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  • 母乳奇妙的味道 The Curious Taste of Human Milk


    关注“国际母乳会LLL”了解更多母乳喂养资





    对母乳的好奇之心

    生孩子之前,我对哺乳知之甚少。仅有的体验是,我在一岁前喝的是母乳但我这段非凡的体验并不普遍,我身边的很多家庭并没有母乳喂养。


    作为一名护士在产科轮科期间,我对人类乳汁和母乳喂养的机制产生了好奇心。在产科病房里,宝宝们努力去含乳,他们甜蜜地享受着乳汁,这些都唤起了我的这种好奇心。


    寻找乳头并有意识地去吃奶新生儿与生俱来的本能—他们的觅食、吸吮和抓握反射共同作用,保证了他们子宫外的早期生命健康


    我还注意到新生儿满怀热情地含乳以及吸吮时的兴奋激动。他们对含乳的渴望是无与伦比的暖人心房。从那时起,我就很想知道母乳的味道。








    哺喂第一个孩子

    后来我生下了第一个孩子小R开始母乳喂养时没有任何问题。我完全按照如何正确含乳的视频来做,以确保我做得没有任何瑕疵(好像就只有这一种方法)。


    我的儿子长得很健壮,跟我在护理学院照护过的那些婴儿很相似,那些生理反射帮助他满怀愉悦、热情和迷恋地去吸吮乳汁。


    随着他长大,那些吞咽声和肢体动作,包括部的扭动以及手的挥舞都表明他吃得很满足。那他品尝到什么滋味了呢?又是什么让他这么开心?








    哺喂第二个孩子

       两年后,我生下了二儿子小O。这一次出师不利。我专门找到了一位愿意让我尝试剖宫产后阴道分娩 (VBAC)的医生,结果没成功,我被紧急推入手术室实施剖宫产。


       后来,我得了产后子宫内膜炎;同时,涨奶又导致了乳腺炎。我筋疲力尽,痛苦不堪。


       尽管如此,小O吃奶吃得相当好,看到他长得好我也很满足。和小R一样,我很关注小O的动作、声音和吞咽,还有顽皮的小手、嘴以及头部的扭动。这些都表明他吃了一顿很满意的大餐


       这时,我的大儿子小R也表现出了我曾经有过的好奇心。他用最甜美的声音问我:“妈妈,你的母乳是什么味道呢?”他的好奇心让我猝不及防。








    解锁母乳成分

    就在那一刻我急中生智。我们干嘛不尝尝我的母乳呢?它很安全,它来自我的身体呀。小O以此为食,而小R也因为吃了足够的乳汁而茁壮成长。


    R兴奋地睁大了眼,他对着我咧嘴笑,那是一个学龄前幼儿给父母的最开心的笑。


    我们都尝了一点儿。我没想到它会如此美味、让人放松。小R也认为它是甜甜的奶。他笑着走开了,继续玩自己的。而我则依旧很好奇它那甜美的味道,因此决定进一步了解母乳的成分。

    那么事实是这样的:母乳富含对婴儿有益的必需天然营养成分。我最近在美国国立卫生研究院 (NIH) 的平台上找到一项研究,详细解释了各个成分及其相关的益处。


    这是一项2021年的研究,标题为《人类母乳的成分和对人类健康的功效:从营养成分到微生物组和微核糖核酸》当然,这是一篇冗长的科学文献。


    不过,它重点强调了以下几点,简而言之,说明了为什么母乳味道甜美。母乳由以下成分组成:

    · 87-88%  水

    · 7%   碳水化合物(乳糖)

    · 3.5-4.5% 脂肪

    · 1%   蛋白质


    这些都是促进婴儿生长发育的纯天然的营养成分。当然,这项研究论述得很详实,但我的观点是,碳水化合物/乳糖的比例很高,就赋予了母乳天然的甜杏仁味。这就是我们看到婴儿吃奶时的热情、迷恋、兴奋和满足的原因。


    每种成分都发挥一个特定的作用来使婴儿受益。乳糖不仅赋予了甜味来安抚婴儿,而且也是人类大脑早期发育所必需的。婴儿需要很高的能量来增加体重、发育大脑、帮助吸收。


    乳糖提供了必需的能量,与此同时,蛋白质和脂肪在全身系统的生长发育中起着至关重要的作用。在这个关键的成长阶段,所有这些成分都在满足儿童健康的免疫和营养需求方面发挥着重要作用。


    此外,有证据表明,人类的乳汁还有助于肠道菌群定植、增强免疫力和预防疾病。这真是互惠互利的双赢!


    乳汁甜美的味道和香气令婴儿愉悦,同时母乳也在每一阶段促进了他们的生长和发育。我很开心我尝过它,也很满意自己为孩子们的健康做出了贡献。我希望你也享受自己的哺育之旅,相信甜蜜的乳汁可以塑造一个健康的孩子。



    The Curious Taste of Human Milk



    I didn’t know much about lactation before I had children. The only fact was that my mother had nursed me during my first year of life. A community of breastfeeding family members did not surround me to normalize this phenomenal experience. During the postpartum rotation in nursing school, my curiosity about human milk and breastfeeding dynamics started. The babies in the postpartum unit attempting to nurse and the sweet commonality among the ones put to the breast ignited that curiosity. It was the inborn knowledge of the newborn looking for a nipple and the awareness to nurse – their rooting, sucking, and grasping reflexes working together to give them a healthy start outside the womb. I also noticed the excitement of a newborn latching and sucking with so much enthusiasm. The thirst for latching was nothing other than heartwarming. For the first time, I wondered about the taste of human milk.









    Then I gave birth to my firstborn, R, who did not have any issues getting started breastfeeding. I even followed videos on how to latch correctly, videos that gave me validation that I was doing it just right (as if there is just one way to do it.) My son was thriving, and similar to those babies I had once cared for during nursing school, R was doing the same — reflexes aiding him to take in breast milk with delight, gusto, and passion. The audible gulps, body movements, head nodding, and playful hands indicated satisfaction as he grew. What was he tasting? What was making him happy?









    Two years later, I gave birth to my second son, O. It was a rough start. I had specifically researched to find a doctor who would let me try for a vaginal birth after cesarean (VBAC). It didn’t work, and I was rushed to the operating room for a cesarean. Afterward, I developed postpartum endometritis, a uterine infection. Simultaneously, engorgement led to a bout of mastitis. I was exhausted and in pain. Despite that, O nursed pretty well, and I was content to see him thrive. Like R, I noticed O’s movements and sounds, the gulps, and the playful hands, mouth, and head rotation. All indicated a satisfactory meal. This time around, R, my eldest, showed the same curiosity I once had. In the sweetest of voices, he asked, “Mama, what does your milk taste like?” He caught me off guard with his curiosity.









    At that moment, I came up with an idea. We would try my milk. Why not? It’s safe; it’s mine. O is living on it, and R was a thriving baby due to its abundance. R’s eyes widened with excitement, and he gave me the most delighted grin a preschooler could give a parent. We both tasted a little. I did not expect it to be so tasty and soothing. R agreed that it was sweet milk. R smiled, walked away, and continued with his play. On the other hand, I was left intrigued as it tasted sweet with a dash of delicacy, and I decided to find out more about the composition of human milk.

    So here is the thing: human milk is full of essential natural components that benefit the baby. I recently found a study on the National Institutes of Health (NIH) platform explaining the components and associated benefits in detail. It was a 2021 study entitled “Human Breast Milk Composition and Function in Human Health: From Nutritional Components to Microbiome and MicroRNA.” Sure, it’s a scientific piece that goes into scientific ramblings. Nevertheless, it highlights the following points that showcase, in a nutshell, why human milk is sweet tasting.


    Human Milk is composed of the following:

    ·87-88% Water

    ·7% Carbs (Lactose)

    ·3.5-4.5% Fats

    ·1 % Proteins


    These are all-natural components that support the growth and development of a baby. Of course, the study went into much more detail, but my point is that a high percentage is from the carb lactose, which gives human milk that natural sweet almond taste. This is the reason we see the gusto, the passion, the excitement, and the satisfaction when the baby nurses.


    Each component has a specific role to fill to benefit the baby. Lactose not only gives the sweetness that brings comfort to the baby, but it’s needed in early human brain development. Babies have high energy demands to increase weight, develop the brain, and aid absorption. Lactose provides necessary energy, while, concurrently, proteins and fats play a crucial role in the growth and development of all systems. All these components play a critical role in fulfilling the immunological and nutritional needs for a child’s well-being during this crucial growth phase. In addition, evidence has shown that human milk also contributes to intestinal colonization, immunization, and prevention of diseases. It’s a win-win situation.


    The sweet taste and aroma are enjoyable to babies, while human milk promotes their growth and development in every phase of the breastfeeding journey. I am glad I tasted it and feel content knowing I contributed to the well-being of my boys. I hope you are also enjoying your journey, knowing the sweet-tasting milk is in the works of building a healthy child.


    END


    作者:以色列 罗拉·拉万

    翻译:美国母乳会

    审稿:传艳, Lynn, Marien

    编辑:幸宝





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    本篇文章来源于微信公众号: 国际母乳会LLL

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  • 伴侣和支持者如何提供帮助HOW PARTNERS AND SUPPORTERS CAN HELP


    关注“国际母乳会LLL”了解更多母乳喂养资讯


    支持者的重要性

    伴侣和其他亲人往往很难知道该如何帮助哺乳期的母亲。虽然喂养关系存在于母亲和宝宝之间,但伴侣和其他人也可以做许多事情来给予支持。


    对于哺乳期妈妈来说,有一个可以一起庆祝小胜利的伴侣、家庭成员或朋友会有很大的帮助。比如,宝宝能舒适地衔乳了、或者宝宝能很好地喝奶了,这些都值得庆祝。


    同样,当新手妈妈面临挑战时,听到伴侣或其他亲人鼓励的话语对她来说意义重大。妈妈的支持者所扮演的重要角色就是在妈妈哺育她的婴儿的同时去“哺育”她。



    图|国际母乳会中国图片库(图文无关)


     1.母乳喂养的妈妈为什么需要支持

    产后恢复需要时间,在最初的几天和几周里,母乳喂养的妈妈在增强信心和技能的同时,要是身边有其他人能提供支持,这会对妈妈很有帮助。


    即便母亲和婴儿都具有本能来帮助引导他们开始母乳喂养,但母乳喂养也是一项在哺乳妈妈之间传授、代代相传的需要学习的技能。


    在不断学习这些技能的同时,母乳喂养的母亲通常也受益于她们所爱的人的支持。


    图|国际母乳会中国图片库(图文无关)


    2.如何帮助您的伴侣

    每个新手妈妈会希望得到不同形式的帮助,因此与伴侣讨论她们希望获得怎样的支持对她们来说很重要。以下是一些建议:


    ☝在喂奶期间给伴侣提供水和零食

    ☝说一些鼓励的话,比如“你做得很好”、“坚持住,你行的”。 

    ☝如果还需要更多的支持,替伴侣主动联系国际母乳会哺乳辅导国际认证泌乳顾问(IBCLC)

    ☝想办法在任何困难的时刻带来幽默和欢乐

    ☝当哺乳妈妈在洗澡或出去喘口气时,直接皮肤贴着皮肤地抱着婴儿,用背巾或背带抱着婴儿。

    ☝当你在陪伴你的伴侣喂奶时,趁这个机会与她沟通和交流。

    做家务:负责购物、买菜、做饭、预约、洗衣服、 打扫卫生等杂事。

    管理访客:限制访客数量和停留时间,以避免干扰母乳喂养。

    ☝告诉您的伴侣哪些事情进展顺利,并在任何挑战中提供情感支持

    ☝给婴儿洗澡、换尿布、婴儿穿衣洗净/烘干婴儿衣物等。

    ☝随着计划的改变灵活变通,例如,考虑安全的同床睡眠,或母婴同睡(让婴儿在几臂距离之内与妈妈同室不同床睡觉)。

    ☝帮助年长的兄弟姐妹适应有了弟弟/妹妹生活。

    ☝记住:一个吻、一句好听的话,或一杯茶都能创造奇迹!


    图|国际母乳会中国图片库(图文无关)
    母乳喂养基础知识

    · 人类的乳汁经历了几千年的进化,为人类婴儿量身打造,就像其他哺乳动物的乳汁为喂养它们的婴儿进化而形成一样。

    · 母乳容易消化。婴儿需要按需频繁进食;在24小时内哺乳至少8-12次是很正常的,这对建立健康的奶量很重要。

    · 在出生后三天到六周之间,一个健康的足月婴儿如果能吃到足够的母乳,他每天会有5- 6片湿尿片(如果是布尿布的话则会更多),和至少3次排便,大小相当于一枚一元人民币的硬币。

    · 母乳喂养是一个完美的供需系统——婴儿喝的母乳越多,身体分泌的乳汁就越多。这就是为什么补充配方奶粉会减少母乳供应量的原因。

    · 皮肤贴皮肤抱着婴儿有利于Ta们的发育,可以改善乳汁供应,也可以帮助父亲或和其他照顾者与婴儿建立亲密连接。

    · 更多信息,请访问www.muruhui.org。

    图|国际母乳会中国图片库(图文无关)


    支持母乳喂养的其他方式

    ☞了解母乳喂养的基础知识:参考上文的建议“母乳喂养基础知识”,考虑参加线上产前母乳喂养课程,并通过国际母乳会的《母乳喂养的女性艺术》第8版或者可靠的网络资源,比如www.muruhui.orgwww.llli.org,来获取相关信息。


    告知医院工作人员,母乳喂养对您的家庭很重要。寻求可能需要的其他帮助来实现您家庭的目标。

    ☞支持、保护和促进:让您的伴侣知道您支持母乳喂养的决定,并且通过您的行动和语言来表达您相信这是正常和重要的。如果朋友或家人不支持你们的喂养选择,确保您传达了您的对她的支持并认可

    她的努力,这样您的伴侣就不会感到受打击和被孤立。只要孩子和母亲希望母乳喂养持续下去,就支持他们。


    ☞通过国际母乳会LLL官网(www.muruhui.org)或公众号、视频号,查询母乳喂养资讯和母乳妈妈聚会信息。同伴支持已经被证明能帮助提高母乳喂养的成功率。我们也鼓励和欢迎更多的爸爸或照顾宝宝的其他家人一起参加聚会。


    图|国际母乳会中国图片库(图文无关)


    参考资源

    https://www.lllc.ca/sites/default/files/How Partners and Supporters Can Help-11.pdf





    HOW PARTNERS AND SUPPORTERS CAN HELP


    THE IMPORTANCE OF SUPPORT PEOPLE

    Partners and other loved ones can often struggle to know how to help the mother, or nursing parent. Although the breastfeeding relationship exists between the nursing pair, there are many things that partners and others can do to provide support.


