Medicines and drugs that are unsafe for breastfeeding

Some medicines can be taken by a nursing mother if she stops breastfeeding for a few days or weeks. She can pump her milk and discard it during this time to keep up her supply, while the baby drinks previously frozen milk or formula. Radioactive drugs used for some diagnostic tests like Gallium-69, Iodine-125, Iodine-131, or Technetium-99m can be taken if the woman stops nursing temporarily.

During breastfeeding, the following prescription drugs should not be taken, so as to avoid doing baby harm:

• Bromocriptine (Parlodel): A drug for Parkinson's disease, it also decreases a woman's milk supply.

• Most Chemotherapy Drugs for Cancer: Since they kill cells in the mother's body, they may harm the baby as well.

• Ergotamine (for migraine headaches): Causes vomiting, diarrhea, convulsions in infants.

• Lithium (for manic-depressive illness): Excreted in human milk.

• Methotrexate (for arthritis): Can suppress the baby's immune system.

• Tobacco Smoke: Nursing mothers should avoid smoking. Nicotine can cause vomiting, diarrhea and restlessness for the baby, as well as decreased milk production for the mother. Maternal smoking or passive smoke may increase the risk of sudden infant death syndrome and may increase respiratory and ear infections.
•  
• Drugs of Abuse: Some drugs, such as cocaine and PCP, can intoxicate the baby. Others, such as amphetamines, heroin and marijuana, can cause a variety of symptoms, including irritability, poor sleeping patterns, tremors, and vomiting. Babies become addicted to these drugs.

APA YANG PERLU ANDA TAHU TENTANG SUSU IBU?

Susu ibu diketahui keistimewaan dan kelebihannya. Tetapi masih ramai ibu yang tidak tahu manfaat dan kelebihan yang bakal diperoleh oleh ibu dan anak. Kecutkan rahim
Menyusukan bayi akan bantu anda kembali kepada bentuk tubuh asal dengan lebih cepat. Rahim yang sebelum ini membesar 20 kali lebih besar berbanding sebelum hamil mudah kecut. Hormon oksotosin yang terkandung dalma susu ibu membantu pengecutan rahim dengan menyingkirkan plasenta. Bagi ibu yang tidak menyusukan bayi, rahim mereka sukar untuk mengecut kepada keadaan asal.

Singkir mekoniumDi dalam usus bayi yang lahir, terdapat beberapa jenis bahan yang dikenali sebagai mekonium. Bahan ini jika tidak dibuang akan memberi kesan yang buruk kepada bayi. Oleh yang demikian, kolostrum yang terdapat dalam susu ibu boleh menyingkirkan bahan tersebut daripada tubuh bayi.

Mudah dihadamkan.Bayi lebih mudah hadam jika menyusu secara ekslusif. Ini disebabkan oleh enzim yang terkandung dalam susu ibu membantu proses penghadaman. Dalam pada itu, khasiat yang terdapat dalam susu ibu lebih cepat diserap ke dalam sistem tubuh bayi berbanding susu formula.

Pencegah penyakitBayi yang disusukan secara ekslusif jarang sekali dihinggapi penyakit. Ini kerana susu badan mengandungi antibodi kepada pelbagai jenis penyakit. Kira-kira 80 peratus sel dalam susu ibu terdiri daripada makrofaj. Sel berkenaan berfungsi untuk membunuh bakteria, fungus dan virus. Oleh itu, jika bayi disusukan secara ekslusif, mereka terlindung daripada daripada pelbagai jenis penyakit berbahaya termasuklah pneumonia, botulism, bronkitis, jangkitan telinga, influenza dan banyak lagi.

Elak pendarahanApabila menyusukan bayi, tubuh anda akan mengeluarkan oksitosin yan gmerangsang kontraksi. Kontraksi tersebut dapat menutup saluran darah maternal. Dengan itu, masalah pendarahan dapat dielakkan.

Kurangkan insulinBerita baik untuk anda yang menghidap penyakit kencing manis. Anda dapat mengurangkan kadar insulin hanya dengan menyusukan bayi. Bukankan itu baik untuk anda!

Stabilkan pertumbuhan endometriosisKajian klinikal menunjukkan penyusuan dapat menghentikan perkembangan endometriosis untuk sementara waktu. Ini kerana ibu yang menyusukan bayinya tidak akan datang haid untuk tempoh yang tertentu. Jadi apabila anda tidak datang haid, keadaan ini akan mengelakkan diri kesakitan akibat endometriosis.

Lindungi daripada masalah penglihatanSusu ibu penuh dengan khasiat dan salah satunya ialah vitamin A. Seperti yang diketahui, vitamin A baik untuk kesihatan mata.

Bertindak sebagai ubat penenangSusu ibu mengandungi oksitosin yang dapat mambantu menenagkan bayi. Apabila disusukan , bayi dengan sendirinya akan tenang setelah meragam.

Penahan sakit semulajadiSusu ibu mengandungi endorfin yang dapat menahan sakit. Sakit yang dirasai akibat bengkak dapat dilegakan selepas beberapa minit penyusuan bayi dilakukan. Jika bayi manjalani rutin suntikan imunisasi, anda digalakkan untuk menyusukan bayi sejurus disuntik. Penyusuan akan membantu mengurangkan kesakitan sekaligus meningkatkan keberkesanan vaksin yang diterima.

Premature And Special Circumstance Babies

Without doubt, breast milk is vital for premature babies. One study of premature babies who were tube-fed breast milk or artificial milk, but were never breastfed directly, showed that the babies who received no breast milk had IQS 8 points lower on average than those who received breast milk. Human milk has special ingredients like DHA (docosohexaenoic acid) and AA (arachidonic acid) which contribute to brain and retinal development. And all breastfed babies tend to spend a lot of their time in the "quiet alert" state which is most conducive to learning.



Breastfeeding has other special benefits for premature infants. Premature breast milk contains different amounts of some nutrients than term breast milk, more suited to the needs of premature babies. Necrotizing Enterocolitis, a serious bowel inflammation, is very rare for breastfed infants. And of course they get the same immune protection, which may be even more critical for prematures, and has been shown to reduce the risk of sepsis in these babies. Suckling at the breast, and digesting breast milk, cause less stress for the premature baby than bottle-feeding does; so most prematures can go to breast as soon as they are able to suckle. It’s vital that a mother of a premature baby breastfeeds her baby as soon as possible. Because of the reduction in infections and the shorter time to full feeding, breastfed premature infants can usually leave the incubator sooner. For some babies, breastfeeding is a life-and-death matter. In addition to its known benefit where water supplies are unsafe or food supplies erratic, breastfeeding lowers the risk of SIDS in all populations.

