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.

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）

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）

这是一次去往陌生地方还带有陌生气味的旅行。刺眼的灯光，忙碌的人群。失去知觉。然后就是一个被仔细清洗过、被包裹着、与妈妈分开的婴儿。任何其他哺乳动物有了这样的开始都会拒绝自己的宝宝的。而许多妈妈都是用理智而不是发自内心去迎接自己的新生宝宝的。这不是履行自信的母职的最佳开始，不是母乳喂养的最佳开始，也不是爱的最佳开始。

陌生的环境，陌生的气味，刺眼的灯光，忙碌的人群。即便你的理智告诉你应该在医院生产，但是你的理想是在家里生产。哺乳动物的妈妈都找一个自己感觉舒服、气味熟悉、私密而安静的地方生产，这个地方她们可以掌控，而不要一个她们无法掌控的地方。因此研究一下你所有的可选择的生产方式，包括家庭分娩。如果你要离开家生产，那就请一个导乐陪伴分娩，她可以将那些讨厌的打扰和不必要的手续都打发走。你可以读一下佩姬•文森特写的《迎接宝宝的人）（“Baby Catcher”）一书。

无知觉。绝大多数哺乳动物都需要生产的知觉。如果没有知觉，那些可以让你更容易做母职的一系列荷尔蒙就被搅乱了。所有哺乳动物的新生儿—包括人类 – 一出生就会寻找并吮吸妈妈的乳头。但在硬膜外麻醉后，宝宝就不太会这样做了。如果你决定要硬膜外麻醉，就要确认术后能否得到好的帮助。如果你离开家生产，问问是否有提供服务的国际泌乳顾问。硬膜外麻醉阻碍了你正常释放内啡肽 – 一种能产生愉悦感的荷尔蒙，也是用来娩出宝宝的。另外长时间的输液会让你的乳头过于肿胀，宝宝不容易吮吸，可能会延迟你奶量的建立。你计划生产的地方补充配方奶的比例有多少？对那些没有母乳库的地方来说，这个尤其重要。不要被那些生育频道的节目所愚弄！正常的生产并不是一次医学治疗或产生剧烈疼痛的来源。它是一个自发的过程，期间孕妇根据自我感觉移动身体，感觉生产，并感觉—在—自己掌控之下。找一个支持自然生产的人来帮忙，而不是找一个告诉你“什么时候该硬膜外麻醉”的人。如果你有朋友“喜欢硬膜外麻醉”，问问她做母亲的头一个月和母乳喂养的情况。你还可以读下面的书籍来了解更多，琳达˙史密斯的《生产干预对母乳喂养的影响The Impact of Birth Interventions on Breastfeeding》，韩慈˙ 高尔的《孕妇生产指南The Thinking Woman’s Guide to a Better Birth》，或莎拉˙巴克利的《温柔生产，温柔育儿Gentle Birth, Gentle Mothering》 。

一个干净、被包裹好的婴儿。你的宝宝期待着闻你的味道，感受到你并和你待在一起。而你自己生理上期待着闻到并能感受着你的宝宝。如果你或者宝宝被洗干净并穿好了衣服，你们的本能就会被改变或者甚至忘记了。你可以阅读一下 南茜˙摩尔巴赫和凯萨琳˙坎道儿-塔科特的《母乳喂养就是这么简单Breastfeeding Made Simple》和国际母乳会的《母乳喂养的女性艺术The Womanly Art of Breastfeeding》这两本书。

让你的生产 – 象你的母乳喂养亲密关系一样 – 变成日后可以带着自豪和愉悦回忆的事情。不要让迷思和误解窃取了你和宝宝那重要的开始！但是首先，你有重要的事情要做，那就是开始阅读！

Why Your Baby’s Birth is Important

Diane Wiessinger, MS, IBCLC, LLL Leader

戴安·维欣吉 国际泌乳顾问 国际母乳会哺乳辅导

 

改编自《母乳喂养的准备：孕妇手册 》

http://store.llli.org/public/profile/797
作者：特里莎·皮特曼
翻译:于莉宛  审核：Daisy，Missy

大多数妈妈们认为母乳喂养是她们“自己”要做的事情。妈妈们明白什么时间需要再次哺乳，她们会把宝宝抱到胸前，把乳头放进宝宝嘴里，她们清楚宝宝是否含乳良好，同时也会准确把握大概什么时间宝宝已经吃得差不多了而结束喂奶。

