Friday, January 7, 2011

Jadual Gaji kakitangan Kerajaan 2011

JANUARI 25.01.2011 SELASA


FEBRUARI 24.02.2011 KHAMIS

MAC 24.03.2011 KHAMIS

APRIL 25.04.2011 ISNIN

MEI 24.05.2011 SELASA

JUN 23.06.2011 KHAMIS

JULAI 25.07.2011 ISNIN

OGOS 24.08.2011 RABU

SEPTEMBER 22.09.2011 KHAMIS

OKTOBER 20.10.2011 KHAMIS

NOVEMBER 24.11.2011 KHAMIS

DISEMBER 19.12.2011 ISNIN

Mastitis

Apakah itu?
Mastitis adalah keradangan buah dada yang mungkin (dan kadangkala cepat) menjadi infeksi. Ia akan membuat anda berasa seperti anda dijangkiti selesema pada masa-masa anda amat memerlukan seluruh tenaga anda. Anda akan mendapati keadaan radang, keras, sakit atau panas dan bengkak di kawasan yang dijangkiti. Selalunya ini dinamakan "duktus tersumbat" sebab anda akan terasa benjolan – disebabkan ketakungan susu dalam duktus buah dada.

Tanda-tanda mastitis yang sering berlaku dan serius temasuklah seram sejuk, sakit kepala, suhu badan melebihi 38.5 darjah C / 101 darjah F dan keletihan. Simptom-simptom ini selalunya disebabkan oleh kongesi tisu di sekitar kawasan jangkitan.

Jika anda mempunyai mastitis, anda bukanlah keseorangan: kira-kira seorang dalam 10 orang ibu yang menyusu badan akan dijangkitinya dan sesetengah ibu yang memberi susu formula juga boleh dijangkiti. Walapun anda mungkin dijangkiti mastitis lebih daripada satu kali, jangkitan itu jarang melibatkan kedua-dua buah dada pada satu-satu masa. (Harap ini menyenangkan hati anda!)


Apakah puncanya?

Apa yang diketahui ialah mastitis selalunya disebabkan oleh "stasis susu" yang mana pengaliran susu terberhenti. Ini berlaku apabila susu "mengundur kebelakang" sebab susu itu dihasilkan lebih cepat daripada ia mengalir keluar. Selalunya ini ialah sebab bayi anda tidak mampu mengosongkan buah dada anda sepenuhnya semasa dia menghisap. Lazimnya punca masalah terletak pada cara bayi anda melekap ke dada semasa menyusu. Jika anda dan bayi anda kurang tahu bagaimana untuk melekap dengan baik, susu tidak akan disedut keluar dengan efisien. Sebab-sebab lain mastitis termasuklah pembengkakan buah dada yang tidak menurun dan kembali normal atau anda tidak menyusukan mengikut rutin terjadual atau trauma kepada buah dada, yang mana akan menyebabkan stasis susu melarat sehingga menjadi mastitis.

Mastitis yang berasalkan infeksi mungkin berlaku disebabkan stasis susu atau serangan kuman; tetapi, bagaimana infeksi boleh melarat ke buah dada adalah kurang difahami. Sesetengah wanita yang pernah menghidapi mastitis juga mempunyai puting yang merekah dan infeksi mungkin menembusi masuk melalui rekahan atau fisur puting dan terus ke sistem limfa buah dada. Ada pula pakar yang berpendapat bahawa mastitis dan puting merekah adalah simptom yang disebabkan teknik melekap yang kurang baik, jadi kedua-dua perkara ini boleh dikatakan berkait juga.

Anda mungkin akan dijangkiti mastitis jika anda menjadi ibu buat pertama kali tetapi ibu-ibu yang lebih berpengalaman menyusu juga boleh menghidapinya. Mastitis boleh berlaku pada bila-bila masa semasa anda menyusukan anak tetapi biasanya ia berlaku dalam bulan pertama selepas bersalin semasa anda baru mula belajar tentang penyusuan.


Bagaimanakah saya boleh merawatnya?

Jangan berhenti menyusu – ini akan memburukkan lagi mastitis. Hubungi doktor anda dengan segera. Doktor anda akan menasihatkan anda supaya berjumpa dengan kaunselor penyusuan atau dia akan memberikan anda antibiotik atau kedua-duanya, bergantung kepada tempoh jangkitan dan berapa serius keadaan anda. (Tanya doktor anda sama ada ubat yang dipreskripsikan kepada anda boleh menjejaskan bayi anda, tapi maklumlah bahawa antibiotik yang biasa diberikan untuk mastitis adalah selamat untuk bayi). Dia juga akan menasihatkan anda supaya berbaring dan rehat, mengambil ubat menahan sakit dan bertuam dengan jaram panas. Dalam masa 24 jam berikutnya, apabila antibiotik mula menunjukkan kesan, anda akan berasa lebih sihat, dan kesan yang sama juga diperolehi jika tiada berlakunya infeksi.

