Senin, 25 April 2011

11 Tips Mengatasi Baby Blues Syndrome

Berikut ini ada beberapa hal yang bisa Anda lakukan untuk mencegah dan mengatasi Baby Blues Syndrome maupun Postpartum Depression:

Sebelum Melahirkan
  1. Mulailah meminta dukungan dan bantuan keluarga sebelum proses melahirkan
  2. Persiapkan mental dan pengetahuan Anda seputar perawatan dan kesehatan bayi
  3. Jika Anda sudah menguasai berbagai kiat merawat bayi sejak sebelum melahirkan, maka mental Anda pun akan siap untuk menjadi seorang ibu
Sesudah Melahirkan
  1. Mintalah bantuan suami, orang tua, mertua, serta kerabat dalam mengurus bayi Anda
  2. Tidurlah selagi ada kesempatan
  3. Ceritakan berbagai kesulitan Anda kepada suami Anda
  4. Bergabunglah bersama komunitas ibu untuk berbagi pengalaman dan perasaan
  5. Jangan terlalu membebani diri Anda
  6. Manfaatkan waktu luang untuk rileks
  7. Perhatikan pola makan Anda
  8. Beri penjelasan kepada suami Anda tentang Baby Blues Syndrome, agar ia bisa memahami berbagai perubahan sikap dan tingkah laku Anda
Pada kasus Postpartum Depression (PPD), situasinya bisa sangat memburuk, sehingga tips-tips di atas tidaklah mencukupi. Sebaiknya konsultasikan dengan dokter Anda jika sepertinya Anda atau keluarga Anda menderita PPD, karena diperlukan perawatan lebih intensif.

Back to Bright Ideas

Bayi Jangan Langsung Dimandikan Setelah Lahir

Cegah Hilangnya Refleks Menyusu
Penelitian di Swedia baru-baru ini memperlihatkan bayi yang diletakkan di dekat puting ibunya segera setelah lahir memiliki respon menyusui yang lebih baik, dibandingkan bayi yang dibersihkan lebih dahulu. Kondisi itu sangat menguntungkan sang bayi karena tidak saja mendapatkan kolostrum dari ASI --yang kaya zat gizi untuk kekebalan tubuhnya-- tetapi juga melatih refleks menyusunya dengan benar.

Dalam sebuah tayang video disajikan bagaimana bayi baru lahir itu diletakkan di samping puting ibunya mampu menggerakkan tangan dan kakinya untuk mendapatkan puting ibunya. Begitu didapat, bayi dengan cepat membuka lebar mulutnya, lalu menyusui tanpa dibantu tangan ibunya. Setelah 10 menit bayi kemudian dibersihkan, kemudian diletakkan kembali ke dada ibunya. Refleks menyusunya sangat cepat dengan menggunakan tenaganya sendiri.

Sementara bayi yang dibersihkan setelah lahir, lalu diletakkan disamping puting ibunya tidak memperlihatkan respon atas puting ibunya. Meski sudah diletakkan diatas puting, bibir si bayi hanya diam saja. Keinginan menyusu dari bayi baru terjadi 10 jam kemudian, itupun harus dipandu sang ibu karena bayi kesulitan mendapatkan puting ibunya sambil menangis.

"Jika begitu lahir bayi langsung dimandikan, refleks menyusu ini langsung hilang 50 persen. Jika bayi lahir dengan operasi Caesar dan langsung dimandikan, refleks itu 100 persen hilang," kata Ketua Sentra Laktasi Indonesia, dr Utami Roesli mengomentari tayang yang menarik itu dalam sebuah diskusi tentang ASI, di Jakarta, Jumat (30/7) sehubungan dengan peringatan peringatan Pekan ASI Dunia 2004 yang jatuh pada 1-7 Agustus.

Penelitian terbaru itu, menurut dr Utami Roesli, seharusnya bisa mematahkan prosedur persalinan yang selama ini langsung membersihkan bayi segera setelah dilahirkan. "Bila melihat efek yang luar biasa pada bayi, kenapa kita tidak mencoba mempraktekkannya. Tetapi memang usaha ini bukan perkara mudah, karena bukan saja terkait dengan kebiasaan yang sudah mengakar masyarakat, tetapi juga harus berhadapan dengan produsen susu formula yang melakukan praktek gelap di rumah sakit," katanya.

Beberapa rumah sakit memberikan susu formula pada bayi yang baru lahir sebelum ibunya mampu memproduksi ASI. Hal itu menyebabkan bayi tidak terbiasa menghisap ASI dari puting susu ibunya, dan akhirnya tidak mau lagi mengonsumsi ASI atau sering disebut dengan "bingung puting".

"Menghisap susu dari botol itu lain dengan menghisap puting susu ibu. Bayi harus belajar sejak awal dan ibu juga harus belajar menyusui, karena ketrampilan itu memang harus dipelajari oleh keduanya," ujar dr Utami Roesli.

Sejak lahir, seorang bayi harus diajari menyusu dengan cara memasukkan seluruh areola payudara (daerah berwarna cokelat di payudara ibu) ke dalam mulut bayi. Jika bayi hanya mengisap puting susu saja, ASI yang keluar hanya sedikit. "Gudang ASI terletak di bawah daerah cokelat itu. Jika yang diisap hanya putingnya saja, ASI yang keluar hanya sedikit. Sedangkan, kalau dari daerah cokelat itu, ASI yang keluar akan banyak sekali," jelas Utami.

Jika ASI di gudang itu habis, pabrik ASI (alveoli) akan segera memproduksi lagi. Alveoli berbentuk bulat dan bergerombol seperti buah anggur. Alveoli dikelilingi otot yang disebut myoepithel. Otot inilah yang memompa ASI keluar dari alveoli menuju gudang ASI.

Namun, kinerja myoepithel sangat tergantung pada hormon oksitosin yang dikirim otak. Jika oksitosin keluar, otot pun bekerja. Sedangkan, oksitosin bisa keluar jika ibu merasa tenang dan disayang oleh suami serta mendapat dukungan dari orang-orang di sekelilingnya. "Makanya hormon ini disebut hormon kasih sayang. Dan di sinilah ayah memegang peranan penting," tegas Utami.

Macetnya proses pemberian ASI ini disebabkan beberapa hal. Misalnya, bayi yang tidak bisa mengisap, posisi menyusui yang salah, ibu merasa tidak nyaman, atau suami dan lingkungan tidak mendukung. "Tidak ada cerita seorang ibu tidak bisa menyusui atau ASI yang tidak cukup.

Perhatikan saja seekor marmut yang kecil bisa menyusui 12 ekor anaknya. Bayi gajah yang besar juga bisa disusui dengan cukup oleh induknya. Mereka tidak memerlukan susu hewan lain untuk memenuhi kebutuhan susu. ASI diproduksi berdasarkan jumlah yang dikeluarkan," ungkap Utami.

Dua Persen


Ia memperkirakan jumlah ibu yang memberikan ASI eksklusif kepada bayinya sampai berumur enam bulan saat ini masih rendah, yaitu kurang dari dua persen dari jumlah total ibu melahirkan. "Itu antara lain terjadi karena pengetahuan ibu tentang pentingnya ASI masih rendah, tatalaksana rumah sakit yang salah, dan banyaknya ibu yang mempunyai pekerjaan di luar rumah," ucapnya.

ASI eksklusif adalah pemberian ASI tanpa makanan tambahan lain pada bayi berumur nol sampai enam bulan. ASI eksklusif adalah makanan terbaik yang harus diberikan kepada bayi, karena di dalamnya terkandung hampir semua zat gizi yang dibutuhkan oleh bayi.

"Tidak ada yang bisa menggantikan ASI karena ASI didesain khusus untuk bayi, sedangkan susu sapi komposisinya sangat berbeda sehingga tidak bisa saling menggantikan," jelasnya.

Menurut dia, ada lebih dari 100 jenis zat gizi dalam ASI antara lain AA, DHA, Taurin dan Spingomyelin yang tidak terdapat dalam susu sapi. Beberapa produsen susu formula mencoba menambahkan zat gizi tersebut, tetapi hasilnya tetap tidak bisa menyamai kandungan gizi yang terdapat dalam ASI. "Lagi pula penambahan zat-zat gizi tersebut jika tidak dilakukan dalam jumlah dan komposisi yang seimbang maka akan menimbulkan terbentuknya zat yang berbahaya bagi bayi," katanya.

