他成分在建立免疫系统上扮演着重要角色,如:α-乳清蛋白、溶菌酶、脂类、乳脂肪球、核苷酸、防御素、细胞因子、荷尔蒙、生长激素、抗分泌激素、白细胞、嗜中性粒细胞、巨噬细胞、淋巴细胞等等。随着越来越多的有益成分被发现,母乳对宝宝的重要性日益明显。正如科学家David Newburg所说:“我对母乳的看法已经完全改变了。以前我把母乳当作营养的最佳来源。如今看来,母乳确实是一把天赐的保护伞。”

    A newborn baby‘‘s immature immune system relies heavily on this protection. Colostrum, the milk produced in the first days after birth, contains higher concentrations of many of these substances. The infant immune system matures during the first year, and is more mature at age two, but the immune system does not reach full maturity until the child is around six years old.
    新生儿不成熟的免疫系统极度仰赖这种保护。婴儿出生后几天妈妈所产生的初乳含有更丰富的这些保护成分。婴儿的免疫系统在出生后的第一年开始成熟,在两岁时更加成熟,但是要到孩子六岁左右时免疫系统才能达到完全成熟。

    So it‘‘s reasonable to assume that mother‘‘s milk gives a useful immune boost for as long as a child is breastfeeding. But what about once they stop? Happily, the effects of breastfeeding on the immune system continue throughout life. This is because breastmilk contains components that direct the development of a child‘‘s own immune system. For example, it was found that the thymus — a central organ of the immune system — is twice as big in breastfed infants compared with formula-fed infants at four months. The size difference was also seen at ten months. Researchers attribute the growth of the thymus in breastfed infants to two components of human milk, IL-7 (a cytokine) and leptin (a hormone). Since the thymus continues to grow throughout childhood, it seems likely that breastfeeding enhances the growth of the thymus for as long as breastfeeding continues.
    因此可以做出这样的合理假设:只要孩子哺乳,母乳便有助于提升免疫力。问题来了,断奶后情况将如何?庆幸的是母乳喂养对免疫系统的贡献将终生受用。因为母乳含有的成分对孩子自身免疫系统的发育有直接影响。拿作为中枢免疫器官的胸腺来说,与人工喂养四个月大的婴儿相比,母乳喂养四个月大婴儿的胸腺是其两倍大。这种差异在婴儿十个月大时依然明显。研究者们把胸腺的这种生长归因于母乳中的两种成分:IL-7(一种细胞因子)和瘦素(一种荷尔蒙)。由于胸腺在整个童年时期持续生长,似乎只要母乳喂养持续,便有助于胸腺的发育。

    The main role of the thymus is in the development of the immune system. It grows steadily in early life and then abruptly stops at puberty and starts to shrink and gradually disappear during adulthood. During those early active years, bone marrow cells enter the thymus and mature into T cells, which then spread to the rest of the body. There are several different types of T cells, all vital to the proper functioning of the immune system — one sort finds and recognizes pathogens and can kill them directly; other types of T cell can instruct other cells of the immune system to kill. Yet others have the role of directing the production of antibodies. Another vital function of the thymus is to learn to recognize the body‘‘s own tissues so that the immune system doesn‘‘t attack them, as happens in autoimmune diseases like rheumatoid arthritis, type 1 diabetes, and multiple sclerosis.
    胸腺在免疫系统发展中扮演重要角色。胸腺在生命初期稳定增长,青春期停止生长,到成年时开始萎缩并逐渐消失。在早期的活跃期,骨髓细胞进入胸腺发育成熟后形成T细胞,随后扩散到整个机体。T细胞具有各自不同的类型,对维持免疫系统正常运转起到至关重要的作用。其中有一类能搜寻和识别病菌并直接将其杀死,另一类T细胞能引导免疫系统内的其他细胞消灭病菌。还有一类T细胞能够直接生产出抗体。胸腺的另一个重要作用是识别机体自身组织免于遭受免疫系统的攻击,这就是类风湿性关节炎、一型糖尿病和多发性硬化症等自身免疫性疾病的原因。

    Since breastfeeding is the biological norm, and since organs of the immune system like the thymus can only develop to their full potential through breastfeeding, an inevitable conclusion must be that people who were never breastfed (or those who were weaned too early) will have deficient immune systems — not just in infancy but for the rest of their lives.
    由于哺乳是生物的自然法则,免疫系统中的器官如胸腺,只能在哺喂母乳的情况下发展出它们最大的潜能,因此很难不这样推断:未曾哺乳(或过早断奶)的人没有充分发展的免疫系统──不仅婴儿期没有,往后也是如此。

    From the outside, babies seem to grow well on formula — they certainly get bigger and longer. But on the inside their vital organs may struggle to grow adequately without support from mother‘‘s milk, which has evolved to meet their needs. Perhaps one brand of formula can argue that it is marginally better than another brand, but can it possibly claim to be “inspired by breastmilk” or to “strengthen the immune system”? Those are claims that the real science simply does not support.
    表面上看,宝宝们在配方奶的喂养下似乎长得不错──确实是个头更大一些。但是从体内的发展来看,缺少那能满足需求的母乳的支持,那些关乎生命的器官,会耗力运作,以便让身体能充分成长。或许一个牌子的配方奶可以表明比另一个牌子的产品好,但是能宣称它“受母乳启发”或“能增强免疫力”吗?那些声称的内容实在是不被现代科学所支持。

    Refer to
    参考文献
    Hanson, L. A. MD, PhD. Immunobiology of Human Milk: How Breastfeeding Protects Babies. Pharmasoft Publishing, 2004.

  • 母乳会存在的价值Why is LLL necessary?

    母乳会存在的价值Why is LLL necessary?

    Breastfeeding is an instinctual and natural act, but it is also an art that is learned day by day.
    母乳喂养是人类本能、自然的行为,同时也是一门日复一日不断学习的艺术。

    Once upon a time, children grew up seeing their mothers, aunts, other relatives and friends breastfeeding. This does not happen very often any more, and often a woman finds herself with her baby in her arms without ever having even seen another woman caring for her child. With the widespread use of formula and the bottle, we have forgotten many notions and ideas that help in breastfeeding successfully, and our expectations regarding children‘‘s needs and behaviors have changed. The ideal image of a healthy child that most people have today – for example, how and how much he will eat, how he will sleep, how much and how fast he should grow – are based to a great extent on the typical behavior of formula fed babies.
    曾几何时,孩子在成长过程中亲眼目睹母亲、阿姨及其他亲戚朋友们哺育自己的孩子。现在这样的情况已不多见,如今的新妈妈们还没见过别的母亲怎样照顾自己的孩子,就已经把孩子抱在怀里了。随着配方奶和奶瓶的广泛使用,我们已经忘记很多能够成功帮助母乳喂养的观念和理念了,而且对孩子的需求及行为的预期也发生了改变。如今人们心中的完美、健康的孩子形象,比如他怎么吃、吃多少、睡眠如何、重了多少、长得多快等等,很大程度上是建立在评价配方奶喂养孩子的典型行为的基础上。