    It can make a big difference to a nursing parent to have a partner, family member or friend who can celebrate the little victories like achieving a comfortable latch or watching the baby drinking well. 


    Similarly, it can mean a lot to a new mother to hear encouraging words from the baby’s father or her partner or other loved ones when she is experiencing challenges. An important role for support people is to nurture the mother while she nurtures the baby.

    1.WHY BREASTFEEDING PARENTS NEED SUPPORT

    Recovering from birth takes time and in those early days and weeks it can be very helpful to have others around who can provide support while the breastfeeding parent grows in confidence and skill. 


    Both mothers and babies have reflexes that can help guide them, but breastfeeding is also a learned skill passed from parent to parent and generation to generation.


    While all of this learning is taking place, breastfeeding parents usually benefit from the support of their loved ones.


    2.HOW TO HELP YOUR PARTNER

    New nursing parents will want help in different ways so it can be valuable for them to discuss with their partners how they want to be supported. Here are some ideas:

    Bringing water and snacks during breastfeeding sessions

    ☝Saying encouraging words like, “You’re doing a wonderful job” and “Hang in there, you can do it.”

    ☝Offering to contact a La Leche League Canada Leader or professional lactation consultant (IBCLC) for additional support. (www.lllc.ca/get-help)

    ☝Finding ways to bring humour and fun into any difficult moments

    ☝Holding the baby skin-to-skin and/or carrying the baby in a sling/wrap while the nursing parent takes a shower or gets a bit of fresh air

    ☝Keeping your partner company during nursing sessions, taking the opportunity to connect with each other.

    ☝Taking care of errands and chores: grocery shopping, meal preparation, booking appointments, laundry, cleaning, etc.

    ☝Managing visitors: limiting the number of visitors and length of stay so that breastfeeding is not disrupted

    Reminding your partner of what is going well, and providing emotional support amidst any challenges

    ☝Bathing the baby, changing diapers, getting the baby dressed, taking care of baby’s laundry, etc.

    ☝Being flexible as plans change, for example, considering safe bed-sharing or having baby within arms reach by co-sleeping

    ☝Helping older siblings adjust to life with a new baby

    ☝Remembering that a kiss, a kind word or a cup of tea can do wonders!


    BREASTFEEDING BASICS


    Human milk evolved over millennia for human babies, just as other mammals’ milk evolved to feed their babies.

    • Human milk is easy to digest. Baby needs to feed frequently and on cue; a minimum of 8-12 times in a 24-hour period is normal and builds a healthy milk supply.

    • Between three days and six weeks, a healthy full term baby who is getting enough milk produces 5- 6 wet diapers (more if cloth) and at least 3 bowel movements the size of a $2 coin per day.

    • Breastfeeding is a perfect supply and demand system— the more breastmilk the baby drinks, the more milk the body makes. This is why supplementation with formula can reduce a mother’s milk supply.

    • Holding a baby skin-to-skin is good for baby’s development, can improve milk supply, and can also help the father, or other parent, and baby bond.

    • Find out more at www.lllc.ca or [www.muruhui.org].


    OTHER WAYS TO SUPPORT BREASTFEEDING



    ☞Know the basics of breastfeeding: (See Breastfeeding Basics, above) Consider taking LLLC’s online Prenatal Breastfeeding course and reading reliable information online at www.lllc.ca and www.llli.org, for example, or in LLLI’s The Womanly Art of Breastfeeding, 8th ed.

    ☞Tell hospital staff that breastfeeding is important to your family. Find the extra supports you may need to meet your family’s goals.

    ☞Support, protect and promote: Let your partner know that you support the decision to breastfeed or chestfeed and that you believe this is normal and important through your actions and your words. If friends or family are not supportive of your feeding choices, ensure that you communicate your support and recognize her efforts so that your partner does not feel undermined and alone. Support the breastfeeding relationship for as long as the child and mother want it to last.

    ☞Find your local LLLC Group or online meeting at www.lllc.ca. Peer-to-peer support has been proven to help increase breastfeeding success. Some Groups even offer Couples’ meetings that non-breastfeeding partners can attend.


    END

    翻译:LLL Canada加拿大母乳会

    审稿:Julia, Lynn, Marien

    编辑:幸宝、沐凡




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  • 鹅口疮 THRUSH


    关注“国际母乳会LLL”了解更多母乳喂养资讯


    编者注


    本文中的“鹅口疮”包括婴儿口腔、臀部的酵母菌病和母亲乳房、乳头、阴道的酵母菌感染,狭义的鹅口疮”通常仅指婴儿口腔酵母菌病。

    2022年3月更新

    鹅口疮(念珠菌病或酵母菌病)是一种由念珠菌引起的真菌感染。念珠菌通常栖息于口腔、胃肠道和阴道。它几乎可以生长在身体的任何部位。


    念珠菌喜好温暖、黑暗、潮湿的环境,如乳房、乳头和婴儿臀部。妊娠、疾病、抗生素使用等因素都可能导致念珠菌过度增生。这就是我们说的“鹅口疮”。


    鹅口疮疼痛又恼人,但是它通常不会导致严重疾病。在治疗感染的同时可继续母乳喂养。


    了解鹅口疮的原因可以帮助您减少念珠菌在体内的生长。如果您怀疑您可能患有鹅口疮,请咨询医护人员。

    01
    乳头/乳房疼痛的其它原因


    在确定是鹅口疮之前,需要考虑乳头疼痛的其他原因。如果在没有鹅口疮症状的情况下出现疼痛,则应首先考虑引起疼痛的其他原因。乳头疼痛最常见的原因是哺乳姿势和含乳问题。其他原因可能包括:

    ·舌系带和唇系带过短

    ·乳头损伤

    ·细菌感染

    ·雷诺氏现象或血管痉挛

    ·乳管堵塞或乳腺炎

    ·皮肤问题:接触性皮炎、湿疹、牛皮癣(银屑病) 

    ·过敏

    ·疱疹

    ·毒葛皮炎

    ·皮癣

    ·吸奶器使用不当


    此外,如果您在最初的几个月后出现奶量减少的情况,乳汁流动缓慢可能会导致婴儿含乳不良。这时的乳头疼痛可能会被误诊为鹅口疮。

    02
    症状和诊断

    医护人员通常根据症状就可诊断鹅口疮,很少需要进行诊断性检查。酵母培养试验通常不可靠。如果出现至少两种症状,则鹅口疮的可能性很大。


    如果妈妈的乳头受损和/或最近服用过抗生素,则患鹅口疮的可能性增加。


    首先出现的症状通常是乳头疼痛,有时也涉及到乳房疼痛。疼痛可能发生在喂奶过程中,并在两次喂奶之间持续存在。泵奶时通常也很痛。疼痛性质一般为烧灼痛或刺痛或扎痛。


    乳头和/或乳晕的症状可能包括:

    · 发痒、起皮屑 

    · 皮肤发亮

    · 皮肤发红,有炎症,有时伴有小水泡

    · 白斑(罕见)


    婴儿也可能有鹅口疮症状,例如:

    ✦舌头、牙龈和颊粘膜上有白色斑点。擦拭后可呈红色,甚至可能出血。(注意:婴儿口腔里经常会有白色的奶渣,但奶渣仅出现在舌头上。)

    ✦尿布疹则呈现红色或带有红斑,且常规治疗无效。

    ✦喂养时婴儿表现烦躁、胀气或不适。这可能会导致婴儿频繁含乳又不断松开乳房。


    其他可能的症状:

    ✦乳房深部的疼痛

    ✦当前或近期患阴道酵母菌感染


    03
    治疗


    ①药物

    医护人员一般会开具局部抗真菌药物(软膏或乳膏) ,如咪康唑、酮康唑或克霉唑,用于乳头外用。


    有些则会开具一种含有抗真菌药物(咪康唑粉)、抗菌药和皮质类固醇的乳膏配方。该处方有时被称为“杰克·纽曼医生通用乳头膏”或“APNO霜”。


    如果局部治疗无效,则可能会开具氟康唑等全身性处方或口服抗真菌药物。


    遵照处方用药很重要。即使症状在治疗周期结束之前消失,也要按照所需要的周期(通常为两周或更长时间)完成治疗。


    更重要的是,即使婴儿没有任何症状,在您治疗自己的同时也要治疗婴儿。治疗通常包括咪康唑、克霉唑、氟康唑或制霉菌素的口服滴剂或口服凝胶。


    值得注意的是,制霉菌素的效果明显不如其他抗真菌药物。制霉菌素仅有三分之一的鹅口疮治愈率。


    如果婴儿有与鹅口疮相关的尿布疹,医护人员可能会开一种臀部抗真菌软膏或乳膏。


    ②替代疗法

    自然疗法对有些妈妈可能有效,可以咨询自然疗法医生(ND)寻求指导。


    一汤匙醋与一杯水混合的溶液可能会有效,尤其是作为辅助方案与其他治疗同时进行时。每次喂奶后,用干净的布或棉球涂抹在乳头和乳晕 (乳头周围的深色区域)上,并让乳头自然风干。


    可以口服益生菌补充剂,有助于抑制消化道中的念珠菌。为了取得最佳效果,应在症状消失后继续服用益生菌两周。有些人甚至发现吃含有有益菌的天然酸奶很有帮助。


    ③家庭护理措施

    任何潮湿或接触婴儿唾液及母乳的物品都可能含有酵母菌。为了预防酵母菌感染,以下方法可能会有所帮助:

    ✦经常洗手,每天更换手巾或用纸巾擦干双手。

    ✦每天将所有玩具、安抚奶嘴、奶瓶奶嘴、泵套件零件、乳头保护罩以及任何接触到您乳房或婴儿口腔的物品煮沸20分钟。即使每天都煮沸,安抚奶嘴奶瓶奶嘴磨牙玩具也应每周更换一次。

    ✦胸垫、胸罩、布尿布和毛巾每次使用后,用洗涤剂在热水中清洗。在水中加入一杯漂白剂或醋也能有效杀灭酵母。物品可在烘干机烘干或在阳光下晒干。

    ✦酵母菌感染可能以多种不同形式出现,例如阴道酵母菌、股癣、手指/脚趾指甲酵母菌感染和尿布疹。宠物也可能感染酵母菌。治疗家庭中任何形式酵母感染可以降低再次发生鹅口疮的几率

    ✦有些人发现饮食改变(如减少糖分摄入),有助于减少酵母生长。自然疗法医生(ND)或注册营养师可提供指导。

    ✦酵母菌感染期间挤出的乳汁无需丢弃。







    THRUSH

    UPDATED MARCH 2022

    Thrush (candidiasis or yeast) is a fungal infection caused by an overgrowth of the Candida organism. Candida normally inhabits the mouth, gastrointestinal tract and vagina. It can grow in almost any part of the body. Candida likes warm, dark, moist areas such as the breasts, nipples and baby’s bottom. Pregnancy, illness, antibiotic use and other factors can lead to an overgrowth of Candida yeast. When this happens it is often called“thrush”.

    The symptoms of thrush are annoying and often painful. However, they do not cause severe illness. Breastfeeding can continue while treating the infection. Understanding the causes of thrush can help you to decrease the growth of Candida yeast in your body. Consult a healthcare provider if you think you might have thrush.

    01

    Other Causes of Nipple/Breast Pain

    It is valuable to consider other causes of nipple pain before concluding it is thrush. If pain is present in the absence of thrush symptoms then other causes of the pain should be considered first. The most common cause of nipple pain is positioning and latch problems. Other causes may be:

    ◆tongue-tie and lip-tie

    ◆nipple injury

    ◆ bacterial infection

    ◆Raynaud’s phenomenon or vasospasm

    ◆plugged ducts or mastitis

    ◆skin issues: contact dermatitis, eczema, psoriasis

    ◆allergies

    ◆herpes

    ◆poison ivy

    ◆ringworm

    ◆improper use of a breast pump


    Also, if you experience a decrease in milk supply after the first couple of months, the slower milk flow can cause your baby to latch poorly. Your sore nipples may be misdiagnosed as thrush.

    02

    Symptoms and Diagnosis

    Healthcare providers usually diagnose thrush based on the symptoms present. Rarely are diagnostic tests done. Yeast culture tests are often unreliable. Thrush is more likely if there are at least two symptoms present.


    There is an increased likelihood for thrush if the mother has damage to the nipples and/or has recently taken antibiotics.


    The first symptom is usually pain in the nipples and sometimes also in the breasts. The pain may begin during a feeding and continue between feedings. Pumping is usually painful as well.


    BABY MAY ALSO HAVE SYMPTOMS OF THRUSH SUCH AS:

    ✦White patches in the mouth on the tongue, gums and cheeks. They  will appear red or may even bleed when scraped. (Note that babies  often have milk residue that is found only on the tongue.)