Ditegaskan, ASI sangat diperlukan untuk pertumbuhan dan perkembangan kecerdasan anak. "Menurut penelitian, anak-anak yang tidak diberi ASI mempunyai IQ (Intellectual Quotient) lebih rendah tujuh sampai delapan poin dibandingkan dengan anak-anak yang diberi ASI secara eksklusif. Karena itu, mengkonsumsi ASI bagi bayi merupakan hak anak yang hakiki," ujarnya.

Anak-anak yang tidak diberi ASI secara eksklusif juga lebih cepat terjangkiti penyakit kronis seperti kanker, jantung, hipertensi dan diabetes setelah dewasa. Kemungkinan anak menderita kekurangan gizi dan mengalami obesitas (kegemukan) juga lebih besar.

Selain pada anak, pemberian ASI juga sangat bermanfaat bagi ibu. ASI, selain dapat diberikan dengan cara mudah dan murah juga dapat menurunkan resiko terjadinya pendarahan dan anemia pada ibu, serta menunda terjadinya kehamilan berikutnya.

Hal lain yang jauh lebih penting adalah timbulnya ikatan bathin (bonding) yang kuat antara ibu dan anak. "Ibu juga tidak perlu susah-susah melakukan diet untuk mengecilkan perut setelah melahirkan, karena hisapan anak pada puting susu ibu merangsang keluarnya hormon yang dapat mengencangkan dinding-dinding perut ibu kembali," katanya. (T-1)

Breastfeed a Toddler—Why on Earth?

Source : http://www.kellymom.com/newman/bf_toddler_01-03.html

Handout #21. Toddler nursing. January 2003
Written by Jack Newman, MD, FRCPC. © 2003

Because more and more women are now breastfeeding their babies, more and more are also finding that they enjoy breastfeeding enough to want to continue longer than the usual few months they initially thought they would. UNICEF has long encouraged breastfeeding for two years and longer, and the American Academy of Pediatrics is now on record as encouraging mothers to nurse at least one year and as long after as both mother and baby desire. Even the Canadian Paediatric Society, in its latest feeding statement acknowledges that women may want to breastfeed for two years or longer. Breastfeeding to 3 and 4 years of age has been common in much of the world until recently, and it is still common in many societies for toddlers to breastfeed.

Why should breastfeeding continue past six months?

Because mothers and babies often enjoy breastfeeding a lot. Why stop an enjoyable relationship? And continued breastfeeding is even good for the health and welfare of both the mother and child.

But it is said that breastmilk has no value after six months.

Perhaps this is said, but it is wrong. That anyone (including paediatricians) can say such a thing only shows how ignorant so many people in our society are about breastfeeding. Breastmilk is, after all, milk. Even after six months, it still contains protein, fat, and other nutritionally important and appropriate elements which babies and children need. Breastmilk still contains immunologic factors that help protect the baby. In fact, some immune factors in breastmilk that protect the baby against infection are present in greater amounts in the second year of life than in the first. This is, of course as it should be, since children older than a year are generally exposed to more infection. Breastmilk still contains factors that help the immune system to mature, and which help the brain, gut, and other organs to develop and mature.
It has been well shown that children in daycare who are still breastfeeding have far fewer and less severe infections than the children who are not breastfeeding. The mother thus loses less work time if she continues nursing her baby once she is back at her paid work.
It is interesting that formula company marketing pushes the use of formula (a very poor copy of the real thing) for a year, yet implies that breastmilk (from which the copy is made) is only worthwhile for 6 months or even less ("the best nutrition for newborns"). Too many health professionals have taken up this absurd refrain.

I have heard that the immunologic factors in breastmilk prevent the baby from developing his own immunity if I breastfeed past six months.

This is untrue; in fact, this is absurd. It is unbelievable how so many people in our society twist around the advantages of breastfeeding and turn them into disadvantages. We give babies immunizations so that they are able to defend themselves against the real infection. Breastmilk also helps the baby to fight off infections. When the baby fights off these infections, he becomes immune. Naturally.

But I want my baby to become independent.

And breastfeeding makes the toddler dependent? Don't believe it. The child who breastfeeds until he weans himself (usually from 2 to 4 years), is generally more independent, and, perhaps, more importantly, more secure in his independence. He has received comfort and security from the breast, until he is ready to make the step himself to stop. And when he makes that step himself, he knows he has achieved something, he knows he has moved ahead. It is a milestone in his life.
Often we push children to become "independent" too quickly. To sleep alone too soon, to wean from the breast too soon, to do without their parents too soon, to do everything too soon. Don't push and the child will become independent soon enough. What's the rush? Soon they will be leaving home. You want them to leave home at 14? If a need is met, it goes away. If a need is unmet (such as the need to breastfeed and be close to mom), it remains a need well into the childhood/teenaged time.
Of course, breastfeeding can, in some situations, be used to foster an overdependent relationship. But so can food and toilet training. The problem is not the breastfeeding. This is another issue.

What else?

Possibly the most important aspect of nursing a toddler is not the nutritional or immunologic benefits, important as they are. I believe the most important aspect of nursing a toddler is the special relationship between child and mother. Breastfeeding is a life-affirming act of love. This continues when the baby becomes a toddler. Anyone without prejudices, who has ever observed an older baby or toddler nursing can testify that there is something almost magical, something special, something far beyond food going on. A toddler will sometimes spontaneously, for no obvious reason, break into laughter while he is nursing. His delight in the breast goes far beyond a source of food. And if the mother allows herself, breastfeeding becomes a source of delight for her as well, far beyond the pleasure of providing food. Of course, it's not always great, but what is? But when it is, it makes it all so worthwhile.
And if the child does become ill or does get hurt (and they do as they meet other children and become more daring), what easier way to comfort the child than breastfeeding? I remember nights in the emergency department when mothers would walk their ill, non-nursing babies or toddlers up and down the halls trying, often unsuccessfully, to console them, while the nursing mothers were sitting quietly with their comforted, if not necessarily happy, babies at the breast. The mother comforts the sick child with breastfeeding, and the child comforts the mother by breastfeeding.

Questions? see my book Dr. Jack Newman's Guide to Breastfeeding (called The Ultimate Breastfeeding Book of Answers in the USA)

Handout #21. Toddler nursing. January 2003
Written by Jack Newman, MD, FRCPC. © 2003

 


This handout may be copied and distributed without further permission,
on the condition that it is not used in any context in which the WHO code on the marketing of breastmilk substitutes is violated


Frequently Asked Questions
Our FAQs present information from La Leche League International on topics of interest to parents of breastfed children. Not all of the information may be pertinent to your family's lifestyle. This information is general in nature and not intended to be advice, medical or otherwise. If you have a serious breastfeeding problem or concern, you are strongly encouraged to talk directly to a La Leche League Leader. Please consult health care professionals on any medical issue, as La Leche League Leaders are not medical practitioners.

What are the benefits of breastfeeding my toddler?

Toddlers breastfeed for many of the same reasons infants breastfeed: for nutrition, comfort, security, for a way to calm down and for reassurance. Mothers breastfeed their toddlers for many of the same reasons they breastfeed their infants: they recognize their children's needs, they enjoy the closeness, they want to offer comfort, and they understand the health benefits. (See LLLI's FAQ, "What are the Benefits of Breastfeeding My Baby?" for more information.) The American Academy of Pediatrics currently recommends that "breastfeeding continue for at least 12 months, and thereafter for as long as mutually desired." * The World Health Organization and UNICEF recommend that babies be breastfed for at least two years.
Breastfeeding a toddler helps with the child's ability to mature. Although some experts say a toddler who is not weaned will have difficulty becoming independent, it's usually the fearful, clingy children that have been pushed into situations requiring too much independence too soon. A breastfeeding toddler is having his dependency needs met. The closeness and availability of the mother through breastfeeding is one of the best ways to help toddlers grow emotionally.
Breastfeeding can help a toddler understand discipline as well. Discipline is teaching a child about what is right and good, not punishment for normal toddler behavior. To help a toddler with discipline, he needs to feel good about himself and his world. Breastfeeding helps a toddler feel good about himself, because his needs are being met.
Just as babies do, toddlers receive health benefits from breastfeeding. Your milk continues to provide immunities and vitamins, and can help protect your toddler from illness and allergies. If your toddler does get sick, nursing will help comfort him. In fact, a toddler with an upset stomach may be able to tolerate nothing but human milk.
Toddlers have a huge world to explore, and breastfeeding provides them (and their mothers!) with some quiet time in their busy, waking hours.
*See "Breastfeeding and Use of Human Milk" in Pediatrics, Volume 100, Issue 6, December 1997, pages 1035-1039.

