Breastfeeding critical for child survival

http://www.who.int/mediacentre/news/releases/2004/pr19/en/

Joint press release WHO/UNICEF

Global Strategy: Breastfeeding critical for child survival
UNICEF and WHO call for increased commitment to appropriate feeding practices for all infants and young children

23 MARCH 2004 | NEW YORK -- Calling on governments to promote and protect breastfeeding, UNICEF and WHO today jointly launched the Global Strategy for Infant and Young Child Feeding. The document, developed over two years of global consultation, pinpoints the main problems affecting infant and young child feeding and identifies approaches to their solution.

"There is no better way than breastfeeding to make sure that a child gets the best start in life," said UNICEF Executive Director Carol Bellamy. "The strategy is an invaluable roadmap for governments to create supportive environments where women can make informed choices about feeding their children."

Breastfeeding alone provides the ideal nourishment for infants for the first six months of life as it provides all the nutrients, antibodies, hormones, immune factors and antioxidants an infant needs to thrive. It protects babies from diarrhoea and acute respiratory infections and stimulates their immune systems.

"Virtually all mothers can breastfeed provided they have accurate information, and support within their families and communities and from the health care system," said LEE Jong-wook, Director-General of WHO. "Governments should move swiftly and effectively to implement this important strategy."

Lack of breastfeeding - and especially lack of exclusive breastfeeding during the first half-year of life - are important risk factors for infant and childhood morbidity and mortality. These risk factors are compounded by inappropriate complementary feeding as infants grow.

"Exclusive breastfeeding in the first half-year of life and continued breastfeeding coupled with appropriate foods reduce the number of children under five who die from malnutrition," said Dr Lee. Malnutrition is associated with more than 50% of deaths among children under five.

The strategy calls for a dramatic increase in the number of infants who are exclusively breastfed. Currently, no more than 35% of infants worldwide are exclusively breastfed during even the first four months of life. Complementary feeding frequently begins too early or too late, and foods are often nutritionally inadequate and unsafe. Malnourished children who survive are more frequently sick and suffer the life-long consequences of impaired development.

"The long-term impact of poor feeding practices in infancy and early childhood include poor school performance, reduced productivity and impaired intellectual and social development," Bellamy said.

In addition to stressing the link between the health and nutritional status of mothers and children, the strategy addresses the challenges of feeding in exceptionally difficult circumstances, such as natural or man-made emergencies.

The strategy also highlights the issue of optimal feeding of the roughly 2.6 million children who are born to HIV-infected women each year. The absolute risk of HIV transmission through breastfeeding - globally between 5% and 20% - needs to be balanced against the increased risk of morbidity and mortality when infants are not breastfed. All HIV-infected mothers should receive information about the risks and benefits of various options and guidance in choosing the most suitable option.

The Global Strategy for Infant and Young Child Feeding, available in six languages, was presented by UN Under Secretary-General for Management Catherine Bertini on 23 March to the Standing Committee on Nutrition session at the UN. It was distributed 24 March during a session on Breastfeeding and Complementary Feeding and their contribution to achieving the UN Millennium Development Goals.

For more information contact:

Randa Saadeh
Telephone: +41 (22) 791 3315
Email: saadehr@who.int

David Porter
Media Officer,
Telephone: +41 (22) 791 3774
Email: porterd@who.int

Erin Trowbridge
Telephone: +1 212 326 7172
Email: etrowbridge@unicef.org

Kate Donovan
Telephone: +1 212 326 7452
Email: kdonovan@unicef.org

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Sumber : http://www.news-medical.net/print_article.asp?id=1381