Jika anda menghadapi masalah yang mana bayi anda kurang cekap melekap dan menyusu dengan baik, antibiotik tidak akan berkesan untuk jangka masa yang panjang. Untuk mengelakkan daripada mastitis, anda disyorkan untuk mendapatkan nasihat terlebih dahulu. Baca dengan lebih lanjut panduan terperinci untuk penyusuan bagi menentukan sama ada bayi anda sudah boleh melekap pada buah dada anda dengan betul.

Anda boleh meminta doktor anda merujukkan anda kepada kaunselor penyusuan atau anda boleh meneliti senarai organisasi penyusuan sebagai sumber tambahan untuk mendapat nasihat. Bacalah artikel kami mengenai duktus tersumbat untuk tip-tip bagaimana boleh mencegah mastitis daripada berlaku berkali-kali dari awal lagi.

Ada juga ibu yang enggan menggunakan antibiotik sehingga mereka telah pasti tiada rawatan lain yang ada. Mungkin anda mahu mencuba penyelesaian sendiri, tapi dalam pada itu, pastikan juga antibiotik ada dalam kabinet bilik mandi sekiranya diperlukan nanti. Apa yang penting ialah pengawasan diri sebab jika mastitis itu tidak beransur sembuh, ia boleh membawa kepada abses buah dada yang merbahaya dan perlu dirawat segera (atau dibedah) untuk mengeringkannya.

Sama ada anda bertindak untuk mengambil antibiotik dengan segera atau menunggu sehingga 24 jam dahulu, anda boleh melegakan keadaan dengan mencuba yang berikut:

• Pastikan bayi anda melekap dengan baik pada buah dada anda dan dia menyusu dengan betul.

• Cuba gunakan beberapa posisi menyusu untuk mendapatkan posisi yang paling membantu bayi melekap dengan baik.

• Untuk memastikan buah dada yang dijangkiti dikosongkan sepenuhnya, susukanlah bayi anda sekerap yang dia mahu.

• Perahkan susu menggunakan tangan atau pam selepas menyusu jika anda merasakan bayi anda tidak menyusu dengan baik.

• Ada ibu mendapati pam buah dada dapat mengeluarkan susu dengan lebih baik daripada hisapan bayi, terutamanya ketika mereka mengalami puting perit.

• Jika anda berasa tidak sihat, rehatlah sebanyak mungkin.

• Anda akan dapati bahawa anda merasa lega jika dikenakan haba kepada kawasan yang terjejas dengan menggunakan kain panas atau jaram atau mandian panas. Sesetengah ibu mendapati bahawa jaram sejuk lebih berkesan.

• Jika urutan buah dada melegakan, urutlah perlahan-lahan semasa bayi anda sedang menyusu untuk melancarkan aliran susu. Urutan yang kuat boleh menjejaskan mastitis sebab susu yang telah "terbocor" akan tertolak masuk kembali ke dalam tisu buah dada.

• Anda juga boleh mengambil ubat penahan sakit untuk membantu melegakan sakit. Parasetamol boleh diambil sepanjang tempoh penyusuan dan boleh membantu mengurangkan keradangan dan juga kesakitan.


Berapa lamakah ini akan berterusan?

Jika didiagnosis di peringkat awal, mastitis adalah mudah dan cepat untuk dirawat, dan anda akan akan berasa 100 peratus lebih sihat dalam sedikit masa. Jika anda mula mengambil antibiotik (juga bagi kes bukan infeksi), pastikan anda menghabiskan semua ubat itu. Jika buah dada anda masih bengkak dan suhu badan masih tinggi, hubungilah doktor anda.


Perlukan saya berhenti menyusu jika saya menghidapi mastitis?

Tidak. Malah, adalah penting bagi anda meneruskan penyusuan semasa mengalami mastitis. Walaupun kadang-kala anda merasa sakit yang terlampau, anda perlu menyusukan bayi anda sekerap mungkin untuk melancarkan pengaliran susu. Cuba letakkan flanel yang hangat pada buah dada untuk beberapa minit sebelum setiap penyusuan – ini akan membantu anda merasa lebih selesa dan memudahkan penyusuan.

Jika bayi anda tidak mengosongkan buah dada yang radang bengkak apabila menyusu, gunakan pam buah dada untuk mengosongkannya. Dan jika anda terasa amat sakit apabila menyusu, cuba perah susu anda dan berikan susu ini kepada bayi anda dengan menggunakan cawan atau botol.


Adakah ia menjejaskan bayi saya?

Betapa sakit dirasakan semasa menghidapi mastitis, ia tidak menjejaskan bayi anda dan adalah selamat untuk bayi anda menyusu pada buah dada yang radang bengkak. Bagi mastitis jenis infeksi pun di mana bayi anda akan menelan bakteria yang terkandung dalam susu buah dada yang terjejas, apa yang berlaku ialah bakteria akan dibunuh oleh asid dalam perut bayi anda.