    The reality is that almost all women can breastfeed, have enough milk for their babies and learn how to overcome problems both large and small. It is almost always simply a matter of practical knowledge and not a question of good luck.At La Leche League meetings, pregnant women or mothers with babies can meet other women who are breastfeeding and in this way derive great benefit from their experience and encouragement.
    事实的真相是几乎所有妇女都可以实现母乳喂养,有足够的母乳给她们的孩子,并且能学会如何克服或大或小的问题。这通常是涉及实用知识的单纯问题,而不是你够不够幸运的问题。在母乳会的聚会上,孕妇或带着孩子的妈妈们能遇见其他母乳喂养的妈妈,通过耳濡目染,从妈妈的经验和鼓励中获得极大的益处。

    Some mothers find it necessary to deal with the consequences of difficult births, inadequate or inaccurate information received immediately following birth, or physical challenges–La Leche League is also here for these mothers, with accurate, up-to-date information that will help the mother make informed decisions that will work for her own particular circumstances.
    有些妈妈发现,她们必须克服困难生产所带来的影响、分娩后得到的不充分或不正确的信息,或者生理上的挑战等。母乳会一直在支持这些妈妈们,为她们提供准确的、最新的信息,帮助她们在信息充分的前提下做出符合各自特殊情况的决定。

    Breastfeeding provides a woman with a unique occasion to experience motherhood in an optimal manner, introducing positive changes within her family and the society. A well informed and involved woman can experience natural processes such as childbirth and breastfeeding in the best way for herself and her baby. She knows when to proceed, when to ask for help and which choices to make. She knows when and how to look for support and can give it to other women, growing as a mother and as a woman at the same time.
    母乳喂养为妇女提供了一个独特的机会来体验如何以适当的方式来做母亲,给她们的家庭和整个社会带来正向的变化。一个掌握充分信息并且全心投入的妇女,能够以对孩子和自身最好的方式来体验如母乳喂养及分娩等自然的过程。她知道何时该前进、何时寻求帮助、及该做哪些选择。由于她知道何时该求助,以怎样的方式求助,因此可以给予其他妇女同样的帮助,在这样的过程中,她经历着一个母亲和一个女人的成长。

    La Leche League also publishes books and leaflets that provide information and support for all women who wish to breastfeed. More information on our organization and how it helps mothers around the world can be found on our General LLL Information page or on our collection of resources about LLL.
    母乳会也出版书籍和宣传册,为希望实现母乳喂养的妈妈们提供信息与支持。如需了解更多关于这个国际组织的信息及我们如何帮助全球各地的妈妈们,可以浏览官方网站或参阅我们整合的关于母乳会的各项资源。

    Our FAQs present information from La Leche League International on topics of interest to parents of breastfed children. Not all of the information may be pertinent to your family‘‘s lifestyle. This information is general in nature and not intended to be advice, medical or otherwise. If you have a serious breastfeeding problem or concern, you are strongly encouraged to talk directly to a La Leche League Leader. Please consult health care professionals on any medical issue, as La Leche League Leaders are not medical practitioners.
    我们的问题解答部分提供给母乳育婴的父母们来自国际母乳会的各类信息。可能不是所有的信息都适用于你的家庭模式。这些信息实际上是通用的,但并不是作为建议、医学指导或其他。如果你在母乳喂养上有严重的问题或忧虑,强烈建议你直接和国际母乳会的哺乳辅导联系。如果你有医学上的问题,请咨询你的专业健康顾问,母乳会的哺乳辅导并不是医务人员。

  • 母乳喂养的重要性 The Importance of Breastfeeding

    母乳喂养的重要性 The Importance of Breastfeeding

    母乳喂养不仅仅是一种生活方式的选择,它还是对母婴双方都很重要的一个健康选择,所以相关的卫生健康部门都支持母乳喂养。

            2001年,世界卫生组织建议: 6个月内纯母乳喂养是最佳的婴儿喂养方式。婴儿添加辅食后,他们建议母亲们将母乳喂养持续到两岁或更长时间。1997年,美国儿科学会发表声明指出,母乳应是所有新生儿的首选食品。美国儿科学会也建议婴儿在出生后的头六个月里应纯母乳喂养,不需添加任何辅食;另外母乳喂养应至少持续12个月或根据母婴双方的共同意愿来决定。这里提供一些国际母乳会和卫生保健机构认为母乳喂养十分重要的理由。
    保护婴儿远离疾病

    母乳喂养的孩子患感冒、中耳炎、上呼吸道感染,甚至慢性疾病(如哮喘)的次数和严重程度都明显降低。母乳喂养的婴儿较少患腹泻、其他肠胃疾病、肺炎、脓毒病、肠胃炎、脑膜炎以及某些儿童癌症。由于患上述疾病的次数和严重程度的降低,母乳喂养婴儿看医生的次数就较少。

    Davis, M.K. Breastfeeding and chronic disease in childhood and adolescence. Pediatr Clin N A 2001; 48(1):125-41.

    Haby, M.M. et al. Asthma in preschool children: prevalence and risk factors. Thorax 2001;56:589-95.

    Oddy, W.H. et al. Maternal asthma, infant feeding, and the risk of asthma in childhood. J Allergy Clin Immunol 2002;110:65-7.

    Scariati, P.D. et al. A longitudinal analysis of infant morbidity and the extent of breastfeeding in the United States. Pediatrics 1997;99(6):e5.

    从出生到成年早期都表现出较高的智商

    研究表明,婴儿时期母乳喂养的孩子和以配方奶喂养的孩子相比,智商的差异多达5至10点。注释中提及的Mortensen研究报告比较了一系列关于智力的研究,该比较综合了其它可能的影响因素,如父母的受教育程度,母亲是否抽烟以及婴儿的出生体重。近期人们才认识到的,天然存在于母乳中的不饱和脂肪酸二十二碳六烯酸(DHA)和花生四烯酸(AA)以及它们在婴儿大脑的发育过程中所起到的作用也许是造成上述智力差异的一个因素。

    Mortensen, E.L. et al. The association between duration of breastfeeding and adult intelligence. JAMA 2002;28(15):2365-71.

    Xiang, M. et al. Long-chain polyunsaturated fatty acids in human milk and brain growth during early infancy. Acta Paediatr 2000; 89(2):142-47.
    剂量反应:母乳喂养越多,提供保护越多

    当婴儿是纯母乳喂养时,母乳喂养为婴儿免患疾病提供了最大的保护。这种保护随婴儿接受辅食量的增加而逐渐减少(辅食包括配方奶、牛奶或其它食物)。母乳喂养的时间越长,婴儿也将得到越多保护。科学研究称这种作用为“剂量反应”。母乳喂养对下述状况呈现出剂量反应:儿童白血病和淋巴瘤,中耳炎,呼吸道感染,腹泻,B型流感嗜血杆菌(HIB),肥胖和超重,达到成长发育的重要指标。

    Bener, A. et al. Longer breastfeeding and protection against childhood leukemia and lymphomas. Eur J Cancer 2001;337(2):234-38.