    ✦Diaper rash that is red or contains red spots and does not respond to usual treatments.

    ✦Fussiness or gassiness or discomfort while nursing. This may cause the baby to pop on and off   the breast frequently.


    PAIN IS OFTEN DESCRIBED AS:

    ✦lBurning

    ✦lStabbing

    ✦lShooting


    OTHER POSSIBLE SYMPTOMS:

    ✦Pain deep in the breast

    ✦A current or recent vaginal yeast infection


    SYMPTOMS ON THE NIPPLES AND/OR AREOLAE CAN INCLUDE:

    ✦Itchy, flaky skin

    ✦Shiny skin

    ✦Red, inflamed-looking skin sometimes with small  blisters

    ✦White spots (rarely)

    03

    TREATMENT

    ①Medications

    Healthcare providers often begin by prescribing a topical antifungal (ointment or cream) such as miconazole, ketoconazole or clotrimazole to be used on the nipples. Many will begin by prescribing a cream formulation containing an antifungal called miconazole powder, in addition to an antibacterial and a corticosteroid. This prescription is sometimes called “Dr. Jack Newman’s All-Purpose Nipple Ointment” or “APNO cream”. If topical treatment has been tried and is unsuccessful, a systemic or oral antifungal like fluconazole, may be prescribed. It is important to follow the prescription instructions. Treatment is usually needed for two weeks or longer, even if the symptoms disappear sooner.


    It is important to treat your baby at the same time as yourself even if your baby has no symptoms. Treatment usually consists of oral drops or an oral gel of miconazole, clotrimazole, fluconazole or nystatin. It should be noted that nystatin is significantly less effective than other antifungals. Nystatin cures thrush in only about one third of cases. If your baby has a diaper rash associated with thrush, the healthcare provider may prescribe an antifungal ointment or cream for your baby’s bum.


    ②Alternative Treatments

    Natural remedies may be effective treatments for some mothers. Parents can consult with a naturopathic doctor (ND) for guidance.


    A solution of one tablespoon of vinegar mixed with one cup of water may be effective particularly when used with other treatments. Apply to the nipples and areola (darkened area around nipple) with a clean cloth or cotton ball after each feeding. Allow the nipples to air dry.

    Oral supplements of probiotics contain good bacteria. They can help to limit the Candida in the digestive tract. For best results, probiotics should be taken for two weeks after the end of your symptoms. Some people even find eating natural yogurt containing good bacteria to be helpful.


    ③Home Care Measures

    Any items that are damp or come into contact with your baby’s saliva or your breast milk may contain yeast. To prevent or treat another yeast infection, the following can be helpful:

    ✦Wash your hands and baby’s hands frequently. Replace the hand towel daily or use paper towels to dry your hands.

    ✦Boil for 20 minutes daily all toys, pacifiers, bottle nipples, pump kit parts, nipple shields and anything else that comes in contact with your breast or the baby’s mouth. Even with daily boiling, pacifiers, bottle nipple/teats and teethers should be replaced weekly.

    ✦Wash breast pads, bras, cloth diapers, and towels in hot water with detergent after every use. One cup of bleach or vinegar added in the rinse water can also be effective in killing yeast.

    ✦Items should be dried in a hot dryer or line dried in the sun.

    ✦Yeast infections appear in many different forms, for example: vaginal yeast, jock itch, finger/toe nail yeast infections, and diaper rash. Even pets can have a yeast infection. Treating any and all yeast infections in the family can reduce chances of thrush happening again.

    ✦Some people find dietary changes such as reducing sugar intake helpful to decrease yeast growth. A naturopathic doctor (ND) or registered dietician can provide guidance.

    ✦Milk expressed during an overgrowth of yeast does not need to be discarded.


    References 

     La Leche League Canada, (2022). Thrush Info Sheet. http://www.lllc.ca/sites/default/files/Thrush+Info+Sheet-6.pdf

     Berens, P., Eglash, A., Malloy, M., et al. (2016). ABM Clinical Protocol #26: Persistent pain with breastfeeding. Breastfeeding Medicine, 11(2).

     Hale, Thomas (2021). Medications and Mothers’ Milk (19th ed.). New York, NY: Springer Publishing Company.

    Morbacher, Nancy (2020). Breastfeeding Answers (2nd ed.). A rlington Heights, IL: Nancy Morbacher Solutions, I nc., 726-31.

    Newman J. (2021) Candida Protocol. International Breastfeeding Centre. https://ibconline.ca/information-sheets/candida-protocol/

     Wambach, K. (2021). Breast- related problems. In K. Wambach & B. Spencer (Eds.), Breastfeeding and Human Lactation (6th ed., pp. 281-312). Burlington, MA: Jones and Bartlett Learning.



    END

    翻译:LLL Canada加拿大母乳会

    审稿:Julia, Lynn, Marien

    编辑:幸宝、沐凡





    设“星标”
    即时收到最新资讯


     

      中国移动手机和宽带用户可访问

    muruhui.com 或muruhui.cn  

    获取更多资讯

    欢迎转发,点赞,在看,让更多母乳妈妈受益!

    本篇文章来源于微信公众号: 国际母乳会LLL

  • 如何知道婴儿是否吃到了足够的母乳 How to Know Your Baby is Getting Enough Milk


    关注“国际母乳会LLL”了解更多母乳喂养资讯





    该预期哪些情况?


    湿尿布:

    • 宝宝出生后的第一天或第二天,每天可能只有一、两片湿尿布。

    • 但会在接下去的2-3天内增加。

    • 第4天后,婴儿应该每天至少有4片非常湿的尿布(如果使用布尿布则更多)。

    • 第6天,您的宝宝应该每天至少有6片非常湿的尿布。


    排便:

    • 婴儿在第一天或第二天排出胎粪,这时宝宝排出的是墨绿色、柏油样的粪便。

    • 第三天,转变为绿色的过渡性粪便。

    • 第五天,婴儿开始每天至少排便三次,每次至少有一个1元硬币(直径约2.5厘米)那么大。粪便通常非常稀,颜色为金黄色,常带有奶瓣。

    • 五周后,婴儿排便频率可能会降低,但每次排便的量会增多。


    婴儿体重:

    体重下降
    如果母乳喂养顺利

    婴儿在出生后的最初3-4天内体重会下降5%至7%


    剖腹产出生的婴儿通常比顺产的婴儿体重减轻得更多


    此外,在分娩前最后2小时内接受静脉输液的母亲所生的婴儿,平均而言比没有接受输液的母亲所生的婴儿体重减轻得更多。

    体重减轻8%至10%对一些婴儿来说可能是正常的。但是,建议应由医护人员对母亲和婴儿进行观察,以评估母乳喂养的情况。





    体重增加
    一旦您的泌乳开始增加

    通常在第三天或第四天,宝宝的体重可能会开始增加。

    婴儿应该在10-14天恢复到出生体重。

    此后,大多数母乳喂养的婴儿每周平均增重5至8盎司(约200克 ),

    或在头四个月每月增重1.5至2磅(约900克 )。

    这里建议的体重增加是平均值;在喂养良好的前提下,一些婴儿增重会更多,而另一些婴儿会较少。 


    如果您的婴儿增重低于平均水平,您可以与国际母乳会(LLL)哺乳辅导或国际认证泌乳顾问(IBCLC)讨论增加乳汁摄入的方法。他们都可以提供改进含乳和/或增加奶量的建议。


    在考虑补充配方奶粉之前,您可能希望对宝宝进行评估,以确定是否存在舌系带过短的可能。舌系带过紧可能会限制婴儿的舌头运动,使其更难获得足够的乳汁。


    来源:国际母乳会中国图片库


    频繁喂奶:

    婴儿需要频繁的母乳喂养,通常每隔1.5至3小时喂奶一次。这个时间间隔指的是从这一次喂养开始到下一次喂养开始的时间。


    婴儿通常在24小时内平均需要喂奶8到12次。早期频繁母乳喂养有助于建立您的奶量。


    婴儿在第一侧乳房吃奶的时间可能较短,而在第二侧吃奶的时间可能更久,但也可能反过来。即使您的宝宝看起来已经喝饱了,每次喂奶时提供双侧乳房仍然很重要。 


    婴儿有自己的吃奶规律:

    • 有些婴儿间隔吃奶的时间比较规律

    • 有些则非常不规律

    • 还有些婴儿需要密集喂食,这意味着他们经常吃奶几个小时,然后睡上好几个小时。


    充足的奶量是建立在跟随婴儿发出的喂养“信号”上的,而不是靠定时喂养来实现。这些信号可能包括:

    • 舔嘴唇

    • 焦躁不安

    • 寻乳(将头转向乳房)

    • 或吃手。

    • 哭泣是一种饥饿的晚期信号。




    宝宝在吃奶的迹象的吮吸指征

    到第3天或第4天,您的乳房通常充满了乳汁。在快速吮吸几秒钟后,您的乳汁就会开始流出。此时您可能会听到规律的吞咽声。当然,许多妈妈从来没听到过吞咽的声音。


    当婴儿在吞咽后呼气时,妈妈们经常会听到“咔”声或一股气流声。您也可以观察宝宝的下巴,看是否有吃奶的迹象。


    吮吸时,婴儿的下巴会上下移动。当宝宝喝了一大口母乳后,吞咽时下巴会向下移动并有一段更长时间的“停顿”。


    来源:国际母乳会中国图片库


    通常,婴儿会休息几秒钟,然后继续这种“吮吸-下巴向下-暂停”的模式。如果宝宝喝了很多奶,您会注意到您的乳房变得更软或不太饱满了。 



    有时,妈妈会认为自己的奶不够给孩子吃,或者认为孩子没有吃到足够的奶。您可以仔细观察宝宝的喂养规律和行为,确保宝宝有效喂养并吃到足够的奶。了解宝宝喝到足够的奶的这些迹象很重要。 

    第6天时:

    • 宝宝的体重在增加。 

    • 宝宝在24小时内至少有6片湿尿布。 

    • 宝宝在24小时内有3-5次大便。 

    • 粪便至少有1元硬币那么大。 

    •  宝宝在不睡觉时会保持警觉和活跃。 

    • 喂奶后,乳房感觉更柔软。 

    • 当宝宝从一侧乳房吃奶时,乳汁可能从另一侧乳房漏出。


       




    一些常见的错误警报


    • 乳房突然显得柔软起来。一旦最初的胀满感消退,这是经常发生的情况。这并不意味着您没有产生足够的母乳;这仅仅意味着您供应的奶量已经适应了宝宝的需求。 

    • 在两次喂奶的间歇乳房不再漏奶。这是表明您的奶量已与宝宝的需求保持一致的另一个迹象。有些妈妈甚至在产后头几个月里还会继续漏奶;而有些人则很少有这种情况。漏奶与您产生的母乳量无关。

    • 您的宝宝可能会经常哭闹。许多婴儿每天都有一段烦燥的时间,而这与饥饿无关。您将学习如何安抚您的宝宝。有些婴儿需要大量的刺激和活动,另一些则需要安抚和温柔的对待。如果烦躁的婴儿在您给他喂奶时平静下来,这表明他通过哺乳得到了安抚,而不是没有吃饱。 在每次观察到宝宝的喂养信号及时喂奶有助于满足宝宝的需求,并保持良好的乳汁供应。 

    • 您的宝宝会突然想要更频繁地喂奶,或者在喂完奶后不久好像又饿了。婴儿在出生后的头三个月(大约3周、6周和3个月时)里会经历几次“猛长期”。在这些时候,他们似乎想一直喝奶,这种情况会持续几天。这是婴儿促进母乳供应量以满足其需求的一种方式。 

    • 您的婴儿哺乳的时间突然缩短,吃每侧乳房的时间可能缩短至5分钟左右。随着婴儿月龄的增长,他们可以更有效地吸出乳汁。这是一个表明母乳喂养顺利的好的迹象,只要婴儿的体重在预期范围内增加即可。

    • 有时候,由于健康问题或其他并发症,婴儿并没有表现出适当的体重增加的所有迹象。如果您对奶量或婴儿的状况感到担忧,请寻求帮助。父母经常能注意到别人不会注意到的细微变化。


    国际母乳会哺乳辅导可以为您提供所需的信息、支持和鼓励,以实现您的婴儿喂养目标。欲了解更多信息,请访问www.muruhui.org 。 如果您的婴儿体重增长缓慢,请让医生、助产士或护士检查您的婴儿是否有健康题。 他们可以观察婴儿在妈妈乳房上吃奶的状态并提出建议。或者他们会将您转诊至IBCLC进行哺乳咨询。您的宝宝可能需要经常称重,来验证这些建议是否有效。


    第一天
    新生儿的胃不能延展


    在产后初期少量频繁的喂养有助于您的婴儿过渡到母体外的生活。

    到第3天,胃开始更容易地扩张。大约在同一时间,在第3天到第5天之间, 您的身体开始产生更多的乳汁。这是多么完美的匹配!


    尿、粪便和体重增加



    How to Know Your Baby is Getting Enough Milk

    What to Expect

    Wet Diapers:Your baby may have only one or two wet diapers per day during the first or second day after birth. This will increase over the next 2-3 days. After day 4 a baby should have at least four really wet diapers per day (more if you use cloth diapers). By day 6 your baby should have at least six heavy wet diapers per day.

    Bowel Movements: Babies pass meconium, the greenish-black, tarry first stool, over the first day or two. By the third day, the colour changes to a greenish transitional stool. By the fifth day, babies begin having at least three bowel movements per day, each at least the size of a $2 coin (2.5 cm). The stools will typically be very loose and bright yellow in colour, often with a seedy appearance. After five weeks of age, babies may tend to have less frequent but larger bowel movements.