但事实上，你的宝宝对母乳喂养的了解比大部分人所知道的都多。像其他的哺乳动物宝宝一样，他天生就具备会吃母乳的本能与技巧。（如果你见过猫妈妈与刚出生的小猫，或是小牛犊与母牛，就会知道，它们很显然会本能地寻找食物。我们的宝宝们也是一样。）

妈妈们当然也天生就具备会喂母乳的能力，并且能够跟她们的宝宝配合得非常好。人类的宝宝不像其他哺乳动物的初生幼崽在体格上那样健壮有力（比如小牛犊在出生几小时后就可以走和跑－而人类的宝宝至少在出生后一年左右是不会走路的。这是很大的差异！），所以他们需要来自妈妈更多的帮助。母牛在给小牛喂奶时仍然只需要站着不动就可以，而人类的妈妈需要做的会比这多一些，但可能没有你想像的那么多。

抱着宝宝

如果有人递给你一个烦躁不安的宝宝，你会怎么做？大部分女人会不假思索地把宝宝竖着抱起靠在胸部或肩膀上，让宝宝的肚子紧贴着她们的胸部，一只手搂在宝宝的肩后，一只手在宝宝的屁股下。这种自然而然的安抚动作同样也是宝宝开始吃奶的最佳起点。

通常的情形是宝宝会首先在你胸前依偎一小会儿，然后他们才会竖起头部，或者向下滑一点。有时父母认为这是因为宝宝的颈部肌肉还不是十分强壮，或者认为这是宝宝的一种随机的动作，但研究者经过大量的观察证明这是宝宝的故意行为。这种行为好似宝宝调整自己找准方位的一种方式：“嗯，我挨着妈妈的身体啦，让我四处看看自己在哪——是的，她的头在这，那么里面有妈妈的奶的好东西应该还要往下一点，一边一个。”

而且，事实上，如果你的宝宝饿了的话，接下来他会朝一侧或另一侧移动，小脑袋朝着妈妈的乳房。有些宝宝在做这个动作时会很大力气——他们似乎是侧着把自己甩了出去。也有些宝宝会朝一侧扭动或摆动。

有些专家认为，当我们抱起正在哭闹的新生儿，用一种我们能想到的哺乳姿势抱着（把宝宝整个身体水平地横抱在我们肚子前，头部贴着乳房），这样做实际上是很容易让宝宝感觉混乱的。新生儿本能的期望被直立抱着，在这个得到安抚的位置，他随后会以自己的方式去找到妈妈的乳房。（当然，一些月龄稍大，吃奶更有经验的宝宝则不太在意这些，一旦他们掌握了母乳喂养，他们对马上被抱到吃奶的位置一点也不介意了。）

衔乳
近年来，宝宝如何在乳房含乳受到广泛关注。护士、哺乳顾问和一些人运用多种不同的技巧来帮助妈妈们把宝宝抱在合适的位置，贴着妈妈乳房。

如今，大部分母乳喂养专家都鼓励妈妈们以“半躺式哺乳法”来开始母乳喂养。这是宝宝充分展示技巧和能力的理想做法，为实现母乳喂养带来良好开端。在本书中有更多的关于半躺式哺乳法的详细内容，但最基本要做的是：
 妈妈处于一个舒适放松的半躺式的位置。
 把宝宝肚子朝下放在妈妈的胸前。
 让宝宝自己找到妈妈的乳头开始含乳吃奶。根据宝宝的实际需要或多或少地给他以辅助。

当让宝宝在这种位置吃奶时，他向下移动到乳头，很自然地可以有良好、深入的含乳，乳头在宝宝嘴里。（而采用其他位置哺乳时，妈妈是直立坐着，宝宝要向上伸脖子去找到乳头，并且如此哺乳时宝宝更容易只含到妈妈的乳头而不是乳房。）