    Raisler, J. et al. Breastfeeding and infant illness: A dose-response relationship? Am J Publ Hlth 1999;89(1):25-30.

    促进婴儿免疫系统发育

    母乳中含有免疫球蛋白、白血球和抗炎症因子,帮助婴儿的免疫系统在出生后发育成熟。婴儿出生后头几天中产生的母乳富含免疫因子。分泌性免疫球蛋白A(IgA),母乳中存在的一种活性分子,可以减少母乳宝宝患急性肠胃疾病的风险。母乳中的免疫球蛋白A(IgA)也可以刺激婴儿的免疫系统制造更多的分泌免疫球蛋白A(IgA)。母乳对婴儿免疫系统的促进作用会持续保护儿童,甚至到断奶以后。

    Feist, N. et al. Anti-endotoxin antibodies in human milk: Correlation with infection of the newborn. Acta Paediatr 2000; 89(9):1087-92.

    Mackie, R.I. et al.Developmental microbial ecology of the neonatal gastrointestinal tract. Am J Clin Nutr !999; 69(Suppl): 1035S-45S.

    Ronayne de Ferrer, P.A. et al. Lactoferrin levels in term and preterm milk. J Am Coll Nutr 2000;19(3):370-73.
    母乳可杀死癌细胞及其它病菌

    在实验室条件下发现:母乳中的物质可杀死肺、咽喉、肾、直肠和膀胱中的癌细胞,以及淋巴瘤细胞,白血病细胞和肺炎球菌。其他研究人员在实验室条件下也观察到了相似的结果:母乳杀死或中和了衣原体孢子、HIV(人类免疫缺陷病毒)和某些种类的细菌。母乳作用的研究成果为研究人员开发新的疾病治疗方法提供了帮助。

    Jensen, R.G. et al. The anticarcinogenic conjugated fatty acid, 9c, 11t-18.2, in human milk: confirmation of its presence. J Hum Lact 1998; 14(1):23-27.

    Lampe, M.F. et al. Killing of chlamydia trachomatis by novel antimicrobial lipids adapted from compounds in human breast milk. Antimicro Agen Chemo 1998;42(5);1239-44.

    Lee-Huang, S. et al. Lysozyme and Rnases as anti-HIV components in B-core preparations of human chorionic gonadotropin. Proc Natl Acad Sci USA 1999; 96:2678-81.
    母乳喂养惠及家庭和社会

    母乳喂养为家庭和社会减少经济压力。除了母乳是免费的这一好处外,母乳喂养还可以减少家庭在卫生保健方面的开支。美国的一项研究表明,根据母乳喂养时间的长短,每个家庭可节省200-800美元不等(约人民币1600-6400元)。

    当低收入母亲选择母乳喂养时,用来帮助困顿人群的社会资源就可得到更长时间的使用。当婴儿接受母乳喂养时,母婴双方一生都会更健康。母乳喂养改善公共健康,减轻医院、保险公司和政府补助项目的经济压力。

    Ball, T.M. Bennet, D..M. The economic impact of breastfeeding. Pediatric Clinics of North America 2001; 48(1):253-62.

    Fok, D. et al. The economics of breastfeeding in Singapore. Breastfeed Rev 1998;6(2):5-9.

    Montgomery, D.L. et al. Economic benefit of breast-feeding infants enrolled in WIC. J Am Diet Assoc 1997; 97(4):379-85.

    母乳喂养有利环保

    母乳喂养不必消耗金属、纸张、塑料,也不存在制造包装和运输配方奶和喂养器械所存在的能源需求。由于母乳可以被婴儿更充分地吸收,因此母乳喂养婴儿减少了污染和废物处理问题。另外,研究显示,纯母乳喂养提供了天然的避孕。虽然我们生活在一个被污染的世界里,科学家们仍一致认为母乳是婴儿最理想的营养来源,它甚至可以保护婴儿免受某些污染的影响。

    Lovelady, C.A. et al. Weight change during lactation does not alter the concentration of chlorinated organic contaminants in breast milk of women with low exposure. J Hum Lact 1999:15(4):307-15.
    如欲了解更多信息,请参照:

    THE WOMANLY ART OF BREASTFEEDING. Schaumburg, IL:LLLI, 1997.

    THE BREASTFEEDING ANSWER BOOK. Schaumburg, IL:LLLI, 2003.

  • 减少乳腺癌风险:哺乳的原因 Cutting Breast Cancer Risk: Reason to Breastfeed

    减少乳腺癌风险:哺乳的原因 Cutting Breast Cancer Risk: Reason to Breastfeed

    Katherine A. Dettwyler, PhD

    Texas A&M University

    From: LEAVEN, Vol. 35 No. 2, April-May 1999, p. 29

    Between the two factors, having been breastfed oneself and breastfeeding one‘‘s own children, one could reduce the risk of breast cancer by almost half. Now breast cancer strikes about one in eight women over the course of their lifetimes. If one could reduce the chances to one in 16, that would be worth doing, I would think.

    有两个因素可以让乳腺癌的发病率降低一半,吃过母乳和哺乳过自己的孩子。当今大约八分之一的女性会在一生中患乳腺癌。我认为,如果这一比例下降至十六分之一,那么这就是值得去做的。

    These studies do not promise anyone that they won‘‘t get breast cancer if they were breastfed and breastfeed their own children; they merely lower the risk by half. Chances are good that you won‘‘t get breast cancer no matter what you do – as seven out of eight women don‘‘t. You can play the odds, or you can change the way you live to reduce your risk.

    这些研究不能保证那些吃过母乳和母乳喂养过自己孩子的人不患乳腺癌,但是它们能降低一半风险。很可能你怎样做都不会得乳腺癌-因为有八分之七的女性可以幸免。你可以赌一赌, 或者你可以改变生活方式来降低风险。

    It is interesting to look at the steady rise in incidence of breast cancer over the last few decades in light of this new information. Let me use my own mother as an example. She was born in 1920, when almost all babies were still breastfed for several years; her mother breastfed her. Thus she got the first type of protection. By the time she started having children in the late 1940s and up to the mid 1950s, many women were not breastfeeding their children anymore (although my mother did). That means that there was an entire cohort of women who had been breastfed as infants, but did not breastfeed their own children. Thus they got the first type of protection, but not the second. As they aged, they were at greater risk for breast cancer than their mothers and grandmothers had been (because their mothers and grandmothers had had both types of protection).