There are very few reasons, particularly from the baby's point of view, to avoid breastfeeding. Most authorities in the West recommend that mothers who are HIV positive not breastfeed; however, in many areas of the world breastfeeding's known benefits outweigh the small risk of transmission from breast milk. Few other medical conditions should prevent a mother from breastfeeding, as there are many medications that are suitable for use in breastfeeding moms.



Breastfeeding's immunologic and developmental benefits may be particularly important for babies with medical problems such as congenital heart disease, cleft palate, Down's syndrome, etc. In cases where the baby has a problem which affects its ability to suckle at the breast, expressed breast milk from mother is still the best choice. Banked human milk, the availability of which is unfortunately limited, would be the second choice. Commercial artificial baby milks are preferable to other alternatives, but far from perfect substitutes for human milk. These companies are always announcing that they’ve added a "new" component to their commercial formula to make it closer to human milk. But for every new artificial cone added, several more components of human milk

Baby Formula label, want a scare?

"Enzymatically hydrolyzed reduced minerals, whey protein concentrate, palm olein, soy, coconut, high-oleic safflower oils, lactose, maltodextrin, patoassium citrate, calcium phosphate, calcium chloride, salt, potassium chloride, magnesium chloride, ferrous sulfate, zinc sulfate, copper sulfate, manganese sulfate, potassium iodide, soy lecithin, mono and diglycerides, inositol, choline bitartrate
sodium ascorbate, alpha tocophyeryl acetate, naicinamide, calcum pantothenate, riboflavin, pyridoxine hydrochloride, thiamine mononitrate, folic acid, phylloquinone, biotin, vitamin D3, vitamin B12, taurine,
L-carnitine"

That's what's in formula!

Whey, one of the main ingredients in almost all formulas, is a waste by-product of producing certain dairy products, particularly cheeses.  Aren't you glad that the manufacturers now have a profitable way to dispose of their former waste products?

Palm, coconut and safflower oils are some of the least expensive oils, and so are used in many snack foods, and such things as movie theatre popcorn. 

And it's not always available, of course.  Disaster can befall you and your baby anywhere, and you don't need to run to the store to get breastmilk. 

The following was excerpted from Milk, Money & Madness: The Culture and Politics of Breastfeeding (Bergin & Garvey), 1995.  1995 Naomi Baumslag and Dia L. Michels. All rights reserved, may not be reproduced, in whole or in part, without permission.

"Jennifer Stolpa knows the miracle of breastfeeding.  Stranded for 8 days in Nevada by a winter storm that buried the region, Jennifer's son Clayton is a thriving child today only because she chose to breastfeed. After spending five nights in their snow-bound truck, James left his wife and five month old son in a cave while he sought help.   Jennifer melted show in her mouth, held Clayton snugly, and nursed him throughout the ordeal. The family survived with little more than frostbite and weight loss. Experts agree that breastfeeding saved Clayton's life.

Heidi Lunn also knows the wonders of breastfeeding. Her Florida house was destroyed in Hurricane Andrew. She was nursing her three-month old baby when the storm hit. Living near the eye of the storm, her neighborhood and all the surrounding communities were destroyed. "We were trapped," Heidi recalls, "we had no water for a week, no fuel, debris covered everything. We couldn't have bought formula then had we wanted to. Thank God I was breastfeeding!"

Most people don't expect to have a disaster befall them. But acts of war, environmental accidents, and natural disasters are part of life. Floods, earthquakes, hurricanes, and ice storms can bring life as we know it to a halt. Breastfeeding mothers in Kuwait, Somalia, and Bosnia know the importance of their food supply, as do all the women who have raised children on breastmilk in concentration camps, refugee camps, and during periods of famine. No one hopes to find themselves in a desperate situation, but knowing you can take care of your child when an emergency hits can help you and your infant survive."



Benefits for Mothers

1.  Delays Fertility
Women who nurse frequently during exclusive breastfeeding remained amenorrhoeic longer than infrequent nursers, introduced supplements later and did not resume menses as promptly thereafter.  Duration of exclusive nursing and night nursing after supplementation were the major influences on amenorrhoea.
Source:  Elias,M.F. "Nursing Practices and Lactation Amenorrhoea."  Journal of Biosco Sci, 1968.

2.  Breast Cancer
Among both premenopausal and postmenopausal women, risk of breast cancer decrease with increasing duration of lifetime lactation experience although the effect was consistently stronger for premenopausal women.
Source:  McTieman, A., Evidence of Protective Effect of Lactation on Risk of Breast Cancer in Young Women."  American Journal of Epidemiology, 1986.

After controlling for age at first full term pregnancy and other potentially compounding factors, parity and duration of breast feeding also had a strong influence on the risk of breast cancer.  Compared with parous women who never breast fed, women who had breast fed for 25 months or more had a lower relative risk.
Source:  Layde, P.M., "The Independent Associations of Parity Age at First full Term Pregnancy, and Duration of Breast Feeding with the Risk of Breast Cancer."  Journal of Clinical Epidemiol, 1989.

If women who do not breastfeed or who breastfed for less than 3 months were to do so for 4 to 12 months, breast cancer among parous premenopausal women could be reduce by 11%; if all women with children lactated for 24 months or longer, the incidence might be reduced by nearly 25%.
Source:  Newcomb,P. etal.  "Lactation and reduced risk of premenopausal breast cancer."  N Engl J Med 1994; 330(2):81-87.

Women who were breastfed as infants, even if only for a short time, showed an approximate 25% lower risk of developing premenopausal or postmenopausal breast cancer, compared to women who were bottle-fed as an infant.
Source:  Freudenheim, J.  "Exposure to breast milk in infancy and the risk of breast cancer."  Epidemiology 1994 5:324-331.

3.  Uterine Cancer
A protective effect against uterine cancer was found for women who breastfeed.
Source:  Brock, K.E., "Sexual, Reproductive, and Contraceptive Risk Factors for Carcinoma-in-Situ of the Uterine Cervix in Sidney.  "Medical Journal of Australia, 1989.
4.  Ovarian CancerBreastfeeding should be added to the list of factors that decrease ovulatory age and thereby decrease the risk of ovarian cancer.
Source:  Schneider, A.P.  "Risk Factor for Ovarian Cancer.  "New England Journal of Medicine, 1987.