你不需要永远都用这种半躺式哺乳法，但在哺乳最开始的时期，它是理想的方式。它使你感到舒适和放松，宝宝可以很好地衔乳，你和宝宝一起让母乳喂养持续。

什么时候喂奶最合适
宝宝并不知道妈妈的乳房是怎样生产母乳的，但他非常清楚如何建立良好的奶量，如何调整奶量以满足自己的需求，如何在他的需求随着时间变化时改变母乳中的脂肪含量和其他营养成分。你要做的就是跟随宝宝的引导。

配方奶和母乳的一个显著差异就是，配方奶的成份一直都是相同的（当然，除非是配方奶生产商发现了一种更便宜的原料油脂并把它添加到配方奶中，这只是举例说明），而人类的乳汁成份随着每次哺乳而不同。比如，有时母乳里会多出某种特定的抗体或脂肪。母乳在傍晚或夜间时会产生一种可以帮助宝宝放松并有助于睡眠的成份。如果妈妈吃过大蒜或者有其他调料的食物，这些味道也会通过母乳传递给宝宝。我们不总是明白这些变化的目的，但显然大部分对于宝宝是非常重要的。

宝宝变换着吃奶模式来保证他所吃到的奶可以满足他的需求。假设宝宝正处于大脑的快速生长期，他需要母乳中更多脂肪来帮他发育脑细胞，频繁的短暂地吃奶会帮助他获得更高脂肪含量的母乳。或者比如，当天气很热的时候，你的宝宝体内需要更多的水份，他就会将两次吃奶的间隔时间拉长一点点，吃奶的时候也会很快地从一边换到另一边，这样的话他就可以获得一些低脂肪的母乳来解渴。

也许四周有病毒传播。你和你的宝宝都暴露在这个环境当中。当你的宝宝开始有一点不舒服时，他更频繁的吃奶，从你的母乳中尽可能多的获取抗体和免疫因子，以帮助减轻疾病对他的影响。

作为一位新手哺乳妈妈，可能会有很多次你想知道，“为什么我的宝宝今天吃奶这么频繁？”或者“哦，宝宝今天下午吃奶的频度明显比平时少，是什么原因？”这些问题通常都没有明显的答案。相信你的宝宝知道自己在做什么。他在调整母乳的成分及奶量以满足他不断变化的需求。而你所要做的就是及时识别出宝宝给的提示，他要吃时就喂奶。

现在你可以了解到为什么妈妈们会把这种时而发生的吃奶频率变化看成问题了，她们假设自己产奶不足，不够宝宝吃而给宝宝添加其他代乳品。没错，这时宝宝是能够吃饱了，但乳房没有得到需要产更多奶的信号，充盈的时间便会变慢，结果是降低产奶量。当宝宝再次回来吃奶的时候就会因为吸不到足够的奶而产生挫败感，因为其实宝宝是想通过频繁吃奶刺激乳房提高产奶量的，而不是降低产量。宝宝试图更加频繁地吃奶。妈妈就会更加确信一定是自己的奶量产生了问题（一定是奶量不够宝宝没吃饱，否则为什么她的宝宝会这么频繁地一个劲儿地想吃奶？），然后再继续增多给宝宝代乳制品的添加量。妈妈的产奶量下降的更多了。很快，妈妈的担心真的变成了事实，她真的没有足够的奶量来满足宝宝的需要了。如果她让宝宝展示自己提升奶量的能力，她本该奶量更多的。

宝宝并不是偷懒、固执、无能，也不是在拒绝你

有时候，当妈妈们在母乳喂养方面遇到了一些困难时，便会有护士、助产士、朋友、家人或者其他帮助和照顾她们母子的人对她们说，她们的宝宝太懒了，或是很固执，或是不愿意努力尝试。一些妈妈会感觉她们的宝宝在排斥她们，认为宝宝拒绝在乳房吃奶是因为不喜欢吃乳房，或者是不想去吸妈妈的奶，最糟糕的是，妈妈们有时还会误解为是宝宝不喜欢她们的妈妈！

所有这些都是不是真的！

如果你把乳房贴近宝宝而宝宝没有吃上奶，并不是因为他固执或是懒惰或是在生你的气，或是他有什么地方不对劲儿。他只是一个小宝宝。吃母乳是他天生的本性。母乳喂养对人类的生存是如此重要，因此这件事不可能被归类到只有“听话的勤快的”宝宝才会做。