Resources for Additional Information

Articles of interest to mothers of breastfeeding toddlers can be found in LLLI's Nursing an Older Baby FAQs.
A variety of articles can be found NEW BEGINNINGS article collection on Extended Breastfeeding.
A BREASTFEEDING ABSTRACTS article on extended breastfeeding and the law is here.
These items are available from LLLI's online catalogue or through your local Leader:
THE WOMANLY ART OF BREASTFEEDING, published by La Leche League International, is the most complete resource available for the breastfeeding mother. (Softcover, 465 pages.)
Breastfeeding Makes a Difference: This popular publication from LLLI has just been revised to include information on DHA and brain growth, protection against obesity, and how human milk kills cancer cells. Great for anyone, from new mothers to health care professionals, that wants to know why breastfeeding really does make a difference. No 1196-17 English, 95¢
MOTHERING YOUR NURSING TODDLER, revised edition, by No

http://www.abm.me.uk/10toddler.htm

10 Good Reasons to Breastfeed Your Toddler

by Elizabeth Bruce

The average American may not be ready to admit it, but myriad cultures past and present have accepted the fact that babies past infancy can benefit from nursing. The !Kung of Africa represent the natural state of human feeding. Mothers of this nomadic tribe breastfeed each child for up to six years. Sherman Silber, MD, points out that
the human species has spent more than 90 percent of its existence leading this type of nomadic hunter/gatherer life, and ‘civilization’ with its pressures is too recent to have had any appreciable impact on their genetic makeup.
In our culture, many men and women are uncomfortable with the functional role of breasts, probably because of our national obsession with breasts as sexual objects. Unfortunately, people’s psychological discomfort seems to increase as the nursing baby grows. Most Americans choose to wean their babies at about six months. Whatever the psychological complexities may be, we can no longer deny the health and social benefits of prolonged breastfeeding. Even the conservative American Academy of Pediatrics now officially recommends that breastfeeding continue for at least 12 months.2 But what about nursing through a baby’s second or even third year? Is breast still best for toddlers? If we can get past our collective ambivalence, I think the answer is a resounding yes.
While most of your neighbours probably aren’t doing it, there are plenty of enlightened mothers out there who are. Alice Bailes, CNM, co-owner of Birth Care and Women’s Health in Alexandria, Virginia, says that the majority of her clients breast­feed well into their babies’ second year. In fact, she has clients who tandem nurse - they continue nursing their toddler through their next pregnancy and even after the new baby is born. Bailes, who has had personal experience tandem nursing, believes that it helps a toddler’s transition into being a big brother or sister.
Of course, the decision to continue nursing is a personal one, and it often is not made until the time comes. Rest assured, according to most moms who have decided to keep going, once you’ve managed to breastfeed through the challenging first year the rest is a breeze. In case you’re still not convinced, I am sharing my top ten reasons to breastfeed your toddler.

Convenience

I must confess that convenience was my number one reason for continuing to breastfeed my babies. OK, call it laziness. For one thing, weaning a baby before he’s ready takes a lot of time and effort. You have to carry messy snacks around and deal with tantrums. Fortunately, by the time the baby turns one, most moms have mastered the art of discretion, so nursing is the easiest thing in the world to do with a minimum of privacy.
Even better, there is no easier way to get a toddler to sleep on your schedule than by nursing him. I always feel sorry for mothers of toddlers who aren’t nursing, because their job is probably a lot harder than mine. If worse comes to worst, I know an induced nap is right around the corner.

Instant Tantrum-tamer

As any parent of a toddler knows, they are naturally insecure creatures. One moment your one year old is happy, and the next she is dissolved in a puddle of tears  seemingly over nothing. Well, surprise! Often the best way to handle your volatile toddler is to briefly treat her like a baby. Take her in your arms, nurse her for a few minutes, and voilĂ ! - your little screamer is transformed into a confident child once again. If you’re at a party when your child melts down, you can discreetly take him or her into another room or to the car. Friends will marvel at your great mothering abilities when you return with a magically transformed, happy toddler.

Less Reliance on "Mommy Substitutes"

The toddler years are peak years for attachment objects like blankets and dolls. The major problem with these objects is that they can be lost. Such an episode can take on tragic proportions. Believe me, I know because my first son never nursed. There’s nothing quite like arriving at a Holiday Inn after a day of traveling with a cranky toddler only to discover you have left the critical object at a rest stop 300 miles back!
Life is too short for all that unnecessary drama. If you are nursing your toddler, you can forget the frantic search for an identical blanket and the Fed-Ex­ing of Barney. With Mommy as the primary security object, you can rest easy on those long family trips. It is basically impossible to lose a breast, no matter how distracted you are! Plus, you never have to steal the beloved object away for a round in the washing machine. Much trauma is spared for all.

Allergy Prevention

My second little boy was so attached to nursing that I became (reluctantly) a toddler nurser. He ate absolutely no solid food until he was 17 months old. Even La Leche League veterans suggested that the situation was, well, unusual. Looking back, I think my baby’s wisdom was in avoiding possible allergens. Studies (as well as anecdotal evidence) indicate that breastfeeding reduces the incidence of allergies.3,4 My first child, who was solely formula-fed, had all sorts of food allergies, including rice and dairy products. In hindsight, my second child’s lengthy, exclusive breastfeeding makes sense. Most likely, it was nature’s way of protecting him from foods his body just was not ready to process. Undoubtedly, some children need longer than others to "outgrow" their allergies, and breastmilk provides the ideal support for their developing immune systems.

Nutrition

Good nutrition is admittedly tricky with toddlers. On some days they cram every morsel offered into their mouths, and other days you can’t coax them to take a bite of even their favourite food. In short, they’re picky eaters, and their appetites are capricious and unpredictable.
One popular myth that even paediatricians promote is that breastfeeding somehow loses its nutritional quality after the first year. In reality, the benefits change, but they are still there. Does it really make sense that after 12 months of providing your baby with optimal nutrition the breasts suddenly get "stupid" and start making something "less than optimal"? Obviously, the addition of solid foods changes the balance, but breastmilk is still an important element in the diet while your baby is sampling what the world has to offer. Certainly, there can be no harm in continuing with nature’s perfect food.

Speech Development

In general, it’s believed that breastfeeding provides better development of the teeth and jaws than sucking a hard, unnaturally shaped nipple.5 Margaret Connor, a 35-year-old mother in Austin, Texas, has discussed the subject at length with her son’s speech therapist. Both of them believe that Connor’s five-year-old son’s speech/motor apraxia would have been worse if his muscles had not been "worked out" through extended nursing. If nothing else, Connor is happy she made the decision she did. "At least I won’t look back and wonder if his articulation would have been better if I had breastfed longer than a year." she says.

Fighting Dehydration during Illness

Unfortunately, toddlers, breastfed and otherwise, get sick. Some get sick a lot, especially those in child care and those with older siblings. When my 14-month-old son got bronchitis, he wouldn’t eat or drink anything other than breastmilk. Had he not been breastfeeding, the situation could have turned into a nightmare. When a bottle-fed baby gets dehydrated, the parents have to struggle to get oral rehydration products down the child. When this tactic doesn’t work, paediatricians have no choice but to order an IV for the child at the hospital. This is not only traumatic for a toddler, but it also exposes him to other germs that could complicate the original infection. With breastfeeding, you can almost always get the child to nurse, which might even save his life! Further, it comforts the mother. It feels so much better to be able to help your child through illness in a uniquely positive way.

