Infants with Special Needs

Human milk has been recognized as the gold standard for human feeding for centuries. Milk of other species that is fed to human infants have been known to contribute to increased in infants mortality.

Importance of Breastmilk for Infants with Special Needs Breastmilk contains:
•Protective immune factors: Help to prevent infection
•Growth factors: Helps baby’s gut and other systems to develop as well as heal diarrhoea
•Enzymes: Make it easier to digest and absorb milk
•Special essential fatty acids help brain development
•Reduces pain from drawing blood or related to the baby’s condition,
•Gives the mother an important role in caring for her baby,
•Comforts the baby
•Strengthen bonding


Babies who require special attention are those who are:

•Not able to take oral feed
•Able to take oral feeds but not able to suckle
•Able to suckle but not for full feeds
•Not able to receive any breastmilk

COMPOSITION OF PRETERM HUMAN MILK (26 to 36 weeks POG)

HEALTH ADVANTAGES OF HUMAN MILK FEEDING FOR PRETERM INFANTS

How to Feed a Pre-Term Infant with Breastmilk?

For expressing breastmilk, you may start expressing after 6 hours post-delivery and collect in small amounts.
Baby can be fed using a syringe as well.

METHOD OF FEEDING PRE-TERM/ TERM LOW BIRTH WEIGHT BABIES

Clockwise from Top Left: IntraGastric Feeding, Spoon Feeding and Cup Feeding Methods

Do ensure a LOTS and LOTS of SKIN TO SKIN Contact!!

SOME COMMON CONDITIONS :

(1) Breastmilk Jaundice

What is "Breastmilk Jaundice" ?

•Occurs in 5-10% of newborns

•Results from inadequate breastmilk volume or insufficient milk intake: Lead to dehydration, low caloric intake

•May occur in 1st week of life in breastfed infants

•Incidence may be reduced by:
–Encouraging early feeds
–Increasing frequency of feeds
–Avoiding use of water to replace breastmilk

Prevention of Severe Jaundice:

•Early initiation of breastfeeding
- Colostrum helps infants to pass the meconium, removes excess bilirubin from the body

•Encourage demand feeding:  8 – 12 feed a day

•Effective suckling: ensure effective milk tranfer

•No supplementary fluid

•Cup feeding with EBM if baby refuse to suck



(2) Babies with Cardiac Problems

•Babies may tire easily

•Short frequent feeds are helpful. The baby can breathe better when breastfeeding

•Breastfeeding is less stressful and less energy is used so there is better weight gain

•Breastmilk provides protection from illness thus reducing hospitalization and helping growth and development.


(3) Babies with Cleft Lip/Palate

•Babies with cleft lip only should be able to breastfeed - tissue of the breast can help the baby to create a seal more effectively

•Babies with a cleft palate are less likely to breastfeed directly from their mother's breast.

•Cleft palate babies often have problem with sucking, and may choke or gag on food that gets into their nose.(severe form )

•Cleft palate babies can be given EBM via special cleft palate bottle (Haberman feeder),spoon or cup.

•Encourage mom to put baby on breast for suckling and bonding

•Following surgery to repair the cleft, breastfeeding can resume as soon as the baby is alert.

Cleft lip and palate - How to feed?

•Hold the baby so that his or her nose and throat are higher than the breast
–This will prevent milk from leaking into the nasal cavity, which would make it difficult for the baby to breathe during the feed

•Breast tissue can fill a cleft in the lip to help the baby maintain suction.


(4) Babies with Down Syndrome

•Babies with Down Syndrome may have Hypotonia (weak Muscle Tone) and poor sucking reflex. Hence, this may lead to Poor Let Down which will result in Inadequate supply. To overcome this matter, Mummies are also encouraged to express milk and feed baby expressed breastmilk as well.

•Proper positioning,manual expression and supporting the breast so that infant do not lose nipple.

Hope this post is helpful for Mummies :-)


Source: National Lactation Centre

DISCLAIMER:
This post is just meant to be a stepping stone of awareness for mothers who have special need babies to not give up Breastfeeding without knowing that it is possible to proceed with breastfeeding.
However, kindly consult a paediatrician and lactation counsellour/consultant for proffesional advice because each individual case varies from one to another.