“不吃母乳”的宝宝没法在母乳喂养。这不是宝宝不想吃，他是想吃母乳的。（或者他愿意吃奶如果宝宝能用成人的思维思考。他会想要母乳带给他的所有好处——与妈妈在一起的亲密感和舒适感，增加抗体和免疫力。但是他并不懂得这些。他只知道身体里的每个细胞都在告诉他去找妈妈的乳房吃奶。）那么，宝宝为什么做不到呢？有很多可能的原因：

产程中的药物使用可能会影响到宝宝寻找妈妈乳房的能力，影响到宝宝的含乳，以及影响到宝宝吮吸和吞咽的协调性。母乳喂养，这件从某些角度来看很简单的事情，需要宝宝具备一些复杂的能力。

宝宝有一些负面的经历，使得他想要保护自己。或许是在出生时宝宝在被清理呼吸道和口腔时巨大的吸力给他造成了创伤，于是他一直避免自己再度张开嘴。又或者是在宝宝刚刚出生的时候他被带到妈妈胸前吃奶的位置，有人把他的头部推向妈妈的乳房，而他的头部可能在产程中有过疼痛的经历，这让他误以为那种可怕的经历又要开始，所以他也会害怕，会产生抗拒。

宝宝意识到有些事的不同。可能宝宝出生后的第一、二次喂奶都是使用奶瓶来喂的。他是个聪明的小家伙：他很快明白了在他饥饿时一直在努力寻找的食物来源自那个硬硬的塑料东西里。现在你再给他提供一个有着小小的柔软乳头的软软的温暖的乳房，他感觉很好，但他却不会知道妈妈乳房同样可以提供美味的食物给他。

还会有一些生理原因会造成宝宝母乳喂养困难。一些宝宝在吃奶时不能很有效地活动舌头（舌系带短）；还有一些宝宝可能由于生产而疼痛或僵硬。这些宝宝需要更多的帮助和耐心来解决这些问题，从而使他们能够成功地母乳喂养。你的宝宝，他从一出生就认识并爱妈妈。当你跟他说话时，即使周围充斥着多种繁杂的声音，他会朝你声音的方向转头。在乳垫上挤一点点你的母乳，他马上会把他的小脑袋转向有你乳汁的方向，而不会去找有其他妈妈乳汁的乳垫。是的，他想要到妈妈这吃奶。帮助你进行母乳喂养的人的最重要的工作就是让你和宝宝的母乳喂养成为可能，而不是批评宝宝或者给宝宝贴标签。宝宝一直是在尽力做到最好，你也是一样。

我第一次在国际母乳会的聚会上听到这样一句话“相信你的宝宝，相信你自己”。这句话当时给了我莫大的鼓励，并且直到现在它仍然是一句好建议。是的，在整个母乳喂养过程中会有时候你需要更多的帮助和支持，但你和你的宝宝对母乳喂养都已经所知甚多。

特里莎•皮特曼成为国际母乳会哺乳辅导近34年，撰写过许多关于母乳喂养及其他育儿话题的书籍和杂志文章。她是《母乳喂养的女性艺术》一书第八版的合著者，经常在各种会议上发言。她是四个成年子女（都是母乳喂养长大的）的妈妈，同时又是6个母乳喂养孩子的祖母。特里莎将她所出版本书的部分收益作为款项捐赠给了加拿大国际母乳会。

What Your Baby Knows About Breastfeeding

Most mothers imagine breastfeeding is something they do. They figure out when it’s time to feed again, they bring the baby to the breast, they put the nipple in baby’s mouth, they make sure the latch is good, and unlatch the baby when the feeding is done.
The truth is, your baby knows a lot more than most people think about breastfeeding. He’s born with the instincts and skills to make breastfeeding work, just like other baby mammals are. (If you’ve ever seen a cat with newborn kittens or a baby calf with its mother, you’ll know that they are clearly hardwired to find food. Our babies are too.)
Of course, mothers also have built-in skills for breastfeeding, and those mesh nicely with the baby’s. Human babies aren’t as physically strong and capable as some others (that baby calf can walk and run within hours of birth—your baby won’t be walking for year or so. That’s a big difference!), so they need more help from their mothers. Mama cow just has to stand still while her baby latches on; you may need to do a bit more than that! But maybe not as much as you think.