Weight Loss for Mom

It’s accepted that a woman’s body stores up enough fat during pregnancy to exclusively feed her infant for at least the first six months. While there are few studies on this topic, anecdotal evidence suggests that a mother’s weight loss may continue during the second year of nursing a baby. The fact is, Mother Nature never intended for human babies to be weaned from their mothers in the early months, so our bodies make sure we have plenty of fat stored up for years.
For the first year, our bodies seem to like to stay soft, almost like a cushion for the infant. After that time, the weight is not quite so resistant to leaving. The increased calorie requirements of toddlers help the process of weight loss as well. For every day she nurses, a lactating woman uses an extra 500 calories. Personally, I found that stubborn fat stores that had lived on my thighs for years melted away during the second year of nursing.

Delayed Menstruation

For those women using Natural Family Planning or the Fertility Awareness Method for birth control, breastfeeding provides a bonus. Research done by the Kippleys in "The Art of Natural Family Planning" showed that a nursing mother who uses no supplements for the first four to six months gets her first post­partum period on average after 13 to 16 months.6 Among the !Kung tribe, babies are spaced about 48 months apart - all due to exclusive breastfeeding.7 Contrast this with the usual six to eight weeks for a bottle-feeding mother. Naturally, PMS and the other related troubles usually disappear for as long as the periods stay away, and the return of fertility is also put off. In addition, delayed menstruation means decreased exposure to oestrogen, which may protect against cancer of the breast and reproductive organs. Breast cancer risk is associated with earlier menarche and later menopause, which points to estrogen exposure as a risk factor for the disease.8,9

It’s Good for the Planet

Breastfeeding is the best ecological thing going. No cups to wash, no bottles to sterilize, and nothing for the landfill. Postponing the use of cows’ milk helps our planet. Because of their methane gas emissions, cows are major destroyers of the atmosphere.10 Overgrazing of land is responsible for serious ecological troubles, as well. As a bonus, the baby is not exposed to the unhealthy hormones and antibiotics injected into dairy cows.
Like most other mothers of toddlers, I originally continued nursing out of a desire for convenience. Frankly, it was just easier to keep going than to stop. Along the way, I discovered how much simpler continuing to breastfeed made our lives. If at all possible, the transition away from Mommy should be a gradual one, made at the baby’s own pace. Toddler life is difficult enough. Why not make it a little more manageable for everyone?
Elizabeth Bruce, MA, currently stays home with her four children, ages 9, 7, 5, and 2. She’s been breastfeeding for seven years and counting.

Notes

1. Sherman J. Silber, MD, How Not to Get Pregnant (New York: Warner, 1990): 92 - 93.
2. American Academy of Pediatrics, "Breastfeeding and the Use of Human Milk" (Policy Statement), Pediatrics 100 (December 1997): 1035 - 1039.
3. E. E. Ziegler et al., "Cow’s Milk Feeding in Infancy," Journal of Pediatrics 116 (1990): 11—18.
4. J. N. Strimac and D. S. Chi, "Significance of IgE Level in Amniotic Fluid and Cord Blood for the Prediction of Allergy," Annals of Allergy 61 (1986): 133 -136.
5. La Leche League International, The Womanly Art of Breastfeeding (New York: Penguin, 1991), 375—376.
6. John and Sheila Kippley, The Art of Natural Family Planning, Third edition (Cincinnati, Ohio: Couple to Couple League, 1991) 201.
7. Sherman J. Silber, MD, How Not to Get Pregnant (New York: Warner, 1990), 92—93.
8. F Grodstein et aI., "Postmenopausal Hormone Therapy and Mortality," New England Journal of Medicine 336, no.25 (1997): 1769—1775.
9. Ruth Westheimer, MD, Dr. Ruth's Encyclopedia of Sex (New York: Jerusalem Publishing House, 1994), 56.
10. Pamela Teisler, 101 Reasons Why I’m a Vegetarian (New York: Pamela Teisler, 1 992).

For More Information

Mothering Your Nursing Toddler, by one of the founders of La Leche League, Norma J. Bumgarner, offers support and guidance for toddler nursing. (La Leche League International, 2000)
Breastfeeding and Natural Child Spacing: How Ecological Breastfeeding Spaces Babies, written by Sheila K. Kippley, a founder of the Couple to Couple League, offers practical advice, even if you don’t agree with the moral overtones. (Couple to Couple League, 1999)
Leche League has leaders in practically every community and can be found in the yellow pages. Their website, www.lalecheleague.org contains a new category of articles called "Extended Breast-feeding" (click on "Breastfeeding Information from LLLI Periodicals" to find it).
For additional information about breastfeeding a toddler, see the following articles in past issues of Mothering - "To Wean or Not to Wean?" no. 97; "Breastfeeding Your Older Baby" no. 69.
This article originally appeared in "Mothering" Magazine, issue no. 103, November/December 2000, and is reprinted with kind permission.


http://www.kellymom.com/bf/bfextended/ebf-benefits.html

Extended Breastfeeding Fact Sheet

By Kelly Bonyata, BS, IBCLC
PDF version (great for printing) | Portuguese | Bulgarian | Russian
Breastfeeding benefits toddlers and young children...
nutritionally, immunilogically and psychologically.

Breast Problems During Pregnancy and Lactation: Frequently Asked Questions

Carol Scott-Conner, M.D.
Department of Surgery
University
of Iowa Hospitals and Clinics

Creation Date: April 2000
Last Revision Date: April 2000
Peer Review Status: Internally Peer Reviewed