5.  Endometrial Cancer
Lactation provides a hypoestrogenic effect with less stimulation of the endometrial lining.  This event may offer a protective effect from endometrial cancer.
Source:  Petterson B, et al.  "Menstruation span- a time limited risk factor for endometrial carcinoma."  Acta Obstet Gyneocol Scand 1986;65:247-55.

6.  Emotional Health
At one month postpartum, women who breastfed their infants had scores indicating less anxiety and more mutuality than the women bottle feeding their infants.
Source:  Virden, S.F., "The Relationship Between Infant Feeding Method and Maternal Role Adjustment." Journal of Nurse Midwives, 1988.

7.  Decrease Insulin Requirements
Breastfeeding decreased insulin requirements in diabetic women. Reduction in insulin dose postpartum was significantly greater in those who were breastfeeding than those who were bottle feeding.
Source:  Davies, H.A., "Insulin Requirements of Diabetic Women who Breast Feed." British Medical Journal, 1989.

8. Decreased Osteoporosis
The odds ratio that a woman with osteoporosis did not breastfeed her baby was four times higher than for a control woman.
Source:  Blaauw, R. et al. "Risk factors for development of osteoporosis in a South African population."  SAMJ 1994; 84:328-32.

9. Promotes Postpartum Weight Loss
Mothers who breastfed exclusively or partially had significantly larger reductions in hip circumference and were less above their pre-pregnancy weights at 1 month postpartum than mothers who fed formula exclusively.
Source:  Kramer, F., "Breastfeeding reduces maternal lower body fat." J Am Diet Assoc 1993;93(4):429-33.

 

Long Term Benefits for Infants

a. Dental HealthAmong breastfed infants, the longer the duration of nursing the lower the incidents of malocclusion.
Source:  Labbok, M.H. "Does Breast Feeding Protect against Malocclusion?  An Analysis of the 1981 Child Health Supplement to the National Health Interview Survey". American Journal of Preventive Medicine, 1987.

b. Toddler HealthMothers of 67 infants were questioned about the types and duration of illness episodes requiring medical care between 16 and 30 months of age.  Breastfeeding was noted to decrease the number of infant illnesses and indirectly improve toddler health.
Source:  Gulick, E.E. "The Effects of Breastfeeding on the Toddler Health.  "Pediatric Nursing, 1986.

c. Diabetes MellitusChildren who developed IDDM in New South Wales, Australia were matched with healthy children (ratio 1:2) of the same sex and age for comparison.  Those who were exclusively breastfed during their first three months of life had a 34% lower risk of developing diabetes than those who were not breastfed.  Children given cow's milk-based formula in their first three months were 52% more likely to develop IDDM than those not given cow's milk formula.
Source:  Diabetes Care 1994;17:1381-1389, 1488-1490.

d. Childhood CancerChildren who are artificially fed or breastfed for only 6 months or less, are at an increased risk of developing cancer before age 15.  The risk of artificially fed children was 1-8 times that of long-term breastfed children, and the risk for short term feeders was 1-9 times that of long term breast feeders.
Source:  Davis, M.K. Infant Feeding and Childhood Cancer.  "Lancet 1988.

e. Chron's DiseaseIn this study, lack of breastfeeding was a risk factor associated with later development of Crohn's disease.
Source:  Koletzko, S., "Role of Infant Feeding Practices in Development of Crohn's Disease in Childhood."  Br Med J, 1989.

f. Hodgkin's DiseaseA statistically significant protective effect against Hodgkin's disease among children who are breastfed at least 8 months compared with children who were breastfed no more than 2 months.
Source: Schwartzbaum, J.  "An Exploratory Study of Environmental and Medical Factors Potentially Related to Childhood Cancer." Medical & Pediatric Oncology, 1991; 19 (2):115-21.

g. Juvenile Rheumatoid Arthritis (JRA)Preliminary data from researchers at the University of North Carolina and Duke University comparing 54 children with JRA and a control group without JRA of similar age and race indicates that children who were breastfed were only 40% as likely to develop JRA.
Source:  "Mother's Milk: An Ounce of Prevention?"  Arthritis Today May-June 1994.

Protection From Allergies

a. Allergic Families  Breastfeeding, even for short periods, was clearly associated with lower incidence of wheezing, prolonged colds, diarrhea, and vomiting.
Source:  Merrett, T.G., "Infant Feeding & Allergy: 12 Month Prospective Study of 500 Babies Born into Allergic Families".  American Allergies, 1988.

b. Eczema  Eczema was less common and milder in babies who were breastfed (22%) and whose mothers were on a restricted diet (48%).  In infants fed casein hydrolysate, soymilk or cows milk, 21%, 63%, and 70% respectively, developed atopic eczema.
Source:  Chandra R.K., "Influence of Maternal Diet During Lactation and the Use of Formula Feed and Development of Atopic Eczema in the High Risk Infants".  Br Med J. 1989.

Enhances Development and Intelligence

a. Higher IQ Children who had consumed mother's milk by tube in early weeks of life had a significantly higher IQ at 7.5 to 8 yr.. than those who received no maternal milk, even after adjustment for differences between groups and mothers' educational and social class.
Source:  Lucas, A., "Breast Milk and Subsequent Intelligence Quotient in Children Born Preterm". Lancet 1992;339:261-62.

b. Cognitive Development Supplementary regression analysis examining the strength of relationship between duration of breastfeeding and cognitive development show a small but significant relationship between duration of breastfeeding and scores on the mental development index of the Bayley Scales at 1 and 2 years.
Source:  Morrow-Tlucak, M.  "Breast Feeding and Cognitive Development During the First 2 years of Life. "Soc Sci Med, 1988.

In 771 low-birth-weight infants, babies whose mothers chose to provide breastmilk had an 8-point advantage in mean Bayley's mental developmental index over infants of mothers choosing not to do so.
Source:  Morley,R., "Mothers Choice to provide Breast Milk and Developmental Outcome."  Arch Dis Child, 1988.

c. Social Development The psychomotor and social development of breastfed babies clearly differs from that of bottle-fed ones and leads at the age of 12 months to significant advantages of the psychomotor and social capabilities.
Source:  Baumgartner, C., "Psychomotor and Social Development of Breast Fed and Bottle Fed babies During their First year of Life".  Acta Paediatrica Hungarica, 1984.