    鉴于这类新信息,我们有趣地发现在过去的几十年中乳腺癌的发病率稳步上升。我来举个我妈妈的例子。她生于1920年,那时候几乎所有的婴儿都吃好几年母乳,所以她妈妈也喂她。因此她得到了第一种保护。在她开始生育期间,即20世纪40年代后期到50年代中期,很多女性不再母乳喂养他们的孩子(但我妈妈仍然这样做)。这意味着这一整代人吃过母乳,却没有母乳喂养过自己的孩子。因此他们只得到了第一种保护,而未得到第二种。当她们年老的时候,患乳腺癌的风险就比她们的母亲和祖母们高得多(因为他们的母亲和祖母们得到了上述双重保护。)

    Then you come to my generation, most of whom were born in the 1950s and 1960s and were not breastfed as children, so they missed out on the first type of protection. When they started to have babies in the 1970s and 1980s, many still did not breastfeed their own children, thus missing out on the second type of protection. As this cohort ages, those who were neither breastfed nor breastfed their own children are at even greater risk than their mothers bad been.

    然后到了我们这一代,即生于20世纪50年代和60年代的人们,她们没有吃过母乳,所以失去了第一种保护。当她们在20世纪70、80年代生育时,许多人仍然没有哺喂她们的孩子,因此也错过了第二种保护。当这群人老了的时候,由于她们既没被哺喂母乳,也未亲自哺乳自己的小孩,所以比她们的母亲患病率更高。

    Could it be that the steady erosion of these two sources of protection account for the steady rise in breast cancer incidence in the US over the past four decades? At the moment, this is just speculation based on the timing of the two processes. I hope I have given you more to think about.

    这两类保护来源的缺失是否是导致美国近四十年来乳癌的上升呢?现在,这个结论只是基于这两个过程时间段的推测。希望引起大家的思考。

    Freudenheim, J et al. Exposure to breastmilk in infancy and the risk of breast cancer. Epid 1994; 5:324-31.

    Newcomb, PA et al. Lactation and a reduced risk of premenopausal breast cancer. New Eng J Med 1994; 330(2):81-87.

    (解青译,Daisy、Shiuh-jane审稿)

  • 什么令母乳如此特别?What Makes Human Milk Special?

    什么令母乳如此特别?What Makes Human Milk Special?

    Sally Myer

    Nebraska

    From: NEW BEGINNINGS, Vol. 23 No. 2, March-April 2006, pp. 82-83

    The most common reason mothers probably choose to breastfeed is the knowledge that human milk is the superior infant food. It contains live cells, like those in blood. Some components of human milk also enhance the effects of others, so the ingredients of human milk work together. In contrast, only a small percentage of some ingredients of formula are absorbed; mixing ingredients in formula does not guarantee they will act together the way they do in human milk.

    妈妈们选择母乳喂养最普遍的理由是:人乳是上好的婴儿食品,含有存在于血液中那样的活细胞。人乳含有的某些成分能够强化其他组成成分的作用效果,因此人乳的各组成成分是协同作用的。比较而言,配方奶的一些成分仅有很小的比例能被吸收;配方奶的组成成分不能保证像人乳这样发挥协同效应。

    Human Milk Is Designed for Babies

    母乳为宝宝量身定做

    Human milk is species-specific. The milk of each mammal species has adapted to supply its offspring with what is needed for optimal growth and survival. Some species milks are relatively high in fat to lay down a thick layer of body fat, while those with high protein use it for rapid growth and maturation. Those species that need readily available sources of sugar to meet the needs of their rapidly growing brains have milk that is higher in carbohydrates. Humans are the slowest growing and maturing mammals, but also have the most advanced brains. So it makes sense that the protein content of human milk is relatively low while the level of carbohydrates is high.

    人乳具有物种特异性。每一种哺乳动物的乳汁都为其后代提供生长和生存所必须的有力保证。一些物种的乳汁含有高含量的脂肪以便为自身机体储备一层厚厚的皮下脂肪层,而另一些物种的乳汁中则含有大量的蛋白质来促进机体的迅速生长和成熟。还有一些物种的乳汁中含有高含量的碳水化合物,而这正是促使大脑快速发育所必须的糖类物质的来源。人类是生长和成熟速度最慢的物种,但却拥有最先进的大脑。因此不难理解为什么人乳中蛋白质的含量较低而碳水化合物的含量较高。

    Human milk contains levels of vitamins and minerals appropriate for the healthy, full-term, human infant. It is ever-changing — from the beginning of the feeding to the end, from feeding to feeding, and from day to day. The infant provides many signals that stimulate some of the changes in his mothers milk. When following her infants feeding cues, a mother can be assured that her child will benefit from those changes. For instance, if the milk taken at a particular feeding is lower in fat (fat is the most variable constituent of mothers milk), the infant will become hungry again sooner. If his cues are followed and he receives the next few feedings close together (cluster feeds), the higher fat milk he receives (fat content goes up when the breast is less full) will ensure his overall fat intake is adequate.

    人乳中含有丰富的维生素和矿物质,适合健康的足月儿食用。各营养组成成分不断变化—每次哺乳的开始到结束、每一餐、每一天,乳汁的成分都会有变化。婴儿发出的信号刺激母亲的乳汁发生一些改变。迎合婴儿的喂养暗示,母亲可以确信自己的孩子将会从这些改变中获益。例如,如果某次摄取的乳汁中脂肪(脂肪是乳汁中含量浮动最大的成分)含量较低,婴儿很快又饿了。如果婴儿的暗示获得响应,得到接下来的高密度频繁哺乳(集中喂养),获取更高脂肪含量的母乳(乳房较不充盈时,母乳的脂肪含量会上升)将保证其总脂肪摄入量是充足的。

    Human Milk Has Anti-Infective Properties

    人乳具有抗感染特性

    Breastfeeding mothers often notice that their children are sick less often than children who arent breastfed. Human milk provides different kinds of defense against disease, including secretory antibodies against specific pathogens. It also contains lactoferrin, which not only is the source of iron for breastfed infants, but also appears to have antibacterial and antiviral properties. Other components in human milk protect infants on a molecular level because their actual shape hinders certain pathogens access to the infant.

    母乳喂养的妈妈们通常会注意到他们的宝宝比非母乳宝宝少得病。人乳为疾病提供不同种类的防御机制,包括抵抗特定病原体而分泌的抗体。还包括乳铁蛋白。乳铁蛋白不仅仅是母乳宝宝铁的来源,同时还能提供抗菌和抗病毒保护。人乳中的其他成分为宝宝提供分子级别的保护,原因在于它们的实际分子尺寸大小能够阻止某些病原体入侵到宝宝体内。

    Because human milk has protective qualities, infants who are not breastfed have more emergency room visits, hospitalizations, and treatments with antibiotics. The protective effects extend beyond weaning. (See the table below.)