Most of the common problems that occur during pregnancy, or lactation, can be managed without interrupting either the pregnancy or the breast-feeding. A woman who develops a lump in her breasts should see her physician because occasionally it is a sign of something more serious.
What are the most common problems a woman faces with her first child and breast-feeding? How can an expecting mom prepare herself for these issues?
The most common problem is nipple irritation and associated with that is mastitis, or inflammation and infection in the breast. The best way to prepare for this is by seeking the guidance of someone who is experienced in breast-feeding. There are now lactation consultants in many communities, and they are excellent sources of information. The nipples are a very sensitive area, and when the new baby starts to nurse, irritation may occur. Careful hygiene and cleanliness are important.
How can a woman prevent "cracking nipples" during lactation?
The best way to prevent cracking nipples is to use an approved lubricant of some kind. Check with your physician or health care provider for something to put on the nipples to keep them from drying out.
What advice would you give someone who developed a significant galactocele during her first lactation? Do I need surgery to correct it?
It may or may not re-accumulate during the 2nd pregnancy and lactation. I would not advise prophylactic surgery. Galactocele's are generally treated by aspiration and if this one recurs, then you should see your physician.
I am not sure if I am in right room, my son is almost 2. I never breastfed him, but I continued to leak until he was 8 mo. Now 2 years later I am leaking again, any ideas?
You should see your physician. That could be something serious.
What is galactocele, and is it preventable?
Galactoceles are single or multiple nodules that contain milk. Anything that obstructs the duct of the breast during lactation may cause a galactocele. Most often, galactoceles occur at the end of breast-feeding when the milk is allowed to stagnate in the breast. Sometimes the mass isn't found until months later. There really aren't any preventive measures, and galactoceles are simply dealt with by aspirating the milk with a needle.
Unfortunately, my OBs had trouble diagnosing the galactocele and it achieved about 8 centimeters in diameter. Would you consider surgery prophylactic at that point?
Again, we don't generally advise prophylactic surgery for galactoceles. If a large galactocele has been a problem in the past, then early detection and aspiration, if it recurs, should solve the problem.
Is there any reason a mother should consider not breastfeeding?
That is an individual decision that a woman should take up with her obstetrician but I am not aware of any specific conditions, with the exception of some very rare illnesses, that would make it wrong for a woman to breast feed. Some medications that a woman might have to take for life-threatening illnesses are excreted in the breast milk and that could be a problem. A woman should talk this over with her obstetrician. Remember, there are numerous benefits to mother and child from breast-feeding. Also, studies show that breast feeding reduces the risk of getting breast cancer later in life.
Can women continue to nurse, even when experiencing problems such as galactoceles?
Yes, a woman can continue to nurse and sometimes keeping the breasts empty by nursing helps the problem go away. Occasional repeated aspiration is needed. If the galactocele keeps coming back, surgery may be required.
Are lactation consultants a good idea?
I think that if it is your first baby, getting advice from someone who knows how to teach you the ins and outs of breast feeding is very important. For many women, a lactation consultant is the best option. Depending upon your circumstances, you may find that a nurse, a nurse midwife, or your obstetrician may be able to offer similar advice. Of course, some women get the support from other women in their family. The La Leche League is a nationwide organization that helps women with breastfeeding.
During lactation, one of my breasts grew quite larger than the other (obviously my son preferred that one because it seemed to produced more milk!) Is there any way to prevent this from happening with my next child?
I don't know of any way to prevent this. It is normal for the breast to increase during size and weight during pregnancy. Usually the increase is symmetric but occasionally one breast enlarges more than the other. It is likely that if this has happened once, it may happen again.
How do you manage breast infections? Do you have to stop breast-feeding?
Breast infections don't have to interrupt breast-feeding. Antibiotics can treat most of the common breast infections, and the woman can continue to breast-feed. Keeping the breasts empty by the baby nursing actually helps by avoiding the accumulation of milk in the breast because milk is a culture medium and the bacteria can grow in the milk. It does not have to interrupt breast-feeding.
What happens if a woman is diagnosed with breast cancer during pregnancy?
We can treat breast cancer during pregnancy without interrupting the pregnancy. Fortunately breast cancer is rare during pregnancy, but it occasionally occurs. Women that have breast cancer have had children come to term and do well. There isn't any danger of transmitting the cancer to the unborn child. We have enough alternatives in treatment now that we can treat the cancer adequately.
I've heard that bloody nipple discharge can be a sign of cancer. What about bloody nipple discharge during pregnancy?
During the last part of pregnancy, that is the last trimester, the nipple undergoes changes preparing for breast-feeding. With these changes, it is fairly common for women to have nipple discharge that may even be bloody. It usually gets better once a woman starts breast-feeding. It is not necessarily a sign of cancer. We don't do anything other than watch and carefully examine the woman.
What are the most common reasons women give up on breast-feeding?
Sometimes women think they don't produce enough milk, and they become discouraged and give up. I think it would be better to supplement with formula if necessary and continue breast-feeding as long as possible. That has probably been the most common reason I have seen women give up.
What should a pregnant woman do if she finds a lump on her breast?
A pregnant woman who finds a lump in her breast should see her physician for a careful examination, an ultrasound of the breast, and possibly an aspiration. Most breast lumps that occur during pregnancy are benign but occasionally women do develop breast cancer during pregnancy. Any lump that develops should be taken seriously whether the woman is pregnant or not. We don't do mammograms in pregnant women because the breasts are so dense from the pregnancy that mammograms are not very effective. Ultrasound is an excellent way to study various masses and is very useful. A woman who develops a lump in her breast during pregnancy should have it evaluated.
When should you stop breast-feeding?
That is something that ought be worked out with your own physician.
Do you need to do anything after you stop breastfeeding to stop the milk production?
Generally, just stopping breast-feeding suppress lactation. In addition, there are medications that a physician can prescribe.
What are some of the more common breast problems experienced during pregnancy? Are they hereditary? What types of breast problems occur in women who are NOT pregnant?
Breast lumps are very common in women who are pregnant and women who are not pregnant. Most of the time, these are caused by benign problems that are not cancerous. Once in a while, a lump is a sign of something serious. For that reason, any women, pregnant or not, who finds a lump in her breast should see her physician and have it checked out. Nipple discharge, as discussed earlier, is also a fairly common sign and in pregnant woman is also less worrisome but again should be evaluated by a physician. Breast pain is a very common and nonspecific problem in both pregnant and non-pregnant women. During pregnancy, the breasts enlarge; they get heavier and the blood supply increases. This makes it harder to feel lumps and makes it very important that a woman have a good breast exam early in pregnancy as a baseline for later comparison. Most of the common problems are not hereditary.
How do you fix an inverted nipple?
We usually leave inverted nipples alone and most women with inverted nipples are able to breast feed. If the nipple inversion is new, that is if the woman has not had it all of her adult life, it may be a sign of a problem and she should see her physician.
Do fibrocystic breast become more "lumpy" after pregnancy?
After pregnancy and after breast feeding, once you are finished breast feeding and they have shrunk down again, or involuted, lumps may be more prominent which creates the appearance of being more lumpy.

Breast is Best!

Department of Nursing:

Children's and Women's Services/OB-GYN Patient Education Committee
Children's Hospital of Iowa
Peer Review Status: Internally Peer Reviewed
Creation Date: Unknown
Last Revision Date: July 2000

Since the beginning of time, women have put their babies to breast. Extending the physical bond that begins at conception, they have fed and protected their babies with their bodies. These tender moments, in return, have brought pleasure and fulfillment to the task of mothering. If you are now pregnant, you are probably looking forward to the time when you will feed, comfort, and protect your baby in the same way as others before you.
Perhaps you already feel committed to the idea of breastfeeding. Or perhaps, you have some uncertainties, but still feel it is worth a try. Your outlook depends on many things; the value you place on breastfeeding, how your partner feels about it, how your friends have fed their babies, your lifestyle, and your feelings about yourself and your body.
Remember to attend one of our Breastfeeding Classes. A weekly afternoon class and a monthly evening class is offered. You will find them helpful in learning correct latching-on techniques and selecting pumping equipment. Ask the scheduling clerk or one of the nurses in the clinic to help you sign-up for one of the classes
Have You Thought About Breastfeeding?
You probably have some ideas what breastfeeding will be like. Perhaps you think it will be easy and convenient. Maybe you worry that it might not fit in with your activities and plans. You may have concerns about your ability to breastfeed. Probably you know other women who tried to breastfeed but soon gave up. Exploring your attitudes, expectations, and concerns about breastfeeding are an important part of deciding what feeding method is best for you and your baby.
Myths About Breastfeeding
  • The milk was not rich enough.
  • One day the milk supply dried up.
  • The milk did not agree with the baby.
  • The baby suddenly decided that he/she wanted a bottle instead.
  • Women with small breasts are not able to breastfeed.
  • Women who are "nervous types" are not able to breastfeed.
  • Breastfeeding causes the breasts to sag. Whether you nurse or not, you may notice a change in the firmness or your breasts after you have a baby. Childbearing, not nursing, along with age and heredity, is a major determinant of the breasts’ ultimate appearance.
Concerns About Breastfeeding
Worries about modesty: Although we all know making milk is the natural function of our breasts, many of us feel embarrassed about exposing them. At first, you may be more comfortable breastfeeding in private, but most women find that with time and experience, breastfeeding in the presence of others can be discreet and comfortable.
You may have heard that breastfeeding can be painful. Normally women find it comfortable and pleasurable. Some women worry about developing sore nipples during the early days of breastfeeding, but most soreness can be avoided by correctly positioning the baby at the breast.
Or perhaps, you have some uncertainties, but still feel it is worth a try. Your outlook depends on many things; the value you place on breastfeeding, how your partner feels
Leaking milk: If you leak breast milk, press down on your nipple with the heal of your hand, through your clothing. Or, without drawing attention to yourself, cross your arms across your chest and apply pressure. You can also use store bought pads without plastic or put clean handkerchiefs or cloth diapers in your bra.
Image of a breast
Preparing nipples: For most women, there is no need to prepare your nipples for breastfeeding your baby. Good skin care for all women includes no soap and no rubbing with a towel. All women should check for flat nipples in the last three months of pregnancy. If you are unsure, ask your health care professional at your next checkup. Your provider may suggest an evaluation of your nipples by the breastfeeding specialist.
Returning to work or school: There are many ways that breastfeeding can be continued after you return to work or school. You will need to express or pump your milk or arrange to have the baby brought to you to breastfeed during meal breaks, so that your breasts do not become too full. You must also plan for your baby to be fed while you are apart, either with your own milk or formula. While it does require some planning ahead, many mothers who work outside the home or attend school, feel that breastfeeding offers emotional compensation for the hours that must be spent apart.
Which Medela breast pump should you choose?
The type of pump you need depends on how often and for how long you need to pump. A mother who is usually at home with her baby will need a different pump than a mother who is working or going to school. If time is important, think about selecting a double pumping breast pump instead of a single one. Pumping both breasts at once can save you time. Below are a list of breast pumps from Medela and suggestions for when they work best.
If you are planning to go to school or work part-time (for occasional or short term pumping): Mini Electric, Double Mini Electric, Manual Spring Express, Manual Electric (this pump contains the parts needed to upgrade to an electric pump).
If you are planning on working or going back to school full-time (pumping 2-3 times a day or more and for long term pumping): Pump-N-Style (looks like a shoulder bag), Lactina Select (for rent only), Classic Medela Pump (for rent only).
If you have a preterm baby who is unable to breastfeed yet and you need to keep up your milk supply, you will need to pump every 3-4 hours daily: Lactina Select (for rent only), Classic Medela Pump (for rent only), *Pump-N-Style (can be used if Lactina or Classic Pump is unavailable).
For information on Medela breast pumps, dial 1-800-TELL YOU and put in your zip code. You will be given a list of places that rent or sell Medela breast pumps and supplies.
After you have your baby at the University of Iowa Hospitals and Clinics, you will be given the choice of a pump or pumping kit to take home. These are Manual Spring Express, Double Pumping Kit (for the Lactina or Classic pump), Pump-N-Style (looks like a shoulder bag and has its own tubing).
If for any reason your insurance company does not pay for the cost of the Pump-N-Style, you will be charged $208.50. The retail price is about $250.00. Insurance companies usually cover the cost for the Manual Spring Express and Double Pumping kits.
We are giving you information on the Medela brand of breast pump as they are the brand stocked here. Other brands are available, but do vary in quality. A poor quality pump may even damage breast tissue. To be sure you get a high quality breast pump, buy or rent one from a medical supply store.
Insurance Coverage of Breast Pumps
Individual plans vary. We encourage all patients to call their insurance company with questions about coverage.
*** The American Academy of Pediatrics recommends breast milk for the first 12 months of baby’s life. ***
Advantages of Breastfeeding for the Baby
  • Breast milk is the ideal food for the baby.
  • Breast milk is easy to digest and absorb, causing less colic.
  • The iron in breast milk is utilized more readily.
  • Breast milk changes to meet the needs of the growing baby.
  • Breast milk contains substances that promote nervous system development and brain growth.
  • Breastfed babies have fewer allergies. In families with a history of allergies, breast-fed babies experience less asthma, food allergies and eczema.
  • Breastfed babies have fewer illnesses, such as ear infections, colds, flu and GI upset. They also have fewer doctor visits and hospitalizations, because of the special protective factors in breast milk.
  • Breast milk may help babies to respond better to vaccines, as antibody levels have been found to be higher in breastfed babies at 7 and 12 months.
  • Breastfeeding may decrease SIDS (crib death).
Advantages of Breastfeeding for the Mother
  • Breastfeeding is inexpensive.
  • Breastfeeding is always available.
  • With breastfeeding, there is nothing to mix, measure, or heat, and no bottles to wash.
  • Breastfeeding makes nighttime feedings quick and easy.
  • Breastfeeding makes travel with baby easier.
  • Breastfeeding promotes attachment between mother and baby.
  • With breastfeeding, there is often less vaginal bleeding after delivery.
  • Breastfeeding promotes a faster return of uterus to its pre-pregnant size.
  • Breastfeeding can help with weight loss.
  • Breastfeeding may decrease ovarian cancer and premenopausal breast cancer.

