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Adakah Pantangan Makanan/Minuman Selama Menyusui?

      Salah satu pertanyaan yang kerapkali dilontarkan Ibu-ibu menyusui adalah makanan apa yang perlu dihindari selama menyusui? Jawabannya adalah TIDAK ADA makanan yang wajib dihindari Ibu hanya karena ia menyusui. Mengkonsumsi beragam jenis makanan adalah diet yang terbaik. Jadi, Ibu bisa meneruskan kebiasaan makan seperti saat tidak menyusui kecuali Ibu mencermati ada reaksi yang jelas pada bayi terhadap jenis makanan tertentu. Jika dalam keluarga Ibu mempunyai riwayat alergi, Ibu bisa saja menghindari makanan pemicu (seperti kacang-kacangan, seafood, atau produk dari susu), namun sekali lagi hal ini berbeda reaksinya untuk setiap anak.

       Konsep nutrisi yang baik adalah makan berbagai ragam makanan secara seimbang dan sebisa mungkin mendekati bentuk yang paling alami.  Arti alami disini sebisa mungkin segar, tanpa tambahan pengawet, masih mengandung semua nutrisi dari bentuk asalnya, tanpa atau sedikit kontaminasi. Pola diet dengan nutrisi yang tepat ini berlaku untuk semua orang, tidak hanya bagi Ibu menyusui. Bagi Ibu menyusui makan dengan pola nutrisi bagus akan memberikan energi positif dan kesehatan yang baik..

Makanan Pedas dan Berbumbu 

Di kultur bangsa kita kebiasaan makan pedas, penuh rempah dan bumbu tidak bisa dihilangkan. Biasanya kala menyusui Ibu-ibu mengurangi atau menghilangkan kebiasaan ini karena khawatir bayi mereka akan rewel, sering kentut atau problem-problem lain akibat ‘rasa’ dan kualitas ASI yang berubah. Anggapan ini ternyata tidak memiliki bukti yang kuat. Beberapa bumbu seperti bawang putih memang akan terkandung dalam ASI namun kandungannya tidak sampai menyebabkan masalah. Bahkan dalam salah satu studi bayi justru menyusu lebih baik setelah Ibu makan bawang putih.

Makanan Mengandung Gas

Kaum Ibu sering diingatkan selama menyusui harap menghindari makanan yang mengandung gas (gassy foods) seperti kubis, kembang kol, brokoli, kacang-kacangan, dll. Jenis-jenis makanan tersebut memang dapat menghasilkan gas karena proses pencernaan partikel karbohidrat kompleks dan serat oleh bakteri dalam usus. Hanya saja baik gas maupun karbohidrat kompleks ini tidak melewati darah Ibu yang merupakan jalur produksi ASI. Jadi dapat dikatakan tidak mungkin ASI Ibu mengandung zat-zat ini dan dapat mengakibatkan bayi Ibu ikut mengeluarkan gas. Hal ini tidak berarti bayi Ibu sama sekali tidak memiliki sensitivitas terhadap makanan tertentu, melainkan makanan yang berpotensi mempengaruhi bayi tidak terkait dengan makanan yang membuat sang Ibu mengeluarkan gas.

Kafein

Berbagai literatur menyusui menyatakan sejumlah tertentuk kafein (sekitar 5 cangkir atau kurang dari 750 ml) tidak akan menimbulkan masalah baik bagi kebanyakan Ibu maupun bayi. Namun perlu diingat bahwa kafein tidak hanya terkandung dalam kopi. Banyak sumber kafein lain yang patut diperhatikan Ibu seperti kola, obat pereda nyeri dan demam, coklat, dan teh. Asupan kafein yang berlebihan akan membuat bayi terjaga, aktif, mata terbuka lebar, dan bisa jadi rewel. Kemampuan bayi memetabolisme kafein mulai terbentuk pada usia 3 hingga 4 bulan. Jadi ada baiknya sebelum usia itu asupan kafein dibatasi. Jika Ibu curiga bayinya bereaksi terhadap kafein, baiknya Ibu perlu menghindari segala sumber kafein selama 2-3 minggu.

Berapa Jumlah Kalori yang Diperlukan Ibu Menyusui?