    由于人乳具有保护特性,因此非母乳宝宝反而有更多的机率生病跑急诊、住院、进行抗生素治疗。母乳的保护效用延续至断奶以后。(请见下表。)

    Human milk offers immunological protection against many chronic diseases. According to Outcomes of Breastfeeding versus Formula Feeding, compiled by Ginna Wall, MN, IBCLC, and Jon Ahrendsen, MD, FAAFP, human milk feeding is associated with less risk of the following diseases: celiac disease, diabetes, multiple sclerosis, sudden infant death syndrome, childhood cancer, autoimmune thyroid disease, appendicitis, osteoporosis, cardiovascular disease, helicobacter pylori infection (associated with gastric ulcers), Crohns disease, colitis, juvenile rheumatoid arthritis, obesity, tonsillitis, allergies, atopic disease, and asthma. (This comprehensive report can be found at www.lalecheleague.org/docs/Outcomes_of_breastfeeding_June_2007.pdf *.)

    针对许多慢性疾病,人乳能提供免疫方面的保护。根据Ginna Wall (MN, IBCLC) 和Jon Ahrendsen ( MD, FAAFP) 编辑的著作《母乳喂养与人工喂养的对比结果》所说,母乳喂养能够降低罹患以下疾病的风险:乳糜泻,糖尿病,多发性硬化症,婴儿猝死综合征,儿童癌症,自身免疫性甲状腺疾病,阑尾炎,骨质疏松症,心血管疾病,幽门螺杆菌感染(胃溃疡相关),克罗恩病,溃疡性结肠炎,幼年型类风湿性关节炎,肥胖,扁桃腺炎,过敏,异位性过敏症和哮喘。(有关综合报告请见 www.lalecheleague.org/docs/Outcomes_of_breastfeeding_June_2007.pdf *.)

    The mechanism of these apparent long-term immunologic benefits remains unclear, although theories abound. Human milk contains bioactive components that enhance the growth and development of the human infant.

    尽管理论研究比比皆是,但明显而长效的免疫获益机制尚不明晰。人乳含有生物活性成分,帮助人类宝宝生长和发育。

    One gastrointestinal hormone, cholecystokinine (CCK) signals sedation and a feeling of satiation and well-being. During suckling, CCK release in both mother and infant produces a sleepy feeling. The infants CCK level peaks twice after suckling. The first peak occurs immediately after the feeding. It peaks again 30 to 60 minutes later. The first CCK rise is probably induced by suckling; the second by the presence of milk in the GI tract. The drop of infant CCK levels 10 minutes after a feeding implies a “window” within which the infant can be awakened to feed from the second breast or to reattach to the first side for additional fat-rich milk. Waiting 30 minutes after the feeding before laying the baby down takes advantage of the second CCK peak to help the infant to stay asleep.

    做为一种胃肠激素,胆囊收缩素(CCK)发出镇静信号,给人以饱腹感和幸福感。在吸吮过程中,母婴双方均释放CCK产生昏昏欲睡的感觉。吸吮后,婴儿的CCK水平先后达到两次峰值。第一次峰值在喂奶后立刻出现。第二次峰值在30至60分钟后出现。CCK值的首次攀升很可能是由吮吸引起,第二次则是因为胃肠道里有奶的存在。喂奶后10分钟婴儿的CCK值回落,这预示着一个机会,婴儿可能醒来轮换吃另一侧的乳房,或者重新吮吸同侧乳房,以获得更多富含脂肪的后奶。充分利用第二次CCK峰值,吃奶后不要立即把婴儿放平,而是等上30分钟,这样有助于婴儿保持睡眠状态。

    Human Milk Contains Essential Fatty Acids

    人乳含有必需的脂肪酸

    The essential fatty acids in human milk optimize cognitive function and vision. Studies have found that premature infants who received human milk via feeding tube were more advanced developmentally at 18 months and at seven to eight years of age than those of comparable gestational age and birth weight who had received formula by tube. Such observations suggest that human milk has a significant impact on the growth of the central nervous system. Also, breastfed infants have higher visual acuity. These benefits of human milk can be attributed to the presence of long-chain polyunsaturated fatty acids, docosahexanoic acid (DHA) and arachidonic acid (AA). Although some formulas have recently added these ingredients, it is unknown if they will have similar effects long-term.

    人乳中所含的必需脂肪酸具有优化认知功能和视觉作用。研究发现,与相同胎龄和出生体重,经由鼻胃管喂食配方奶的早产儿相比,喂食母乳的早产儿在18个月和七到八岁的时间段内有较好的发育。这项观察显示,人乳对中枢神经系统的发育影响重大。同时,母乳宝宝具有更高的视觉灵敏度。这些益处都要归功于长链多不饱和脂肪酸二十二碳六烯酸(DHA)和花生四烯酸(AA)的存在。尽管现今的一些配方奶粉中已经添加了这些成分,但还不确定这些人工添加的成分是否能够发挥长期的相似作用。

    The hormones, live antibacterial and antiviral cells, and essential fatty acids are just some of the reasons why human milk is the vastly superior infant food. It is a truly unique substance that cannot be copied artificially.

    含有荷尔蒙、活的抗菌和抗病毒细胞以及必须的脂肪酸恰恰部分解释了为什么人乳是婴儿绝对上好的食物这一观点,并且这些非凡的物质成分无法被人工复制。

    Resources

    Lawrence, R. and Lawrence, R. Breastfeeding; A Guide for the Medical Professional. St. Louis: Mosby. 2005.

    Riordan, J. Breastfeeding and Human Lactation. Sudbury: Jones and Bartlett 2005.

    (晓琳 翻译 Shiuh-jane、Daisy审稿)

  • 一个未公开的秘密: 母乳喂养对母亲的益处

    Alicia Dermer, MD, IBCLC
    Old Bridge NJ USA
    From: NEW BEGINNINGS, Vol. 18 No. 4, July-August 2001, p. 124-127

    Very few people are unaware of the benefits of breastfeeding for babies, but the many benefits to the mother are often overlooked or even unknown. From the effect of oxytocin on the uterus to the warm emotional gains, breastfeeding gives a mother many reasons to be pleased with her choice. These documented effects are outlined in this excerpt from Breastfeeding Annual International 2001, a recently published anthology which was edited by Dia Michels, co-author of the classic breastfeeding advocacy book, Milk, Money, and Madness. Both books are available from LLLI.
    很少人不知道母乳喂养对婴儿的益处,但母乳喂养对母亲的好处却常常被忽略、甚至不为人知。从催产素促进子宫收缩到充满强烈情感的母婴关系,母乳喂养让妈妈有很多理由为自己的选择感到高兴。在最近出版的《2001年国际母乳喂养年度文集》中,摘录了已发布的母乳喂养对母亲的好处。该文集由经典的母乳喂养宣传书籍《牛奶、金钱与疯狂》的共同作者Dia Michels编辑。这两本书都可以从国际母乳会获得。