Rabu, 20 April 2011

7 Keajaiban Balita

Ada sejuta ulah anak balita. Ayahbunda pilihkan 7 yang paling ajaib, beserta rahasia di baliknya.
  1. Penjelajah Ulung. Semua benda di rumah menjadi obyek penjelajahan dan sasaran rasa ingin tahu balita. Bahkan barang-barang yang tanpak “tak bermutu”, seperti kotak sabun, plastik bekas, dan botol air mineral, dianggapnya harta karun.
  2. Meniru. Orang yang lebih besar, entah itu ayah, ibu, atau kakak, adalah panutan balita. Sebagai “fans berat”, ia akan meniru segala sesuatu yang dilakukan idolanya. Entah itu menggosok gigi, menyisir rambut, memakai lipstik, bahkan bercukur!
  3. Main Pura-Pura. Bukan hanya sibuk menjelajahi dunia luar, balita juga asyik menjelajahi alam pikirannya sendiri. Inilah saatnya dia bermain dengan imajinasi. Jangan buang kardus bekas pembungkus barang elektronik, karena itu bisa menjadi bahan pembuat kapal perang atau kereta kencana.
  4. Hobi mengulang-ulang. Balita bisa minta dibacakan buku cerita yang sama 350 kali tanpa bosan sedikit pun. Atau, menceritakan lelucon yang sama berulang kali sembari tertawa terbahak-bahak. Padahal, telinga Anda sudah merah lantaran mendengarnya berulang-ulang.  
  5. Melompat-lompat. Jangan heran bila balita menjadikan berbagai macam benda landasan melompat; kasur, lantai, paving-block di taman, hingga anak tangga!
  6. Menemukan kata-kata baru. Bruk! Dor! Gedebuk! Wuss! Coba ucapkan kata-kata itu di depan bayi. Pasti dia tersenyum. Kalau diucapkan di depan balita? Dia bisa tertawa terbahak-bahak sampai berguling-guling di lantai.
  7. Bertanya terus. Pertanyaan yang diajukan terus tanpa kenal lelah, ciri khas balita dari belahan dunia mana pun. Mulai dari pertanyaan kritis dan membuat kita takjub.

Selasa, 19 April 2011

5 Tahapan Inisiasi Menyusu Dini

Begitu bayi lahir, ia langsung diletakkan di dada ibunya selama 1-2 jam. Apa saja yang dilakukan bayi selama itu?

Iniasisi Menyusu Dini (IMD) merupakan proses penting yang sebaiknya dilakukan langsung setelah bayi dilahirkan. Dari IMD ini Anda bisa melihat perilaku menakjubkan antara bayi dan bundanya dalam jam-jam pertama setelah bayi dilahirkan.

Ada lima tahapan perilaku yang dilakukan bayi sebelum ia berhasil menemukan puting susu ibunya dan menyusu:
  1. 30 – 45 menit pertama. Bayi akan diam dalam keadaan siaga. Sesekali matanya membuka lebar dan melihat bundanya. Masa ini merupakan masa penyesuaian atau peralihan dari dalam kandungan ke luar kandungan.
  2. 45 – 60 menit selanjutnya. Bayi akan menggerakkan mulutnya seperti mau minum, mencium, kadang mengeluarkan suara, dan menjilat tangannya. Bayi akan mencium dan merasakan cairan ketuban yang ada di tangannya. Bau ini sama dengan bau cairan yang dikeluarkan payudara ibu. Inilah yang akan membimbing bayi menemukan payudara dan puting susu ibu. Itulah sebabnya tidak dianjurkan mengeringkan kedua tangan bayi pada saat bayi baru lahir.
  3. Mengeluarkan liur. Saat bayi siap dan menyadari adanya makanan di sekitarnya, bayi mulai mengeluarkan air liur.
  4. Bergerak ke arah payudara. Areola payudara akan menjadi sasarannya dengan kaki bergerak menekan perut ibu. Bayi akan menjilat kulit ibu, menghentakkan kepala ke dada ibu, menoleh ke kanan dan kiri, serta menyentuh dan meremas daerah puting susu dan sekitarnya dengan tangannya.
  5. Menyusu. Akhirnya bayi menemukan puting susu ibunya, membuka mulut lebar-lebar, dan melekat dengan baik serta mulai menyusu.
 
Sedemikian pentingnya tahapan-tahapan ini, sehingga sangat baik jika bunda bisa meminta waktu cukup lama agar bayi bisa melampaui semua tahapan IMD ini. Secara alamiah, bayi akan melakukan semua tahapan-tahapan ini, jadi bunda tidak perlu khawatir soal keadaan bayi ketika diletakkan di dada Anda.

Pengalaman Melahirkan - Normal

Pengalaman Melahirkan :)

Saat itu tgl 2 Agustus 2008 adalah jadwalnya kontrol ke dokter.
Pagi-pagi udah siap berangkat karena kemarernnya di telpon dari RS disuruh datang pagi karena dapet nomer awal.
Setelah pamitan sama ibu mertua yang nungguin dan adik ipar, berangkatlah bunda sama ayah naek motor.
Nyampe RS ternyata dokternya belum datang, jadi ga telat deh kami.
Nimbang dulu ternyata berat bunda udah mencapai angka 63kg, naek 18 kg !!!