Indahnya Syariat Penyusuan Ibu Susuan

Salam Sejahtera Ibu-ibu Sekalian.

Penulis Artikel ini iaitu Puan Zunaidah Mohd Marzuki. Beliau adalah seorang pensyarah Jabatan Quran dan Sunnah, UIAM, Gombak. Beliau sekarang sekarang sedang melanjutkan pelajaran sebagai seorang pelajar PhD. Beliau merupakan seorang ibu kepada tiga orang putera, dan juga mempunyai pengalaman menyusukan semua cahaya matanya dengan penyusuan susu ibu.



Harap Ibu-Ibu dapat inspirasi daripada artikel ini :-)

Untuk pengetahun semua, artikel sebenar ini telah diterbitkan di majalah Solusi (ms 84-85).

Gambar hanya illustrasi semata-mata. Tiada berkaitan dengan artikel tersebut.

Indahnya Syariat Penyusuan Ibu Susuan

Zunaidah Binti Mohd Marzuki

           

            Penyusuan ibu susuan adalah suatu pilihan yang kadang-kadang menjadi satu keperluan atau kemestian. Ada ibu-bapa yang mempunyai ibu susuan untuk anak mereka kerana ibunya sendiri mempunyai masalah dalam penyusuan seperti sakit atau kekurangan susu. Ada juga ibu meninggal sewaktu bersalin, lalu anaknya disusui ibu susuan.

            Kebanyakan bayi berumur dua tahun kebawah dapat menerima susu formula selain susu ibu sendiri. Namun ada bayi yang alah dengan susu formula sehingga menyebabkan sembelit, cirit-birit, alahan kulit dan sebagainya.

Ada juga bayi yang alah dengan laktosa dalam susu formula.Justeru, terdapat pelbagai pilihan susu formula dipasaran. Susu formula ramuan khas, susu tanpa laktosa, susu berasaskan soya, berasaskan susu lembu dan berasaskan susu kambing.

Namun susu ibu adalah pilihan terbaik untuk bayi, samada susu ibu sendiri atau susu ibu susuan. Penyusuan ibu susuan adalah alternatif terbaik bagi ibu-ibu yang mempunyai masalah dalam penyusuan. Al-Quran dan Hadis telah memberikan panduan berkenaan ibu susuan. Sirah Rasulullah SAW boleh dijadikan pedoman.

Penyusuan Rasulullah SAW

Orang  pertama yang menyusukan Rasulullah SAW selepas ibunya ialah Thuwaybah. Dia adalah hamba Abu Lahab dengan susu bayinya yang bernama Masruh. Sebelum itu dia juga telah menyusui Hamzah bin Abd Al-Muttalib dan selepasnya dia menyusui Abu Salamah bin Abdul Asad al-Makhzumiy.

 Menurut adat masyarakat Arab setempat ketika itu, mereka akan mencari perempuan-perempuan yang menyusui anak-anak mereka dengan tujuan menghindarkan anak tersebut daripada dijangkiti penyakit-penyakit setempat. Disamping itu  juga, ia bertujuan melatih  anak-anak mereka mahir dengan Bahasa Arab jati sewaktu masih kecil lagi.

Setelah itu, Rasulullah SAW disusui oleh Halimah Binti abu Dhu’ayb isteri alHarith bin Abdul Uzza. Dia lebih dikenali sebagai Halimah As-Sa’diah daripada keluarga Bani Sa’ad bin Bakr. Dengannya, Rasulullah SAW mempunyai adi-beradik sesusuan iaitu Abdullah bin Alharith, Anisah Binti Alharith, Hudhafah atau Judhamah binti alHarith-iaitu al-Shayma, gelaran yang lebih dikenali dari nama asalnya-.

Penyusuan Dalam Hadis

Hadis-hadis berkenaan penyusuan (Ar-Rado’ah الرضاعة) sangat banyak dan merangkumi pelbagai aspek. Jika kita membaca huraian kepada kitab-kitab Hadis seperti Sahih Bukhari, Sahih Muslim, Sunan Abu Daud, Sunan An-Nasai, Muwatta’ Malik dan sebagainya, kita akan dapati isu penyusuan ibu susuan dikupas dengan begitu teliti oleh para ulama.

