自然哺育新技巧研討會

林茵怡將應邀出席「香港母乳育嬰協會」之會員活動,主講「自然哺育新技巧研討會」。

哺乳類動物世界裹,小動物出世後都懂得自己去哺乳,那我們的寶寶出生後,又是否可以自然地哺乳?我們過去學習過不同的哺乳姿勢,含乳方法,多數以媽媽為主導,但最新研究發現有一些姿勢與哺乳方式,可以令母嬰自然地展開母乳餵哺,使母乳餵哺更順利。本研討旨在與您探討最新的哺乳技巧,以及如何把哺乳看成為很自然的事,讓媽媽寶寶可以享受哺乳之樂,加強親子關係。

日期: 2012年4月28日(星期六)
時間: 下午2:00-4:00(研討會) 下午4:00-5:00(周年大會)

地點: 北角 福蔭道 7號 銅鑼灣社區會堂 會議室﹝近炮台山地鐵站﹞

研討會主講: 國際哺乳顧問﹝IBCLC﹞林茵怡女士
研討會內容:

  • 產前產後如何令母乳餵哺自然發生
  • 最新哺乳姿勢及方式
  • 討論:母乳餵哺如何有助親子?
  • 問答時間

本活動歡迎香港母乳育嬰協會之會員參加。詳情參考網該會網站

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Risks of Informal Breastmilk Sharing versus Formula Feeding

當妳遇到哺乳上的困難,需要補奶的時,根據世界衛生組織的指引,首選是媽媽自己擠出來的母乳,其次是別人的母乳,亦即古時候的奶媽,最後是才是奶粉。但最近有些討論,私下捐贈的母乳有風險,但奶粉亦有很多風險,那如何選擇?

以下這篇文章有詳細分折。

無論如何,當遇上哺乳困難,最重要尋求協助,而在使用補奶之時,同時要有返回乳房餵哺的方案,才可讓媽媽們成功餵哺自己的孩子。

展望將來,政府應設立母乳庫,好像血庫一般,幫助有需要的寶寶。

Risks of Informal Breastmilk Sharing versus Formula Feeding.

奶粉原來不可以賣廣告

文:  林茵怡 B.So.Sci. (Hon), IBCLC  國際哺乳顧問

有沒有想過, 假如有一天,所有奶粉廣告都消失了,由報章到電視,由戶內到戶外,再沒有人向你說,吃了奶粉寶寶如何健康活潑精靈。

假如有一天,所有奶粉商贊助之宣傳活動都取消了,再沒有講座、展銷、產前班,以講母乳為名,宣傳奶粉為實。

還有奶粉商之BB會也沒有了,不再向媽媽們派樣本及贈品,不再聯絡媽媽們提議她們餵奶粉。

那一天會在哪時出現?

其實那一天, 本來早應該在三十年前出現。

原來三十年前,為保護及推廣母乳餵哺,早已禁止了奶粉賣廣告和宣傳。在1981年, 世界衞生組織和聯合國兒童基金會頒佈了《國際母乳代用品銷售守則》,規條包括:

  •  禁止向公眾作廣告宣傳母乳代用品、奶瓶及奶嘴;
  • 禁止向媽媽們提供免費樣品;
  • 禁止在醫療保健機構中推銷這些產品;
  • 禁止公司派員向媽媽們直接推銷這些產品;
  • 禁止向醫療保健工作者贈送禮品或樣品,醫療保健工作者亦不可將樣品轉送予媽媽們。

可是三十年來香港政府遟遟沒有立法執行有關《守則》,亦沒有監管,業界沒有遵守,形同虛設。所以才有今天成行成市的奶粉廣告。

有時候奶粉商辯稱,廣告只推銷6個月後的大仔奶粉,沒有違規,其實這是大話,第一,大仔奶粉例如2號、3號,包裝設計跟初生裝幾乎全完一樣,令到無論那一款廣告,都對品牌全線起推銷作用。第二,世界衛生組織清楚訂明,純母乳餵哺6個月,之後加固體食物,持續餵母乳至兩歲及以後。如此,這期間所有取締母乳的食品或飲品,包括所謂2號、3號奶粉,都成了母乳代用品,皆受規管。

其實除了奶粉,也包括所有母乳代用品,例如奶瓶奶咀,嬰兒食物及飲品,都是不容許賣廣告及作宣傳和派發樣本的。

可幸是衛生署已成立「香港母乳代用品銷售守則專責小組」,正討論如何在香港落實《守則》,可望日後情況得以改善。

我們雖然不能低估廣告的威力,但最重要,是社會大眾對母乳餵哺的支持。新手媽媽學習正確知識,相信自己作為媽媽是有哺乳本能,若遇到困難第一時間找專家協助解決。

傳媒機構,商戶網站,為支持母乳餵哺,應拒絕為母乳代用品作宣傳。

社會人士,公司機構,應鼓勵母乳餵哺,方便哺乳媽媽。

母乳不只是食物,還有很多抗體等保障成份,也是寶寶的最大安撫。母乳餵哺是孕育寶寶成長所必須的,缺乏母乳餵哺對母子皆帶來長遠健康風險,造成沉重的醫療開支負擔。

假如有一天,當所有奶粉廣告都消失了,換來了支持母乳餵哺的廣告,相信會是新一代的最大福氣。

參考資料:

愛嬰醫院香港協會, http://www.babyfriendly.org.hk/

Spatz D, Lessen R, Risk of Not Breastfeeding, ILCA, USA, 2011

(updated: Jan 2012)

© Copyright 2012 By Lam Yan Yee Heidi, B.So.Sci.(Hon), IBCLC. All Rights Reserved. 版權所有。  [Web: http://www.heidi.hk]  [Facebook: http://www.facebook.com/ibclcHeidi%5D  [Email: ibclcHeidi@gmail.com]  [Tel: (852) 93016381]

無限次添飲

文:  林茵怡 B.So.Sci. (Hon), IBCLC

記得以前,有一些餐廳,當你叫了一杯咖啡或是檸檬茶,便可以免費添飲,一杯飲完了,又重新添滿。如是者坐足一日,不斷添飲,你大可以飲足十杯八杯!

我常常跟媽媽們作比喻,餵母乳也好像免費添飲的道理!

很多時候,媽媽不清楚造奶的過程,向我訴說:已經又飲魚湯,又飲多奶茶,又找人按摩,又睡覺休息,但奶量仍然很少。

於是我問:「那妳一天共餵了多少次母乳?」

回答說:「那也怕有三四餐吧!」

乳房造奶的快慢與多少,就好像那拿著大壺咖啡的仕應一樣,如果你的咖啡一口氣飲完,便會立即添滿,如果你的咖啡仍是滿滿的,那即使你等足一天,也得不到更多咖啡。

當寶寶吃了母乳,乳房清了,又會再造奶,新造的奶吃完了,又會再造,於是乳房又滿了,那不就好像是無限次添飲?

但如果乳房愈脹,或長時間沒有餵哺,便會減慢造奶速度和產量。因為母乳內有一種稱為FIL的乳清蛋白(Feedback Inhibitor of Lactation),作用是減慢造奶的速度,當乳房積存大量母乳時,FIL 的數目多,造奶便更慢,相反乳房愈空,FIL的數目少,造奶便更快。

此外乳房內造奶的細胞是需要有泌乳激素(prolactin)來造奶的。可是乳房愈滿愈膨脹,泌乳激素愈難進入造奶的細胞,於是便會減少造奶。

因此要增加奶量,最重要是頻密地餵哺,把乳房的奶清走,如不能餵哺便要頻密擠奶。所有其他方法,魚湯也好,多奶茶也好,都只是輔助性質。

寶寶吃奶,媽媽無限次添飲,大自然原來是那麼豐足的!

(updated: Jan 2012)

© Copyright 2012 By Lam Yan Yee Heidi, B.So.Sci.(Hon), IBCLC. All Rights Reserved.  Web: http://www.heidi.hk  Email: ibclcHeidi@gmail.com Tel: (852) 93016381

Baby’s Journey from Sterile to Germs

By Heidi Lam, B.So.Sci(Hon), IBCLC

We are living in a world full of microorganism like bacteria, virus and fungi. Even varies part of the human body have bacteria, like the skin, gut, and mucosal membranes.  They are needed for a normal life.  When we look closely into the immunology of breast milk, we will be amazed how Mother Nature intends to protect our offsprings to sustain a world full of bacteria.

 Born Naturally from Sterile to Germs

Baby lives in a sterile environment inside the mother’s womb, well nourished, protected and germs free. Suddenly, one day, the baby is born right next to mother’s anus, where you will expect plenty of bacteria.

Then the baby is put on to the mother’s body for skin-to-skin contact.  He touches and licks the mother’s skin, contacting bacteria there.

So what would happen to all those germs?

These are actually normal bacteria that will colonized the baby’s skin, gut and varies mucosal membranes, namely microflora.  The microflora will prevent the growth of dangerous bacteria by competing them for nutrients and space.

In the baby’s gut, the normal bacteria flora will compose of more “good” bacteria like Bifidobacteria and Lactobacilli, and less “bad” ones such as E. coli and Staphylococcus aureus.

However, babies are born very immature comparing to other mammals.  All their body systems are still developing.  The epithelium lining of infant’s gut is not yet intact, meaning germs and antigens may get through the “holes” of the “leaky gut” and goes into the blood stream and body tissues.

If that happens, a war will rise between the bacteria and the baby’s still immature immune system! The baby will defense his body against the “invader” and starts a series of reaction, namely infection.  This will cause inflammation, tissue damage, clinical symptoms and high energy cost.

To put it plainly, the baby gets sick.