Survey serious misunderstandings about breastfeeding

Posted By: News-Medical in Women's Health News

Published: Monday, 10-May-2004

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A survey published today by The UK Department of Health for National Breastfeeding Awareness Week (9 - 15 May) shows that serious misunderstandings may be stopping women, particularly young women, from breastfeeding. Although the benefits of breastfeeding are well known, the UK has one of the lowest breastfeeding rates in Europe. Almost a third of women (29%) in England and Wales never try to breastfeed compared to 2% in Sweden. Younger women in particular are less likely to breastfeed with over 40% of mothers under 24 never trying. The new survey of 1000 women shows: Myth: Over a third (34%) of women believe that modern infant formula milks are very similar or the same as breast milk Fact: Infant formula milk does not contain the antibodies, living cells, enzymes or hormones present in breastmilk. Breastmilk is designed for each individual baby and changes over time whereas infant formula milk is designed for every baby. Myth: A fifth (20%) of young women aged 16-24 years believe that breastfeeding will ruin the shape of their breasts/body Fact: Breastfeeding uses up 500 extra calories a day. It helps the womb return back to normal and does not affect the shape of breasts in the long term Myth: Over two thirds (67%) of women believe that the general public find breastfeeding in public unacceptable Fact: Most people (84%)think it's fine for mothers to breastfeed their babies discreetly in public/in front of others (5) Myth:  Nearly all (95%) women believe that breastfeeding comes naturally to some and not to others Fact:  Breastfeeding is a skill and takes practice. It is important that women feel able to ask for help. Myth: Nearly all women (87%) believe that some women don't produce enough milk to be able to breastfeed. Fact:   Virtually all mothers can breastfeed provided they have accurate information and support. (4) Minister for Public Health, Melanie Johnson, says: "Breastfeeding is a major public health issue. A decision to breastfeed, especially if sustained for the first six months of a baby’s life, can make a major contribution to infant health and development as well as benefiting mums. "Our message is a simple one – if you are an expectant or new mum don’t let these myths discourage you from giving breastfeeding a go!" Give it a Go is the theme of National Breastfeeding Awareness Week this year which focusses on encouraging those with the lowest breastfeeding rates such as the young and those in disadvantaged areas to start breastfeeding. Among events planned are a series of evening presentations at Mothercare stores where health professionals will explain the benefits of breastfeeding and answer questions. Breastfeeding advocates include film and TV personalities Sadie Frost, Fiona Phillips, Davina McCall and Donna Air who says: “Because Freya is my first child I was extra cautious to give her the best start in life. Breastfeeding was a great way to help her avoid allergies and infections. I am so pleased I made the decision to breastfeed. It has proved tough at times, but is also very rewarding for both myself and Freya.” Davina McCall agrees: “Breastfeeding isn't always easy.  Both times I've nearly given up at six weeks but with some encouragement and reassurance I've persevered and I'm glad I did.  It's a wonderful experience and I always feel sad about stopping.”

How can I tell if my baby is getting enough milk?

This may be the most asked question for La Leche League Leaders. It is understandable, since breasts are neither see-through nor marked off in ounces. Thank goodness there are other signs that indicate baby is getting enough milk.

Typically during the first few days, while the baby is receiving mother’s thick, immunity-boosting colostrum, he will wet only one or two diapers per day.

Once mother's milk comes in, usually on the third or fourth day, the baby should begin to have 6-8 wet cloth diapers (5-6 wet disposable diapers) per day. (An easy way to feel the weight of a wet disposable diaper is to pour 2-4 tablespoons of water in a dry diaper.)

In addition, most young babies will have at least two to five bowel movements every 24 hours for the first several months, although some babies will switch to less frequent but large bowel movements at about 6 weeks.

A baby that is sleeping rather than feeding every 2-3 hours or is generally lethargic may need to be assessed by a health care provider to make sure that he is adequately hydrated.

These are additional important signs that indicate your baby is receiving enough milk:

·         The baby nurses frequently averaging at least 8-12 feedings per 24-hour period. 

·         The baby is allowed to determine the length of the feeding, which may be 10 to 20 minutes per breast or longer. 

·         Baby’s swallowing sounds are audible as he is breastfeeding. 

·         The baby should gain at least 4-7 ounces per week after the fourth day of life. 

·         The baby will be alert and active, appear healthy, have good color, firm skin, and will be growing in length and head circumference.