Contohnya, dalam buku “Takmilah Fathul Mulhim Bi Syarhi Sahih Muslim” iaitu kupasan terhadap hadis-hadis dalam Sahih Muslim. Buku karangan Syeikh Muhammad Taqi Usmani, seorang ulama kontemporari Pakistan telah memberi kupasan berkenaan makna penyusuan, hikmah penyusuan, hak-hak anak yang disusui, kadar minimum penyusuan yang melibatkan hukum ibu susuan, tempoh penyusuan dan sebagainya.

Ibu Susuan suatu Keperluan

            Seperti yang dinyatakan, ibu susuan menjadi suatu keperluan bagi sesetengah bayi yang hanya boleh menerima susu ibu. Bayi-bayi seperti ini lazimnya ada alahan atau masalah dengan susu formula.

            Antara faktor bayi memerlukan ibu susuan adalah kerana ibunya meninggal, atau sakit, atau kekurangan susu. Ada juga sesetengah bayi yang menghidap penyakit seperti kanser yang amat memerlukan susu ibu. Bayi yang menghadapi masalah-masalah diatas tidak dapat tidak, perlu bergantung kepada susu ibu susuan samada dalam bentuk EBM(expressed breast milk atau susu perahan) atau terus menyusu dari ibu susuan.

            Manakala sesetengah ibu juga perlu mencari anak susuan kerana mereka mempunyai lebihan stok susu perahan yang dibekukan didalam peti sejuk. Susu ibu yang diperah dengan tangan atau dipam dengan pam susu yang disimpan didalam peti sejuk mempunyai jangka hayat sehingga 6 bulan bergantung kepada suhu peti sejuk, atau paling lama sehingga setahun.

            Ibu-ibu yang mempunyai susu yang banyak melebihi keperluan anaknya sendiri  perlu mencari anak susuan bagi mengelakkan pembaziran .Katakan susu perahan seorang ibu setiap hari sekitar 80 oz( 1oz bersamaan 30ml), dan keperluan anaknya sekitar 20-40 oz sehari, tentulah susu ibu tersebut berbaki lagi.

Susu yang berbaki ini kadang-kadang apabila disimpan akan memenuhkan peti sejuk sehingga tidak muat atau tamat jangka hayat. Jika tidak mencari  anak susuan, maka susu itu akhirnya terpaksa dibuang. Ada juga sesetengah ibu menggunakan susu lebihan sebagai siraman tanaman, atau mandian susu atau jadikan sabun susu untuk anaknya.

Hikmah penyusuan ibu susuan

            Syariat penyusuan ibu susuan yang terdapat garis panduannya dalam Al-Quran, Hadis dan huraian-huraian ulama amat indah untuk diamalkan. Indahnya syariat ini dapat dirasai, dihayati dan disyukuri oleh ibu-ibu dan bayi-bayi yang terlibat.

Penyusuan ibu susuan dapat membantu menyelesaikan masalah bayi-bayi yang memerlukan susu ibu ,yang mempunyai alahan dengan susu formula atau susu segar, justeru dapat membantu perkembangan bayi agar sihat dan kuat.

Penyusuan ibu susuan juga membantu merungkaikan masalah ibu-ibu yang mempunyai susu melebihi keperluan anak sendiri, justeru dapat mengelakkan pembaziran.

            Penyusuan susu ibu susuan juga membuatkan sebuah keluarga dapat berkenalan dengan sebuah keluarga yang lain seterusnya membina jalinan hubungan persahabatan, persaudaraan dan kekeluargaan. Justeru, hubungan ini dapat melahirkan masyarakat yang saling kenal dan bekerjasama.

            Sebagai masyarakat yang sudah maju dalam ilmu pendidikan, masyarakat seharusnya menggalakkan penyusuan susu ibu. Ibu-bapa seharusnya tidak perlu ragu-ragu dengan penyusuan susu ibu susuan. Apa yang penting, adalah memahami hukum-hakam berkenaannya dan menjaga hubungan susuan dengan baik.

           

 Harap Ibu-Ibu sekalian dapat manfaat dari perkongsian ini.