He needs to use a lot of his energy to fight the war, and normal growth and development is compromised.

Breast Milk Defenses

This sounds a bit scary. So let’s go back to the newborn at the mother’s chest after birth.

He moves and searches and touches his mother’s nipple by his tiny hand.  After some efforts his mouth finds the nipple!  He latches on easily and gets colostrum in reward.

As you can see now, having contact with all the germs right after birth, the baby has a far greater need for immunological protection than for nutrition in the early days.

Mother nature is well aware of this too! The quantity of colostrum is low, but it has a high concentration of a major protein component called SlgA antibodies.

SlgA antibodies in breast milk are specific to mother’s bacteria in the gut. Can you see now how lucky that baby is born next to mother’s anus, so that he gets the same bacteria of his mother, which the SlgA antibodies are targeting to.

One important function of SlgA is to protect against the “bad” bacteria that colonized the newborn’s gut.  SlgA antibodies will bind the specific microorganism, so that they cannot attach to baby’s mucosal membrane, thus avoiding infection.  SlgA also support the development of baby’s own immune system.

 Varies components works together

Other breast milk protein components also work together with SlgA to protect the baby.  Lactoferrin kills bacteria, virus and fungi, while Lysozyme, working with Lactoferrin and SlgA will attack E. coli.

Moreover, carbohydrates call oligosaccharides will act as food for the “good” bacteria and enhance the growth of bifidobacteria and lactoobacilli.  More “good” bacteria in the gut means less space and food the “bad” pathogenic bacteria to grow.  Oligosaccharides will also catch and sweep the bacteria from the intestine and urinary tract and get excreted.

Now, what a good news to the baby’s still mature immune system.  Mother’s breast milk defenses.  Breast milk get rids of the enemies before they can go into the blood stream and tissue.  Infection is avoided and the baby does not need to react with inflammation, tissue damage, clinical symptoms, nor to lose energy.  War is relieved!

 Importance of normal gut bacteria

This first contact of mother’s bacteria, together with the defense of breast milk, is a good education for the baby’s immune system. The normal bacterial colonization in baby’s gut significantly stimulates the growth of his immune system.  It learns how to defend the baby from infection. It also learns not to react to normal substance such as food or pollen, which may otherwise induce allergic reactions.

These lessons are learned in a safe and energy saving way.  Now the baby can use his energy for optimal growth and development.

What a happy and healthy breast-fed baby mother nature has intended!

 Risk when against the nature

Now lets consider another scenario.

Baby was born via cesarean section.  He did not contact mother’s gut flora near the anus. He was then separated with mother for hospital procedures while mother being sewed up.  The baby was handled by varies hospital staffs, other than his mother and father.  He came in contact with the bacteria of other people’s skin and hospital environment.

After two hours, baby was brought to the mother to nurse. However, the most alert timing for the baby after birth is passed, and he seemed to be very sleepy.  He latched briefly and went to sleep.  Mother was in pain and baby was kept in the nursery.  Every 3-4 hours the nurse would bring the baby to the mother but breastfeeding did not go smoothly.  After trying for a few times, the baby started formula.

Since baby did not develop the normal gut and skin flora as his mother did, he had a different bacterial colonization.   He also contacted germs of other people, which he may not have those specific SlgA antibodies from colostrum to fight for.  With early start of artificial feeding, he do not have the supply of necessary SlgA and other factors to promote a growth of “good” bacteria in the gut, nor to help killing and blocking out pathogenic bacteria.  Since his immune system was still immature, when some bacteria was able to attach to the mucosa in the gut or urinary tract, so unfortunately, infection occured.

The baby then had to fight a war between his immature immune system and the germs. He had inflammation, tissue damage, energy loss and clinical symptoms.

He was then prescribed antibiotic.  However antibiotic treatment has a strong effect on the gut microflora.  It promotes the growth of some “bad” bacteria like Klebsiella and Enterobacter, risking for more serious illness. Antibiotic may also suppress the growth of some “good” bacteria, risking the colonization of disease causing bacteria.

Furthermore, cows milk protein is a common allergen.  It may, leak through the immature “leaky gut” and goes into the blood stream, which then cause a series of allergic reaction.

This tragic condition does sound very familar!  How many times we see baby get sick early on and having allergic reactions?

By looking into the different scenarios, we can see breastfeeding is a natural way to protect our babies and allow him to have a normal and healthy growth and development.

Starts skin-to-skin contact with baby after birth and goes on to breastfeeding is the key!

{End}

Reference:

Hanson Lars A., Immunobiology of Human Milk: How Breastfeeding Protects Babies, 2004, Sweden, Pharmasoft Publishing.

(updated: Nov 2011)

© Copyright 2011 Lam Yan Yee Heidi.  All rights reserved. No reprint or upload in any format and in any media without permission. Enquiries or reprint permission contact Heidi. Email: ibclcHeidi@gmail.com Tel:(852) 9301 6381