Protects Against Illnesses

a. General Infants of a middle class and well-educated populations benefit from the breastfeeding practice and its protective effect, more so if they are exclusively breastfed and for a longer period.
Source:  Palti, H., "Episodes of Illness in Breast Fed & Bottle Fed infants in Jerusalem".  ISR J MED SCI, 1984.

b. Immunologic Development Enhanced fecal SIgA in breastfed infants is not cause solely by the presence of IgA in breast milk; it represents a stimulatory effect of breastmilk on the gastrointestinal humeral immunologic development.
Source:   Koutras,A.K., "Fecal Secretory Immunoglobulin A in Breast Milk vs. Formula Feeding in Early Infancy".  J Ped Gastro Nutr, 1989.

c. Wheezing Breastfeeding seems to protect against wheezing, respiratory tract illnesses in the first four months of life, particularly when other risk factors are present.
Source:  Wright, A.L., "Breastfeeding and lower respiratory Tract Illnesses in the First Year of Life."  British Medical Journal, 1989.

d. SIDS A study indicated that breastfeeding was protective against SIDS, Consistent with an effect mediated through the prevention of gastrointestinal and/or respiratory disease.
Source:  Hoffman, H.J., "Risk Factors for SIDS: Results of the National Institute of Child Health and Human Development SIDS Cooperative Epidemiologic Study".  Ann NY ACAD Sci, 1988.

Not breastfeeding at discharge from an obstetric hospital at any stage of the infants life was associated with an increased risk of SIDS.
Source:  Mitchell, A. "Results from the First Year of The New Zealand Count Death Study".  N.Z. Med A, 1991; 104:71-76.

e. General Morbidity There is an inverse relationship to breastfeeding and morbidity.  This was most prominent in the first year of life, but it was also present in the first three years.
Source:  Van Den Bogaard, C.  "Relationship Between Breast Feeding in Early Childhood and Morbidity in a General Population".  Fan Med, 1991; 23:510-515.

f. AIDS The lack of a dose response affect between breastfeeding and perinatal HIV-1 transmission in the presence of the protective effect of breastfeeding against common causes of early childhood morbidity and mortality support the current WHO recommendation that breastfeeding should continue to be promoted in all developing countries, including those with high HIV-1 prevalence rates in women of child bearing age.
Source:  Ryder,R., "Evidence from Zaire that Breastfeeding by HIV-1 seropositive Mothers is not a Major Route for Perinatal HIV-1 Transmission but does Decrease Morbidity".  AIDS 1991; 5(6):709-14.

g. Infant Survival There is an association between breastfeeding up to 6 months of age and survival of infants throughout the first year of life.  The younger the infant and the longer the breastfeeding, the greater the estimated benefits in terms of death averted.
Source:  Habicht, J.P., "Does Breast Feeding Really Save Live, or Are Apparent Benefits due to Biases?"  Am J Epidemiology, 1986.

h. Gastroesophageal Reflex Breastfed neonates demonstrate gastroesophageal reflux episodes of significantly shorter duration than formula-fed neonates.
Source:  Heacock, H.J., "Influence of Breast vs.  Formula Milk in Physiologic Gastroesophageal Reflux in Health Newborn Infants".  J. Pediatr Gastroenterol Nutr, 1992 January; 14(1): 41-6.

i. Multiple Sclerosis Although thought to be multifactorial in origin, and without a clearly defined etiology, lack of breastfeeding does appear to be associated with an increased incidence of multiple sclerosis.
Source:  Dick, G. "The Etiology of Multiple Sclerosis. " Proc Roy Soc Med 1976;69:611-5.

j. Inguinal Hernia Human milk contains gonadotropin releasing hormone, which may affect the maturation of neonatal testicular function.  This case control study showed breastfed infants had a significant dose response reduction in inguinal hernia.
Source:  Pisacane, A. "Breast-feeding and inguinal hernia" Journal of Pediatrics 1995:Vol 127, No. 1, pp 109-111.

k. Cryptorchidism (Undescended Testicle) This case controlled study showed a significant association of cryptorchidism and lack of breastfeeding.
Source:  Mori, M. "Maternal and other factors of cryptorchidism: a case-control study in Japan" Kurume Med J 1992:39:53-60.

Protects Against Infection

a. DiarrheaChildren less than 12 months of age had a lower incidence of acute diarrheal disease during the months they were being breastfed than children that were fed with formula during the same period.
Source:  Lerman,Y. et al. "Epidemiology of acute diarrheal diseases in children in a high standard of living settlement in Israel".  Pediatr Infect Dis J 1994; 13(2);116-22.

b. Haemophilus InfluenzaIn a population based case control study of risk factors for primary invasion of haemophilus influenza, type B disease, breastfeeding was protective of infants less than 6 months of age.
Source:  Cochi, S.L. "Primary Invasive Haemophilus Influenza Type B Disease, A Population Based Assessment of Risk Factors".  Journal of Pediatrics 1986.

c. Enhances Vaccine ResponseThe antibody levels of immunized infants were significantly higher in the breastfed than the formula-fed group.  These findings are strong evidence that breastfeeding enhances the active humoral immune response in the first year of life.
Source:  Papst, H.F. , Spady, D.W.  "Effect of Breast Feeding on Antibody Response to Conjugate Vaccine".  Lancet, 1990.

The breastfed group had significantly higher antibody levels than two formula-fed groups together. Breastfed infants thus showed better serum and secretory responses to perioral and parenteral vaccines than the formula-fed, whether with a conventional or low-protein content.
Source:  Van-Coric, M.  "Antibody Responses to Parental & Oral Vaccines Where Impaired by Conventional and Low-Protein Formulas as Compared to Breast Feeding". Acta Paediatr Scand 1990; 79: 1137-42.

Human milk can transfer specific or nonspecific immunities to the external mucosal surface of the intestine and possibly to the respiratory tract of the newborn.  The acquisition of such passive immunity is particularly important in the early neonatal period when the immune system is immature.
Source:  Chang, S.J. "Antimicrobial Proteins of Maternal and Cord Sera and Human Milk in Relation to Maternal Nutritional Status". A. M. J.  CLIN NUTR, 1990.

d. NECAmong babies born at more than 30 weeks gestation, confirmed necrotizing enternal colitis was rare in those whose diet included breast milk; it was 20 times more common in those fed formula only.
Source:  Lucas, A., Cole, T.J., "Breast Milk and Neonatal Necrotizing Enteral Colitis". Lancet 1990; 336:1519-23.

e. Otitis MediaShort duration of breastfeeding involved another significant risk of recurrent respiratory infections and otitis media.
Source:  Alho, O., "Risk Factors for Recurrent Acute Otitis Media and Respiratory Infection in Infancy".  Int J Ped Otorhinolaryngology 1990; 19:151-61.