Sebagian besar Ibu di negara berkembang (termasuk Indonesia) memerlukan ekstra tambahan 500 kalori setiap hari untuk mendukung proses menyusui yang baik. Bagi Ibu yang sudah bergizi baik dan memiliki berat badan cukup selama kehamilannya memerlukan lebih sedikit kalori karena mereka dapat menggunakan lemak badan dan cadangan nutrisi lain selama hamil. (Cttn: mungkin inilah penyebab keluhan Ibu menyusui tidak berkurang berat badannya walau sudah memberikan ASI eksklusif, ternyata kalori per harinya ‘berlebih’ 🙂 )

Catatan:

Selama 6 bulan pertama, bayi yang mendapatkan ASI eksklusif tanpa tambahan apapun kecil kemungkinannya mengalami mencret atau sembelit akibat ASI. Di masyarakat kita anggapan bayi mencret karena Ibu salah mengkonsumsi makanan seringkali terkait dengan pengetahuan yang kurang tepat mengenai ‘perilaku’ BAB bayi. Wajar bayi yang menyusu eksklusif BAB cukup sering atau sebaliknya, yaitu tidak setiap hari. Perilaku bayi mencerna ASI unik dan tidak dapat disamakan untuk semua bayi. Selama bayi Ibu tidak rewel, terlihat ceria, dan penambahan BB cukup, Ibu tidak perlu risau.

Referensi

http://www.llli.org/nb/nbmaternalnutrition.html

http://www.kellymom.com/nutrition/mom/index.html

http://www.llli.org/nb/nbmarapr04p44.html

http://www.linkagesproject.org/media/publications/frequently%20asked%20questions/FAQMatNutEng.pdf

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Mungkinkah Menyusui Bayi yang Diadopsi?

Berikut kutipan status facebook seorang konselor laktasi:

“Seorg bayi yg hampir dibuang ibunya kemudian diambil orang & dirawat di RS PMI Bogor. Sebelum pulang DSA RS tsb meminta agar bayi tsb mulai disusui oleh ibu adopsinya. Setelah 1 mggu ibu adopsi tersebut mulai berhasil memproduksi ASI. Subhanallah!Ibu adopsi ini sama sekali belum pernah mempunyai seorang anak pun selama 7 tahun dia menikah.So semangat moms!U can do it!”

Cerita sama pernah kami dengar juga, namun sayangnya sumber kurang dapat dipertanggungjawabkan 🙂 yaitu tentang seorang nenek yang berhasil menyusui cucunya. Status diatas tentu mengundang banyak sekali komen, rata-rata menganggap itu suatu keajaiban. Namun benarkah hal itu sesuatu yang ajaib? Mungkinkan seorang wanita yang tidak pernah memiliki anak bisa menyusui bayi yang tidak ia kandung? Ternyata jawabannya: BISA! Berikut artikel dari situs Dr Jack Newman mengenai “keajaiban” ini.

Breastfeeding Your Adopted Baby or Baby Born by Surrogate/Gestational Carrier

You would like to breastfeed your adopted baby, or one born with a surrogate or gestational carrier? Wonderful! Not only is it possible, chances are you will produce a significant amount of milk. It is different, though, than breastfeeding a baby with whom you have been pregnant for many months. With some determination and perseverance, you will enjoy the wonderful bond that breastfeeding brings and both you and baby will benefit from this experience.

Breastfeeding and breastmilk

There are really two issues in breastfeeding the baby with whom you were not pregnant. The first is getting your baby to breastfeed. The other is producing breastmilk. It is important to set your expectations at a reasonable level because only a minority of women will be able to produce all the milk the baby will need. However, there is more to breastfeeding than breastmilk and many mothers are happy to be able to breastfeed without expecting to produce all the milk the baby will need. It is the special relationship, the special closeness, and the emotional attachment of breastfeeding that many mothers are looking for. As one adopting mother said, “I want to breastfeed. If the baby also gets breastmilk, that’s great”.

Getting the baby to take the breast

Although many people do not believe that the early introduction of bottles may interfere with breastfeeding, the early introduction of artificial nipples can indeed interfere. The sooner you can get the baby to the breast after he is born, the better. The more you can avoid the baby’s getting bottles before you start breastfeeding, the better. However, babies need flow from the breast in order to stay latched on and continue sucking, especially if they have gotten used to getting flow from a bottle or another method of feeding (cup, finger feeding). So, what can you do?