Sumber: http://www.babycenter.com.my/malay/baby/mastitis/

Thursday, January 6, 2011

7 WAYS BREASTFED BABIES BECOME HEALTHY ADULTS

The health benefits of breastfeeding extend far past weaning. As researchers look at the various factors associated with different diseases, they often find that children and adults who were breastfed as infants are less likely to experience problems with chronic diseases. In some cases, even minimal amounts of breastfeeding may provide some protection against disease in later life, but usually the longer a baby is breastfed the greater the protective effect. Here are some of the ways that breastfeeding builds a lifetime of good health:





1. Breastfeeding prevents obesity. Even in infancy, breastfed babies as a group are leaner than their formula-fed peers. Studies have shown that children who are breastfed are less likely to be obese during adolescence, and that longer periods of breastfeeding greatly reduce the risk of being overweight in adulthood. Overweight children are more likely to become overweight adults. Since breastfed babies themselves control how much they eat (aided by the changes in fat levels during a feeding session), children who are breastfed learn to trust their bodies' signals about how much they need to eat and when. This builds healthy eating habits right from the start. Although parents might urge a formula-fed baby to finish up the last ounce or two of milk in the bottle, you can't do this to a breastfed baby. When she's done, she's done!

2. Better teeth. Breastfed babies have better jaw alignment and are less likely to need orthodontic work as they get older. A study of 10,000 children found that those who were breastfed for a year or more were 40 percent less likely to require orthodontic treatment. The sucking action used to breastfeed involves complex motions of the facial muscles and tongue. This improves the development of facial muscles and the shape of the palate. The better jaw alignment associated with breastfeeding can even mean less snoring and a lowered risk for a condition known as obstructive sleep apnea--the blockage of air flow during sleep, which can disturb sleep patterns and lead to other health problems.

3. Lowered risk of heart disease. All the evidence isn't in yet, but some researchers believe that breastfeeding during infancy may lower the risk of heart attacks and strokes in later life. This is due in part to the higher levels of cholesterol in human milk. Some heart researchers theorize that because of the cholesterol content of human milk, a breastfed baby's liver learns to metabolize cholesterol better than formula-fed infants. This leads to lower blood cholesterol levels as adults and thus a lower risk of heart disease. Though limited in number, some studies have shown that adults who were formula-fed as infants tend to have higher blood cholesterol and are more likely to have arterosclerotic plaques than those who were breastfed.

4. Lowered risk of juvenile diabetes. Babies who are breastfed are less likely to develop type 1 diabetes mellitus in childhood. Researchers have attributed this lowered risk of diabetes to the delayed introduction of cow milk in breastfed babies. In addition, researchers have shown a lower insulin release in breastfed infants compared to infants fed formula. This preventive effect is particularly important if you have a family history of diabetes.

5. Lowered risk of multiple sclerosis. Multiple sclerosis, a degenerative muscle disease that strikes adults, may be caused in part by myelin breakdown. However, multiple sclerosis is less common in countries where breastfeeding rates are high. Human milk's contribution to the myelin formation may help to prevent multiple sclerosis in later life.

6. Lowered risk of asthma and allergy. Studies have shown that breastfeeding lowers the chances of a child developing allergies and asthma symptoms. Breastmilk's immune components protect babies from allergens in the first months of life. Breastfeeding also delays the introduction of potentially allergenic foods, such as cow milk and soy protein, into the diet until the baby is older and the immune system is more mature.

7. Other diseases. Research suggests that breastfeeding may also play a role in preventing digestive diseases, such as ulcerative colitis and Crohn's disease, as well as childhood cancers. This makes sense: nourish an infant's body with the unique food designed for it by nature and that body will function in a healthier way, perhaps for the child's entire life.

Breastmilk's influence on health is probably more far-reaching than researchers have even dared to imagine, but studies of factors that affect the development of disease in adults seldom ask their research subjects how they were fed as infants (and many adults would have trouble giving accurate answers to these kinds of questions). New studies of what breastmilk contains suggest that this living biological fluid carries substances that are critical to the optimal development of many systems in the body. This early development may very well affect the progress of many diseases throughout life.

LITTLE KNOWN BENEFITS OF BREASTFEEDING

1. BREASTFED BABIES SMELL BETTER

Unlike the stinky stools of a formula-fed baby, the stools of a breastfed infant have a less offensive buttermilk-like odor. Changing the diaper of a breastfed infant is not an unpleasant task--which is fortunate, because most breastfed babies have several bowel movements a day. When the baby looks at the face of the diaper-changing caregiver and sees happiness rather than disgust, he picks up a good message about himself - perhaps a perk for building self-esteem.

2. BREASTFED BABIES HAVE NICER SKIN

Many pediatricians who have developed a keen eye and sense of touch over years of examining babies report that they can often tell by the look and feel of an infant's skin whether or not the baby is breastfed or formula-fed. The skin of a breastfed baby often has a softer, smoother feel. There is also less delineation between where the fat under the skin ends and the underlying muscle begins. The skin of formula-fed babies tends to be rougher with dry, often sandpaper-like, patches. Breastfed babies feel more solid. Researchers report that the subcutaneous fat in breast and formula-fed infants actually has a different composition.