    One of the best-kept secrets about breastfeeding is that it‘‘s as healthy for mothers as for babies. Not only does lactation continue the natural physiologic process begun with conception and pregnancy, but it provides many short and long-term health benefits. These issues are rarely emphasized in prenatal counseling by health care professionals and all but ignored in popular parenting literature. Let‘‘s look at all the benefits breastfeeding provides   mothers and speculate as to why so few are finding out about them.
    关于母乳喂养最不为人知的是,妈妈可以和婴儿一样从中获得健康。母乳喂养不仅仅是延续受孕和怀孕之后的自然生理过程,它还能带来很多短期和长期的健康益处。在专业医护人员提供的产前辅导中很少会强调这些,而且在通常的父母教育类著作中也都被忽略。让我们看看母乳喂养提供给妈妈们那些帮助,也猜测一下为什么很少找到对这些益处的描述。

    Physiologic Effects of Breastfeeding
    Immediately after birth, the repeated suckling of the baby releases oxytocin from the mother‘‘s pituitary gland. This hormone not only signals the breasts to release milk to the baby (this is known as the milk ejection reflex, or “let-down”), but simultaneously produces contractions in the uterus. The resulting contractions prevent postpartum hemorrhage and promote uterine involution (the return to a nonpregnant state).
    母乳喂养对妈妈生理上的影响
    从一出生开始,婴儿的反复吸吮让母亲的脑下垂体释放催产素(缩宫素)。这种激素不仅让乳房分泌乳汁给宝宝(即所谓的喷乳反射或“奶来了”),同时也引起子宫收缩。由此产生的收缩防止产后出血,促进子宫恢复(回到非妊娠状态)。

    Bottle-feeding mothers frequently receive synthetic oxytocin at birth through an intravenous line, but for the next few days, while they are at highest risk of postpartum hemorrhage, they are on their own. As long as a mother breastfeeds without substituting formula, foods, or pacifiers for feedings at the breast, the return of her menstrual periods is delayed (Lawrence and Lawrence 1999). Unlike bottle-feeding mothers, who typically get their periods back within six to eight weeks, breastfeeding mothers can often stay amenorrheic for several months. This condition has the important benefit of conserving iron in the mother‘‘s body and often provides natural spacing of pregnancies.
    奶瓶喂养的妈妈们通常在宝宝出生时会接受点滴静脉注射人工合成催产素,但是在接下来的几天,是产后出血风险最高的时候,她们只能凭自己的力量面对。如果妈妈只有母乳喂养,没有替代的配方奶、食物和奶嘴,她恢复月经的时间常常会延迟(Lawrence and Lawrence 1999),经常可以好几个月没有月经,不像人工喂养的妈妈一般在产后6-8周恢复月经。这种现象对母体保存铁质有重大的好处,而且经常达到自然避孕,保持一定的生育间隔。

    The amount of iron a mother‘‘s body uses in milk production is much less than the amount she would lose from menstrual bleeding. The net effect is a decreased risk of iron-deficiency anemia in the breastfeeding mother as compared with her formula-feeding counterpart. The longer the mother nurses and keeps her periods at bay, the stronger this effect (Institute of Medicine 1991).
    妈妈身体分泌乳汁所需要的铁量,远小于月经中失血所流失的铁量。实际的好处是母乳喂养的妈妈患缺铁性贫血的风险比配方奶喂养的妈妈低。妈妈母乳喂养时间越长,闭经的时间越长,这方面的益处就越大(Institute of Medicine 1991)。

    As for fertility, the lactational amenorrhea method (LAM) is a well-documented contraceptive method, with 98 to 99 percent prevention of pregnancy in the first six months. The natural child-spacing achieved through LAM ensures the optimal survival of each child, and the physical recovery of the mother between pregnancies. In contrast, the bottle-feeding mother needs to start contraception within six weeks of the birth (Kennedy 1989).
    至于生育能力,哺乳闭经法(LAM)是被充分证明了的避孕方法,在产后头6个月有98%-99% 的避孕成功率。通过哺乳闭经法实现自然避孕,确保每个孩子得到最佳的生存保证,以及妈妈在两次怀孕之间体力的恢复。与此相比,配方奶喂养的妈妈就必须在产后6周内开始实施有效的避孕方法。(Kennedy 1989)

    Long-Term Benefits of Breastfeeding
    It is now becoming clear that breastfeeding provides mothers with more than just short-term benefits in the early period after birth.
    母乳喂养的长期益处
    目前确定的是:母乳喂养给妈妈带来的长期益处比仅在出生后获得的短期益处要多得多。

    A number of studies have shown other potential health advantages that mothers can enjoy through breastfeeding. These include optimal metabolic profiles, reduced risk of various cancers, and psychological benefits.
    有些研究已表明,通过哺乳,妈妈们可以享受其他潜在的健康优势,包括最佳状况的新陈代谢、降低数种癌症的风险以及心理上的益处。

    Production of milk is an active metabolic process, requiring the use of 200 to 500 calories per day, on average. To use up this many calories, a bottlefeeding mother would have to swim at least 30 laps in a pool or bicycle uphill for an hour daily. Clearly, breastfeeding mothers have an edge on losing weight gained during pregnancy. Studies have confirmed that nonbreastfeeding mothers lose less weight and don‘‘t keep it off as well as breastfeeding mothers (Brewer 1989).
    生产乳汁是一个活跃的代谢过程,平均每天消耗200-500卡路里。要消耗同样多的能量,一个配方奶喂养的妈妈必须每天在游泳池来回游30圈以上,或者骑自行车爬坡一个小时。很明显,母乳喂养的妈妈在消耗孕期存储的脂肪上更有优势。研究也发现,和母乳喂养妈妈相比,非母乳喂养的妈妈减掉的体重更少,并且更难保持(Brewer,1989年)。

    The above finding is particularly important for mothers who have had diabetes during their pregnancies. After birth, mothers with a history of gestational diabetes who breastfeed have lower blood sugars than nonbreastfeeding mothers (Kjos 1993). For these women who are already at increased risk of developing diabetes, the optimal weight loss from breastfeeding may translate into a decreased risk of diabetes in later life.
    以上的发现对那些孕期患有糖尿病的妈妈尤其重要。分娩后,曾患有妊娠糖尿病的哺乳妈妈,比不哺乳妈妈的血糖水平更低(Kjos,1993年)。而对那些患糖尿病风险已经在增加的妈妈们,由于母乳喂养带来的最大体重减轻可能使后续患糖尿病的风险下降。