Significantly increased risk for acute otitis media as well as prolonged duration of middle ear effusion were associated with male gender, sibling history of ear infection and not being breastfed.
Source:  Teele, D.W., Apidemilogy of Otitis Media During the First Seven Years of Life in Greater Boston: A prospective, Cohort Study".  J of INFEC DIS.1989.

f. Herpes SimplexMothers milk could play a role in the protection of newborns from Herpes Simplex virus II contamination.
Source:  Lopez, I., "Neutralizing Activity Against Herpes Simplex Virus in Human Milk". Breast Feeding REV 1990; 11(2): 56-58.

g. Respiratory Syncytical Virus (RSV)Breastfeeding was associated with a lower incidence of RSV infection during the first year of life.
Source:  Holberg,C.J., "Risk Factors for RSV Associated lower Respiratory Illnesses in the First Year of Life".  AM J Epidemiol 1991; 133 (135-51).

h. Respiratory InfectionsThe authors presented results found in infants with two or more episodes of acute chronic bronchitis.  They found that approximately twice as many bottle-fed infants presented with the problem as those who were breastfed.
Source:  de Duran, C.M. "Cytologic Diagnosis of Milk Micro Aspiration".  IMM ALLERGY PRACTICE 1991; xiii (10);402-5.

There was a strong negative effect modification by breastfeeding: relative odds of respiratory illness with maternal smoking were seven times higher among children who were never breastfed then among those who were breastfed.
Source:  Woodwar, A. "Acute Respiratory Illness in Adelaide Children: Breast Feeding Modifies the Effect of Passive Smoking".  J Epidemiol in Comm Health 1990;44:224-30.

Kelebihan anak SUSU IBU

Kajian perubatan menunjukkan bahawa wanita yang menyusu badan mengurangkan pendedahan kepada hormon estrogen (endogenous estrogen)oleh itu risiko mendapat barah buah dada adalah kurang. Puan tidak perlu bimbang kerana puan boleh menyusu badan.Jika puan merancang untuk mendapat anak lagi bolehlah menyusu badan tanpa campuran susu formula selama 2 tahun. Bagi bayi yang tidak menyusu badan,mereka tidak mendapat kebaikan susu ibu seperti berikut: 

• Susu ibu mengandungi zat khusus untuk perkembangan otak, kebanyakan bayi  menyusu badan IQ tinggi 

• Susu ibu mengandungi antibodi untuk mencegah penyakit ceret beret dan lelah 

• Susu ibu mengandungi zat makanan dalam nisbah yang betul dan isi kandungannya berubah mengikut tumbesaran bayi, tiada sembelit 

• Susu ibu mengurangkan risiko pencemaran yang mungkin berlaku dalam kaedah penyusuan lain 

• Susu ibu boleh memberi bayi keselesaan dan ketenangan emosi yang diperlukan. 

• Susu ibu mengeratkan hubungan anda dan anak 

JAGAAN BUAH DADA DAN PUTING

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Puting yang tenggelam sedikit boleh ditarik keluar perlahan-lahan sekali atau dua kali sehari. Adalah tidak digalakkan penggunaan sabun ke atas puting kerana ini mengeringkan minyak asli yang keluar semasa mengandung. Jika ibu kehendaki, kolustrum yang terdapat dalam buah dada semasa mengandung bolehlah perlahan-lahan 4 minggu yang akhir sebelum bersalin. Pegang buah dada dalam tangan yang meletakkan ibu jari di atas dan jari telunjuk di bawah buah dada di tepi kawasan aereola. Picit ibu jari dan jari telunjuk bersama. Ulangi beberapa kali. Anak baju mestilah dipakai untuk menahan buah dada supaya buah dara tidak mudah kendur atau jatuh.

5 hari pertama penyusuan

Sebaik sahaja bayi dilahirkan, letakkan pada puting susu ibu kerana proses penghisapan akan mempercepatkan dan mempermudahkan pengeluaran air susu. Biasanya pada hari pertama atau hari kedua selepas kelahiran, air susu belum banyak keluar, malah kadang-kadang tidak ada langsung. Saya ingin menegaskan penghisapan putting perlu dilakukan berulang-ulang kali untuk mempercepatkan proses pembentukan air susu.

Pada waktu ini sesetengah wanita mengeluarkan air jernih bukan susu yang digelar colostrums. Ini juga mengandungi khasiat pemakanan yag baik untuk bayi. Pada hari pertama dan berikutnya jika susu ibu tidak mencukupi, bayi boleh diberikan susu botol.

Biasanya susu keluar pada hari kedua atau ketiga, namun demikian ada sesetengah ibu susunya keluar lebih lambat seperti tiga hingga lima hari kemudian. Kelambatan ini tidak perlu dibimbangkan kerana susu pasti akan keluar juga akhirnya.

Bagi ibu yang melahirkan anak sulung, proses penyusuan adalah satu pengalaman baru. Ibu mungkin terasa kekok pada mulanya. Sedutan atau hisapan bayi yang terlalu kuat mungkin menimbulkan rasa sakit. Jika percubaan pertama atau berikutnya masih gagal untuk memberi hisapan yang sepuasnya kepada bayi, kita tidak perlu putus asa dan terus memberhentikan usaha untuk menyusukan bayi. Seperti yang saya nyatakan tadi, jika kita berulang-ulang kali meletakkan bayi pada puting buah dada, dia akan cuba menghisap. Kadangkala bayi berasa hampa dan menangis kerana tidak ada susu yang keluar pada hari pertama dan kedua.

Buah buahan

Penyusuan ibu memerlukan persediaan sejak dari awal lagi khususnya sejak ibu mula mengandung. Puting susu bolehlah dibersihkah dengan air panas atau sabun. Buah dada juga elok diurut menghala ke arah puting. Segala kekotoran pada puting buah dada perlu dibersihkan kerana ini boleh menyebabkan aliran susu tersumbat. Kejayaan penyusuan juga banyak bergantung kepada taraf kesihatan dan pemakanan ibu yang mengandung. Jika ibu mengalami sebarang masalah kesihatan dan masalah kekurangan zat pemakanan, keadaan ini boleh menjejaskan atau mengganggu proses penyusuan. Penting bagi ibu mendapatkan sumbet zat protein yang mencukupi, vitamin serta zat logam khususnya zat besi kerana zat pemakanan ini akan masuk ke dalam air susu bagi memenuhi keperluan bayi.