Assalamualaikum.

WHY BREASTFEEDING IS THE BEST FEEDING?

Dear Mummies,
Ever wondered what is the big deal about breastfeeding?
Are all those sleepless nights and time & effort spent pumping milk for your baby worth it???

Read on and you'll never regret Breastfeeding!
Even a drop of breastmilk has such wonderful nutrients that NO other artificial milk can replace.

What is Breastmilk made of?

Just the right amount for your Baby

Water is the main composition of Breastmilk. 

This is why Babies age 6 months and below do not need additional water.

WORRIED THAT BABY'S JAUNDICE MIGHT PROLONG BECAUSE OF EXCLUSIVE BREASTFEEDING & NO WATER?
BELOW IS EVIDENCED BASED PROOF  EXCLUSIVE BREASTFEEDING DOES NO HARM.

WORRIED THAT BABY MIGHT GET CONSTIPATED BECAUSE OF EXCLUSIVE BREASTFEEDING & NO WATER?
THIS IS HOW AN EXCLUSIVELY BREASTFED BABY'S STOOL USUALLY LOOK LIKE

Watery, Yellowish & Seedy

How is Breastmilk Superior to Other Milk in Terms of Composition?

Both Human & Cow Milk has Proteins.
Hoevever, as shown in the graph above,
Human Milk is much easier to digest compared with Cow's Milk.
EVER WONDERED WHY A BABY DRINKING FORMULA SLEEPS THROUGH THE NIGHT,
WHEREAS A BABY BREASTFEEDING GETS UP OFTEN TO FEED?
Because a breastfed baby digests the milk easily, hence gets hugry faster.
Whereas a baby drinking formula has difficulty digesting it, hence sleeps through the night to save calories working hard digesting the formula.
SO MUMMIES, PLEASE DO NOT CONCLUDE THAT YOU DO NOT HAVE ENOUGH BREASTMILK IF YOUR BABY FEEDS OFTEN  :-)

Both Human & Cow Milk has Vitamis.
The Quantity of Vitamins is higher in Human Milk.

How does Breastfeeding Boosts Baby's Immunity?

Gone with the days of mythology whereby you cannot breastfeed your baby when you are ill.
The actual fact is, YOU SHOULD CONTINUE BREASTFEEDING & IT BENEFITS YOUR BABY!

Still Not Convinced Mummies?

Below are some Evidence Based Prove That Breastmilk has Anti-Infective Properties.

WHAT OTHER BENEFITS BABY GAIN FROM BREASTFEEDING?

- (THE WOMANLY ART OF BREASTFEEDING,7th Revised Edition, page 350). “Breastfed babies have a decreased likelihood for allergies and dental caries. They also benefit from appropriate jaw, teeth and speech development as well as overall facial development. This means that people who were artificially fed may experience more trips to doctors and dentists “

-American Journal of Clinical (1999)- Meta-analysis (7000 children) showed that the IQ of a breastfed baby is 5.2 points higher that a non-breastfed baby. 

-Bonding with Mother


WHAT DO MOTHERS GAIN FROM BREASTFEEDING BABIES?

-Reduces the risk of breast cancer. Women who breastfeed reduce their risk of developing breast cancer by as much as 25 percent.. The more months or years a mother breastfeeds, the lower her risk of breast cancer.

-Reduces the risk of uterine and ovarian cancer. Estrogen levels are lower during lactation, hence the less estrogen available to stimulate the lining of the uterus and perhaps breast tissue also, the less the risk of these tissues becoming cancerous.

      -Lessens osteoporosis. Non-breastfeeding women have a four times greater chance of developing osteoporosis than breastfeeding women and are more likely to suffer from hip fractures in the post-menopausal years.

       -Benefits child spacing. Since breastfeeding delays ovulation, the longer a mother breastfeeds the more she is able to practice natural childspacing, if she desires

        -Promotes emotional health. Studies show that breastfeeding mothers show less postpartum anxiety and depression than do formula-feeding mothers.

-Promotes postpartum weight loss. Breastfeeding mothers showed significantly larger reductions in hip circumference and more fat loss by one month postpartum when compared with formula-feeding moms. Breastfeeding mothers tend to have an earlier return to their pre-pregnant weight.