    Women with Type I diabetes prior to their pregnancies tend to need less insulin while they breastfeed due to their reduced sugar levels. Breastfeeding mothers tend to have a high HDL cholesterol (Oyer 1989). The optimal weight loss, improved blood sugar control, and good cholesterol profile provided by breastfeeding may ultimately pay off with a lower risk of heart problems. This is especially important since heart attacks are the leading cause of death in women.
    在怀孕前患有I型糖尿病的女性,在哺乳期常需要的胰岛素更少,因为她们的血糖水平会下降。而且母乳妈妈往往具有较高的高密度脂蛋白胆固醇(Oyer,1989年)。由哺乳带来的最大体重的降低、经改善的血糖水平和好的胆固醇状态,最终会降低心脏问题的风险。这一点尤其重要,因为心脏病突发是妇女死亡的首要原因。

    Another important element used in producing milk is calcium. Because women lose calcium while lactating, some health professionals have mistakenly assumed an increased risk of osteoporosis for women who breastfeed. However, current studies show that after weaning their children, breastfeeding mothers‘‘ bone density returns to prepregnancy or even higher levels (Sowers 1995). In the longterm, lactation may actually result in stronger bones and reduced risk of osteoporosis. In fact, recent studies have confirmed that women who did not breastfeed have a higher risk of hip fractures after menopause (Cummings 1993).
    另一个产生乳汁所需要的重要元素是钙。由于妇女泌乳时会引起钙的流失,一些健康专业人士误认为哺乳会使妇女患骨质疏松的风险增加。然而,目前的研究表明,当孩子断奶之后,哺乳妈妈的骨密度水平会恢复到和孕前相同甚至更高的水平(Sowers,1995年)。从长期来看,沁乳可能使骨骼更强壮和降低骨质疏松的风险。事实上,最近研究已经证明,没有哺乳过的妇女绝经后髋部骨折的风险更高(Cummings,1993年)。

    Non-breastfeeding mothers have been shown in numerous studies to have a higher risk of reproductive cancers. Ovarian and uterine cancers have been found to be more common in women who did not breastfeed. This may be due to the repeated ovulatory cycles and exposure to higher levels of estrogen from not breastfeeding. Although numerous studies have looked at the relationship between breastfeeding and breast cancer, the results have been conflicting. This is largely due to flaws in study design and lack of uniform definition of breastfeeding, resulting in difficulty comparing the data. (In some studies, breastfeeding has been defined as having breastfed at least once a day, while in others it is defined as exclusive breastfeeding, using no supplements or artificial nipples.) Despite this, it is now estimated that breastfeeding from six to 24 months throughout a mother‘‘s reproductive lifetime may reduce the risk of breast cancer by 11 to 25 percent (Lyde 1989; Newcomb 1994). This phenomenon may also be due to suppressed ovulation and low estrogen, but a local effect relating to the normal physiologic function of the breast may also be involved. This was suggested by a study in which mothers who traditionally breastfed on only one side had significantly higher rates of cancer in the unsuckled breast (Ing, Ho, and Petrakis 1977).
    没有母乳喂养的母亲已经在众多研究中被证明有更高的患生殖系统癌症的风险。卵巢癌和子宫癌已经被发现在没有母乳喂养的妇女中更常见。这可能是由于反复的排卵周期和不哺乳造成的高雌激素水平。虽然有很多研究讨论母乳喂养和乳腺癌之间的关系,但结果是相互矛盾的。这主要是由于研究设计的缺陷和缺乏母乳喂养的统一定义,所以结果很难相互比较。(一些研究中定义母乳喂养是一天至少一次哺乳,而其他的则定义为完全以乳房哺喂,不使用任何其他补充食物和橡胶乳头。)尽管如此,还是可以推论出在母亲的生育期中有6-24个月的母乳喂养将降低患乳腺癌的风险11-25个百分点(Lyde,1989年;Newcomb,1994年)。这一现象可能由于哺乳抑制排卵和保持较低的雌激素水平,但与乳房的正常生理功能的局部影响也可能有关。一项对传统上只用一边乳房喂养的妈妈进行的研究指出,没有喂奶的一边有较高的患癌风险(Ing,Ho,和Petrakis,1977年)

    In two studies, there appeared to be an increase in flare-ups of rheumatoid arthritis in breastfeeding mothers (Jorgensen 1996; Brenna 1994). However, in another study, overall severity and mortality of rheumatoid arthritis was worse in women who had never breastfed (Brun, Nilson, and Kvale 1995). There have been no other studies showing any detrimental health effects to women from breastfeeding. Bottom line: Breastfeeding reduces risk factors for three of the most serious diseases for women-female cancers, heart disease, and osteoporosis-without any significant health risks.
    在两项研究中发现哺乳妈妈患类风湿性关节炎有所增加(Jorgensen,1996年;Brenna,1994年)。但另一项研究表明,整体来看类风湿性关节炎的严重程度和死亡率,从未哺乳过的妇女结果更糟(Brun,Nilson和Kvale,1995年)。再无其他研究表明哺乳对妇女有不利健康的影响。所以最基本的,哺乳可以减少三项严重疾病的风险:女性癌症、心脏病和骨质疏松症,而不会增加其他健康风险。

    Psychological Issues for Breastfeeding Mothers
    How do you measure the peace of mind of having a healthy baby who is developing optimally? Where do you factor in the financial burden of formula prices and increased medical costs?
    母乳妈妈的心理获益
    如何衡量由于拥有一个健康的宝宝且成长良好而带来的心态的平和的价值?如何估算配方奶支出和医疗支出不断上涨的财务压力所带来的影响?

    Public health agencies advocate for breastfeeding because of its well-documented health advantages to babies, but they fail to convey to individual mothers and families the potential emotional impact of this very crucial infant-feeding decision. In Western society, the decision about breast or bottle is still seen very much as a personal choice based on convenience. The potential stress of living with a child with recurrent illnesses, or the loss of the unique bond that comes from breastfeeding, are often omitted from the decision-making process.
    公共卫生机构提倡母乳喂养,因为已被证实的母乳喂养婴儿的健康优势,但他们没有向母亲和家庭传递这个具有决定性的婴儿喂养选择所带来的情感作用。在西方社会,母乳喂养还是人工喂养仍被视为是基于便利性考虑的个人选择。因孩子反复生病和失去只有母乳喂养才能带来的独特亲子连接导致的潜在压力,却常常在决定过程中被忽略。

    There is much more to breastfeeding than the provision of optimal nutrition and protection from disease through mother‘‘s milk. Breastfeeding provides a unique interaction between mother and child, an automatic, skin-to-skin closeness and nurturing that bottle-feeding mothers have to work to replicate. The child‘‘s suckling at the breast produces a special hormonal milieu for the mother. Prolactin, the milk-making hormone, appears to produce a special calmness in mothers. Breastfeeding mothers have been shown to have a less intense response to adrenaline (Altemus 1995).
    除了母乳所提供的最佳营养和免疫保护,母乳喂养还有更多益处。哺乳提供了一种独有的母亲和婴儿之间的互动,一种自发的肌肤贴着肌肤的亲密和滋养。而人工喂养的妈妈必须格外努力来复制这一过程。孩子吮吸乳房令妈妈产生一种特别的激素环境。催乳素,促进乳汁分泌的激素,可以让母亲特别地平静。母乳喂养妈妈被证实面对肾上腺素的刺激,更少引起激烈的反应(Altemus,1995年)。