Holding Your Baby
If someone hands you a fussy baby, what do you do? Most women, without even thinking about it, will hold the baby vertically against their chests or shoulders, with baby’s tummy against their chest, one hand behind baby’s shoulders and the other behind his bottom. This natural position for soothing is also the perfect spot for the baby to begin feeding.

What typically happens is that the baby will first snuggle into your chest a little, and then will lift up his head, or even throw his head back. Sometimes parents think this is because the baby’s neck muscles aren’t very strong, or imagine it’s just a random movement, but researchers who have observed many babies tell us that it’s deliberate. It seems to be part of the way the baby orients himself: “Hmm, I am in contact with my mother’s body, let’s look around and see where I am—yup, there is her head, so those nice things with the milk in them should be a little lower, one on either side.”

And, in fact, if your baby is hungry, what he’ll do next is move to one side or the other, heading towards the breast. Some babies do this very vigorously—they practically throw themselves sideways. Others squirm or wiggle to one side.

Some experts feel that when we pick up a crying newborn and hold him in what we think of as a breastfeeding position (horizontally across our tummies, head toward the breast) that we are actually confusing the baby. His instinctive expectations are to be held vertically, in that soothing position, so that he can find his own way to the breast. (Of course, an older, more experienced baby is less concerned—once they’ve mastered breastfeeding, they don’t mind at all being moved into breastfeeding position right away.)

Latching On
In recent years, a lot of attention has been paid to how babies latch on to the breast. Nurses, lactation consultants, and others have used a variety of techniques to help mothers get their babies properly positioned and attached to the breast.

Today, most breastfeeding experts encourage mothers to start with what some call “laid-back breastfeeding.” It’s ideal for letting the baby show off his skills and abilities, and for getting breastfeeding off to a good start. There’s more detailed information about this in the book, but basically here’s what you do:
• Get in a comfortable, semi-reclining position.
• Put the baby, tummy-down, on your chest.
• Let the baby find the breast and latch on. Help a little or a lot, as needed.

When the baby latches on in this position, he is coming down onto the nipple from above, and will naturally get a good, deep latch, with the nipple well back in his mouth. (In other positions, with the mother sitting upright, the baby is reaching up to the nipple, and it’s easier to just latch on to the nipple, not the breast.)

You don’t have to use this position forever, but during the early days, it’s ideal. It’s comfortable and restful for you, your baby will latch on well, and you’re working together to get breastfeeding going.

When to Feed
Your baby doesn’t know the mechanics of milk production and how the breast functions, but he knows exactly how to establish a good milk supply, how to adjust the milk supply to meet his needs, and how to change the fat content and other components of the milk as his needs change over time. All you have to do is follow his lead.

One of the significant differences between formula and human milk is that formula is always the same (unless, of course, the manufacturer finds a cheaper type of oil to add to it, for example), while human milk changes at every feeding. Sometimes it has more of a certain type of antibody, for example, or more fat. Milk produced in the evening or night has components that help to relax the baby and encourage sleep. If the mother has eaten garlic or foods with other flavors, those flavors come through in the milk. We don’t always understand the purpose of all these changes, but many of them are clearly important for the baby.

The baby varies his feeding patterns to make sure the milk he gets is meeting his needs. Let’s say he’s going through a period of rapid brain growth, when he needs more of the fats in the milk to build brain cells. Frequent, short feedings will bring him more of the high-fat milk. Or let’s say it’s a hot day and your baby needs more liquids. He may go a bit longer between feedings, and then want to switch quickly from one breast to the other, so he gets more of the lower fat milk to quench his thirst.

Maybe there is a virus going around. You and your baby have both been exposed to it. As your baby starts to feel a bit ill, he nurses more often to maximize the antibodies and immune factors he will get from your milk to reduce the impact of the illness.

As a new nursing mother, there may be many times that you wonder, “Why is my baby nursing so often today?” or “Hmm, what’s causing him to nurse less often this afternoon than usual?” Often there is no obvious answer. Trust that your baby knows what he’s doing. He’s adjusting the components of your milk and your milk production to meet his everchanging needs. All you have to do is recognize his cues and feed him when he asks.