The physical act of breastfeeding is more than the quantity of milk that is supplied, as you will find once you hold your baby in your arms. Breastfeeding is warmth, nutrition, and mother's love all rolled into one. Understanding and appreciating the signs of knowing when your baby is getting enough to eat is the one of the most important things a new mother can learn. If you have any concerns regarding your baby, they should be addressed with your health care practitioner.

If you do need to increase your milk supply after keeping track of wet diapers, bowel movements and weight gain, there are several options you can try to increase your milk supply. See our FAQ on “Increasing Your Milk Supply” for further information. Keep in touch with your health care provider if your baby is not gaining well or is losing weight. In most cases, improved breastfeeding techniques will quickly resolve the situation, but occasionally, weight gain may indicate a health problem.

La Leche League's THE WOMANLY ART OF BREASTFEEDING is the most complete resource available for the breastfeeding mother and can be ordered from our online catalogue or through your local Leader. The online catalogue also has information sheets, such as “How to Know Your Healthy Full-Term Breastfed Baby is Getting Enough Milk” and “Increasing Your Milk”. These are also available from your local Leader. You can find a LLL Leader and Group by going to our Web page on finding a local Leader.

Last updated Tuesday, December 11, 2001 3:48 PM by sak.

http://www.lalecheleague.org/FAQ/enough.html

FAQ Seputar Penyimpanan ASI

BERAPA LAMA ASI HASIL POMPA/PERAS BISA DISIMPAN PADA SUHU RUANG?
Jika ruangan tidak ber-AC, disarankan tidak lebih dari 4 jam
Jika ruangan ber-AC, bisa sampai 6 jam
-catatan: suhu di atas harus stabil, misalnya ruangan ber-AC, tidak mati
sama sekali selama botol ASI ada di dalamnya.

BERAPA LAMA ASI HASIL POMPA/PERAS BISA DISIMPAN PADA SUHU LEMARI ES?
Jika Ibu mengetahui bahwa dalam 4 jam ke depan ASI hasil pompa/peras tidak akan diberikan pada bayi, maka segeralah simpan di lemari es. ASI ini bias bertahan sampai 8 (delapan) hari dalam suhu lemari es, jika ditempatkan dalam compartment yang terpisah dari bahan makanan lain yg ada di lemari es tsb.
Jika lemari es Ibu kebetulan tidak memiliki compartment terpisah untuk
menyimpan botol ASI hasil pompa/perasan, maka sebaiknya ASI tersebut jangan disimpan lebih dari 3 x 24 jam.
Ibu juga dapat "membuat" compartment terpisah dengan cara menempatkan botol ASI dalam container plastik yang tentunya dibersihkan terlebih dahulu dengan baik.

BERAPA LAMA ASI HASIL POMPA/PERAS BISA DISIMPAN PADA SUHU FREEZER?
ASI hasil pompa/perasan dapat disimpan dalam freezer biasa sampai 3 (bulan) lamanya. Namun Ibu jangan menyimpan ASI ini di bagian pintu freezer, karena bagian ini yang mengalami perubahan dan variasi suhu udara terbesar.

Jika Ibu kebetulan memiliki freezer penyimpan daging yang terpisah (biasanya disebut deep freezer) yang umumnya memiliki suhu lebih rendah dari freezer biasa, maka ASI hasil pompa/perasan bahkan dapat disimpan sampai dengan 6 (enam) bulan di dalamnya.