  1. Speak with the staff at the hospital where the baby will be born and let the head nurse and lactation consultant know you plan to breastfeed the baby. They should be willing to accommodate your desire to have the baby fed by cup or finger feeding, if you cannot have the baby to feed immediately after his birth. In fact, more and more frequently, arrangements have been made where you will be present at the birth of the baby and will be able to take the baby immediately to the breast. The earlier you start the better. This is a situation that should be discussed ahead of time with the woman giving birth and if there is a lawyer, speak with him or her as well.
  2. Keeping your new baby skin to skin with you, you naked from the waist up and baby naked except for the diaper, is very important at this time. It helps to establish the necessary exchange of sensory information between you and your baby and helps the baby stabilize several physiological and metabolic processes: maintenance of baby’s blood sugars, heart rate, breathing rate, blood pressure and oxygen saturation. At the same time, close contact between you and the baby results in the germ free baby (at birth) being colonized by the same germs as you. Furthermore, it helps baby to adapt to this new habitat while at the same time encourages him to breastfeed while helping you to make milk.
  3. Some birth mothers are willing to breastfeed the baby for the first few days. With adoption, there is some concern expressed by social workers and others that this will result in the biological mother’s changing her mind. This is possible, and you may not wish to take that risk. With surrogacy, this may set up some unexpected feeling of resentment and remorse between the surrogate and the biological mother. This is a theoretic possibility but it would be helpful if the birth mother did in fact breastfeed the baby thus helping the baby learn to breastfeed. It allows the baby to breastfeed, get colostrum, and not receive artificial feedings at first. Another option is to ask the woman who gave birth to express her milk for the first few weeks so you have breastmilk to supplement your own, using a lactation aid at the breast (see section ‘s’).
  4. Latching on well is even more important when the mother does not have a full milk supply as when she does. A good latch usually means painless feedings. A good latch means the baby will get more of your milk, whether your milk supply is abundant or minimal. (See the information sheet When Latching).
  5. If the baby does need to be supplemented, supplementation should be done with a lactation aidwhile the baby is on the breast and breastfeeding (See the information sheet Lactation Aid). Babies learn to breastfeed by breastfeeding, not cup feeding, finger feeding, or bottle feeding. Of course, you can use your previously expressed breastmilk to supplement. And if you can manage to get it, banked breastmilk is the second best supplement after your own milk. With a lactation aid used at the breast, the baby is still breastfeeding even while being supplemented; after all, isn’tbreastfeeding what you wanted for your baby?
  6. If you are having trouble getting the baby to take the breast, come to the clinic as soon as possible for help. In fact you should be followed by a lactation consultant or someone experienced in helping mothers with breastfeeding.

Producing Breastmilk

As soon as a baby is in sight, contact a breastfeeding clinic and start getting your milk supply ready. Please understand that you may never produce a full supply for your baby, though you may. You should not be discouraged by what you may be pumping before the baby is born, because a pump is never as good at extracting milk as a baby who is sucking well and well latched on. The main purpose of pumping before the baby is born is to draw milk out of your breast so that you will produce yet more milk, not only to build up a reserve of milk before the baby is born, though this is good if you can do it.

Using the medications discussed below in A. and B., helps to prepare your breasts to make milk. We are trying to make your body think you are pregnant. The medications are not an absolute requirement for you to produce milk, but they do help you make more.

A. Hormones—Oestrogen and Progesterone. If you know far enough in advance, say at least 3 or 4 months, treatment with a combination of oestrogen and progesterone will help prepare your breasts to produce milk. A birth control pill is one way of taking these hormones, but you skip the placebos (sugar pills for one week out of every four weeks) and go right to the next package; another way is to use oestrogen patches on the breast plus oral progesterone. Get information about this protocol from the clinic and see the Newman-Goldfarb Protocols for Induced Lactation at http://www.asklenore.info). We encourage you to take the hormones until about 6 weeks before the baby is to be born.
B. Domperidone. See the information sheets Domperidone, Getting Started and Domperidone, Stopping. The starting dose is 30 mg three times a day, but we have gone as high as 40 mg 4 times a day. The domperidone is continued when the hormones are stopped. Usually it is necessary to continue it for several months after you start breastfeeding. Check the information sheets for more information. Ask at the clinic.
C. Pumping. If you can manage it, rent an electric pump with a double setup. Pumping both breasts at the same time takes half the time, obviously, and also results in better milk production. Start pumping when you stop the birth control pill. Do what is possible. If twice a day is possible at first, do it twice a day. If once a day during the week, but 6 times during the weekend can be done, fine. Partners can help with nipple stimulation as well (See the information sheet Expressing Milk)

But will I produce all the milk the baby needs?

Maybe, maybe not. If you do not, breastfeed your baby anyhow, and allow yourself and him to enjoy the special relationship that it brings. In any case, some breastmilk is better than none.

Very Important: If you decide to take the medications (the hormones and/or the domperidone), your family doctor must be aware of what you are taking and why. It is very important to have a physical and have your blood pressure checked before starting the protocols. Significant side effects have been rare, but that does not mean they cannot happen. Your doctor needs to be following you, and once the baby is with you, your baby’s doctor needs to know that you are breastfeeding him and needs to follow the baby’s progress just as s/he would any other baby.