3. BREASTFED BABIES HAVE BETTER VISION

Not only does breastmilk build brighter brains and healthier bodies, it's valuable to baby's vision. Studies comparing breastfed and formula-fed infants show that visual development (called visual acuity) is more advanced in breastfed babies. This finding is particularly noticeable in premature infants. The presence of DHA may be one of the reasons for this. DHA is one of the prime structural components of the retina of the eye. As with all tissues, the better you feed it, the better it grows and functions. So, the better you feed the retina, the better the vision, another reason why breastfed babies have a healthier "outlook" on life. (For more about DHA, see "Breastfeeding Builds Brighter Brains".)

BREASTFEEDING BENEFITS FROM TOP TO BOTTOM

Breastfeeding is good for every part of baby's body--from the brain to the diaper area. Here's a list:

• Brain. Higher IQ in breastfed children. Cholesterol and other types of fat in human milk support the growth of nerve tissue.

• Eyes. Visual acuity is higher in babies fed human milk.

• Ears. Breastfed babies get fewer ear infections.

• Mouth. Less need for orthodontics in children breastfed more than a year. Improved muscle development of face from suckling at the breast. Subtle changes in the taste of human milk prepare babies to accept a variety of solid foods.

• Throat. Children who are breastfed are less likely to require tonsillectomies.

• Respiratory system. Evidence shows that breastfed babies have fewer and less severe upper respiratory infections, less wheezing, less pneumonia and less influenza.

• Heart and circulatory system. Evidence suggests that breastfed children may have lower cholesterol as adults. Heart rates are lower in breastfed infants.

• Digestive system. Less diarrhea, fewer gastrointestinal infections in babies who are breastfeeding. Six months or more of exclusive breastfeeding reduces risk of food allergies. Also, less risk of Crohn's disease and ulcerative colitis in adulthood.

• Immune system. Breastfed babies respond better to vaccinations. Human milk helps to mature baby's own immune system. Breastfeeding decreases the risk of childhood cancer.

• Endocrine system. Reduced risk of getting diabetes.

• Kidneys. With less salt and less protein, human milk is easier on a baby's kidneys.

• Appendix. Children with acute appendicitis are less likely to have been breastfed.

• Urinary tract. Fewer infections in breastfed infants.

• Joints and muscles. Juvenile rheumatoid arthritis is less common in children who were breastfed.

• Skin. Less allergic eczema in breastfed infants.

• Growth. Breastfed babies are leaner at one year of age and less likely to be obese later in life.

• Bowels. Less constipation. Stools of breastfed babies have a less-offensive odor

(Source: Askdrsears.com)

Monday, January 3, 2011

Breastfeeding—Starting Out Right

Breastfeeding is the natural, physiologic way of feeding infants and young children, and human milk is the milk made specifically for human infants. Formulas made from cow’s milk or soybeans (most formulas, even “designer formulas”) are only superficially similar, and advertising which states otherwise is misleading. Breastfeeding should be easy and trouble free for most mothers. A good start helps to assure breastfeeding is a happy experience for both mother and baby.


The vast majority of mothers are perfectly capable of breastfeeding their babies exclusively for about six months. In fact, most mothers produce more than enough milk. Unfortunately, outdated hospital routines based on bottle feeding sill predominate in too many health care institutions and make breastfeeding difficult, even impossible, for too many mothers and babies. For breastfeeding to be well and properly established, a good start in the early few days can be crucial. Admittedly, even with a terrible start, many mothers and babies manage.

The trick to breastfeeding is getting the baby to latch on well. A baby who latches on well, gets milk well. A baby who latches on poorly has more difficulty getting milk, especially if the supply is low. A poor latch is similar to giving a baby a bottle with a nipple hole that is too small—the bottle is full of milk, but the baby will not get much. When a baby is latching on poorly, he may also cause the mother nipple pain. And if he does not get milk well, he will usually stay on the breast for long periods, thus aggravating the pain. Unfortunately anyone can say that the baby is latched on well, even if he isn’t. Too many people who should know better just don’t know what a good latch is. Here are a few ways breastfeeding can be made easy:



1. A proper latch is crucial to success. This is the key to successful breastfeeding. Unfortunately, too many mothers are being "helped" by people who don’t know what a proper latch is. If you are being told your two day old’s latch is good despite your having very sore nipples, be sceptical, and ask for help from someone else who knows. Before you leave the hospital, you should be shown that your baby is latched on properly, and that he is actually getting milk from the breast and that you know how to know he is getting milk from the breast (open mouth wide—pause—close mouth type of suck). See also the websites www.breastfeedingonline.com/newman.shtml for videos on how to latch a baby on (as well as other videos). If you and the baby are leaving hospital not knowing this, get experienced help quickly (see handout When Latching). Some staff in hospital will tell mothers that if the breastfeeding is painful, the latch is not good (usually true), so that the mother should take the baby off and latch him on again. This is not a good idea. The pain usually settles, and the latch should be fixed on the other side or at the next feeding. Taking the baby off the breast and latching him on again and again only multiplies the pain and the damage.