Buah- buahan adalah makanan yang lengkap untuk mendapatkan segala nutrien yang diperlukan. Ibu wajib mengamalkan pengambilan buah-buahan sebagai sumber serat & mineral bagi penghasilan susu yang sempurna.

DOUBLE PUMPING

Mengepam sambil menyusukan anak. Satu teknik yang baik untuk meningkatkan dan mengekalkan penghasilan susu yang sempurna. Selalunya apabila sebelah payu dara di hisap oleh bayi, sebelahnya lagi akan mengeluarkan susu juga. Ada baiknya kita membuat teknik mengepam serentak dengan penyusuan semulajadi. Susu akan bertambah setelah dirangsang.

Sekiranya bayi sudah berhenti menyusu atau tidur, ibu boleh meneruskan mengepam di kedua-dua bahagian sehingga terasa kosong. Susu baru akan dihasilkan dengan cepat setelah payu dara kosong. Ini juga baik bagi memastikan kandungan zat dalam susu benar-benar sempurna.

Pengalamanku bersama SPECTRA 2&3

SPECTRA 3

SPECTRA 2

4 tahun lalu, aku mengenali ilmu penyusuan susu ibu secara mendalam sewaktu aku mengandungkan izz. Sewaktu itu aku membuat pemeriksaan kehamilan di Pusrawi, Jln Tun Razak. KL. Aku menghadiri kelas ante-natal dan dari situ aku mempelajari ilmu penyusuan dari pakar O&G, nurse terlatih. Kesedaran disitu menguatkan lagi niat & semangat aku untuk memulakan penyusuan kepada anak yang bakal lahir. Kebetulan pula aku memang sedar kebaikan susu ibu kerana aku sendiri anak hasil penyusuan susu ibu sempurna melebihi 3 tahun. Bukanlah aku nak katakan aku pandai tapi ada kecerdikan dan kecekapan otak aku ni berlainan dari adik beradik yang lain. hehehe.. Dari segi kesihatan, sepanjang usia sebelum meningkat 20-an, aku memang jarang mengidap masalah kesihatan yang teruk malah demam juga jarang. Mungkin disebabkan imune yang kuat hasil susu ibu mak aku dulu.

Selepas bersalin, aku bertuah kerana hari pertama susah ada susu yang banyak. Kebetulan izz mengidap jaundis, nurse di situ menyarankan aku bf sepenuhnya. Disebabkan aku ni mempunyai susu yang terlalu banyak sehinggakan terpaksa di pam, stok susu dah dibuat sewaktu di hospital.

Apa yang aku selalu amalkan ketika mengandung, aku pastikan meminum susu secukupnya, air masak, sayuran yang mengalakkan penghasilan susu spt bayam, sawi, carrot,kurma, soya & tempe sebagai menu wajib harianku. Maybe disebabkan amalan tersebut, susu aku terhasil dengan begitu banyak selepas melahirkan.

Semasa di ward Pusrawi itulah, aku di ajar mengendalikan breast pump. Di pusrawi ,mereka menggunakan pam jenama SPECTRA. Pada mulanya kekok, tapi berkali-kali mengepam, aku menjadi selesa. Tambahan pula semangat aku berkobar-kobar bila melihat rakan ibu dan staff nurse yang juga mengepam dengan hasil yang sangat mengagumkan. Aku jatuh cinta pada BREST PUMP SPECTRA. Jadi setelah pulang ke rumah, aku membeli spectra 3 untuk kegunaan semasa pantang. Senang sekali.. setelah 4 hari mengepam. Hasil susu semakin bertambah sehingga menjangkau 4-5oz. Alhamdulillah rezeki anak ku. Aku terus menggunakan spectra 3 sehingga bermula masa untuk kembali bekerja. Lebih 100 lebih beg stok ebm aku terhasil atas bantuan spectra 3.

Setelah bekerja, aku mengambil keputusan membeli Spectra 2 tapi 2nd hand dari ibu yang menjual di laman susu ibu. Aku menggunakan spectra 2 di ofis dan spectra 3 di rumah. Spectra ni memang bagus dari segi suction dan tidak bising. Sedutan yang boleh dilaraskan mengikut kesesuaian badan dan ia menghasilkan susu yang banyak kerana sedutan itu meransang sel-sel breast untuk meningkatkan penghasilan susu. Permulaan membeli spectra ni mmg agak mahal, dengan harga RM368 ketika itu..amat la berbaloi kerana pam ni dapat bertahan sehingga kini dan penggunaan yang heavy melebihi 5kali sehari. Sekali mengepam memakan masa 30minit ke 1jam tanpa henti.

Aksesori pula mudah didapati dan pusat servis juga ada di subang jaya.

Kalau ditanya pam apa yang sesuai & berbaloi?.. saya akan katakan belilah SPECTRA.

Sejarah tertinggi dan terakhir hasil susu di pam setelah izz menjangkau 2 tahun 3 bulan menjangkau 15-20oz sekali pam kurang sejam. :)

Masalah kerap berlaku semasa berpantang

Beberapa masalah buah dada boleh berlaku selepas bersalin. Pertama, bengkak buah dada atau breast engorgement. Ini biasanya disebabkan oleh saluran susu pada puting tetek tersekat. Untuk menjauhkan masalah ini penting bagi setiap bakal ibu membersihkan puting buah dada dengan air bersih. Urutlah buah dada ke arah puting untuk memudahkan aliran susu. Jika buah dada selalu diurut, nescaya masalah saluran puting susu tersumbat boleh diatasi. Bengkak buah dada biasanya kerap berlaku di kalangan ibu yang tidak menyusukan anaknya.

Sebaiknya setiap ibu patut menyusukan bayinya dengan susu sendiri kerana khasiat makanan yang terkandung di dalamnya. Susu ibu sudah tersedia dan apa yang lebih pentingnya penyusuan ibu dapat merapatkan hubungan emosi antara bayi dan ibu. Bagi ibu yang telah membuat keputusan tidak akan menyusukan anaknya, masalah bengkak buah dada boleh diatasi dengan memakan ubat yang khusus untuk menyekat pengeluaran susu. Ubat ini mengandungi hormon estrogen yang dimakan lebih kurang lima hari. Ubat terbaru di pasaran untuk menyekat pengeluaran susu dan mencegah bengkak dan sakit buah dada ialah Bromocryptine yang dimakan selama beberapa hari.