    Baby’s Weight: When breastfeeding is going well, a baby loses between 5% to 7% of birth weight during the first three or four days. Babies born by cesarean birth usually lose more weight compared to babies born vaginally. Also, babies born by mothers who received IV fluids within the final two hours before birth lose more weight, on average, than babies of mothers who do not receive such fluids. A weight loss of 8% to 10% may be fine for some babies. However, it is recommended that mother and baby be seen by a healthcare provider to evaluate the breastfeeding.

    Once your milk supply becomes more plentiful, usually on the third or fourth day, expect your baby to begin gaining weight. Babies should regain their birth weights by the time they are 10 to 14 days old. After that, most breastfed babies gain an average of five to eight ounces (200 grams) per week or one-and-a-half to two pounds (900 grams) a month for the first four months. The weight gains suggested here are averages; some babies who are feeding well will gain more, some less. If your baby is gaining less than the average, you can discuss ways to increase milk intake with a La Leche League (LLL) Leader or International Board Certified Lactation Consultant (IBCLC). Either can offer suggestions to  improve the latch and/or increase your milk supply. Before considering supplementation, you may want to have your baby evaluated for a possible tongue tie. A tongue tie, or tight frenulum, can restrict the baby’s tongue movement and make it harder to get enough milk.

    Frequent Feedings: Babies breastfeed frequently, often every one-and-a-half to three hours. Feeds are timed from the start of one feed to the start of the next. Typically babies have an average of eight to twelve feeds in 24 hours. Frequent breastfeeding in the early days helps to establish your milk supply. Baby may feed for a shorter time on the first side and longer on the second or the other way around. Even if your baby seems finished, it is important to offer both breasts at each feeding.

    Babies have their own feeding patterns. Some feed at regular intervals. Others feed very irregularly. Some babies cluster feed. This means they nurse very often for a few hours and then sleep for several hours. A good milk supply is established by following your baby’s feeding cues, not scheduling feedings. Cues may include licking lips, restlessness, rooting (turning head towards breast) or mouthing hands. Crying is a late hunger cue.


    Signs that Baby is Drinking


    By day 3 or 4 your breasts are often full of milk. After several seconds of rapid sucking, your milk will start flowing. At this time you may be able to hear regular swallowing. However, many mothers don’t hear swallowing at all. Often parents can hear a “kah” sound, or a puff of air, when their baby breathes out after swallowing. You can also look at your baby’s chin for signs of drinking. A baby’s chin moves up and down when sucking. When your baby is drinking a mouthful of milk the chin will drop for a longer “pause” while swallowing. Often babies rest for a couple of seconds before continuing a pattern of “sucks – dropped jaw – pause. If your baby drinks a lot of milk, you will notice that your breast feels softer or less full. See 
    Positioning and Latching.

    Parents sometimes think they do not have enough milk for their babies, or they think  that their babies are not getting enough milk. You can carefully watch your baby’s feeding patterns and behaviour to ensure your baby is feeding effectively and getting enough milk. It’s important to know the signs that your baby is getting plenty to drink. See Low Milk Production for more information.


    By day 6:

    • Baby is gaining weight.

    • Baby has at least 6 wet diapers in 24 hours.

    • Baby has 3-5 stools in 24 hours.

    • Stools are at least the size of a $2 coin.

    • Baby is alert and active when not sleeping.

    • Breasts feel softer after a feeding.

    • Milk is leaking from one breast while your baby is feeding on the other.
       

    Some common false alarms:

    • Breasts suddenly appear to be soft. This frequently happens once the initial feeling of fullness subsides. It does not mean you are producing insufficient milk; it simply means that your production has adjusted to your baby’s needs.

    • Breasts no longer leak between feedings. This is another sign that your milk supply is in tune with your baby’s needs. Some mothers continue to leak even after the early months; others seldom leak. Leaking is not related to how much milk you are producing.

    • Your baby seems fussy. Many babies have a fussy time every day that is not related to hunger. You will learn what works to comfort your baby. Some babies need lots of stimulation and activity. Others need soothing and gentleness. If your fussy baby settles down when you offer him the breast, it is a sign that he is comforted by nursing, rather than not getting enough to eat. Breastfeeding each time your baby cues helps meet the baby’s needs and maintains a good milk supply.

    • Your baby suddenly wants to nurse more often or seems hungry again soon after being fed. Babies go through several “growth spurts” during the first three months (at approximately 3 weeks, 6 weeks and 3 months of age). At these times they seem to want to nurse all the time for a few days. This is one way babies increase mothers’ milk supplies to meet their needs see Growth Spurts and Frequent Feeding Days.

    • The time your baby spends nursing suddenly decreases, perhaps down to five minutes or so at each breast. As babies get older, they can become very efficient at removing milk. This is a positive sign that breastfeeding is going well, as long as your baby is gaining weight in the expected range.

    Occasionally, because of health problems or other complications, a baby does not show all the signs of appropriate weight gain. If you have concerns about your milk supply or how your baby is doing, seek out help. Parents often notice subtle changes that others may not. La Leche League Canada Leaders can provide you with the information, support and encouragement you need to meet your infant feeding goals. Find out more at www.LLLC.ca

    If your baby is gaining slowly, have a doctor, midwife or nurse check your baby for health issues. They can observe baby feeding at breast and make suggestions. Or they may refer you to an IBCLC for a lactation consultation. Your baby may need to be weighed frequently to see if the suggestions help.


    参考资源:

    How to know your baby is getting enough milk (lllc.ca)



    END

    原文:加拿大母乳会

    翻译:加拿大母乳会

    审稿:Julia, Lynn, Nannan

    编辑:沐凡




     

      中国移动手机和宽带用户可访问

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    获取更多资讯








    设“星标”
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      中国移动手机和宽带用户可访问

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    欢迎转发,点赞,在看,让更多母乳妈妈受益!

    本篇文章来源于微信公众号: 国际母乳会LLL

  • 妈妈的故事|在聚会中成长

    关注”国际母乳会—中国—LLL了解更多母乳喂养资讯!


    在聚会中成长
    breastfeeding story 

    图|国际母乳会中国图片库(图文无关)


    因为奶很好吃



    上个周末,早上还没全醒,我就出门了。那天我参加了国际母乳会的月聚会并且积极参与话题的讨论。


    我说话一般都是短句。所以那天在谈到“宝宝为什么想继续吃奶、不想离乳”时,只说了一句因为奶很好吃”。


    参加聚会的每个阿姨听了都朝我笑。我想,她们喜欢我说的话。


    我非常高兴。因为我在逐渐长大,会的本领也越来越多。而且仍然可以经常吃到奶。


    奶让我感觉甜美又安慰,尤其是在我不开心或者不舒服的时候。




    母乳聚会帮我保住了夜奶



    在聚会上吃奶,对我来说已经是去年的事了。那时我还是个两岁多的小宝宝呢。现在我可是三岁多的大哥哥了,通常只在家里吃奶。


    现在,妈妈总会带我一起玩或做各种事。一忙起来,我很容易忘记要吃奶这事,但睡前我一定会记得的!


    听妈妈说,我们都是已经参加了两三年母乳会聚会的孩子喽。


    她跟别的妈妈介绍自己的时候,总说她是在我七八个月大时第一次来参加聚会的。

    那会我晚上老是想吃奶,她睡不好有点烦呢。而爸爸又担心我睡得不好会耽误长身体。


    真感谢她勇敢的迈出那一步去参加聚会,一直顶着熊猫眼给我继续喂夜奶。




    聚会让妈妈和我都很开心


    我喜欢跟妈妈一起去参加聚会在那个小房间里有时还会碰到几个和我差不多大的小朋友呢。

    我感觉到她非常期待每个月能见到那些总是笑眯眯、从来不批评我们的阿姨们。她心情好,我的心情也好。


    那里似乎是我们唯一不会被人问“还在喂奶吗?”的地方。在那里妈妈说她总是得到鼓励。



    图|国际母乳会中国图片库(图文无关)



    而我也喜欢在聚会场地走走逛逛,到处看看。我可是个安静宝宝,不会吵到妈妈开心聊天的。


    去年的一次聚会里,闲逛的我看到Missy阿姨朝我伸出手臂,果断的一屁股坐在她怀里,妈妈说我看起来一脸自豪。



    活动丰富的聚会



    我最喜欢跟妈妈一起去参加那些熟悉的阿姨和宝宝们也都在的“玩”的活动。比待在房间里两个小时有意思多了。


    我和妈妈去草地上参加过野餐、爬过山,到有些阿姨家做客。


    去年这个时候,2岁2个月的我还帮忙吹了生日蜡烛呢,而且吹了两次!虽然妈妈说本来是要所有小朋友一起吹的。那是母乳会厦门小组两岁的生日蜡烛,可我离那么近,吹蜡烛又那么好玩,怎么等得及啊?


    每年的五月都是妈妈打扮的漂漂亮亮带我去拍哺乳照的时候。她说最近几年流行拍哺乳照,希望能留下一些纪念。



    图|国际母乳会中国图片库(图文无关)



    虽然我越来越不喜欢吃奶的时候有人拿相机对着,但是妈妈喜欢,我就配合一下吧。如果她邀请我多吃一顿奶,我是不会拒绝她的!我觉得,在等待拍照时,有人一起玩、能吃东西、能看书也挺不错的呀。


    今年拍完照,我听到妈妈和其他几个阿姨在聊天:“不知道这些孩子们明年还吃奶吗?”看来她们这就开始想明年拍照的事了。



    有安全感才更酷



    每当我在聚会上经常听到“奶”字,都觉得特别安心。在那儿聊喂奶的事好像特别让那些阿姨们放心。


    当有人问妈妈什么时候要给我断奶,妈妈总是会跟他们讲喂奶的好处,还有她自己的体会。


    当有人对我说,你都这么大了,应该不要再吃奶时,我通常都很酷的保持沉默或者走开去别的地方玩。


    我知道不管他们说什么,妈妈都会跟我想到一起的,只要她觉得我真的还想吃奶,就愿意尊重我的想法。


    我觉得我妈妈才是最酷的!当然,我们去参加聚会的这三年也过的很酷!



    期待分享你的故事

    我们非常期待母乳喂养的妈妈们与我们分享你在哺乳期间的故事。


    特别是:


    • 如何解决乳头疼痛、乳管阻塞、频繁哺乳、肠绞痛、早产儿、疲劳或者婴儿慢性健康问题的;


    • 你在慢性疾病(如糖尿病或高血压)治疗期间是如何进行母乳喂养的;


    • 你为一岁以上孩子的哺乳经验,你如何用爱心引导学龄前或更大的孩子。



    你的故事的篇幅大约为600-1000字。


    在讲述你的经历时,请注意平衡细节的描述与感受的分享。


    为了让你的文章更动人,请在文章中插入你的孩子或全家的彩色照片。


    如果你的文章被选出发表,所有版权属于国际母乳会。


    我们将会推荐发在我们的微信微博,或是母乳会中文会刊,或翻译成英文发到国外的相关刊物。


    请投稿至:assistant@muruhui.org


    请在电子邮件中注明你的全名和通讯地址



    作者:Missy, Kenan

     编辑:沐凡


    END


    欢迎转发,点赞,在看,让更多母乳妈妈受益!

    本篇文章来源于微信公众号: 国际母乳会LLL

  • 乳腺炎 Mastitis


    关注“国际母乳会LLL”了解更多母乳喂养资讯





    2022年更新

     (以下文章是母乳喂养医学会临床指南#36《乳腺炎谱系》2022修订版中的信息汇总)

    乳腺炎是一系列与乳房炎症相关的症状。您可能从未患过乳腺炎,或者您可能发现自己需要采取些措施来预防其复发。 
     

    当您产奶时,在众多输送母乳的小导管(即乳腺管)中,有一些会变得过度充盈。您可能偶尔感到不适或触痛,但婴儿哺乳后或您挤出一些乳汁后就会缓解。


    如果您注意到乳房上某个部位发硬、肿胀、发热、疼痛或发红(如果您的肤色较浅),通过哺乳或者吸奶也无法缓解的话,有可能一根或多根乳腺管已经发炎了。 


    好消息是,护理得当的话,乳腺炎会好转,您能在整个炎症期间一直哺乳。


    乳腺炎通常起始于一根乳腺管的单纯炎症,导致导管狭窄,乳汁流动减慢。这通常被称为乳管“堵塞”,实际上并没有一个“塞子”堵在那儿,这个词可能有误导性。


    乳腺炎也包括乳腺组织更大面积的炎症。您可能会感到疼痛,伴有发烧、寒战和心动过速,类似于得了流感。有时这种炎症会继续发展为细菌感染,可能需要抗生素治疗。


    乳腺炎不会传染。不需要定期吸奶器配件、安抚奶嘴或家用物品消毒尽早治疗可以减轻炎症,有助于避免感染。任何阶段的乳腺炎均可被治愈。 



    如果您的乳房肿胀,反向按压软化法同时用手挤出少量乳汁,就可让宝宝更容易地含乳。 


    如果您的乳房非常疼痛,或您感觉浑身酸痛乏力,可能很难积极地给宝宝哺乳。这时要尽可能多休息,尽量减少生活中的压力,向国际母乳会中国的哺乳辅导寻求帮助。 

    图一:乳腺炎早期,发热、发硬、发红、红斑状条纹 

    图二:症状加重,发热、发硬、发红、水肿。 

    图三:症状更严重。脓肿形成了一个肿块,正从已红肿的乳腺组织中(图片中上部)突起。 



    01

    该怎么办?