2. The baby should be at the breast immediately after birth. The vast majority of newborns can be at the breast within minutes of birth. Indeed, research has shown that, given the chance, many babies only minutes old will crawl up to the breast from the mother’s abdomen, latch on and start breastfeeding all by themselves. This process may take up to an hour or longer, but the mother and baby should be given this time together to start learning about each other. Babies who "self-attach" run into far fewer breastfeeding problems. This process does not take any effort on the mother’s part, and the excuse that it cannot be done because the mother is tired after labour is nonsense, pure and simple. Incidentally, studies have also shown that skin-to-skin contact between mothers and babies keeps the baby as warm as an incubator (see section on skin to skin contact).



3. The mother and baby should room in together. There is absolutely no medical reason for healthy mothers and babies to be separated from each other, even for short periods.

• Health facilities that have routine separations of mothers and babies after birth are years behind the times, and the reasons for the separation often have to do with letting parents know who is in control (the hospital) and who is not (the parents). Often, bogus reasons are given for separations. One example is that the baby passed meconium before birth. A baby who passes meconium and is fine a few minutes after birth will be fine and does not need to be in an incubator for several hours’ "observation".

• There is no evidence that mothers who are separated from their babies are better rested. On the contrary, they are more rested and less stressed when they are with their babies. Mothers and babies learn how to sleep in the same rhythm. Thus, when the baby starts waking for a feed, the mother is also starting to wake up naturally. This is not as tiring for the mother as being awakened from deep sleep, as she often is if the baby is elsewhere when he wakes up. If the mother is shown how to feed the baby while both are lying down side by side are better rested.

• The baby shows long before he starts crying that he is ready to feed. His breathing may change, for example. Or he may start to stretch. The mother, being in light sleep, will awaken, her milk will start to flow and the calm baby will be content to nurse. A baby who has been crying for some time before being tried on the breast may refuse to take the breast even if he is ravenous. Mothers and babies should be encouraged to sleep side by side in hospital. This is a great way for mothers to rest while the baby nurses. Breastfeeding should be relaxing, not tiring.

4. Artificial nipples should not be given to the baby. There seems to be some controversy about whether "nipple confusion" exists. Babies will take whatever gives them a rapid flow of fluid and may refuse others that do not. Thus, in the first few days, when the mother is normally producing only a little milk (as nature intended), and the baby gets a bottle (as nature intended?) from which he gets rapid flow, the baby will tend to prefer the rapid flow method. You don’t have to be a rocket scientist to figure that one out, though many health professionals, who are supposed to be helping you, don’t seem to be able to manage it. Note, it is not the baby who is confused. Nipple confusion includes a range of problems, including the baby not taking the breast as well as he could and thus not getting milk well and/or the mother getting sore nipples. Just because a baby will "take both" does not mean that the bottle is not having a negative effect. Since there are now alternatives available if the baby needs to be supplemented (see handout #5 Using a Lactation Aid, and handout #8 Finger Feeding) why use an artificial nipple?




5. No restriction on length or frequency of breastfeedings. A baby who drinks well will not be on the breast for hours at a time. Thus, if he is, it is usually because he is not latching on well and not getting the milk that is available. Get help to fix the baby’s latch, and use compression to get the baby more milk (handout #15 Breast Compression). Compression works very well in the first few days to get the colostrum flowing well. This, not a pacifier, not a bottle, not taking the baby to the nursery, will help.



6. Supplements of water, sugar water, or formula are rarely needed. Most supplements could be avoided by getting the baby to take the breast properly and thus get the milk that is available. If you are being told you need to supplement without someone having observed you breastfeeding, ask for someone to help who knows what they are doing. There are rare indications for supplementation, but often supplements are suggested for the convenience of the hospital staff. If supplements are required, they should be given by lactation aid at the breast (see handout #5), not cup, finger feeding, syringe or bottle. The best supplement is your own colostrum. It can be mixed with 5% sugar water if you are not able to express much at first. Formula is hardly ever necessary in the first few days.



7. Free formula samples and formula company literature are not gifts. There is only one purpose for these "gifts" and that is to get you to use formula. It is very effective, and it is unethical marketing. If you get any from any health professional, you should be wondering about his/her knowledge of breastfeeding and his/her commitment to breastfeeding. "But I need formula because the baby is not getting enough!". Maybe, but, more likely, you weren’t given good help and the baby is simply not getting the milk that is available. Even if you need formula, nobody should be suggesting a particular brand and giving you free samples. Get good help. Formula samples are not help.

Under some circumstances, it may be impossible to start breastfeeding early. However, most “medical reasons” (maternal medication, for example) are not true reasons for stopping or delaying breastfeeding, and you are getting misinformation. Get good help. Premature babies can start breastfeeding much, much earlier than they do in many health facilities. In fact, studies are now quite definite that it is less stressful for a premature baby to breastfeed than to bottle feed. Unfortunately, too many health professionals dealing with premature babies do not seem to be aware of this.