    This calming effect is hard to measure in a society largely unsupportive of breastfeeding such as the United States, where breastfeeding beyond the early weeks is not the norm. Mothers who try to breastfeed in this climate often experience physical and emotional problems. These problems result from a lack of breastfeeding role models among family and friends, and are compounded by the easy availability of formula and a lack of access to knowledgeable and supportive health care professionals.
    在一个大多数人不支持母乳喂养的社会,例如美国——母乳喂养超过最初几周是不常见的,这种平静的情绪效果很难衡量。在这种氛围下尝试哺乳的母亲常常遇到身体和情绪的问题。这些问题源于家庭和朋友中缺少母乳喂养的榜样,而太容易获得配方奶粉以及缺少具有知识和支持性的医疗保健专业人士也加剧了这种情况。

    Even if a mother overcomes physical problems, she may still encounter negative comments, such as “Are you still nursing?” or “Your milk may not be strong enough-why don‘‘t you add formula?” Or her employer may make it impossible for her to continue breastfeeding on returning to work. Or she may be harassed for breastfeeding in public. No wonder that few mothers get to fully experience the relaxing effects of breastfeeding.
    即使一个妈妈克服了身体问题,她可能还会遇到很多负面评价,例如“你还在喂奶吗?”、“你的奶已经不够营养了,为什么不加点配方奶呢?”或者当她回到工作岗位后,雇主可能使她无法继续母乳喂养。又或者当她在公共场所哺乳时,可能受到骚扰。难怪很少有母亲充分体验到母乳喂养对情绪的放松作用 。

    New motherhood is a time fraught with emotion. The baby blues are common, often exacerbated by lack of support and a sense of isolation. The role of breastfeeding in postpartum emotional upheavals has not been well studied, but breastfeeding mothers with depression need treatment just as much as any other mother. Such women present a unique challenge to health care professionals. Since medications may pass into breast milk, many physicians believe the safest solution is to wean the child. However, in most cases of depression, women do better if they continue to breastfeed. Unfortunately, too often physicians insist that mothers wean their child in order to take antidepressant medicines.
    做新妈妈的日子充满情绪的斗争。产后抑郁很常见,而且由于缺少支持和孤独感而加剧。在产后的情绪动荡期间,母乳喂养的作用还没有得到很好的研究,但是母乳喂养的母亲患抑郁症需要治疗的情况跟其他母亲一样。这些妈妈给医疗保健专业人士带来了独特的挑战。因为药物可能进入乳汁,所以很多医生相信最安全的方式就是断奶。但是在多数抑郁的情况中,妈妈们只要继续哺乳就会复原得快。可惜太多医生坚持妈妈需要断奶来服用抗抑郁药物。

    A review of the literature, however, has demonstrated that several antidepressants pose minimal, if any, risk to the nursing child. A mother who feels that her nursing relationship with her child is the only thing going right in her life can now continue to breastfeed while receiving appropriate medications for her depression.
    然而文献显示,已经证实一些抗抑郁药物,即使有影响乳儿的风险,机会也很少。在妈妈服用抗抑郁药物期间,当她感觉到与宝宝建立的喂养关系是她生活中唯一正确的事情,那她可以继续母乳喂养。

    Why Don‘‘t More People Know How Good Breastfeeding Is?
    Clearly, breastfeeding is good for mothers both physically and emotionally. And yet, many mothers decide to breastfeed based solely on the benefits to the baby. Breastfeeding in the context of a bottle-feeding society tends to be perceived as inconvenient and uncomfortable.
    为什么没有更多人了解母乳喂养的好处?
    很明显,母乳喂养对妈妈的身心健康都有益处。但是很多妈妈决定母乳喂养是基于对宝宝的好处。在一个以奶瓶喂养为主的社会,母乳喂养被看做是不方便和不舒服的。

    Often, mothers see breastfeeding as martyrdom to be endured for their baby‘‘s health. If they stop early, they may feel guilty about depriving the baby of some health benefits, but their guilt is often soothed by well-meaning people who reassure them that “The baby will do just as well on formula.” Perhaps if they knew that continuing to breastfeed is also good for their own health, some mothers might be less likely to quit when they run into problems.
    通常,妈妈们把母乳喂养看做为了宝宝健康的而作出的一种牺牲。如果她们过早断奶,可能为剥夺了一些宝宝健康的好处而感到内疚。但这些内疚常常得到好心人的安慰说“配方奶也对宝宝很好。”如果她们知道继续母乳喂养对她们自己的健康也有好处,也许有的妈妈在遇到问题时就不会选择断奶了。

    Many mothers are not being told how good breastfeeding is for their health. Whether out of ignorance or due to the influence of the artificial baby milk industry, many health care providers fail to inform mothers of the facts. It‘‘s time for this well-kept secret to come out. As word spreads about these little-known facts, more mothers will not merely choose to breastfeed briefly to provide early disease protection for their baby, but will continue to breastfeed, providing optimal outcomes both for their children and for themselves.
    多数妈妈没有被告知母乳喂养对她们自己身体的好处。无论是因为无知还是受到婴儿配方奶行业的影响,很多医疗保健人员没有给妈妈们提供事实真相。现在应该让这个秘密得到公开了。如果这个鲜为人知的事实得到广泛传播,会有更多妈妈不仅为了给宝宝提供早期疾病防护而进行短暂的母乳喂养,还会继续哺乳下去,为自己和宝宝获取最多益处。

    Alicia Dermer, MD, IBCLC, is Clinical Associate Professor in the Department of Family Medicine at the University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School in New Brunswick, New Jersey. She has a special interest in wellness and health promotion. As part of this interest, she has gained expertise in breastfeeding education and promotion. She successfully sat for the certifying examination of the International Board of Lactation Examiners in 1995. She lectures extensively on the subject of lactation, is actively involved in health care professional and lay education about breastfeeding, and has several publications on the subject.
    Alicia Dermer, MD, IBCLC,在新泽西州新不伦瑞克的罗伯特•伍德•约翰逊医学院、新泽西医学和牙科大学的家庭医学部任临床副教授。她对促进健康和保健方面有特别的兴趣。作为这个兴趣的一部分,她已经获得了母乳喂养的教育和宣传方面的专业知识。她在1995年成功参加国际沁乳顾问资格考试委员会的认证考试。她广泛讲授和哺乳有关的课题,积极参与有关母乳喂养方面的健康专业及非专业的教育,还出版了几本这方面的书。

    (黄寅 翻译,Shiuh-jane、Daisy审稿)

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