    ◆跟随宝宝的喂养信号频繁地哺乳或挤奶,将有助于防止乳房过度充盈。如果您把宝宝时刻放在身边就更容易做到。没有必要“排空”乳房,这会远超宝宝的需求量。 

    ◆将宝宝的下巴对准疼痛部位,可以帮助他更有效地从该处移除乳汁。 

    ◆以下是其他人发现有助于减轻炎症和疼痛的方法: 

     每小时敷一次冰/冰袋,如果感觉良好,可以增加频率。 

     考虑服用非类固醇抗炎药物如布洛芬来缓解炎症和疼痛。 

     必要的话,考虑服用止痛药物,如对乙酰氨基酚。 

     考虑服用卵磷脂补充剂(大豆或向日葵),可以减少乳脂的粘性。服用量需遵照包装上的说明。母乳喂养医学会建议每日口服5-10克。 如果您对剂量有疑问,请咨询医护人员。 

    ◆如果您的乳房涨得很不舒服,在喂奶间隙用手挤出少量乳汁可以缓解。请点击“阅读原文”观看手挤奶视频。 

    ◆对乳房深度按摩会加重炎症和组织水肿。您可改为轻轻扫过皮肤并温和地触摸。 

    ☞在您的脖子底部、锁骨上方位置划10个小圈。 

    ☞在您的乳房和腋下交界处划10个小圈。 

    ☞从乳头向胸部、锁骨和腋下轻轻扫过。 

    ◆穿着合身的、支撑好的内衣会更舒服。 

    ◆服用益生菌可能有帮助,它有助于在您体内重建微生物平衡。如果要服用益生菌,里面应含有特定的经证明可有效对抗乳腺炎病原体的菌株。 (请参照下文“乳房怎么了”)。 

    ◆治疗乳头白泡(乳头上的小白点): 

     和医护人员讨论是否可在乳头上涂抹外用类固醇乳膏。卵磷脂补充剂可能也有帮助。 

     避免在乳头上用盐水浸泡、蓖麻油摩擦和使用其他外用产品。 

     不要试着挑开白泡。 


    使用上述方法后,大多数乳腺炎病症可在数天内消退。如您还需要额外的帮助,请联系国际母乳会的哺乳辅导。 

    02

    情况没有改善该怎么办?

    如果24小时后您仍感觉没有好转,还继续发烧和/或心跳加速(心动过速),请和医生讨论是否要用抗生素。一般不建议使用抗生素,除非怀疑有细菌感染。您可以在用抗生素的同时继续给宝宝哺乳。 


    治疗性超声(TUS)使用热能来减轻炎症,可能是乳腺炎的有效治疗方法。对几天内尝试了其它方法仍未解决的情况可能尤为有用。专业培训过的理疗师可以提供这项服务。 


    有时乳腺炎会发展为更严重的情况,称为脓肿,即液体聚集在某个明确的乳房区域并被感染。这种情况下就有必要手术引流。


    在抽吸或置管引流后,您可以从患侧乳房继续母乳喂养。如果需要住院,请和医护人员商量能否把宝宝带在您身边,这样就能继续根据婴儿的意愿频繁哺乳了。 


    如果您反复发作乳腺炎,可让医护人员做乳汁培养来证明是否存在细菌感染和/或识别导致感染的病原体。避免长时间不喂奶或不挤奶也有帮助。 


    请记住乳腺炎在各个阶段都可治愈。如果您怀疑乳房发炎,请联系国际母乳会的哺乳辅导或医护人员。 

    03

    乳房怎么了?

    就像宝宝的肠道一样,您的乳房也有一个微生物群,它在各种微生物正好平衡时工作最佳。抗生素和过度泌乳(即乳汁过多)都会破坏这种平衡,造成炎症和乳汁微生物群的破坏(称为乳腺菌群失调)。 


    ①抗生素和益生菌的使用 

    使用抗生素治疗炎性乳腺炎会改变乳房中正常的细菌平衡,实际上增加了进展成细菌性乳腺炎的风险。 


    抗生素当然可用来治疗细菌性乳腺炎或其它疾病。这种情况下,服用益生菌可能有帮助。


    用的话,里面应含有证明对乳腺炎病原体(即细菌)有效的特定菌株(发酵粘液乳杆菌,以前分类为发酵乳杆菌,或最好是唾液联合乳杆菌,以前分类为唾液乳杆菌)。


    ②乳汁过多(过度泌乳) 

    如果您产出的乳汁超出了婴儿的需求,就很可能引起炎症,从而导致乳汁微生物群被破坏(即乳腺菌群失调)。


    过度泌乳可能是由于频繁挤出比婴儿所需更多的奶量(例如,为了存奶填满冷冻室),或者是由于常常挤奶至排“空”乳房为止。


    乳腺菌群失调本身可造成导管狭窄和炎症,从而进一步破坏乳汁微生物群。


    如果您与宝宝母婴分离或纯吸奶喂养,那目标就是只产出宝宝需要的母乳量即可,不需要挤太多。 


    吸奶器的喇叭罩尺寸合适很重要,这样吸奶才会舒服,乳汁也容易流出。喇叭罩尺寸不合适、吸奶器吸力过高以及吸奶时间过长均会对乳头和乳腺组织造成损伤。 


    纯吸奶喂养时,婴儿和乳房之间不会互相交换有益微生物。这会增加您患乳腺炎的几率。 


    通过避免使用吸奶器,以及喂奶间歇觉得乳房胀得难受时用手挤出少量奶,可以调低(减少)奶量。


    如果您是纯吸奶喂养,达到挤出宝宝健康生长所需的母乳量即可。


    更多信息,请参照国际母乳会中国的母乳喂养信息《如何知道健康、足月的母乳宝宝得到了足够的母乳?


    请点击“阅读原文”观看手挤奶的视频以了解更多信息。 


    ③乳盾

    使用乳盾会加重炎症,最好避免使用。它们无法解决母乳喂养问题的根本诱因。如果您很难做到让婴儿含乳含得舒服有效,请联系国际母乳会的哺乳辅导或哺乳顾问寻求帮助。

    请记住,母乳喂养可以并且应该在乳腺炎的整个治疗过程中继续进行。如果您需要信息和支持,国际母乳会中国将在此提供帮助。浏览https://www.muruhui.org/?page_id=12616找到您当地的母乳会小组。







    如需分享更多关于乳腺炎和治疗方案的信息给医护人员,请参阅: 母乳喂养医学会临床指南#36《乳腺炎谱系》2022修订版。 




    MASTITIS A MATTER OFINFLAMMATION


    (The following article is a summary of information found in the Academy of Breastfeeding Medicine Clinical Protocol #36: The Mastitis Spectrum, Revised 2022)

    Mastitis is the name given to a range of conditions that all involve inflammation in the breast. You may never experience mastitis or you may find that you need to take steps to prevent it from recurring.

    As you produce milk, some of the many, many small ducts (tubes) that transport your milk can get overly full. You may occasionally feel discomfort or tenderness that gets better after your baby nurses or you express some milk. If you notice an area that is hard, swollen, warm, painful or red (on lighter skin tones) that isn’t relieved by nursing or pumping, one or more of those ducts may have become inflamed.


    The good news is that with supportive care mastitis does get better and you can continue to breastfeed through it all. Mastitis usually starts with a simple inflammation in just one milk duct which causes the duct to narrow, slowing down the flow of milk. This has often been called a“plugged”duct; since there isn’t really a“plug,”this term can be misleading. Mastitis may also involve a much larger area of inflammation in the breast tissue. You may feel achy,    with fever, chills and a rapid heartbeat, similar to having the flu. Sometimes this inflammation goes on to become a bacterial infection, which may require antibiotic treatment. Mastitis is not contagious. You don’t need to routinely sterilize pump parts, pacifiers or household items. Early treatment to reduce the inflammation can help you avoid an infection. All stages of mastitis are treatable.



    If your breasts are engorged, reverse pressure softening along with hand expression of small amounts of milk will make it easier for your baby to latch.


    If your breast is really sore, or you’re feeling achy and rundown, it can be hard to stay motivated about nursing your baby. Get as much rest as possible, do what you can to reduce any stress in your life, and reach out to a La Leche League Canada Leader for support.



    01

    What to do ?

    ◆Nursing or expressing milk regularly, following your baby’s cues, will help prevent the breast getting overly full. This is much easier if you keep your baby close to you. There’s no need to ‘empty’your breasts beyond what your baby wants to drink.

    ◆Positioning your baby with their chin in line with the sore area can help themremove milk more effectively from that spot.

    ◆The following are ways others have found helpful to decrease inflammation and pain:

     Apply ice/cold packs every hour or more often, if it feels good.

     Consider using a nonsteroidal anti-inflammatory drug like ibuprofen to relieve inflammation and pain. 

     Consider taking lecithin supplements (soy or sunflower) which can reduce the stickiness of milk fat. For how much to take, follow the instructions on the package. The Academy of Breastfeeding Medicine recommends 5- 10 g/day. If you have questions about dosage, consult your healthcare provider.

    ◆If your breasts are uncomfortably full, hand expressing small volumes of milk between feedings can provide some relief.Click “Read more” to watch  Hand Expression Video.

    ◆Deep massage of your breasts can increase the inflammation and tissue swelling. Instead use light sweeping of your skin and a very gentle touch. 


     Make 10 small circles at the base of your neck, just above your collarbone.

     Make 10 small circles where your breast meets your underarm.

     Sweep from your nipple toward your chest,collarbone and underarm.

    ◆Wearing a well-fitted, supportive bra can be more comfortable.

    ◆Taking probiotics, which can help reestablish the microbial balance in your body, may be helpful. If probiotics are used, they should contain specific strains shown to be effective against mastitis  pathogens (see What’s Happening in the Breast below).

    ◆To treat a nipple bleb (white bump on your nipple):

     Talk to your healthcare provider about applying a topical steroid cream to the nipple. Lecithin supplements can help here too.

     Avoid salt water soaks, castor oil rubs, and other topical products on your nipples. 

     Do not try to open the bleb.


    Most cases of mastitis resolve in a few days of using the strategies above. Contact a La Leche League Leader for additional support.


    02

    What if things aren′t improving?

    If you are not starting to feel better after 24 hours and continue to have a fever and/or fast heart rate (tachycardia),talk with your healthcare provider about the possible use of antibiotics. Antibiotics are not recommended unless a bacterial infection is suspected. You can continue to nurse your baby while you are taking antibiotics.


    Therapeutic ultrasound (TUS) uses thermal energy to reduce inflammation and may be an effective treatment for mastitis. This can be particularly useful for cases that do not resolve within a few days of trying other strategies.Trained physiotherapists can provide this service.


    Sometimes mastitis progresses to a more serious condition called an abscess. This is where fluid collects in a well-defined area of the breast and becomes infected. In this case, surgical drainage becomes necessary. After aspiration or drain placement, you can continue breastfeeding from the affected breast. If hospital admission is necessary, talk to your healthcare provider about keeping your baby with you, so you can continue to breastfeed as often as your baby likes.


    If you have recurring bouts of mastitis, ask your healthc are provider about culturing your milk to verify that there is a bacterial infection and/or to identify the pathogens responsible for the infection. It is also helpful to avoid long periods without feeding or expressing milk.


    Remember that mastitis is treatable at all stages. Contact a La Leche League Leader or your healthcare provider if you suspect inflammation in your breast.

    03

    What′s happening in the breast?

    Just like your baby’s gut, your breasts have a microbiome that works best with the right balance of  microorganisms. Antibiotics and hyperlactation (too much milk) can disrupt that balance, resulting in inflammation and disruption of the milk microbiome (called mammary dysbiosis).


    Use of Antibiotics and Probiotics 

    Treating inflammatory mastitis with antibiotics can change the normal bacterial balance in the breast and actually increase the risk of developing bacterial mastitis.

    Of course, antibiotics may be needed to treat bacterial mastitis or may be prescribed for other reasons. When that’s the case, it may be helpful to take probiotics as well. If probiotics are used, they should    contain specific strains shown to be effective against mastitis pathogens (‘germs’) (Limosilactobacillus fermentum, formerly classified as Lactobacillus fermentum, or, preferably, Ligilactobacillus salivarius    formerly classified as Lactobacillus salivarius).


    Too Much Milk (Hyperlactation)

    If you produce more milk than your baby needs, you are more likely to experience the inflammation that can lead to disruption of the milk microbiome (mammary dysbiosis). Hyperlactation can be caused by frequently pumping more milk than a baby is taking (to build up a freezer stash, for example), or by regularly pumping until the breasts are“empty”. Mammary dysbiosis itself can lead to narrowing of the milk ducts and inflammation, which can lead to further disruption of the milk microbiome. If you are separated from your baby or are exclusively pumping, aim to produce only the amount of milk your baby needs and not more.


    It’s important that pump flanges fit well, so pumping is comfortable and milk flows easily. Flanges that are the wrong size, suction that is too high, and pumping for too long can all cause damage to the nipple and breast tissue.


    When exclusively pumping, the exchange of beneficial microorganisms between baby and breast doesn’t happen. This may increase your chances of developing mastitis.


    Milk production can be downregulated (reduced) by avoiding pump use, and hand expressing small volumes of milk between feedings when your breasts feel uncomfortably full. If you are exclusively pumping, aim to pump only as much milk as your baby needs to grow well.

    Please Click “Read more” to watch this video to learn more about Hand Expression.


    Nipple Shields

    Using nipple shields may increase inflammation. It’s best to avoid them. They do not address the underlying causes of breastfeeding problems. If you are having trouble latching your baby comfortably and effectively, contact a La Leche League Leader or lactation consultant for support.

    Remember that breastfeeding can and should carry on throughout treatment for mastitis. If you  need information and support, La Leche League China is here to help. Click https://www.muruhui.org/?page_id=12616 to find your local LLL Group.







    For more information about mastitis and treatment options to share with your healthcare provider, see: Academy of Breastfeeding Medicine Clinical Protocol #36: The Mastitis Spectrum, Revised 2022.



