Hírolvasó

Amikor a baba nem akar szopni – a szopási sztrájk kezelése

A szopási sztrájk a szopás elutasítását jelenti, egy már bizonyos mértékig kialakult szoptatási kapcsolatban. Nem csoda, hogy ebben a helyzetben a tehetetlenség és kétségbeesés hullámai uralkodhatnak el rajtunk.

Miért nem szopik? Beteg? Nincs elég tejem? Ki fog száradni? Hogy etessem meg?

Az addig harmonikus szoptatási kapcsolatba ilyenkor a bizonytalanság és a félelem költözik.

Sok édesanyát váratlanul ér, amikor azt tapasztalja, hogy kisbabája egy-egy szopi alkalmával vagy bizonyos napszakokban részlegesen vagy akár teljes mértékben elutasítja a szopást. Az ilyen esetek nagy részénél szopási sztrájkról beszélünk. Ennek a jelenségnek a megértése segíthet, hogy a kétségbeesés és tehetetlenség helyett a babádban és magadban bízva vissza tudjatok térni a harmonikus szoptatáshoz.

Hogyan ismerhető fel a szopási sztrájk? – a szopási sztrájk leggyakoribb tünetei

A legszembetűnőbb jele a sztrájknak a baba viselkedésében megjelenő ellentmondásosság.
Egyrészt azt jelzi, hogy szopni szeretne: az újszülött cuppog, tátog, dugdossa a nyelvét kifelé, forgatja a fejét, öklét a szájába teszi. Nagyobbacska baba fúrja a fejét a mellhez, ölbe mászik, esetleg a megszokott szavakat mondja. Másrészt azonban, az előzőekben felsorolt jelzések ellenére a szopás megkezdése előtt vagy közben, akár már a szopási testtartáshoz való készülődéskor, feszültté, frusztrálttá válik és elutasítja a mellet.

A totyogó korú gyerekeknél találkozhatunk hirtelen felbukkanó elkerülő viselkedéssel, amikor nem kéri a korábbi megszokott helyzetekben a mellet, édesanyja kínálására pedig feszültség, nyugtalanság látható rajta.

A cikk folytatása itt olvasható: Amikor a baba nem akar szopni – a szopási sztrájk kezelése

judit 2020. 11. 18., sze – 21:40 Tags Szoptatás Szoptatási nehézségek

A tejtermelés: tények és tévhitek anyai félelmeink tükrében

Rengeteg tévhit él a köztudatban a szoptatással kapcsolatban. Ezek nagy része megalapozatlan, felületes következtetéseken, tévesen értelmezett személyes élményeken, hiányos ismereteken alapul, mégis képes legmélyebb anyai félelmeinket felerősíteni.

A információk, amik a tévhiteket cáfolják, ugyan csak részben nyújtanak megnyugvást, mégis fontos kapaszkodók lehetnek. A helyes ismeretek mellett persze szükséged van a környezeted szeretetteljes támogatására, olykor szakemberek segítségére, és kisbabád fejlődésének örömteli tapasztalatára ahhoz, hogy legmélyebb félelmeid szelídüljenek és biztonságérzeted megerősödjön.

A leggyakoribb szoptatással kapcsolatos kérdések a tejtermelés körül forognak: Lesz-e elegendő tejem a kisbabám számára? Mi van, ha elapad? Biztosan elég jó a tejem?

Mintha csak azt kérdeznénk: Vajon életben tudom tartani a kisbabámat? Bízhatok a testemben, hogy képes őt táplálni? Elég jó anya vagyok?

A cikk folytatása itt olvasható: A tejtermelés: tények és tévhitek anyai félelmeink tükrében

judit 2020. 11. 18., sze – 21:23 Tags Szoptatás Anyaság Szoptatási nehézségek Válaszkész gondoskodás

A tejtermelés: tények és tévhitek anyai félelmeink tükrében

Rengeteg tévhit él a köztudatban a szoptatással kapcsolatban. Ezek nagy része megalapozatlan, felületes következtetéseken, tévesen értelmezett személyes élményeken, hiányos ismereteken alapul, mégis képes legmélyebb anyai félelmeinket felerősíteni.

A információk, amik a tévhiteket cáfolják, ugyan csak részben nyújtanak megnyugvást, mégis fontos kapaszkodók lehetnek. A helyes ismeretek mellett persze szükséged van a környezeted szeretetteljes támogatására, olykor szakemberek segítségére, és kisbabád fejlődésének örömteli tapasztalatára ahhoz, hogy legmélyebb félelmeid szelídüljenek és biztonságérzeted megerősödjön.

A leggyakoribb szoptatással kapcsolatos kérdések a tejtermelés körül forognak: Lesz-e elegendő tejem a kisbabám számára? Mi van, ha elapad? Biztosan elég jó a tejem?