Setelah dipanggil suster, kami segera masuk.
Dokter tanya apakah masih aman ? (baca: ada kontraksi ga ? )
Aman dok, seringnya sakit perut pengen ke belakang... :D
Langsung disuruh tiduran mau di USG, tapi sebelum cek USG dokter sempet komentar 'perutnya besar amat ya ?'
Ternyata beneran, pas di cek BB dedek udah antara 3400 - 3700 gram.
Dokter bilang kalau mau normal bunda harus kuat ngeden, atau nanti dilakukan tindakan cesar.
Weks, cesar ??? Ga pernah kepikiran tuh.

Apalagi kata ayah "Mau cesar apa mobil?"
oh pilihan yang sangat sulittt ;))
Abisnya kalau cesar, harus ngambil uang tabungan yang udah dipersiapkan untuk beli mobil.

Menurut dokter kalau menunggu sampai berasa sakit, artinya seminggu lagi takutnya BB dedek makin membesar mencapai 4000 gram.
Karena bunda mungil, dokter tidak berani mengambil resiko jika harus lahir normal dengan BB besar.
Dan tanpa pikir panjang, bunda langsung menantang dokter untuk INDUKSI saja !!!
Dokter mengiyakan, katanya ada temennya tadi yang sebelum bunda juga minta di induksi aja.


Karena kondisinya mendukung, bunda sudah pembukaan 2 dan posisi kepala sudah dijalan lahir.
Akhirnya bunda dibawa ke ruang observasi, sementara itu ayah booking kamar.

Sebelum di induksi, detak jantung dedek dipantau dulu selama 15 menit pakai alat (entah apa namanya lupa :D )
Setelah 15 menit ternyata normal, maka bisa langsung diinduksi.
Awalnya bunda sedikit takut, takut cerita orang-orang yang katanya kalau di induksi itu rasanya lebih sakit.
Infus pertama gagal tertancap di tangan kiri, karena pembuluh darah pecah akhirnya bengkak deh tangannya (duh bidan Tri bijimane nih?)
Akhirnya bidan Yuli yang menginfus di tangan kanan, sekali tancap berhasil tepat pukul 10 pagi.
Masih sempet poto-poto biar ada kenangannya, lagian belum berasa apa-apa.


Sekitaran jam 1 siang ayah pulang jemput ibu mertua dan adik ipar untuk menunggui, takut ntar ga bisa jemput keburu bunda kesakitan.
Akhirnya bunda sendirian dikamar observasi dan berusaha untuk tidur, tapi ga bisa karena deg-deg an mau ketemu dedek dan penasaran ntar rasanya gimana ya...
Jam 3 sore mertua dan adik ipar datang, mereka bawa makan siang, tapi bunda dapat jatah dari RS dan sudah habis (menunya lupa, yang penting enak :D )
Sampai jam 3 sore itu bunda belum merasakan apa2. Akhirnya dibuat jalan-jalan aja biar cepet pembukaannya.
Tapi sampai jam 5pun ga ada rasa apa2, akhirnya ayah memutuskan untuk pindah ke kamar saja.


Aktivitas dikamar lebih enak karena ada TV, jadi jalan-jalan sambil liat TV.
Sampai jam 9 malam ga ada rasa apa2, di periksa dalam juga masih saja pembukaan 2.
Ternyata ada temen yang senasib, bedanya dia ga diinduksi jadinya bisa jalan-jalan keluar RS.
Dia dari pagi juga baru bukaan 2.
Akhirnya saran bidan bunda disuruh tidur saja untuk menyiapkan tenaga, dan untuk yang lain jg tidur hemat energi :D



Tiap jam bidan datang untuk cek tekanan darah dan tiap 6 jam sekali cek pembukaan.
Malam itu bunda tidur ga tenang, abis deg-deg an menunggu rasa mulas.
Bunda hanya merasa kebelet pipis yang bisa ditahan, dan kalau dibuat pipis rasa itu hilang, apa emang itu rasa kebelet pipis ya ? :D

Sampai pagi pun ga ada rasa apa2, sempet protes juga ke bidan abisnya udah lama ga ada hasilnya.
Tapi kata bidan ini merupakan hal yang wajar, bahkan bisa sampai 2 hari baru terasa.
Ya sudah bunda hanya bisa bersabar dan berdoa saja.
Pagi itu ayah dan ibu mertua pulang mo ngambil baju.
Jadinya bunda hanya ditemeni adik ipar.

Ga berapa lama, sekitar jam 8 lewat dikit ternyata bapak dari Nganjuk datang.
Karena ibuk ga bisa datang, jadi diwakilkan bapak saja.
Setelah bapak sarapan buryam, bunda ajak bapak jalan-jalan, tapi sempet dicegat bidan karena mau di cek dalam.
Akhirnya balik lagi ke kamar dan siap2 diperiksa dalam.
Pas diperiksa rasanya sakiiittt, ga kayak terakhir diperiksa ga berasa apa2.
Katanya udah bukaan 3, disuruh banyak jalan lagi.
Yuksss maree jalan-jalan mpe gempor :D
Tapi koq sakit abis diperiksa ga ilang-ilang ya.
Sakitnya kayak kita nahan pipis gitu lho, klo dibuat pipis masih kayak mo pipis lagi (Jawa: anyang-anyangen)

Kata bapak emang gitu kali rasanya (secara bapak ga pernah ngerasain, tapi pernah nungguin ibuk mo lahiran juga :D )
Ayah belum datang juga padahal udah jam 11an, akhirnya ngajak bapak jalan2 di koridor bawah biar ada pemandangan.
Sayangnya karena ada infus jadinya ga bisa keluar2, padahal bunda udah bosen muterin RS tp ga ada bukaan :(

Sekitar jam 1an Ayah datang bawa makan siang, gado-gado tanpa lontong !!! (ga nendang kaleeeee... )
Akhirnya bunda disuapin sambil sedikit merintih, abisnya rasa sakitnya ga ada jedanya, sakit terus-terusan.
Setelah abis sepiring bunda ngajak Ayah jalan lagi, karena kalau dibuat jalan sakitnya lumayan reda, mungkin karena bunda liat sekeliling dan tidak memikirkan sakit jadinya ga berasa apa-apa.

Jam 2 an (agak2 lupa) diperiksa dalam lagi udah bukaan 4 (weks lambat banget yakkksss ???), masih boleh jalan-jalan diluar tapi sejam lagi disuruh balik.
Saat udah bukaan 4 ini udah ada darah yang keluar tapi masih dikit.
Sementara bunda jalan-jalan, Ayah makan siang jatah RS.
Bunda ga selera coz menunya ga menarik, lagian bunda kepengen pup tapi ga keluar2, ada yang ganjel dibelakang tp klo dibuat ngeden ga keluar apa2.

Jam 3 balik lagi ke ruang observasi buat dicek, ternyata bukaan nambah jadi 5 (walahhhhhh dikit amat ya ???)
Sama bidan udah ga boleh jalan-jalan diluar lagi, disuruh jalan diruang observasi aja.
Baiklah, karena bosen ditempat tidur, bunda pura-pura ijin pipis biar bisa keluar.
Setelah jalan-jalan diluar, bunda ngerasa pengen pipis bangetttt...
Tapi pas di kamar mandi, pipisnya ga keluar, meski dibuat jongkok.
Jadinya bunda berdiri jongkok terus biar rasa pipisnya ilang, tapi ternyata ga ilang-ilang, huhuhuhu...

Balik lagi ke ruang observasif (entah jam berapa) dan dicek dalam.
"Udah bukaan 7 bu Ragil, ibu ditempat tidur aja ya jangan kemana-mana" kata bidan Tri.
Tapiiii bunda bandel, masih penasaran dengan rasa kebelet pipis, bunda ajak Ayah ke kamar mandi lagi.
Hampir dihadang bidan tapi alesan mo pipis, akhirnya dibolehin.
Ternyata di kamar mandi cuman berdiri jongkok doang, abisnya ga keluar pipis padahal tadi mimik air putihnya banyak.