    END


    翻译:加拿大母乳会,何圆圆

    审阅:温传艳,Victoria

    编辑:幸宝、沐凡




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  • 乳房爬行 The Breast Crawl


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    编者注

    多年来,许多“经典”的《新起点》文章都可通过国际母乳会美国和国际母乳会总部的网站获得。


    随着这些网站的更新,能否获得《新起点》往期的文章有了变化,因为许多曾经在网站上找得到的文章可能不复存在了。


    我们计划回一些早年的育儿宝典。针对发表在2013年第4期上的这篇“经典”文章,我们更新了原文的部分内容,文中詹妮弗皮特金分享了她与第二个孩子乳房爬行的经历以及她是如何为此做准备的。我们还收录了2013年发表时的照片。


    如果你想看发表在《新起点》博客上“尘封多年”的文章,但不再有权限访问,请发邮件nbeditor@lllusa.org给我们留言。


    虽然我们的实物过期期刊不够完整,但我们有权限访问大型过期期刊库,也许为你挖掘出一个特定的故事来。


    我第一次怀孕时对乳房爬行一无所知。自从第一胎经历过各种哺乳启动不顺利后,我非常坚定让哺育第二个孩子的旅程不再重蹈覆辙我和大女儿出生后所经历的问题。我知道,如果我的分娩没有药物干预的话,再加上有个健康机敏的宝宝,我们就会尝试乳房爬行。


    在大女儿一岁多一点时,我和丈夫发现我怀了第二个孩子。我观看了一个乳房爬行的视频,过程令我非常着迷。因此我开始竭尽全力去探究这件事,并下决心组成一个团队来帮助我和孩子。


    在准备第二个孩子的出生时,我和丈夫制定了一个相对简单的分娩计划书给医生看:分娩后就把宝宝放在我的肚子上,在肚子上面把宝宝擦干净(手除外),用毯子盖住宝宝的背部, 等到宝宝吃完奶后再做任何检查和处理。今想起当初我的导乐在产房墙上的白板上写下了“请把‘黏黏糊糊’的宝宝抱给妈妈”,我都不禁一笑。


    生产完后,我记得是丈夫第一个告诉我生了个男孩!然后儿子被放在我的肚子上。他花了一个来小时跋涉到了乳房,这期间丈夫一直轻抚着我的头,泪流满面地告诉我他太自豪了。


    我从读过的研究中得知乳房爬行平均需要一个小时左右——的确如此!美妙之处就在于,直到看了导乐拍的儿子乳房之旅视频,我才知道花了多长时间。那时我没看过表,一直注视着孩子,无法将目光从小宝贝身上挪开。我和丈夫在分娩后可以借此放松放松。我们花时间专注于每一步,宝宝也一样——确实如此!我和宝宝在分娩后、母乳喂养之前能一起享受这一特殊时光。他真做到了!他用小脚抵着我的肚子前行,用胳膊和手留下了羊水的痕迹,引领他爬向乳房。他竟然自己含上了乳房!




    01
    什么是乳房爬行

    婴儿天生具有一种踏步反射的本能,如果他们的脚接触到一个平面,就会开始走路他们虽然无法支撑自己的体重,但在适当情况下,他们可以为自己提供所需的杠杆作用,以便在分娩后借着母亲的腹部推动自己。


    我的孩子爬向乳房期间,他的手在身前带路,上面的羊水留下一道气味的痕迹,引导他爬到乳房。他把手伸向我的乳房,脚蹬着我已柔软下来的肚子向前,像在轻柔地按摩我的腹部。



    02
    乳房爬行五阶段

    美国儿科学会发表的一篇文章解释说,如果把新生儿擦干放在母亲的腹部、没有母婴分离的话,乳房爬行会依次呈现五个本能阶段。


    1.30 分钟:新生儿休息,偶尔看看母亲。

    2. 30-40分钟:新生儿开始咂吧嘴并将手指放到嘴里。

    3. 新生儿利用踏步反射蹬着母亲的腹部向前移动,爬向乳房时会左右转动头部.

    4. 到达母亲胸骨边缘时,婴儿会上下晃动着头,埋入母亲的胸膛。

    5. 当新生儿接近乳头时,嘴巴张得大大的去含住乳头。

    正如我丈夫所说我们过多地干扰了自己的本能,而忘了小宝宝也有本能。

    03
    乳房爬行的好处

    乳房爬行的研究强调了众多好处,包括对婴儿新陈代谢和温度的调节以及更高品质的亲子关系。新生儿在母亲腹部的踏步反射有助于胎盘的娩出,母亲的催产素水平也高于那些分娩后与婴儿分离的母亲的。


      我看到了我的儿子在出生后第一个小时有多能干,也很感激自己给了他机会展示给我看。

    01
    参考资料

    乳房爬行视频(点击“阅读原文”可直接观看):

    med.stanford.edu/newborns/professional-education/breastfeeding/early-initiation-of-breastfeeding.html

    Tiwari V, Purohit A, Verma M. A recent advance in first hour feeding– breast crawl. J PediatrRes. 2017;4(08):537-543.doi:10. 17511/ijpr.2017.08.07 

    https://pediatrics.medresearch.in/index.php/ijpr/article/view/309/616





    The Breast Crawl: From The New Beginnings Archives


    Editor’s Note


    Over the years, many “classic” New Beginnings articles were available through both the La Leche League USA and La Leche League International websites. As these websites have been updated, the availability of the New Beginnings archives has changed, and many articles that were once found online may no longer be there. We plan to bring back some of these parenting gems from earlier years. For this “classic” posting from Issue 4 of 2013, we’ve updated portions of the original article in which Jennifer Pitkin shared about her experience with the breast crawl with her second child and how she prepared for it. We’re also including photos that were published in 2013.


    If you would like to see a “blast from the past” published on the New Beginnings blog that you no longer have access to it, drop us a note at nbeditor@lllusa.org. While our physical archives are not complete, we do have access to a large library of back issues and may be able to dig up a particular story for you.


    I knew nothing about the breast crawl during my first pregnancy. After a rough start nursing my firstborn, I was extremely committed to begin the journey with my second child without the issues my daughter and I encountered after she was born. I knew that if I had a non-medicated birth, coupled with a healthy and alert baby, we would attempt the breast crawl.


    My husband and I found out I was pregnant with our second child when our daughter was a little over one year old. I watched a video of the breast crawl, and I became fascinated with the process. I began researching everything I could about it and became determined to build a team to help support the baby and me.


    While preparing for the birth of our second child, my husband and I developed a fairly simple birthing plan for the doctor: put baby on my abdomen after delivery, wipe the baby off (except hands) while on my abdomen, cover baby’s back with blankets, and wait until the baby has nursed before taking any measurements. To this day, it makes me laugh that my doula had written “Give baby to mama all gooey” on the white board on the wall of the delivery room.


    After I gave birth, I remember my husband being the first to tell me it was a boy! My son was then placed on my abdomen. During the hour or so that it took my son to make his journey to the breast, my husband was stroking my head, telling me he was so proud, with tears streaming down his face.


    I knew from the research I had done on the average breast crawl that it would take about an hour, and it did. The wonderful thing was I didn’t know the amount of time that it took for us until I watched the video my doula took of my son’s voyage to the breast. I didn’t watch the clock. I watched my son the whole time. I couldn’t take my eyes off of my new baby. My husband and I were able to relax after delivery. We had time to focus on the next steps and so did our baby  literally. He and I were able to enjoy this special time with each other after pregnancy and before breastfeeding. He really did it. He pushed his little feet into my abdomen. He used his arms and hands to leave a trail of amniotic fluid to lead him to the breast. He latched himself.


    01

    What is the breast crawl?

    Babies are born with an instinctive “stepping reflex“ where, if their feet touch a flat surface, they’ll start “walking”. They can’t support their own weight, but in the right situations can give themselves the leverage they need to push themselves along the mother’s abdomen after delivery.


    During my son’s breast crawl, his hands were in front of him leading the way, leaving a scent trail from the amniotic fluid on his hands to guide him to the breast. He stretched out his hands toward my breasts and pushed his feet into my now soft abdomen, gently massaging my stomach.


    02

    five-point sequence in the breast crawl

    In an article published by the American Academy of Pediatrics, it is explained that there is a five-point sequence in the breast crawl if the little one is dried off, placed on the mother’s abdomen, and not separated from the mother.


    • First 30 minutes: newborn rests and occasionally looks at mother.

    • 30-40 minutes: newborn begins to smack lips and bring fingers to mouth.

    • Newborn uses stepping reflex to push against mother’s abdomen and move forward. Newborn turns head side to side while crawling up to breast.

    • When newborn reaches the tip of the sternum, the baby bounces their head up and down and into the mother’s chest.

    • As the newborn nears the nipple, the mouth opens and the baby latches onto the nipple.


    As my husband said, “We interfere with our instincts too much and we forget that little ones have instincts, too.”



    03

    Benefits of the breast crawl

    Studies of the breast crawl note extensive benefits, including metabolic and temperature regulation in the infant and a better quality of attachment. The newborn’s stepping reflex on the mother’s abdomen aids in the delivery of the placenta, and a mother’s oxytocin levels are higher than in those who are separated from their infants after delivery.


    I saw what my son was capable of in his first hour of life, and I’m so thankful I gave him the opportunity to show me.


    02

    Resources

    Breast crawl video(Click Read more” to watch the Breast crawl video) 

    med.stanford.edu/newborns/professional-education/breastfeeding/early-initiation-of-breastfeeding.html

    Tiwari V, Purohit A, Verma M. A recent advance in first hour feeding– breast crawl. J PediatrRes. 2017;4(08):537-543.doi:10. 17511/ijpr.2017.08.07 

    https://pediatrics.medresearch.in/index.php/ijpr/article/view/309/616


    END

    翻译:加拿大母乳会、许悦

    审稿:核桃、传艳、Marien

    编辑:幸宝




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    本篇文章来源于微信公众号: 国际母乳会LLL

  • 建立奶量Establishing Your Milk Supply

    关注“国际母乳会LLL”了解更多母乳喂养资讯
























    几乎每个产后妈妈都可以通过正确的信息和支持来建立和维持良好的奶量。


    当您了解到您的身体和宝宝的身体如何共同作用来建立奶量时,就更容易避免可能对乳汁分泌产生负面影响的选择。

    让奶量建立有一个良好的开始的关键时刻在于宝宝出生后的最初几个小时和最初几天。但是,即使最初几天起步艰难,奶量也可以在最初几周得到改善。

    如果您担心宝宝的体重增长问题,请医疗保健专业人员、医生或助产士对您的宝宝进行检查。


    尽早开始并频繁哺乳

    要建立良好的奶量,重要的第一步是在婴儿出生后的第一个小时内开始母乳喂养之后,让您的宝宝在最初几天和几周内频繁、无限制地吃奶。新生儿通常大约(平均)每2至3小时吃一次奶,或在24小时内至少吃奶8至12次


    偶尔,婴儿每天吃奶次数较少也能茁壮成长,但是需要监测他们的体重以确保适当的增重。许多婴儿甚至会需要更频繁的哺乳。


    哺乳时段在一天中可能不是均匀分布的。有些婴儿会密集地吃几顿奶,然后睡得更久。乳汁分泌是一种“供求”关系。宝宝喝的母乳越多,身体分泌的乳汁就越多。


    分娩后,立即要求将婴儿放在您的腹部,刚好在乳房下方进行肌肤接触。助产士可以在婴儿放在您身上时擦干婴儿,然后用一条轻薄干燥的毯子把婴儿盖住。不应擦干婴儿的手,因为您乳头的气味与婴儿手上的气味相似,这将有助于婴儿找到您的乳头。


    如有需要,把自己调整到一个舒适的半躺姿势要求将宝宝放在您的身体上不受干扰至少一小时或直到第一次喂养结束。只要有时间和耐心,大多数婴儿都可以自行爬到胸部,并在第一次喂奶时成功自主含乳。(请参看全球健康媒体的以下视频:https://globalhealthmedia.org/videos/breastfeeding-in-the-first-hours-after-birth/)或点击“阅读原文”观看。


    婴儿出生后第一次吃到的母乳叫初乳,它是您的身体在怀孕的最后几个月里开始分泌的。它富含抗体和其他保护因子。少量的初乳可以让您的宝宝有机会学习如何吮吸,而不会一下子因大量的母乳应接不暇。


    胎盘的娩出向身体发出信号开始生产成熟的乳汁,而到产后第3-5天开始“下奶”时奶量会显著增加。

    经常与宝宝肌肤接触

    您的身体视为婴儿的自然栖息地会有帮助。不仅在产后即刻,而且在产后数周、甚至数月内保持与宝宝肌肤接触也是有益的。与您的肌肤接触有助于宝宝在学习母乳喂养时保持放松。


    宝宝可以通过触觉和嗅觉找到乳头并自主含乳。肌肤接触时间有助于调节宝宝的体温和心率。它还会提高促进母乳分泌的荷尔蒙水平。


    确保宝宝有效含乳和吸吮

    含乳良好时,您的婴儿需要大口含乳,轻柔地将您的乳头拉伸到软腭部位,这样一来您的宝宝能够有效地吸出乳汁。


    这确保了您的婴儿能得到足够的母乳,而您的身体也会收到信号,继续制造更多的母乳。深含乳还可防止乳头被舌头和硬腭挤压。较浅的含乳经常会导致乳头疼痛。


    有一小部分婴儿,由于舌系带过紧, 舌头就会受到限制。因此,婴儿可能无法将乳头足够深地拉入嘴里。


    如果尝试改善宝宝的含乳后仍有疼痛,建议您寻求国际认证哺乳顾问(IBCLC)的帮助。如有必要,您可咨询擅长诊断和治疗舌系带过短的医护人员。


    留意“喝”和“吮吸”之间的区别很重要。吞咽是您的婴儿正在喝母乳的一个迹象。吮吸时,婴儿的下巴会上下移动,但当婴儿含着一大口母乳时,婴儿的下巴会下降并有较长的“停顿”以便吞咽。您可能会听到婴儿吞咽后在呼气时的“咔”声。