BAGAIMANA CARA MENYIMPAN ASI HASIL POMPA/PERASAN YANG BAIK?
- Simpan ASI dalam botol yang telah disterilkan terlebih dahulu
- Botol yang paling baik sebetulnya adalah yang terbuat dari gelas/beling,namun jika terpaksa menggunakan botol plastik, pastikanlah bahwa plastiknya cukup kuat (tidak meleleh jika direndam dalam air panas)
- Jangan pakai botol susu yang berwarna / bergambar, karena ada kemungkinan catnya meleleh jika terkena panas
- Jangan lupa bubuhkan label setiap kali Ibu akan menyimpan botol ASI,
dengan mencantumkan tanggal dan jam ASI dipompa/peras
- Simpan ASI di dalam botol yang tertutup rapat (jangan ditutup dengan dot,karena masih ada peluang untuk berinteraksi dengan udara)
- Jika dalam satu hari Ibu memompa/memeras ASI beberapa kali, bisa saja Ibu menggabungkan hasil pompa/perasan tsb dalam botol yang sama, dengan catatan bahwa suhu tempat botol disimpan stabil, antara 0 s/d 15 derajat Celcius).
Penggabungan hasil simpanan ini bisa dilakukan asalkan jangka waktu
pemompaan/pemerasan pertama s/d terakhir tidak lebih dari 24 jam

BAGAIMANA CARA PEMBERIAN ASI YANG SUDAH DIDINGINKAN KEPADA BAYI?
- Panaskan ASI dengan cara:
(a) membiarkan botol dialiri air panas (bukan mendidih) yang keluar dari
keran
ATAU
(b) merendam botol di dalam baskom / mangkuk yang berisi air panas (bukan mendidih)

- Jangan sekali-sekali memanaskan botol dengan cara mendidihkannya dalam
panci, menggunakan microwave atau alat pemanas lainnya (kecuali yang memang di-design untuk memanaskan botol berisi simpanan ASI)

- Ibu tentunya mengetahui berapa banyak bayi Ibu biasanya sekali meminum
ASI. Sesuaikanlah jumlah susu yang dipanaskan dengan kebiasaan tsb. Misalnya dalam satu botol Ibu menyimpan sebanyak 180 cc ASI tetapi bayi Ibu biasanya hanya meminum 80, jangan langsung dipanaskan semua. INGAT bahwa susu yang sudah dipanaskan tidak bisa disimpan lagi!

BAGAIMANA SAYA MENGETAHUI APAKAH ASI YANG DISIMPAN SUDAH BASI?
Sebenarnya jika Ibu mengikuti pedoman pemompaan/pemerasan ASI dan penyimpanan yang baik, ASI tidak akan mungkin basi. Kadang memang setelah disimpan / didinginkan akan terjadi perubahan warna dan rasa, tapi itu tidak menandakan bahwa ASI sudah basi. Asalkan Ibu berada dalam keadaan bersih ketika memompa/memeras, menyimpan ASI dalam botol yang steril & tertutup rapat, dalam jangka waktu yang dijabarkan seperti di atas dan saat memanaskan juga mengikuti petunjuk, mudah-mudahan ASI Ibu terjaga dalam kondisi yang baik.

Dibandingkan susu formula, ASI lebih tahan lama. Pada saat berinteraksi dengan udara luar, biasanya yang terjadi bukan pembusukan ASI tetapi lebih merupakan berkurangnya khasiat ASI, terutama zat yang membantu pembentukan daya imun bayi.

SELAMAT ! Bayi Ibu sungguh beruntung memiliki Ibu yang menyadari betul arti dan manfaat pemberian ASI dalam awal kehidupannya. Semoga ia tumbuh sehat dan selalu berada dalam lindungan Tuhan. Amiin.

------------------------------------------------------------------------

Nara Sumber:

Barger, J. and Bull, P.A., Comparison of the bacterial composition of breast milk stored at room temperature and stored in the refrigerator. Intl Journal of Childbirth Ed 2: pages 29 and 30 1987.

Hamosh, M. et al., Breastfeeding and the working mother effect of time and temperature of short term storage on proteolysis, lipolysis, and bacterial growth in milk. Pediatrics 97 (4) 492 to 498, 1996

Mohrbacher, N. and Stock, J., The Breastfeeding Answer Book, La Leche League International, 1997, pp 30 to 31.

Pardou, A. et al., Human milk banking: influence of storage processes and of bacterial contamination on some milk constituents. Biol Neonate 65:302 to 309, 1994