Disuruh balik lagi ke ruang observasi karena mo dicek dalam lagi.
"Ibu Ragil, sekarang udah bukaan 8, jangan jalan-jalan lagi ya." kata bidan Tri dengan senyum yang mengisyaratkan agar bunda tidak bandel lagi.
"Tapi saya pengen pipis" wajah saya memelas pengen balik ke kamar mandi lagi.
"Ibu pipisnya di pispot aja ya..." dan bidan Tri ambil pispot.
Tapi karena make pispotnya sambil tiduran, bunda ga nyaman.
"Bidan, saya ga bisa pipis tapi pengen pipis" rengek bunda ke bidan Tri.
Di cek sama bidan Tri, ternyata kandung kemih bunda udah penuh akhirnya bunda di 'cateter' (klo ga salah denger).
Setelah di cateter pipis bunda keluar banyak, tapi rasa kebelet pipisnya ga ilang-ilang.
"Udah ya bu pipisnya, jadi jangan kemana-mana" wedewww...
Ya udah bunda akhirnya tiduran miring ke kiri sambil merem, dan ayah tetap menemani meskipun keliatan banget ayah udah kelelahan :D
Emagn aneh, mendekati bukaan lengkap mata bunda pengennya merem mulu, kayak ngantuk tapi ga bisa bubuk.

Tapi kayaknya bunda termasuk pasien yang anteng.
Abisnya disebelah udah merintih dan tereak-tereak mulu padahal baru bukaan 3.
Sampai bidannya bilang sama ibu2 sebelah "Bu jangan teriak2, dihemat tenaganya buat nanti persalinan"
Ternyata si ibu itu udah ga tahan akhirnya minta di operasi cesar aja ke suaminya, terus suaminya bilang ke bidan minta operasi karena dia (suaminya) udah ga tahan denger istrinya mengeluh terus (wedewwww)

Ga berapa lama (sekitar jam 5an), baju bunda diganti pakai baju warna ijo dari RS.
Wah bunda udah merasa pengen pup.
Langsung bunda bilang ke bidan, "bidan, saya pengen ngeden".
Bidannya langsung bilang "Jangan ngeden bu ya, nanti jalan lahirnya bengkak dan bukaannya berkurang karena bengkak itu. Jadinya lama lagi nunggunya."
"belum boleh ya..." kata bunda sambil meringis menggenggam tangan kosong.

Jam setengah 6an, bunda udah dibawa ke ruang melahirkan.
Tapi sama bidan masih belum boleh ngeden juga, bunda akhirnya pasrah nahan sambil bubuk miring ke kiri.
Sementara itu ayah masih setia menunggui.
Saat bunda pengen ngeden, bunda ambil nafas panjang sambil terus istighfar, ga lupa bunda meremas-remas tangan ayah, tapiiiiiiii ayah protes katanya tangannya sakit. (dalam hati bunda bilang, masih sakitan perut bunda yahhh)
Terus bunda inget ada temen yang cerita klo pas dia mo lahiran minta doa restu suami, terus bilang kesuami kalau ada apa2 jangan nikah lagi ya.
Aku coba bilang gitu ke ayah, eh yg ada ayah malah marah sama bunda, tapi bunda langsung senyum aja :D

Tiap bunda tanya ke bidan kapan boleh ngeden, bidan bilang bentar lagi bu, ini masih bukaan 9.
Padahal rasa ngedennya udah kuat banget :(
Kayaknya bidan nunggu dokter datang deh.

Bener kan, pas dokter datang saya nanya lagi sama bidan.
"Udah boleh ngeden ga ?" eh yang jawab dokternya "boleh aja bu, dari tadi juga udah boleh" dengan entengnya bilang gitu, padahal belum pake baju operasi.
Weleh dengan semangat 45 bunda ngeden sebisanya, padahal ga tau ngedennya bener pa ga, wong bidannya belum megangin, yang megang cuman ayah.
Pas dokter datang bunda lagi berusaha ngeden, tapi koq rasa ngedennya dah ilang ya....
Akhirnya dipandu sama dokter "Ayo bu ngeden lagi"
Uuugghhhh... bunda ngeden sambil merem.
Dokternya marah-marah, "ibu ini ngedennya salah, cuman sampai dada. Ibu jangan merem, pak ini liat pembuluh darahnya udah merah di mata karena ibunya ngeden sambil merem" kata dokter kenceng.
"Ayo bu dikit lagi, ambil nafasnya yang panjang"
Sebenere bunda bingung ngeden yang bener gimana, apalagi udah ga ada yang mendorong rasa ngedennya.
Akhirnya nyoba ambil nafas panjang trs ngeden lagi, uuuggghhhh... baru sebentar udah ga kuat nafasnya.
Sampe berkali-kali ga bisa-bisa, dokter juga marah2 ampe kaki bunda ditepok2 saking gemesnya kalii...
Bunda akhirnya nangis "Ga kuat dok, ga bisa nafassss..."
"Ibu jangan gini, nanti saya lakukan tindakan lho" Bunda jadi mikir, gpp deh dok di vacuum biar cepet keluarnya.
Tapi dokter ga melakukan apa2, akhirnya bunda dikasih oksigen.
Coba ngeden lagi gagal, katanya klo ngeden badannya sambil diangkat.
Bunda bilang ga kuat ngangkat badan, minta ayah yang ngangkat tapi ga boleh sama dokter, harus dari bunda sendiri yang angkat.
Udah lama ga keluar2 sampai ayah marah2, "bunda kasihan dedeknya kejepit, jangan pendek2 ngedennya"
Dalam hati bunda "bunda jg ga pengen pendek2, tapi ga kuat nafasnya, dadanya ada yg nyesek jadi nafasnya pendek".
Wah semakin memanas aja suasananya, bidan Tri dan bidan Yuli ikutan marah.
Hwaaa... smua orang memarahi bunda, akhirnya bunda ngeden lagi sekuat-kuatnya sambil punggung didorong sama bidan Yuli.
Uuuuggghhh.... lalu ada suara "ceplukkk" dan dokter langsung bilang "Waduh ibuuuu anaknya cantik bangetttt"
Lho dah lahir to ? Masih antara sadar dan tidak bunda langsung liat kebawah.
Wawwww, dedek udah lahirrrr...
Terus setelah itu tangisan pertamanya terdengar kenceng, Subhanalloh walhamdulilah wala ila hailalloh...
Ayah langsung mengadzani dan meng iqomatkan dedek padahal belum dipotong pusernya, setelah itu baru ayah yang potong puser.
Setelah potong puser dedek langsung ditaruh di dada bunda untuk IMD, eh dedek langsung diem nangisnya.
Bunda dan ayah langsung memanggil dedek dengan sebutan "Aiiisss... Aisyah"
Sedangkan dokter entah apa yang dilakukan disana bunda udah ga ngerasa sakit lagi.

Tapiii baru sekitar 15 menit dan dedek belum menemukan puting, dedek udah diangkat.
Terus tiba-tiba semua keliatan panik.
Dokter minta aku disuntik beberapa kali sama bidan.
Terus infus dipindah ke tangan kiri, infus ga jalan.
Di pindah lagi jarumnya masih ga jalan.
Perut bunda dimessage terus, sampe dokter tereak ke bidan supaya cepet2 memasang infusnya.
Akhirnya infus berhasil dipasang.
Ayah juga kelihatan panik, ngajak ngobrol bunda terus.
"Bunda pusing ga ? Ngerasa lemes ga?" Bunda hanya bisa bingung dan bilang ga merasakan apa-apa.
Ga berapa lama akhirnya dokter selesai melakukan jahit menjahitnya dan pindah ke ruangan sebelah karena ada yang mo melahirkan juga.
Tetapi bidan Yuli masih terus mijat2 perut bunda, akhirnya bunda tanya ke bidan ada apa ?
Bidan cuma bilang "Gini yang bikin sport jantung bu"
Wedewwww... Ada apa yaks ???
Pas bunda udah diganti bajunya, bunda tanya sama ayah.
Ada apa sih yah ? Koq dedek diambil ?
"Tadi bunda pendarahan banyak banget, Alhamdulilah dulu bunda ada tambahan feritin jadinya bisa diatasi"

Alhamdulilahhh...

Sejam kemudian dedek dibawa lagi ke bunda, dalam keadaan sudah bersih dan diam.
Dia sudah membuka mata dan merasa bingung, aku dimana ya ? Kan lom waktunya lahiiirrr... :D
Kira-kira itu yang dipikirkan :D