    如果吞咽速度减慢,当婴儿开始吮吸时,您可以用整个手轻轻挤压或按压乳房,这将增加母乳流量,并鼓励您的宝宝继续吃奶。当乳汁流动减慢时,您的宝宝可能希望继续吮吸以寻求安抚。这对婴儿和母亲来说都是非常愉快的。

    婴儿表现饥饿时喂奶

    每个宝宝都是独一无二,所以观察宝宝,知道什么时候该喂奶很重要。在您的婴儿出现饥饿迹象时进行喂奶被称为“基于提示的喂奶”(也就是按需喂养)。


    • 您的宝宝饿了的迹象包括:

      烦躁不安寻乳(头转向您的胸部)、头在您的胸前摆动吃手和舔嘴唇

    • 哭泣是饥饿晚期的信号,如果您等到宝宝很饿,可能会发现宝宝太烦躁,无法有效地衔乳。

    • 刚出生的头几天,婴儿在乳汁流出前通常会经历衔乳和突然松开乳房,来回反复几次。最终,您的宝宝将学会一次就衔乳成功,吮吸并等待乳汁流出。


    随着您对宝宝的了解, 您也将熟悉哺乳的规律。当您回应您宝宝的提示时,您的身体会收到信号,分泌宝宝所需的奶量。您的宝宝也学会了相信他们的需求会得到满足。

    嗜睡的婴儿

    如果您的婴儿在两次喂奶之间经常睡眠超过三个小时并且体重增长不佳则可能需要在白天每隔两个小时唤醒他进行喂奶,直到您的奶量充分建立为止。


    注意宝宝睡着时的身体动作。这是浅层睡眠的表现。与深层睡眠相比,您可以更容易地唤醒处于浅层睡眠的宝宝。


    温和地唤醒宝宝方法包括:

    (相关链接:https://www.muruhui.org/?p=11834)

    • 抱着宝宝肌肤相亲

    • 打开包被或脱下宝宝的衣服

    • 竖着抱宝宝

    • 移动宝宝的胳膊和腿或者揉他的脚

    • 调暗灯光

    • 用湿布擦拭宝宝的脸

    • 和宝宝说话,把几滴初乳放进他的嘴里品尝,用半躺式姿势鼓励他衔乳。(半躺式链接:https://www.muruhui.org/?p=11897

    每次喂双侧乳房

    每次喂奶时提供双侧乳房以确保充足的奶量很重要,尤其是在早期。只要您看到宝宝活跃地吮吸和吞咽,就让您的宝宝继续待在第一个乳房上。


    当吮吸速度减慢时,您的婴儿可能会主动离开乳房,或者您可以松开衔乳。这通常是更换尿布或轻轻地将婴儿直立放在胸前拍嗝的好时机。再提供第二个乳房。


    大多数婴儿会从第二个乳房吃一些母乳,有些会吃很多。偶尔,您的宝宝可能根本不想再吃。这有时被描述为“第一道是主菜,第二道是餐后甜点。”下次喂奶时,先提供第二个乳房。

    需求和供给

    宝宝喝的母乳越多,妈妈身体分泌的乳汁就越多。这就是为什么遵循上述提示以确保充足的奶量如此重要。


    但同样重要的是要知道供给和需求也可以反向运行。如果补充配方奶粉,您的身体将不会收到在第二天分泌同样多母乳的信号,这将导致奶量减少。如果您需要补充配方奶粉,您需要用手或吸奶器将乳汁从乳房中移除,以刺激您的身体在第二天产出更多的乳汁。当您这样做的时候,您可能不会得到很多奶,但是您的身体仍然会收到制造更多乳汁的信号。


    如果您试图将宝宝的喂奶间隔拉开,比宝宝想要的更长,奶量也会减少。让您的宝宝决定两次喂奶之间的间隔时间是有用的。通常在婴儿2-3个月大的时候,您的婴儿在两次喂奶之间的时间可能会更长,在乳房上的时间能会更少。这是因为他们能够比以前更快地移除乳汁。


    如果您的宝宝持续增重良好,说明您的乳汁能满足宝宝的需求。如果您的婴儿增重不足, 请咨询国际认证哺乳顾问(IBCLC)以了解资讯和寻求帮助。


    使用安抚奶嘴

    大多数母乳喂养的婴儿不需要安抚奶嘴,因为他们在吮吸乳房时自然会获得足够的安抚。安抚奶嘴是为奶瓶喂养的婴儿发明的,因为喂饱后,他们可能需要更多的时间来吮吸。


    但在母乳喂养中,安抚吸吮是自然发生的,因为母乳在哺乳快结束时流速会变慢,这给了宝宝时间进行安抚性吮吸,而不是为了吸到更多的奶。母乳喂养可以同时满足饥饿和吸吮的需求。


    如果您在最初几天或几周内使用安抚奶嘴,您可能会错过宝宝的喂养信号。这可能会延迟下一次喂养,或者您的婴儿可能会完全错过下一次喂养。这可能会影响产奶量和婴儿的体重增加。


    如果您还是想用安抚奶嘴,最好至少等待一个月再使用。在婴儿学会母乳喂养之前给他们安抚奶嘴或奶瓶可能会让他们感到困惑。给您的宝宝一个机会吧,一次只学一件事。








    猛涨期或频繁哺乳期

    在最初的三个月里,您的宝宝会经历三到四次猛长期。此时通常需要非常频繁哺乳两到三天。遵循宝宝的提示,当宝宝想吃奶时尽可能频繁地喂奶,您的奶量也会因此增加,以满足宝宝的成长需求。








    从艰难的开始中修复

    有时母乳喂养会因为种种原因而起步艰难。鼓舞人心的是,我们知道通过遵循这些提示,您可以增加奶量,改善宝宝的增重,同时还能保护哺乳关系。








    除了饥饿,婴儿吃乳的原因还有很多

    通过频繁的哺乳,您的宝宝可能会因为靠近您的身体和听到您的心跳而感到安全和舒适。这是正常的,有助于支持健康发育。您的宝宝也可以通过哺乳,满足吮吸的需求。满足这些需求不会宠坏您的宝宝。它将教会您的宝宝相信您会让他们安全舒适。

    父母需要他人的支持协助

    国际母乳会聚会是能够帮助您寻求他人支持的绝佳地方。国际母乳会的哺乳辅导是经过培训的志愿者,她们可以帮助您享受母乳喂养的时光。关注“国际母乳会-LLL”微信公众号、视频号或访问www.muruhui.org了解我们的聚会信息和其他哺乳资讯。






    Establishing Your Milk Supply





















    Almost everyone giving birth can establish and maintain a good milk supply with the right information and support. When you understand how your body and your baby’s body work together to build your milk supply, it is easier to avoid choices that can negatively impact milk production. The hours and days after your baby’s birth are very important in getting things off to a good start. But even with a difficult start, milk supply can be improved in the early weeks. If you are concerned about your baby’s weight gain, have your baby checked by a healthcare professional, doctor or midwife.

    Breastfeed early and often

    An important first step in establishing a good milk supply is to breastfeed, or chestfeed, your baby within the first hour after birth. After that , allow your baby frequent, unlimited access to your breast in the early days and weeks. Newborns usually feed about every two to three hours (on average), or at least 8-12 times in 24 hours. Occasionally, babies can thrive on fewer feedings per day but they should be monitored for appropriate weight gain. Many babies nurse even more frequently. Nursing sessions may not be spaced evenly throughout the day. Some babies cluster several feeds together and then sleep for a longer stretch. Milk production is a “supply and demand” relationship. The more milk your baby drinks, the more milk your body will produce.


    Immediately after birth, ask for your baby to be placed skin-to-skin on your belly, just below the breasts. Your baby can be dried off by the birth attendant while on your body, and then covered with a light, dry blanket. Your baby’s hands should not be dried. The smell of your nipples is similar to the smell on your baby’s hands and this will help your baby to find your nipples. If needed, adjust yourself into a comfortable reclined position. Ask that your baby be left undisturbed on your body for at least an hour or until after the first feeding is finished. Given time and patience, most babies can make their way to the chest and latch themselves for this first feeding. See the following video by Global Health Media.


    The first milk the baby gets after birth is called colostrum, which your body begins producing in the last few months of pregnancy. It is rich in antibodies and other protective factors. The small quantities give your baby a chance to learn how to suckle without being overwhelmed by large volumes of milk. The delivery of the placenta signals to the body to begin producing mature milk and by day 3-5, the milk “comes in” and the volume increases substantially.

    Hold baby skin to skin often

    It can be helpful to think of your body as your baby’s natural habitat. It is beneficial to hold your baby skin-to-skin not only during the immediate postpartum period but for weeks, and even months afterwards. Being skin-to-skin with you helps your baby remain calm while learning to breastfeed. Using the senses of touch and smell, your baby can find the nipple and latch on. Skin-to-skin time helps to regulate your baby’s temperature and heart rate. It also heightens your hormones that are involved in milk production.

    Ensure latch and sucking are effective

    With a good latch your baby takes a large mouthful of breast which gently stretches your nipple to the soft part of your baby’s palate. When this happens, your baby is able to effectively remove the milk. This ensures that your baby gets plenty of milk and your body gets the message to keep making more milk. A deep latch also prevents the nipple from being pinched by the tongue and the hard palate. A shallow latch often results in sore nipples. Please Click “Read more” to read the original article  Positioning and Latching for more information on achieving a comfortable latch. In a small percentage of babies the tongue is restricted because of a tight frenulum or tongue tie. Because of this the baby may not be able to pull the nipple deeply into the mouth. If the latch is still painful even after trying to improve it, you are encouraged to seek the help of a professional International Board Certified Lactation Consultant (IBCLC). Then, if necessary, you may want to consult with a healthcare professional who specializes in diagnosing and treating tongue ties.


    It is important to note the difference between “drinking” and “sucking”. Swallowing is a sign that your baby is drinking the milk. Your baby’s chin will move up and down when sucking but when there is a mouthful of milk your baby’s chin will drop with a longer “pause” in order to swallow. You may hear a “kah” sound as the baby breathes out after a swallow. If swallowing slows down, you can gently squeeze or compress your breast with your whole hand when your baby starts sucking. This will increase milk flow and encourage your baby to keep drinking. Your baby may want to continue sucking for comfort as the milk flow slows down. This can be very pleasant for both baby and mother.

    Feed when baby shows signs of hunger

    Every baby is unique and so it is important to watch your baby to know when it’s time to feed. Feeding when your baby shows signs of hunger is called “cue-based feeding”. Some cues that your baby is hungry are: restlessness, rooting (head turning towards your chest), head bobbing on your chest, mouthing hands and licking lips. Crying is a late hunger cue. If you wait until your baby is hungry you may find that your baby is too upset to be able to latch effectively. In the early days it is common for babies to latch and pop off several times until the milk starts flowing. Eventually your baby will learn to latch once, suck and wait for the milk to flow. You also will begin to recognize patterns in your nursing sessions as you get to know your baby. When you respond to your baby’s cues, your body gets the message to make the amount of milk that your baby needs. And your baby learns to trust that their needs will be met.

    sleep baby

    If your baby regularly sleeps more than three hours between feedings and is not gaining well, he may need to be awakened for feedings around every two hours during the day until your milk supply is well established. While your baby is sleeping, watch for movement. This is a sign of light sleep. You can wake your baby more easily from a light sleep than from a deep sleep. Gentle ways to wake 


    your baby are:


    • holding your baby skin-to-skin

    • unwrapping or undressing your baby

    • holding your baby upright

    • moving your baby’s arms and legs or rubbing his feet

    • dimming the lights

    • wiping baby’s face with a damp cloth

    • talking to your baby putting a few drops of colostrum into his mouth to taste

    • using the laid-back position to encourage him to latch. (Click “Read more” to read the original article Positioning and Latching )



      Offer both breasts at each feeding

      It is important to offer both breasts at each feeding, especially in the early days in order to ensure a plentiful milk supply. Let your baby stay on the first breast as long as you see active sucking and swallowing. When the sucking slows down, your baby may come off the breast or you can release the latch. This is often a good time to do a diaper change or gently place your baby upright on your chest to encourage a burp. At this point offer the second breast. Most babies will take some milk from the second side and some will take a lot. Occasionally, your baby may not want any at all. This is sometimes described as “the first side is the main course and the second side is dessert.” At the next feeding, offer this second breast first.

    Demand and supply

    The more milk your baby drinks, the more milk your body will make. This is why it is so important to follow the tips above to ensure a plentiful milk supply. But it is important to know that supply and demand can work in reverse as well. If supplemental formula is introduced, your body will not get the message to make that amount of milk the next day. This will lead to a decrease in your supply. If you need to supplement with formula, it is important to express milk from your breasts, by hand or with a breast pump, to stimulate your body to produce more milk the next day. You may not get much milk when you do this, but your body will still get the message to make more milk.


    Milk supply can also decrease if you try to space your baby’s feedings farther apart than your baby wants. It’s helpful to let your baby decide when to go longer between feedings. This often happens around 2-3 months of age. Your baby may go longer between feedings and spend less time at the breast. This is because they are able to remove the milk much faster than they used to. If your baby continues to gain well and then your body is making what your baby needs. If your baby is not gaining well, consult an International Board Certified Lactation Consultant (IBCLC) for information and support.


    Use of a soother/pacifier/dummy

    Most breastfed babies don’t require a soother because they naturally get enough comfort sucking at the breast. Soothers were invented for bottle fed babies because, when full, they may need more time to suckle. During breastfeeding, suckling happens naturally because the milk flows more slowly at the end of a feeding. This gives the baby time to suckle for comfort and not get a lot of milk. Hunger and sucking needs are both met by breastfeeding.