Mintha csak azt kérdeznénk: Vajon életben tudom tartani a kisbabámat? Bízhatok a testemben, hogy képes őt táplálni? Elég jó anya vagyok?

A cikk folytatása itt olvasható: A tejtermelés: tények és tévhitek anyai félelmeink tükrében

judit 2020. 11. 18., sze – 21:23 Tags Szoptatás Anyaság Szoptatási nehézségek Válaszkész gondoskodás

Is there a specific approach to early positioning that nursing families can use to reduce by half the incidence of nipple and breast problems? Yes, according to THIS brand-new randomized controlled trial from Italy.

This New Italian Study

For years, when giving talks to lactation supporters, I asked aspiring researchers to please study the impact of using the Natural Breastfeeding (NB) approach to early positioning (aka “biological nurturing” and “gestalt breastfeeding”) on the incidence of nursing problems. The NB approach involves using relaxed, semi-reclined feeding positions (see photos) rather than sitting upright to nurse. From what I knew from experience and previous studies, its impact was huge.

Finally, the study I was hoping for is here, and its conclusions are just what I expected. Its research team randomized 188 pregnant women to one of two groups. Before delivery, the usual-care group was taught to nurse sitting upright. The intervention group watched videos of families using the NB approach. After birth, both groups had skin-to-skin contact with their newborns, were encouraged to nurse on cue, had 24-hour rooming-in, and as needed, were helped in the hospital with the approach to positioning that was consistent with their group.

During the first 4 months of nursing, the researchers found significant differences between the two groups. Compared with the usual-care (upright) group, those using the NB (semi-reclined) approach experienced about half the incidence of nipple and breast problems, such as nipple pain and cracks, engorgement, and mastitis. Before hospital discharge, the NB group had fewer latching struggles. Although not statistically significant, the study team noted a trend toward more exclusive breastfeeding among those in the NB group.

The study’s authors concluded that the NB approach was effective in a real-life hospital setting and that anything that cuts in half the incidence of nipple and breast problems “has the potential to become an important public-health measure for the promotion of breastfeeding.” These conclusions were the same I reached more than a decade ago.

The Natural Breastfeeding Approach

My own “aha moment” about early positioning came in 2009, when I happened upon a UK STUDY that challenged my assumptions and changed my practice. As I began to use this new positioning strategy, I saw many families quickly overcome some of the thorniest nursing challenge simply by making small changes in their nursing positions. There will never be an intervention that works 100% of the time, but because this one takes advantage of the innate feeding behaviors present in healthy babies at birth, I’ve found that in most cases, it makes a great starting point.

When I promoted this approach during my talks to clinicians, sometimes my colleagues were willing to give it a try—often only as a last resort—but more often they weren’t or told me later, “I tried it once and it ‘didn’t work.’”

An entrenched practice such as upright positioning can sometimes be difficult to change. But I kept honing my message and developing new teaching tools, because I saw with my own eyes what a night-and-day difference it made for so many families struggling to nurse their newborns.

NB Digital Teaching Tools

As I attempted to find the words and images that made this approach easier for parents and professionals to use, I partnered with OB Dr. Theresa Nesbitt. We named this approach Natural Breastfeeding and created a simplified vocabulary and easily accessible visuals. We included a free demo video on the home page of our Natural Breastfeeding website HERE, so families can become familiar with this approach both before and after birth. We hoped that watching a diverse group of mothers with different body types discussing the adjustments that worked for them might get the message across in a format many of today’s parents prefer. I created an ad-free YouTube channel HERE, where families and colleagues can watch short clips of mothers and newborns using the NB approach.

For providers, we created the Natural Breastfeeding Professional Package (NBPP) HERE, which offers licensing rights to use our teaching videos and images in hospitals, public-health departments, and private practices. (See also our short video about the NBPP HERE.) A subscription to the NBPP allows providers to give an unlimited number of families access to our 6-module NB digital program. A perfect educational option during a pandemic, families can view this lactation course (and its more than 60 short videos) before and after birth at their own pace on their phones, tablets, and computers. The NBPP also includes staff training materials and handouts.

For those who still think that nursing upright during the newborn period is best, it’s time to rethink this assumption. Please read this new study, watch our videos, and give the NB approach a try. For a more detailed, fully referenced explanation of the NB approach, see Chapter 1 of my new book for lactation supporters, Breastfeeding Answers, Second Edition.