You can see why it’s a problem when mothers react to these frequency days—as sometimes happens—by assuming they are no longer making enough milk for their baby and giving him a supplement instead. Now he’ll be full, true, but instead of getting signals to make MORE milk, the breasts will fill up more slowly and respond by making LESS milk. The baby gets more frustrated when he goes back to the breast because he was trying to increase milk supply, not decrease it. He tries to nurse even more often. The mother is more convinced than ever that something is wrong with her milk supply (why else would her baby be nursing all the time?), and increases the supplement. Her milk production drops even more. And soon her concern becomes reality, and she doesn’t have enough milk to satisfy her baby. She would have, though, if she’d let her baby demonstrate his skill at increasing milk production.

Your Baby Is Not Lazy, Stubborn,Incompetent, or Rejecting You

Sometimes mothers who are having some difficulties breastfeeding are told—by nurses, midwives, friends, family, and others who are helping or supporting them—that their babies are lazy, or stubborn, or not trying. Sometimes mothers feel that their babies are rejecting them, that they refuse to take the breast because they don’t like it, or don’t want to breastfeed, or, worst of all, that they don’t like their mothers.

NONE OF THESE THINGS ARE TRUE!If you offer your baby the breast and he doesn’t latch on, it’s not because he’s stubborn or lazy or mad at you. Or because there’s something wrong with him. He’s a baby. He is hardwired to breastfeed; breastfeeding is so important to the survival of the human species that it couldn’t possibly be relegated to something only “compliant and hard-working” babies do.

A baby who “won’t” breastfeed can’t breastfeed. It’s not that he doesn’t want to, he does. (Or he would if he was able to think that way. He’d want all the good things that breastfeeding offers—the closeness and comfort, the optimal development, the antibodies and immune support. But he doesn’t know about those things. All he knows is that every cell in his body tells him to find the breast and get milk.)So why can’t he? Well, there are many possible reasons:

• Medications given in labor may be affecting his ability to find the breast, latch on, and coordinate sucking and swallowing. Breastfeeding, while simple in some ways, requires some complex abilities on the baby’s part.

• He’s had some negative experiences and is trying to protect himself. Perhaps he had deep suctioning of his mouth and airways at birth and found that traumatizing—so he’s avoiding opening his mouth at all. Or perhaps the first few times he was held in a breastfeeding position, someone pushed his (possibly sore from the birth) head into the breast, and he’s afraid that will happen again.

• He’s learned something different. Maybe his first feeding or two was given via bottle. He’s a smart kid: he quickly figured out that food comes from those firm plastic things, and that’s what he’s looking for when he’s hungry. Now you offer him a soft, warm breast with a smaller, softer nipple. He thinks it’s nice, but has no idea that this could also be a food source.

• There are some physical issues making breastfeeding hard for him. Some babies can’t move their tongues effectively (tongue-tied); others have some pain or stiffness due to the birth. They need some help and patience to resolve these problems, so they can breastfeed successfully.

Your baby, right from the start, knows and loves you. Talk to him, even in a room with a dozen other voices, and he’ll turn toward the sound of your voice. Express a little of your milk onto a breast pad, and he’ll turn his head towards it rather than a breast pad with some other woman’s milk on it. Yes, he does want to breastfeed. The job of people who are helping you with breastfeeding is to make it possible—not to criticize him or label him. He really is doing the best he can, and so are you.

One of the phrases I heard at my first La Leche League meeting was “trust your baby, trust yourself.” It helped me a lot then, and it is still a good piece of advice today. Yes, there will be times when you need extra help and support, but you and your baby both already know a lot about making breastfeeding work.

Teresa Pitman has been a La Leche League Leader for nearly 34 years and has written many magazine articles and books about breastfeeding and other parenting topics. She’s one of the co-authors of The Womanly Art of Breastfeeding, 8th Edition, and frequently speaks at conferences. She’s the mother of four grown children (who were all breastfed) and the grandmother of six (also all breastfed). Teresa is donating a portion of any proceeds she receives from the new book to La Leche League Canada.