Bengkak buah dada boleh menimbulkan masalah jangkitan kuman, mengakibatkan mastitis. Ini menyebabkan rasa sakit serta demam panas. Bagi mengawal keadaan ini, perlulah ibu berjumpa doktor yang kemudiannya akan memberi ubat antibiotik dan juga penawar sakit. Masalah jangkitan kuman pada buah dada boleh berlarutan menimbulkan masalah nanas atau abcess. Jika keadaan ini berlaku satu pembedahan kecil perlu dilakukan di hospital untuk mengeluarkan nanah itu. Ubat antibiotik, penawar sakit dan juga hormon untuk menyekat pengeluaran susu akan diberikan bagi merawat abcess ini.

Amalan menyusukan bayi dengan susu sendiri boleh mengatasi masalah yang saya nyatakan di atas. Di samping itu, kajian telah menunjukkan penyusuan ibu mungkin boleh menghindarkan atau mengurangkan risiko penyakit kanser buah dada. Oleh itu saya sering menasihatkan ibu menyusukan bayinya sendiri kerana menyusu sendiri itu amat banyak faedahnya. Penyusuan juga dikehendaki oleh agama Islam seperti yang ternyata dalam Surah al-Baqarah 233 yang bermaksud bahawa ibu patut menyusukan bayinya selama dua tahun.

Sup ketam

gambar dari google

• 4 ekor ketam
• Sup bunjut Adabi
• 3 ulas bawang merah
• 5 ulas bawang putih
• 2 inci halia
• 1 keping asam keping
• Daun Sup/bawang
• Bawang goreng
• Kentang
• Tomato
• Carrot
• Garam secukup rasa
• Sedikit Minyak untuk menumis
• Air

Cara-cara Memasak:

1. Tumbuk/hiris bawang merah,putih dan halia.
2. Panaskan sedikit minyak.Tumiskan bawang merah,putih dan halia hingga naik bau.
3. Masukkan air, sup bunjut dan asam keping. Biarkan seketika.
4. Masukkan kentang dan carrot yang telah dipotong
5. Bila air dah mendidih, masukkan ketam. Biarkan sehingga 5-10 minit supaya ketam tidak terlebih masak.
6. Masukkan garam dan tomato.
7. Angkat dan taburkan sedikit daun sup, daun bawang dan bawang goreng

Pegaga

Pokok Pegaga atau juga dikenali sebagai pokok Antanan (bahasa Inggeris: pennywort) adalah sejenis pokok ulam yang terdapat di hutan Malaysia serta di negara-negara ASEAN. Nama botaninya Centella asiatica.

Terdapat pelbagai jenis pegaga di Malaysia seperti:

pegaga cina atau pegaga nyonya yang berdaun kecil,

1. Pokok Pegaga Daun Lebar,
2. Pokok Pegaga Kelantan,
3. Pokok Pegaga Renek
4. Pokok Pegaga Salad
5. Pokok Pegaga Gajah
6. Pokok Pegaga Brunei

Di Indonesia, jenis-jenis pegaga yang ada adalah Daun kaki kuda, Tikusan, Pani gowang, Pegagan.
Pegaga sebagaimana tumbuhan herba hijau yang lain kaya dengan pelbagai zat makanan seperti protin, gentian, zat besi, vitamin A dan C.
Pegaga banyak terjual di pasar terutamanya di pasar tani dan sering dimakan sebagai ulam.



JINTAN MANIS

Jintan manis merupakan sejenis rempah. Nama sains jintan manis adalah Pimpinella anisum.
Jintan manis banyak khasiatnya. Ia dapat melegakan kesakitan dalam badan, melancarkan aliran keluar haid, membanyakkan susu dan membuang gas dalam usus. Ia juga boleh digunakan dalam bentuk serbuk dan disapu di sekeliling mata bagi menguatkan pandangan mata.

Selain itu juga,jintan manis ini dapat membuang lemak di pangkal peha dengan cara rebus jintan manis dengan 5 cawan air sehingga mendidih,selepas itu biarkan sejuk.Amalkan meminum air rebusan jintan manis ini pagi dan petang selama empat minggu.

Kobis

Brassica oleracea merupakan nama sains bagi bunga kobis dan sayur ini berasal dari keluaraga Brassica. Sayur ini mengandungi belerang, iaitu sejenis zat galian yang penting untuk kesihatan. Kobis bukan sahaja berkesan untuk mengubati penyakit ulser dan barah malahan juga berkesan untuk mengubati masalah -masalah lain di usus.

Kobis yang kaya dengan kalsium, fosforus, zat besi, sodium, potasium dan vitamin A, B- Kompleks dan C dapat meredakan masalah di bahagian perut dan hati seperti yang dialami oleh mereka yang lali arak. Kompaun belerang dalam kubis dapat menghindarkan pengeluran carcinogen, sejenis bahan kimia berbahaya dalam tubuh badan.

Amalan memakan kobis dapat menghalang carcinogen daripada bergabung menjadi sel-sel darah. Selain itu asid amino yang mengandungi belerang dalam kubis juga bertindak menurunkan paras kolestrol , meredakan saraf dan menenangkan fikiran dan sekaligus membantu seseorang itu tidur dengan selesa pada waktu malam.

Longan kering

Longan kering amat sinonim dalam alternatif menyelesaikan masalah susu ibu merundum. Amalan meminum air atau membuat sup longan boleh membantu meningkatkan penghasilan susu ibu. Longan ini boleh di dapati di kedai-kedai ubat cina atau supermarket.

Dikatakan longan kering jelas terbukti hasilnya berbanding longan mentah.

Bayam

Bayam merupakan tanaman annual (semusim) yang berasal dari Amerika Tropis. Dalam perkembangannya di Amerika Latin, bayam dipromosikan sebagai tanaman pangan sumber protein, terutama bagi negara-negara berkembang. Sedangkan bayam sebagai sayuran hanya umum dikenal di Asia Timur dan Asia Tenggara, sehingga disebut dalam bahasa Inggris sebagai Chinese Amaranth.

Batang bayam berbentuk tegak dengan beberapa cabang lateral berbentuk semak. Tingginya bisa mencapai 150 cm. Batangnya sendiri berair dan kurang berkkayu serta berwarna hijau atau kemerahan. Daunnya bertangkai berbentuk bulat telur, lemas, berwarna hijau, merah, atau hijau keputihan. Tulang daunnya jelas, berwarna hijau atau kemerahan. Bunganya berbentuk bulir dan bijinya berwarna hitam, kecil, dan keras.

Amalan memakan bayam juga dapat membantu menghasilkan susu badan.