Questions? (416) 813-5757 (option 3) or drjacknewman@sympatico.ca or my book Dr. Jack Newman’s Guide to Breastfeeding (called The Ultimate Breastfeeding Book of Answers in the USA)



Handout #1. Breastfeeding—Starting Out Right. Revised January 2005


Written by Jack Newman, MD, FRCPC. © 2005


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 markeing of breastmilk substitutes isvioated


http://www.breastfeedingonline.com Cindy Curtis, RN, IBCLC t l

Are Used Breast Pumps a Good Option? Issues to Consider

Nancy Mohrbacher, IBCLC

http://www.artofbreastfeeding.com/

From: LEAVEN, Vol. 40 No. 3, June-July 2004, pp. 54-55.

What new mother wouldn’t like to save money on a breast pump? That’s why we are often asked: “Do you have used breast pumps available?” Some mothers have friends or relatives offering to lend them a used pump. Is a used pump a good option?



Open Systems vs. Closed Systems

Some mothers mistakenly assume that because rental pumps are safely shared by mothers that it is also safe to share purchase pumps. This is not true. Rental pumps and purchase pumps are designed differently. The collection kits (the bottles and tubing that attach to the pump) used with the rental pumps are designed so that the milk never touches the working parts of the pump that are shared with other mothers. This is considered a “closed system.”



Most purchase pumps, for example Medela’s Pump In Styles, DoubleEase, and MiniElectric, are “open systems.” This means that the pump motor is “open” to contact with the mother’s milk particles. In a Pump In Style, for example, the breastshield (the part held against the breast) is open to the tubing that attaches to the back of the shield, which is also open to the diaphragm on the pump motor that creates the suction and release. This means that an invisible mist of milk particles can travel from the shield into the tubing and back onto the pump diaphragm. The diaphragm cannot be removed or sterilized, so it cannot be cleaned well enough between mothers to insure safety. When there are milk particles on the pump diaphragm, even with a brand new set of bottles, tubing and breastshields, with every suction and release another mother’s milk particles will be blown into your milk. Even if milk particles are not visible, they can still be there. (One sure sign is mold growing in the tubing, which sometimes happens with normal use.)



Health and Hygiene Issues

Does it matter if your baby receives another mother’s milk particles? Potentially, yes. Although your milk is without a doubt the best possible food for your baby, it is currently recommended that any donor milk a baby receives from a milk bank or from another mother be pasteurized to kill viruses. Your baby has already been safely exposed to the viruses in your system during pregnancy, so there is no risk. But if another mother carries a virus in her system that you do not, it can be passed to your baby via the other mother’s milk and your baby may become seriously ill.



A mother can have a virus in her milk without even knowing that she is a carrier. Some of the potentially dangerous viruses that can be transmitted through human milk include cytomegalovirus (CMV) and HIV (AIDS). Most mothers with CMV, for example, are unaware that they are a carrier. The FDA says:



There are certain risks presented by breast pumps that are reused by different mothers if they are not properly cleaned and sterilized. These risks include the transmission of infectious diseases...FDA believes that the proper cleaning and sterilization of breast pumps requires the removal of any fluid that has entered the pumping mechanism itself. If proper sterilization of the breast pump cannot be achieved, FDA recommends that it not be used by different mothers.



Legal and Liability Issues

These issues are serious enough that if a mother contacts Medela and tries to order a new set of bottles and tubing for a used Pump In Style, Medela will refuse to sell it to her. Medela does not want to be legally responsible if a baby should become seriously ill. On its Web site Medela says:



It is not advisable to use a previously owned breast pump. Breast pumps are single-user products, or personal care items, much like a toothbrush, and are registered with the FDA as single user items. For safety, breast pumps should never be shared, resold, or lent among mothers. Medela strongly discourages mothers from re-using or re-selling previously owned breast pump equipment....



What If a Borrowed Pump Breaks?

If in spite of the above health/hygiene/liability issues you decide to borrow a used pump, there are other issues to consider. Recently several mothers have come to us in the following unenviable situation: within weeks or months (in one case, days) of borrowing a pump, the used pump stopped working. It had reached the end of its natural life.



Because these mothers were good people, they felt they had to replace the pump so they could return it to the original owner as promised. This meant they ended up paying the full purchase price for a new pump but could not even keep it for their next baby. They had to return it to the original owner. As it turned out, it would have been much cheaper for them to rent or buy than to borrow.



When considering borrowing a used pump, also keep in mind that the best of these purchase pumps have a one-year warranty. And no matter how new the pump, its warranty is automatically voided if it is used by more than one person.



Also, even if the borrowed pump doesn’t fail while you have it, you have shortened the life of another mother’s pump. To calculate how much, subtract the length of time you have used it. How would you feel (and what would you do) if you returned the pump to its original owner in working order, but when she has her next baby, it breaks a week later? It’s important to be clear about these issues up front. What looks like a great deal could end up costing you more in the end than buying a new breast pump.