翻译：鲁鹭. 审校：Missy，戎锦，Daisy

妈妈们常常对宝宝出牙会如何影响母乳喂养关系感到好奇。有时我们听到的说法是担心宝宝会咬妈妈，或出牙会导致喂奶变得不舒服。有些妈妈甚至会考虑断奶。世界卫生组织（WHO）建议母乳喂养持续最少两年。同样，美国儿科学会（AAP）建议母乳喂养持续至少一年，之后则由宝宝和妈妈的共同意愿来决定。大部分宝宝会在第一年里长出第一颗牙齿，不少妈妈可能想知道长牙期该如何进行哺乳。

当宝宝正确地含乳时，他的嘴唇外翻、他的牙龈在乳晕（环绕乳头的深色区域）的后方施力，这是我们理解这一问题的重点。他的下牙被舌头覆盖，因而完全接触不到妈妈的乳晕。正因为如此，一个正确衔乳、积极吃奶的婴儿不会咬人。然而，如果宝宝只含住了乳头，他就会咬住乳头使妈妈感到疼痛.。良好的哺乳姿势和含乳技巧能避免被咬的疼痛。

许多妈妈发现真正的挑战发生在婴儿牙齿萌出的活跃期，而非牙齿完全萌出后。出牙期，宝宝会感到明显不适，他们有时会调整姿势，或改变含乳方式，以避免碰到牙龈上的痛点。这就导致妈妈的乳头出现短暂疼痛或不适。以下是一些可能有用的建议：

❖喂奶之前：

◆给宝宝提供一块凉的、湿的毛巾或者冷藏过的磨牙玩具来咀嚼。

◆如果宝宝目前有吃固体食物，给他一个冻过的面包圈（或其他硬、冷的食物）。给宝宝任何食物时，都要密切关注，避免发生窒息。当食物开始变得潮湿或出现碎裂时，把食物拿走。

◆轻轻用干净的手指按摩宝宝的牙龈。

◆在使用非处方药品来轻度麻醉牙龈缓解不适前咨询宝宝的儿科医生。这些产品可能也使宝宝的舌头，偶尔也包括妈妈的乳晕感到麻木，给哺乳造成困难。

❖喂奶时：

◆试试不同的哺乳姿势，并确保宝宝吃奶时，他的体重能得到稳妥的支撑。

◆每次哺乳都确认宝宝已经正确衔乳。温柔地提示宝宝衔乳前要把嘴巴张得很大。

◆在宝宝对你的乳头用力之前，他得把舌头移开以免咬伤自己。一位善于观察的妈妈能及时将手指塞进宝宝的嘴角，这样被咬住的就是手指而非乳头。

◆在母乳会网站阅读其他关于乳房被咬的建议。

❖喂奶之后：

◆可用凉水冲洗乳头，因为有的妈妈感觉宝宝在出牙期增加的唾液会使乳头不适。

◆有的妈妈感觉涂一些专为母乳妈妈研制的100%羊毛脂膏会有帮助。

有时，宝宝的新牙萌出会以其他形式造成妈妈的困扰。妈妈可能发现乳晕上有宝宝的牙印，或宝宝在含乳或松开乳头时，牙齿刮擦到妈妈的乳晕。如果这情况发生在你的身上，下面的建议可能有用：

◆确认宝宝的嘴巴大大张开并且良好地含乳。

◆确认宝宝姿势良好，他的体重得到了很好的支撑。有时宝宝重心不稳、下坠会拉扯乳头，并造成上述问题。

当宝宝长牙后，一些妈妈会引入鸭嘴杯。宝宝通常喜欢咬鸭嘴，有些宝宝会在吃奶时，就会象咬鸭嘴一样咬乳房。如果你怀疑这种情况发生了，以下是一些可以尝试的措施：

◆暂停使用鸭嘴杯。

◆试着使用敞口杯（只用于装水，因易于清洁）

◆试着给普通杯子配上吸管和盖子使用。

许多妈妈发现，当宝宝进入快乐和挑战并存的学步期后，在宝宝出牙期间继续哺乳是母职工具箱里增加的一件宝贵的工具。如您尝试过上述建议后，仍感觉遇到困难，请联系当地的国际母乳会哺乳辅导，她将在您宝宝成长的里程碑时期里，给您提供更多的支持和信息。

更多信息资源《母乳喂养的女性艺术》，全新第8版，著者：国际母乳会，是对母乳妈妈而言最完整的母乳喂养信息库。

 

Do I Need to Stop Breastfeeding When My Baby Gets Teeth?