SAWI

Sawi (brassica juncea) termasuk ke dalam famili Curciferae merupakan tanaman semusim yang berdaun lonjong, halus, tidak berbulu, dan tidak berkrop. Batang tanaman sawi pendek dan lebih langsing dari tanaman petsai. Ia mempunyai akar tunggang dengan banyak akar samping yang dangkal. Bunganya mirip petsai, tetapi rangkaian tandan lebih pendek. Ukuran kuntum bunganya lebih kecil dengan warna kuning pucat spesifik. Bijinya berukuran kecil dan berwarna hitam kecokelatan serta terdapat dalam kedua sisi dinding sekat polong yang gemuk.

Sawi juga berkhasiat untuk ibu yang mengandung bagi mengelakkan anemia. Ibu menyusukan anak juga elok untuk merangsangkan penghasilan susu badan. 1 mangkuk sawi amat baik untuk diet ibu menyusu.

Nursing bra fitting

If you plan to breastfeed your baby, it is very important that you select a high quality supportive nursing bra with a comfortable fit. The best time to purchase a nursing bra is a few weeks before your due date so that your rib and bust size will be close to the same size as they will be following delivery of your baby. Also, you need to be sure to have a few nursing bras on hand for the first few hectic weeks after the baby is born as you certainly will not have the time or energy for a shopping expedition!

 

 

To ensure the best fit, take these measurements at home while wearing a good fitting but unpadded bra:

 

 

 

• For your Band Size: Measure around your body just under your arms while keeping the tape snug but not tight. If the measurement is an odd number, round up to the next even number. This number is your band size.

 

 

• For your Cup Size: Measure around your body over the fullest part of your bust. Subtract this measurement from your band size. Each 1" difference represents one cup size. 1"=A Cup, 2"=B Cup, 3"=C Cup, 4" = D Cup, 5" = DD Cup, etc. So, if your band size is 36" and your measurement across the fullest part of your bust is 40", then you would wear a 36D.

 

 

If your current bra you are using for measurements is too small or not very supportive, you many understate your true cup size. There should be no breast tissue beyond the side seam on either side of your bra. Also, there should be not spilling out of the top of your bra, as you would have in a too small or push up bra, as this will also affect your measurements.

 

 

 

For a proper fit, the bra band should be snug and should not ride up on your back as you wear it. Most women's upper bodies do slim down quite a bit following delivery, so make sure that the bra you choose is either adjustable around the rib cage and you are on the last set of hooks, of has a stretchy band which will continue to fit a shrinking rib cage.

 

 

 

When your milk comes in, usually by 3-5 days postpartum, allow some extra room in the cup. You may need to purchase a larger size bra after your milk comes in and you can switch back to a smaller size once your milk supply is regulated and your hormones subside, usually 2-3 months postpartum. Also, your cup size will probably be bigger for those first few days when your milk comes in and subside some in the following weeks. Oftentimes women rotate through several sizes in a nursing bra during the first few months until their size is more stabilized.

 

 

 

Many women ask about wearing underwire nursing bras. Many lactation consultants prefer nursing mothers to wear softcup bras for the early weeks of breastfeeding as your milk supply comes in and your size is changing. Underwire bras, particularly if they are too small or tight, can dig into your breast tissue and clog a milk duct which can lead to mastitis. However, many women prefer the support of an underwire bra, and can comfortably wear one. If you do choose an underwire bar, make sure that the bra fits properly and that the wire is not pressing on any part of your breast.

Breastfeed Both an Infant and a Toddler?

The common term (in the USA) for breastfeeding siblings concurrently is "tandem nursing." Mothers have practiced tandem nursing for centuries, and today there are still many families with nursing toddlers who do not wean when their mother becomes pregnant, or who resume breastfeeding after the birth of a new sibling


Some mothers express concern that their toddler may be taking milk meant to nourish their baby. These mothers may take comfort in the fact that breasts are marvelous things that can adjust their production to meet the demands placed upon them--if they are asked to produce enough milk for two, they usually can! Also, most toddlers breastfeed considerably less frequently than an infant, and get most of their nutrition from other foods.

Many mothers find that children who tandem nurse are closer with each other than children who do not.

It is normal even for mothers who choose to tandem nurse to sometimes wish they weren't so tied down to two babies or to want to breastfeed only one baby at a time.

It is often the case that a baby or toddler will want to breastfeed much more often when a younger sibling is born. Many want to breastfeed every time the baby does. Many mothers suggest allowing this for a period of perhaps three weeks. After that time, try telling the older child that you prefer to be able to really pay attention to him/her while breastfeeding, and request that he/she wait until the baby is done before he/she breastfeeds. This will not eliminate the constant double-nursing, but may very well cut it down.

Enjoy both your babies!

Many mothers have found that tandem nursing is a good way of meeting the needs of both children.

Breastfeeding Your Twins

Breastfeeding is an intimate moment between you and your newborn twins.
Here are some tips on how you can make the most out of this precious time.

By Associate Professor Dr Poh Bee Koon, Nutritionist.

Breastfeeding has many benefits for you and your babies. Besides providing the best source of nutrients for your babies, breastfeeding is also an excellent opportunity for you to bond with your babies. However, you may find breastfeeding tiring and frustrating at times. These tips below can help you breastfeed your twins more comfortably and effectively: Do It Simultaneously. Try the breastfeeding positions illustrated below. Alternate breasts between babies with every feed to produce equal amounts of milk in both breasts and decrease the chance of blocked ducts. Invest In A Good Nursing Pump. Pumping stimulates your milk production, so don’t worry about not producing enough milk. It also allows you to stockpile extra milk should you need to bottle feed your babies at any time, or if you are away. Use a pump to express milk from both breasts at the same time. An electric pump will work best. Keep Count.  Keep count of your babies’ wet nappies and observe their bowel movements. Each baby should have one wet nappy in the first 24 hours after birth, two on the second day, three the third day, and so on. After the first week, you should be changing seven to eight nappies a day for each child. You can expect your babies to feed eight to 12 times in a 24-hour period. Develop a chart of feeding times to help you keep track of your babies’ bowel movements. Get Help. Enlist the help of a friend, mother-in-law or partner. He or she can help carry your babies to you for breastfeeding, change babies’ diapers and burp babies after you have breastfed them. Also, get support of other parents of twins. Ask them questions so that you can gain first-hand knowledge on breastfeeding twins. Relax! Feeding your babies is your ultimate priority. Find a quiet place where you won’t be distracted. Look at your babies, touch them, sing to them and enjoy this private moment. Also, remember to take good care of yourself. Get plenty of rest, drink lots of water and eat nutritious food. Your babies also benefit when you feel more energised while breastfeeding.