© Nancy Mohrbacher, 2004



Clarification subsequently printed in the August-September 2004 issue of LEAVEN:

The article, "Are Used Breast Pumps a Good Option?" which appeared in the June-July issue of LEAVEN, was written by Nancy Mohrbacher, IBCLC. Nancy is currently employed as a lactation consultant by Hollister, Inc., manufacturer of the Ameda breast pumps. When this article was originally written, however, Nancy was an independent lactation consultant in private practice and was not affiliated with Hollister.



Page last edited Sun Oct 14 09:31:41 UTC 2007.

Sunday, January 2, 2011

Tempoh simpan susu ibu

Lagi..Panduan Penyimpanan susu ibu

Panduan asas penyimpanan susu ibu


Panduan Menyimpan EBM

Susu ibu yang diperah boleh disimpan di dalam keadaan dan tempoh masa berikut:



* Di dalam suhu bilik (19 hingga 26 °C), tahan sehingga 4 jam



* Di dalam bekas penyejuk (cooler bag/box) (kurang 4 °C), tahan sehingga 12-24 jam



* Di dalam peti sejuk (kurang 4 °C), tahan sehingga 7 hari



* Di dalam peti sejuk bahagian beku (-18 hingga -20 °C), tahan antara 3 hingga 6 bulan





Expressed Breast Milk (EBM)


Panduan asas penyimpanan susu ibu:

* bekas penyimpanan susu hendaklah dibasuh dengan bersih menggunakan sabun, dibilas

dengan air didih dan dikeringkan dengan sempurna sebelum digunakan

* catatkan tarikh perahan pada bekas susu sebelum menyimpannya

* simpan susu dalam kuantiti mencukupi untuk 1 kali penyusuan untuk 1 bekas,

contohnya 2 - 4 oz sahaja setiap bekas

* jangan penuhkan bekas sehingga ke penutupnya, tinggalkan sedikit ruang untuk

membolehkan pengembangan berlaku apabila susu dibekukan

* susu yang hendak dibekukan sebaiknya hendaklah disimpan di bahagian sejuk terlebih

dahulu sebelum dipindahkan ke bahagian beku peti sejuk

* jangan simpan susu perahan di bahagian pintu peti sejuk kerana suhu di bahagian pintu

tidak stabil (kerana kekerapan membuka dan menutup pintu peti sejuk)

* sebaiknya simpan susu perahan di bahagian paling atas dan paling dalam kerana suhunya

lebih stabil dan malar

* jika menggunakan bekas penyejuk (cooler bag) pastikan ice pack yang digunakan

mencukupi, ganti jika perlu dan kurangkan kekerapan membuka bekas penyejuk

Sumber: www.momschoice.com.my/blog

Panduan Penyimpanan susu ibu

S : Setelah kembali bekerja, saya mengepam 3 atau 4 jam sekali kerana susu terlalu banyak. Saya menyimpan susu perahan di dalam bekas dadih yang diletakkan di dalam kabus ais. Apabila kembali ke rumah barulah saya meletakkannya ke dalam peti ais beku. Apakah betul cara yang saya praktikkan dan apakah bekas dadih selamat digunakan?




Mass, Puchong, Selangor



J : Bagi menjawab persoalan puan, saya merujuk kepada Protokol 8 ABM Clinical: Human Milk Storage Information for Home Use for Full-Term Infants yang disediakan oleh The Academy of Breastfeeding Medicine (badan bertanggungjawab dalam mengeluarkan protokol-protokol berkaitan hal-hal perubatan yang mungkin akan mempengaruhi penyusuan ibu).



Terdapat kajian yang telah dilakukan untuk menilai bekas penyimpan susu ibu. Menerusinya didapati bahawa:



1. Bekas penyimpan kaca dan polypropylene menunjukkan kesan serupa ke atas kebolehlekatan nutrien larut lipid ke permukaan bekas berkenaan, kepekatan immunoglobulin A dan bilangan sel darah putih dalam susu yang yang disimpan.



2. Penggunaan bekas penyimpan polyethylene menunjukkan penurunan 60% immunoglobulin A.



3. Bekas penyimpan keluli pula dikaitkan dengan pengurangan jumlah dan keberdayaan sel jika dibandingkan dengan polyethylene dan kaca.



Terdapat keprihatinan tentang pencemaran susu ibu yang disimpan di dalam beg plastik polypropylene kerana risiko pencemaran akibat kebocoran plastik. Sekiranya beg plastik polypropylene digunakan untuk menyimpan susu ibu, ia sepatutnya kuat, boleh ditutup rapat dan disimpan di kawasan kurang berisiko untuk plastik berkenaan bocor. Bekas penyimpan yang dihasilkan daripada bisphenol A yang terdapat di dalam sesetengah bekas penyimpan plastik termasuk botol susu seharusnya dielakkan berdasarkan bukti kukuh bahawa ia memberi kesan buruk kerana mengganggu sistem endokrin.



1. Susu ibu segar seharusnya disimpan pada suhu bilik. Bagi suhu bilik di antara 27ºC to 32ºC, jangka waktu 3 - 4 jam adalah had munasabah untuk menyimpan susu ibu perahan (SIP). Untuk SIP yang dikendalikan dalam keadaan paling bersih dengan suhu bilik paling rendah, adalah munasabah untuk menyimpannya antara 6 - 8 jam.