       -Costs less to breastfeed.

SO WHAT IS SO BAD ABOUT FORMULA MILK?

MANY CHILDREN GROW UP WITH IT...???

What is infant formula?

Infant formula is an industrially produced milk product designed for infant consumption. Usually based on either cow or soy milk, infant formula strives to duplicate the nutrient content of natural human milk. Since the exact chemical properties of breast milk are still unknown, 'formula' is necessarily an imperfect approximation.

The composition of formula, is a CHEMICAL PREPARATION subject to:

1.Human error

2.Raw materials – including water at manufacturing level and household level

Formulas are at risk of contamination from:

-Arsenic from contaminated well water

-Lead (from boiled-lead containing water)

-Manganese (which may lead to learning disabilities & altered brain chemistry)

-Atrazine (a carcinogen)

-Enterobacter Sakazakii (can cause meningitis)

WHAT ABOUT SOY MILK??

We sincerely Hope you Breastfeed Your Baby with Full of Love, Pride & Joy!

EVERY DROP OF BREASTMILK IS PRECIOUS!

SOURCE: NATIONAL LACTATION CENTRE

Methods of Feeding Your Child Expressed Breastmilk

Training an infant to accept expressed breastmilk should be initiated at an age not less than 4 weeks.
Training an infant to accept expressed breastmilk should be initiated when baby is calm & not too hungry.

Expressed Breastmilk can be fed to Infants Using:

(1) Syringe

(2) Spoon

(3) Cup Feeding

How to Cup Feed your Baby?
1. Position: Baby has to be Upright (90 degrees) or Semi-Upright (45 degrees);
on caregiver's lap, supported at the back, head, neck & buttocks.
2. Hold the feeding cup and let it come into contact with baby's lower lip with the edge of cup's surface touching baby's upper lip.
3. When baby is alert, he/she will respond by opening his eyes or mouth. Slant the cup slightly & let baby taste the milk slightly. Baby will then initiate to lick and swallow the milk slowly.
4. When baby is full, baby will automatically stop feeding.
5. NEVER ATTEMPT TO POUR MILK INTO BABY'S MOUTH BY YOURSELF.
6. Practice Makes Perfect. This method might be clumsy for a start, but it's worthwhile :-)

Why are Bottle Feedings not encouraged?

Because Bottle Feedings may lead to a scenario called "Nipple Confusion".

Nipple confusion is used to describe those times when a baby is reluctant to breastfeed, and seems to find it easier to bottle-feed expressed milk.

Bottle teats are fairly rigid, with a constant reservoir of milk, so your baby won't have to work hard to get at the milk he wants. But to feed from your breast, your baby must first open his mouth wide to latch on. Then he'll need to use about 40 facial muscles, which he'll work constantly to get his tummy full of milk.

To avoid that scenario, cup feeding is a suggested better option :-)


How to Introduce Expressed Breastmilk to Toddlers?
Sippy Cups are an option to introduce expressed breastmilk to toddlers :-)

For babies with Special Needs, there are other various methods to feed EBM which will be blogged about in another topic. Hope this was helpful :-)

Breastmilk Storage Guidelines & Handling Expressed Breastmilk

Suggested Schedule to Teach Baby to Accept Expressed Breastmilk

Suggested Schedule for Expressing Breastmilk for Working Mothers

Greetings. Assalamualaikum..

Breastfeeding is the Best Feeding for your little loved ones indeed.

With the increasing number of women contributing to economical growth lately, it is possible for these working mothers to `exclusively breastfeed'?

If there is a will, There is a way. (Inshallah)

Mothers, you can express breastmilk for your loved ones to feed on while you are away at work.
You may express either by hand (Marmet technique) OR using a breastpump.

When to Start Expressing Breastmilk?
You may start as early as 2 weeks post partum.

As precautionary measure, do ensure your hands and utensils used while expressing breast milk are clean and sterilized.  Breast milk should be expressed into a clean & suitable container with a cover.
Below is a suggested schedule for beautiful mummies to try out :-)

**Note: MSI stands for "Memerah Susu Ibu" which can either be Tandem Pumping or Pumping/Expressing Breastmilk.