    If you use a pacifier in the early days and weeks, you may miss your baby’s cues to feed. This may delay the next feeding, or your baby may completely miss the next feeding. This could affect milk production and baby’s weight gain.


    If you find that you want to use a soother, it is best to wait for at least a month before introducing it. Giving babies soothers or bottles before they have learned how to breastfeed can be confusing for them. Give your baby a chance to learn one thing at a time.








    Growth spurts or frequent-feeding days

    Three to four times in the first three months your baby will go through growth spurts. This usually involves very frequent feeding for two to three days. Follow your baby’s cues and feed as often as your baby will go to the breast and your milk supply will increase to meet your baby’s growing needs.








    Recovering from a difficult start

    Sometimes breastfeeding gets off to a difficult start for one reason or another. It can be encouraging to know that by following these tips you can increase your milk supply and improve your baby’s weight gain while also protecting the nursing relationship.








    Bayby nurse for many reasons other than hunger

    Your baby may nurse often because of the feeling of security and comfort from being close to your body and hearing your heartbeat. This is normal and helps to support healthy development. Your baby may also nurse to satisfy the need to suck. Meeting these needs will not spoil your baby. It will teach your baby to trust that you will keep them safe and comfortable.

    www.lllc.ca/establishing-your-milk-supply


    END

    翻译:国际母乳会加拿大

    审阅:敏怡,Lynn, Marien

    编辑:李幸、沐凡





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  • 母乳储存


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    有时,您可能希望将自己的母乳挤出并储存起来,以备后用。由于其抗菌特性,人乳在不同环境适应力强且很好储存。然而, 储存母乳的时间总是越短越好。换句话说,母乳越新鲜越好。安全储存母乳将有助于保持其质量,并将储存过程中抗体和营养物质的损失降至最低。第一步是在挤出母乳之前,一定要用热肥皂水洗手。




    储存容器的类型:

    在每个母乳容器上贴上注明吸奶日期的标签很重要。如果母乳将在日托中心提供给您的宝宝,请在标签上写上您宝宝的名字。

    1

    可重复使用的硬容器:

    · 带盖子能盖紧的玻璃或硬塑料容器(例如,小玻璃瓶或奶瓶)都是极好的选择。


    · 如果使用塑料容器,请避免含化学物质双酚A (BPA)和双酚S (BPS)的材质。


    · 将容器放入热肥皂水中清洗,充分冲洗,然后在倒入挤出的母乳之前晾干,或在洗碗机中清洗并烘干。

    · 考虑到母乳在冷冻后体积会膨胀,如果冷冻您的母乳,请留出一英寸(约2.54厘米)的空间。(您一定不希望容器在冰柜里破裂或盖子被顶开脱落吧!)

    2

    母乳储存袋:

    · 选择专为储存人乳而设计的袋子。(奶瓶内胆塑料袋和塑料食品保鲜袋不是安全的储存选择,因为它们可能会破损而导致乳汁漏出来,并且有些种类的塑料可能会破坏人乳中的一些营养成分 )。两层包装有助于防止意外破损。


    · 密封前挤出顶部的空气,如果母乳要被冷冻,留出大约一英寸(约2.54厘米)的空间让其膨胀。


    · 将储存子直立放在冰箱或冰柜的硬容器中。

    每个容器里放多少母乳:

    · 为了避免浪费奶,根据宝宝的月龄,可以储存不同的量可能是15 毫升、30毫升、60毫升和120毫升。


    · 注意: 任何在喂奶过程中曾接触到宝宝的嘴的母乳,如果没有喝完,需要在1-2小时内将母乳倒掉。储存不同量的母乳,可以帮助您更好准备宝宝一次想吃的量,避免浪费宝贵的母乳。


    · 乳汁量越少越容易解冻。在24小时内挤出的任何母乳都可以加入冰箱中的同一容器中。首先,将新挤出的母乳放在冰箱的另一个容器中冷却30至60分钟,然后将其加入冰箱中已有的母乳容器中。

    母乳储存指南

    储存处

    最长储存时间


    室温下

    (新鲜母乳)


    16~26°C

    最佳4小时;6-8小时

    在非常清洁的条件和较低的室温下。

    (母乳挤出后,最好立即冷藏。)


    隔热冰包


    -15~4°C

    24小时

    (这个数字是根据有限的研究得出的。时间越短越好。冰袋应接触母乳储存容器,并尽量减少打开冰包。)

    冰箱冷藏室

    < 4°C

    最佳4天;5-8天

    在非常干净的条件下

    冰箱内的

    非独立门冷冻室

    (例如,在酒吧式冰箱内 )


    -15°C


    2周

    带单独门的

    冰箱冷冻室

    (标准家用冷柜)


    -18~20°C


    最佳3个月;6个月可接

    冷冻柜

    -18~-20°C

    最佳6个月;12个月可接受


    01
    加热母乳

    ·母乳不需要加热到特定的温度。婴儿可以直接喝冷藏的或在室温下的母乳,但许多婴儿确实更喜欢将其加热至体温。


    · 小心不要将从冷冻室里取出的玻璃容器直接放在非常热的水下,因为玻璃可能会破裂。


    · 可通过以下方式解冻冷冻母乳:

    ①放入冰箱冷藏室过夜;
    ②使用电动温奶器;
    ③放在温暖的流水下;
    ④置于一杯温水中(不超过40°C)。

    · 在冰箱中缓慢解冻比用温水解冻脂肪损失更少。


    · 解冻的母乳或冷藏的母乳可以在温水下慢慢加热、放入一杯温水中、或使用电热装置加热。


    · 避免煮沸母乳,因为这会导致宝贵营养的损失。


    · 避免微波加热母乳,因为这会使母乳受热不均匀,产生热点,当婴儿饮用时可能会烫伤婴儿的嘴。微波也会导致重要营养物质的损失。(ABM,2017)。


    02
    使用储存的母乳

    · 加温过但未使用过的冷母乳可以放回冰箱供以后使用。


    · 婴儿饮用过的容器中剩余的母乳,可以在接下来的1-2小时内提供给婴儿。在那之后,它应该被丢弃。


    · 解冻后的冷冻母乳可在冰箱中保存长达24小时。在那之后,它应该被丢弃,而不是重新冷冻。


    · 请记住,冷藏母乳会比曾经冷冻过的母乳更新鲜。提前做好计划对决定是否要把母乳冷藏或冷冻有帮助。


    · 避免将母乳与配方奶粉在同一次喂奶中混合。当牛奶配方奶与挤出的人乳混合时,人乳中的溶菌酶数量减少,大肠杆菌含量可能增加(Jones,2019)。


    03
    其他建议

    · 储存时,人乳可能会分为乳清层、乳脂层,这很正常。在喂给宝宝之前,轻轻地摇晃使之混合。


    · 如果您患有鹅口疮(体内真菌过度生长),可在治疗期间继续以母乳喂养您的婴儿。在鹅口疮治疗期间挤出的母乳可以安全地喂养给婴儿,但应该贴上标签,表明您当时患有鹅口疮。需要注意的是,冷藏和冷冻不能杀死酵母菌。没有证据表明,用酵母菌爆发期间挤出的母乳喂养您的婴儿会导致酵母菌感染复发。


    · 偶尔,已解冻后的冷冻母乳可能会有肥皂味或金属味,或与新鲜母乳有所不同。这是由于乳脂随着时间的推移会分解。这种母乳是安全的,大多数婴儿仍然会喝它。


    · 粘稠、气味难闻的母乳应该扔掉,不要喂给您的宝宝。



    STORING HUMAN MILK



    There may be times when you wish to express and store your own milk for later use. Human milk is remarkably resilient and stores well, due to its antibacterial properties. However it is always preferable to store milk for as  short a time as possible. In other words, the fresher the milk, the better. Storing your milk safely will help to maintain its quality and minimize the loss of antibodies and nutrients while in storage. The first step is to always wash your hands in hot soapy water before expressing milk.





    Types of Storage Containers

    It is important to label every container of milk with the date it was expressed. Put your baby’s name on the label if the milk will be given to your baby in a day care setting.










    1

    Reusable Hard Containers

    · Glass or hard plastic containers with well-fitting lids (for example, small mason jars or bottles) are excellent choices. 


    · If using plastic containers, avoid the chemical bisphenol A (BPA) and bisphenol S (BPS). 


    · Wash containers in hot, soapy water, rinse well, and allow them to air-dry before filling with expressed milk, or wash and dry in a dishwasher.


    · If freezing your milk, leave an inch of space to allow the milk to expand as it freezes. (You don’t want your containers to break or the lid to come off in the freezer!)

    2

    Milk Storage Bags

    · Choose bags that are specifically designed for storing human milk. (Bottle liner bags and plastic food bags are not considered safe storage options because they may leak and the type of plastic may destroy some nutrients in human milk). Double-bagging can help prevent leakage accidents.


    · Squeeze out the air at the top before sealing and allow about an inch for the milk to expand if it is going to be frozen. 


    · Stand the bags in a rigid container in the refrigerator or freezer.

    MILK STORAGE GUIDELINES






    How much milk to put in each container

    · In order to avoid wasting milk, store in a variety of amounts, perhaps 15ml, 30ml, 60ml and 120ml, depending on the age of your baby.


    · Note: any milk that touches your baby’s mouth during a feeding will need to be thrown out within 1-2 hours if it isn’t consumed. Storing in a variety of volumes allows you to choose the amount your baby is likely to want to eat at a single feeding and avoid wasting valuable milk.


    · Smaller quantities are easier to thaw.


    · Any milk expressed in the same 24-hour period can be added to the same container in the refrigerator. First, cool the newly expressed milk in a separate container in the refrigerator for 30 to 60 minutes and then add it to the container of milk already in the refrigerator.


    Warming Milk

    · Milk does not need to be warmed to a particular temperature. Babies can drink milk straight from the refrigerator or at room temperature but many do often prefer it to be warmed to body temperature.


    · Be careful not to place glass straight from the freezer under very warm water because the glass can break.


    · Frozen milk can be thawed by:

    ①being placed in the refrigerator overnight;
    ②using an electric milk warmer;
    ③being held under warm running water;
    ④placed in a cup of warm water (no more than 40°C).


    · Slow thawing in the refrigerator results in less fat loss than thawing using warm water.


    · Thawed milk or milk that has been refrigerated can be warmed slowly under lukewarm water, placed in a cup of warm water or warmed using an electric warming device.


    · Avoid boiling human milk as this causes the loss of valuable nutrients.


    · Avoid microwaving human milk as this heats the milk unevenly, creating hot spots that may burn the baby’s mouth when the baby drinks it. Microwaving also causes the loss of important nutrients. (ABM, 2017).


    Using Stored Milk

    · Cold milk that is warmed but untouched can be returned to the fridge for a later feeding.


    · Milk that is left over in the container after the baby drinks from it can be given to the baby within the next 1-2 hours. After that time it should be discarded.


    · Frozen milk which has been thawed can be kept in the refrigerator for up to 24 hours. After that it should be discarded, not refrozen.


    · Remember that refrigerated milk will stay fresher than milk that was once frozen. It is helpful to plan ahead before deciding whether to refrigerate or freeze your milk.


    · Avoid mixing human milk with formula to make a full feeding. When cow’s milk formula is mixed with expressed human milk, there is a decrease in the number of lysozymes in human milk and a potential increase in E-coli (Jones, 2019).


    Some Other Thoughts

    · Human milk may separate into a milk layer and a cream layer when it is stored. This is normal. Swirl it gently to mix it up before giving it to your baby.


    · If you have thrush (overgrowth of yeast in the body), you can continue to breastfeed your baby during treatment. Milk expressed during treatment for thrush is safe to give your baby but it should be labelled to indicate that you had thrush at the time. It is important to note that refrigeration and freezing does not kill yeast. There is no evidence that feeding your baby milk that was expressed during a yeast outbreak leads to a recurrence of the yeast infection.


    · Occasionally, breastmilk that has been frozen and thawed may smell soapy or metallic, or just different than fresh milk. This is due to the breakdown of milk fats over time. This milk is safe and most babies will still drink it.


    · Milk that is stringy, smells foul should be thrown out and not fed to your baby.



    【Reference】参考资料:

    1.STORING HUMAN MILK UPDATED FEBRUARY 2022 www.lllc.ca

    2.Academy of Breastfeeding Medicine. (2017). ABM clinical protocol #8: Human milk storage information for home use for full-term infants. Breastfeeding Medicine, 12(7), 390-395.

    3.Centers for Disease Control and Prevention (CDC). (2017). Proper Handling and Storage of Human Milk. Retrieved from https://www.cdc.gov/breastfeeding/recommendations/handling_breastmilk.htm 

    4.Jones, F. (2019). Best practices for expressing, storing and handling human milk in hospitals, homes, and child care settings. (4th ed.) Texas: Human Milk Banking Association of North America (HMBANA).

    5.Morbacher, Nancy (2020). Breastfeeding Answers (2nd ed.). Arlington Heights, IL: Nancy Morbacher Solutions, Inc., 726-31.

    6.Toronto Public Health and BFI Strategy for Ontario (2019) Breastfeeding Protocol: Expressing, Collecting, and Storing of Human Milk. https://breastfeedingresourcesontario.ca/sites/default/files/pdf/Res_BFI_ExpressingStoring_FNL2.pdf12




    END

    翻译:加拿大母乳会

    审阅:Lynn、Marien、Victoria

    编辑:李幸、沐凡






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    欢迎转发,点赞,在看,让更多母乳妈妈受益!

    本篇文章来源于微信公众号: 国际母乳会LLL