2. Sangat sedikit kajian yang menilai keselamatan penyimpanan susu ibu pada 15ºC, di mana ia sama dengan pek ais biru di dalam pendingin kecil (beg atau bekas pendingin). Hamosh et al. menyatakan susu ibu selamat pada suhu 15ºC untuk 24 jam berdasarkan kepada perkembangan minimum bakteria yang terkandung di dalam sampel kajiannya. Walau bagaimanapun, terdapat pek ais yang digunakan mampu menyimpan susu ibu pada suhu seperti di dalam peti ais iaitu 4ºC. Oleh itu, pastikan kualiti pek ais yang puan gunakan.



3. Terdapat beberapa kajian yang menunjukkan keselamatan penyimpanan susu perahan di peti ais dan didinginkan pada suhu 4ºC. Kapasiti bakterisidal susu ibu yang didinginkan menurun dalam tempoh 48 - 72 jam. Walau bagaimanapun, kajian pemerahan susu ibu dengan sedikit pencemaran ketika pengepaman menunjukkan perkembangan bakteria adalah pada paras rendah dalam tempoh 72 jam. Malah, ia masih selamat selepas 4 - 8 hari didinginkan.



4. Membeku susu ibu perahan (-4ºC hingga -20ºC) adalah selamat untuk sekurang-kurangnya 3 bulan. Vitamin A, E dan B, jumlah protein, lemak, enzim, laktosa, zink, immunoglobulin, lysozyme dan laktoferin lazimnya kekal apabila dibekukan. Sedikit kajian mendapati peningkatan vitamin C dalam susu ibu beku selepas 3 bulan. Perkembangan bakteria tidak ditemui dan tidak menjadi masalah kepada susu ibu beku sekurang-kurangnya 6 minggu.



Aktiviti anti-bakteria susu ibu beku dikekalkan sekurang-kurangnya 3 minggu. Pembekuan makanan pada suhu -18ºC atau 0ºF adalah selamat daripada pencemaran bakteria walaupun proses enzimatik terkandung dalam makanan boleh berlaku dengan kemungkinan perubahan dalam kualiti susu. Susu ibu beku perlu disimpan di bahagian belakang peti sejuk beku untuk mengelakkan pemanasan semula akibat kekerapan membuka dan menutup peti sejuk. Jadi, semua bekas penyimpan susu ibu perlu ditutup rapat untuk mengelakkan pencemaran.



5. Selepas bekas penyimpanan diisi dengan susu ibu, sedikit ruang perlu ada di bahagian atas bekas penyimpan untuk membenarkan ia mengembang ketika dibekukan. Semua bekas penyimpan susu ibu perlu dilabel dengan tarikh susu dipam. Nama anak perlu dilabel terutamanya jika anda membekalkannya kepada pengasuh yang perlu memberi susu ibu perahan kepada ramai bayi lain. Lazimnya, bayi memerlukan 60 - 120 ml susu ibu setiap sesi penyusuan ketika berada di rumah pengasuh. Jadi, simpan susu ibu dalam stok 60 - 120 ml setiap satu adalah cara mudah untuk mengelakkan pembaziran.



6. Elakkan menambah susu ibu yang masih suam ke dalam susu yang telah dibeku. Ini bagi mengelakkan pemanasan semula susu yang telah dibekukan. Adalah lebih baik jika anda menyejukkan terlebih dahulu susu ibu yang baru dipam sebelum dicampur bersama stok sedia ada.



7. Susu ibu yang disimpan mungkin berubah bau dan rasa asalnya kerana aktiviti lipase (proses pemisahan lemak yang membantu proses penghadaman bayi terutamanya bayi pramatang). Ia tidak mendatangkan mudararat walaupun ada sesetengah bayi mungkin menolak susu berkenaan. Memanaskan susu lebih daripada 40ºC tidak digalakkan kerana ia boleh mengurangkan aktiviti enzim susu ibu.

(Sumber: http://www.majalahpama.com.my/Motivasi/artikel.asp?art=2010/1008/6446358632&sec=S )

Selamat tinggal 2010 dan selamat datang 2011

Nda kesedaran masa berlalu kan? akhirnya dengan izin Allah Yang Maha Kuasa dapat lagi kita menemui tahun baru 2011. Tinggallah 2010 sebagai satu lagi memori kenangan yang perlu kita simpan...mana yang baik jadikan teladan dan mana yang buruk jadikan sempadan.



Apa agaknya azam yang mahu dicapai tahun ini? bg ummi rasanya meneruskan saja azam2 tahun lalu, antaranya tahun ni insyaAllah nak menjadi muslimah yang sentiasa diberkati dan dirahmati oleh-Nya, ummi mau memantapkan lagi kedai online ummi yang down to earth saja bah tu hehe, projek bf untuk ahli keluarga baru yang bakal lahir april nanti, dan macam2 lagi dalam kepala...tau ajalah manusia merancang Alla Maha Penentu segala..




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