Journal of Human Lactation, Ahead of Print.
IntroductionPuerperal mastitis, a complication occurring during the breastfeeding period, is often caused by Staphylococcus aureus. Here we report on severe streptococcal mastitis in a lactating breast, with subsequent invasive disease and wound healing problems.Main issueThe 41-year-old woman (G2, P2) presented at 2 weeks postpartum to our hospital with painful swelling and reddening of the left breast, in addition to fever and malaise, and complained about a nipple fissure on the left breast. Previously, her 4-year-old son was treated for an acute otitis media and her husband experienced flu-like symptoms.ManagementDue to the severity of the symptoms, Clindamycin antibiotic treatment was initiated intravenously. Streptococcus pyogenes was isolated in the milk. This strain is commonly known to cause infections of the upper respiratory tract, skin, and soft tissue, but rarely mastitis. Furthermore, the participant developed invasive disease with abscess formation and skin erosion with a milk fistula. Special dressing was applied to promote wound healing. The participant continued breastfeeding well into the child’s 2nd year of life.ConclusionThis rare form of complicated mastitis with invasive disease caused by Streptococcus pyogenes called for an interdisciplinary approach. We want to draw attention to other pathogens causing mastitis and to alert health care workers to promote hygiene in lactating women to prevent transmission.

Journal of Human Lactation, Ahead of Print.
BackgroundThis case presents a mother’s feeding experience of an infant born with a complete unilateral cleft lip and palate from birth until both were repaired. She fed him directly at the breast with assistance, controlling the delivery of the mother’s own milk. The infant received only his mother’s own milk, no bottles, and the excess expressed milk was donated to a milk bank.Main issueThe Cleft Team supported the mother’s wish to breastfeed but expressed realism that cleft lip and palate infants could not create suction. Success had never been observed in the unit. Instead, the team suggested expressing to deliver as much of the mother’s own milk. The mother had previously breastfed her three children and was keen on finding innovative ways to breastfeed.ManagementSeveral techniques were trialed with the help of an International Board Certified Lactation Consultant. The most sustainable and successful was the use of a nipple shield applied to the maternal nipple areola complex to cover the lip palate. Underneath, a nasogastric tube connected to a syringe delivered the mother’s own milk. Exclusive expressing protected maternal supply, the infant’s nutrition and growth were monitored carefully and this technique reinforced mother–infant bonding.ConclusionFeeding with the modifications was challenging at times. However, maternal satisfaction was high because the mother had achieved her goal of breastfeeding without assistance post cheiloplasty and palatoplasty. This case adds to the limited body of research about feeding infants with cleft lips and palates directly at the breast.

Journal of Human Lactation, Ahead of Print.
BackgroundThe human milk donor pool in South Africa is severely limited due to the low rate of continued breastfeeding and the HIV pandemic. It was crucial to determine why willing donors did not donate to determine if infrastructure could be implemented to prevent this loss.Research aimTo determine why mothers who had committed to donating to a human milk bank in South Africa did not donate their milk.MethodsParticipants (N = 37) were interviewed using a telephone administered questionnaire. Variables measured were initiation and continuation of breastfeeding, reasons for discontinuation, age of introduction of solids and type, and reasons for not donating. Data were interpreted using descriptive statistics and Pearson’s chi-square test.ResultsParticipants were mainly unemployed (70.2%, n = 26), single (73%, n = 27), black African (83.7%, n = 31), Christian (62.2%, n = 23) women with a M age of 25.7 (5.2) years, and a secondary or higher education level (81.1%, n = 30). Most lived in urban areas (70.2%, n = 26), with piped water (100%, n = 37), electricity (100%, n = 37), and refrigerators (100%, n = 37). Only 29.7% (n = 11) owned a vehicle. The major barrier was infrastructure related, as 62.2% (n = 23) were unaware of the process after discharge. This was followed by practical issues including no transport (21.6%, n = 8), no freezer for milk storage (18.9%, n = 7), or working (5.4%, n = 2).ConclusionThe major barrier was ignorance of the post discharge process and lack of support from clinic staff. No transportation challenged the maintenance of the cold chain. A potential solution is mothers donating only at clinic immunization visits.

Journal of Human Lactation, Ahead of Print.

Journal of Human Lactation, Ahead of Print.
BackgroundOptic neuritis is a rare condition that can lead to sudden blindness and also could be a precursor to multiple sclerosis. When it occurs postpartum during lactation, it is called lactation optic neuritis.Main issueWe present four cases of optic neuritis in lactating mothers, two of which had additional features of demyelinating disease upon neurological imaging.ManagementAll participants were treated with high dose intravenous steroids followed by 11 days of oral steroids, per the optic neuritis treatment trial, which led to complete recovery of vision. Two participants with demyelinating disease on magnetic resonance imaging scans were advised to wean, because of a need for immunosuppressive therapy later.ConclusionOptic neuritis during lactation should be suspected following acute loss of vision. Prompt referral to an ophthalmologist is mandated for early diagnosis and treatment to prevent long-term co-morbidities.

Parents’ decisions about how to feed their newborns are influenced by multiple factors. Our objective was to identify the factors that can influence the decision to breastfeed.

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