Mothers are often curious about howteething will affect their breastfeeding relationship. Sometimes there isconcern that baby may bite, or that teething will cause breastfeeding to becomeuncomfortable. Some mothers may even consider weaning. The World HealthOrganization (WHO) recommends that breastfeeding continue for a minimum of twofull years, and similarly, the American Academy of Pediatrics (AAP) recommendsthat breastfeeding continue a minimum of one year, and as long thereafter asbaby and mother mutually desire. Some mothers may wonder how theserecommendations can be applied when most babies cut their first teeth duringtheir first year.

It is important to understand that when ababy is latched on to the breast correctly, his lips are flanged and his gumsland far back on the areola (the dark area around the nipple). His bottom teethare covered by his tongue and do not come in contact with the mother’s areolaat all. For this reason, a baby who is latched on correctly and activelynursing cannot bite. However, if a baby is latched onto the nipple only, thebaby can clamp down and cause pain to the mother’s nipple. Good positioning andlatch-on techniques can prevent painful bites.

Many mothers find the real challenge occursduring the time that the baby is actively cutting teeth, rather than after theteeth have erupted. Babies can experience significant discomfort due toteething and will sometimes alter their positioning or latch to avoid hittingthe sore spots on their gums. This can cause mothers temporary nipple sorenessor discomfort. Here are some suggestions that might help:

Before Nursing:

◆Offer your baby a cold,wet washcloth or a cold teething toy to chew on.

◆If baby is eatingsolids, offer a frozen bagel (or other hard, cold food). As with any food,watch baby closely to avoid choking, and discard the food once it begins to getsoggy and disintegrate.

◆Try massaging yourbaby’s gums with a clean finger.

◆Before usingover-the-counter gum numbing preparations, consult your baby’s doctor. Theseproducts may also numb baby’s tongue, and occasionally mother’s areola, makingbreastfeeding difficult.

During Nursing:

◆Try different nursingpositions and ensure that the weight of your baby’s body is well supported whenhe is latched on.

◆Make sure that babylatches on well every time. Gently remind him to open wide before latching on.

◆Before baby will clampdown on the nipple, he has to move his tongue out of the way or risk bitinghimself. The observant mother can be ready to stick a finger in the corner ofhis mouth so the clamping is done on the finger and not the nipple.

◆Read more suggestionsfor dealing with biting in our Biting FAQ.

After Nursing:

◆Consider rinsing yournipples with cool water, as some mothers find that baby’s increased saliva fromteething irritates the nipples.

◆Some mothers find ithelpful to apply a 100% lanolin preparation intended for nursing mothers.

On occasion, baby’s new teeth can irritatein other ways. A mother may find that baby’s teeth leave indentions on herareola, or baby’s teeth scrape as he latches on or off. If this happens to you,it might help to:

◆Assure that baby openswide and latches on well.

◆Assure that baby ispositioned well, and his weight is well supported. Sometimes the weight of babycan drag down the nipple and contribute to the problem.

Around the time that a baby gets teeth,many mothers introduce a sippy cup. Babies often chew on the spouts of thesecups and some babies might transfer this same mouth activity to the breast. Ifyou suspect this is happening, here are a few things to try:

◆Take a break from thecup for a while.

◆Try an open cup (wateronly for easy clean up).

◆Try a cup with a strawand lid.

Many mothers find that continuing to nurseas their baby cuts teeth adds a priceless tool to their toolbox when the joysand challenges of toddlerhood begin. If you are still experiencing difficultiesafter trying the above suggestions, contact a local La Leche League Leader whocan offer more support and information during this milestone in your baby’slife．

Resources for Additional Information

THE WOMANLY ART OF BREASTFEEDING, NEW 8thEdition, published by La Leche League International, is the most completeresource available for the breastfeeding mother.

THE BREASTFEEDING ANSWER BOOK (2003), p.478

American Academy of Pediatrics PolicyStatement on Breastfeeding and the Use of Human Milk

World Health Organization Global Strategyon Exclusive Breastfeeding