Saturday, September 24, 2011

LAM- The Lactational Amenorrhea Method

 

U.S. mother and infantWhat is LAM?  
The Lactational Amenorrhea Method (LAM) 
It is a well known fact that breastfeeding suppresses a woman's fertility in the early months after delivery. However, many women do not feel comfortable relying on breastfeeding as a form of birth control because they have been told it is unreliable, or perhaps because they know someone who became pregnant while breastfeeding.  
 
The Lactational Amenorrhea Method (LAM) was created to allow women to safely rely on breastfeeding as a family planning method. Based on scientific research, the method uses three measures of a woman's fertility: 1) the return of her menstrual period, 2) her patterns of breastfeeding, and 3) the time postpartum. 
Who can use LAM? 
A woman can use LAM if: 
1. her menstrual period has not returned since delivery (Bleeding or spotting during the first 56 days is not considered menstrual bleeding.)   AND 
2. she is breastfeeding her baby on demand, both day and night and not feeding other foods or liquids regularly (Occasional tastes of foods or other liquids are permitted, but they should never replace a feeding at the breast.)   AND 
3. her baby is less than six months old.   
When all three of these conditions exist, she has less than a two percent chance of becoming pregnant. However, the woman is encouraged to begin using a complementary family planning method when any of the three conditions changes, or whenever she chooses.   

Scientific studies conducted around the world by the Institute for Reproductive Health and other organizations have proven that when used correctly, LAM is an effective, safe, convenient short-term way for breastfeeding women to delay pregnancy. 
Study/Date 
N 

Efficacy
(%) 

Pregnancies
(#) 
Chile*/1989 422 
99.5 

1
Ecuador*/1993 330
99.8

2
Pakistan**/1995 391 
99.4 

Philippines**/1996 485 
99.0 

Multicenter*/1996 519
98.5 

* Study conducted by the Institute for Reproductive Health. 
** Study conducted by Family Health International. 

When is LAM no longer effective? 
A woman who chooses to rely on LAM should be advised that the method is short-term (up to six months) and is no longer effective when any one of the three criteria changes. 
The LAM user should be counseled to use another contraceptive method for continued protection when: 
1. Her menstrual periods return.  
Menstrual bleeding is the most important indicator of fertility. After the initial 56 days postpartum, two consecutive days of bleeding/spotting or the woman's perception that her period has returned, whichever of the two comes first, should be considered an indication that fertility is returning. A woman can ovulate before her period returns, however, studies indicate this rarely occurs when the woman is breastfeeding intensively and less than six months postpartum.  
OR 
2. She begins feeding her baby other liquids or foods regularly, or her baby sleeps through the night.  
Ovulation is suppressed in the breastfeeding woman as the baby suckles at the breast. When the baby begins taking other foods or liquids she/he generally suckles at the breast less, thus reducing the fertility-suppressing effect of breastfeeding. This is also true when the baby begins sleeping through the night--long intervals between breastfeeds (more than four hours during the day and six hours at night) should be avoided.  
OR 
3. Her baby is older than six months. 
At about six months the baby should begin eating other foods as their nutritional needs change at this time. Usually the baby will breastfeed less when this happens, thus, LAM becomes less effective. 
Any one of these changes will reduce LAM's high efficacy. At this time, the LAM user should be counseled about complementary family planning methods that do not interfere with breastfeeding. 
Medical conditions when LAM would not be advisable 
Medical conditions that affect the use of LAM are few. Generally, the conditions listed below make breastfeeding inadvisable, which in turn makes LAM use impossible. 
LAM should not be used under the following conditions:  
  • Specific infant metabolic disorders. 
  • Maternal use of mood-altering drugs. 
  • Maternal use of reserpine, ergotamine, antimetabolites, cyclosporine, bromocriptine, radioactive drugs, lithium, or anticoagulants. 
LAM usually is not recommended under the following conditions, except on the basis of careful clinical judgement, taking into account the severity of the condition and the availability and acceptability of other methods: 
AIDS or confirmed HIV+. The HIV virus can be passed through breastmilk. According to the World Health Organization, if a safe alternative to breastfeeding is available and affordable, a woman who is HIV+ or has AIDS should be informed of the risks of breast and bottle feeding. 
Active tuberculosis. Tuberculosis does not spread through breastmilk but through direct contact with the mother. If the mother has an active case of tuberculosis, breastfeeding increases the risk of infection due to the frequent and intimate contact with the infant.  
This page was adapted from the original web site of the Institute for Reproductive Health, a project funded by the United States Agency for International Development (USAID) under the terms of Cooperative Agreement DPE-3061-A-00-1029-00. Information (photos excluded) and publications may be reproduced, adapted, and disseminated without permission, provided the Institute for Reproductive Health is acknowledged and the material is distributed free of charge, or not for profit. 
 

The LAM section was originally developed by Shirley Coly   
Photograph on this page by Noureddine El-Warari. 
 

(source:  http://www.waba.org.my/resources/lam/ )

Perjumpaan Kumpulan Ibu Menyusu Sabah kali Pertama

Ummie paste gambar saja dulu ya, keletihan baru balik KK tadi, ni pun dapat dari facebook geng SGSIS (Support Group susu ibu Sabah) iaitu Aima dan saya dapat foto ni dari facebook, terima kasih ya Aima sebab sudi tagged kaka. Ha ni kenalan ummi yg sudah bertukar 'status', bah jan dulu bingung ya :) , MAKSUDNYA DARI STATUS KENALAN ONLINE SUDAH TUKAR KENALAN OFFLINE hihi :)

Wednesday, September 21, 2011

Nursing Tips for the Large Breasted Mother

Here are some suggestions that I have found helpful:
(Source: http://www.breastfeedingbasics.com/html/Large_Breasted_Tips.shtml )
  1. Find a nursing bra that really fits. Small- breasted women don't need as much support as larger breastfed women, so finding a supportive bra is more of a priority for the mother with larger breasts. Breast size will increase during pregnancy, but by the last trimester, the majority of prenatal growth has occurred and that is a good time to purchase nursing bras. It is impossible to predict exactly how much larger your breasts will get when your milk comes in, but you can estimate that you will be a size or two larger in both cup and band size. It may help to get a back extender to use during the latter stages of pregnancy or the early stages of engorgement, because this can easily be removed as your size changes. Your ribcage expands during the last months of pregnancy, and the extender may help make you more comfortable during this stage. Start out with only a couple of bras, and invest in more once the initial engorgement has subsided and you reach your long-term nursing size. Good nursing bras are expensive, and you don't want to end up investing in a drawer full of bras that don't fit anymore after the first couple of weeks of nursing. You should try to avoid under-wire bras if possible (they can press against breast tissue and cause problems with plugged ducts and mastitis) as well as tight athletic bras. Bras that are too loose can also cause problems for large breasted women. The best option for obtaining a comfortable, supportive bra is to have it fitted by a professional, but this isn't always possible. Many maternity stores don't carry a large range of sizes, so you may have to order one instead. Plan to order far enough in advance to allow time for returns if the fit isn't' just right. The best online resource I have found for nursing bras is birthandbaby.com. Go to the home page and look under "breastfeeding". Click on "nursing bras" and you will go to the family resources page. They have an excellent selection of bras in a wide range of brands and sizes, along with detailed information about how to fit and order the bras.
  2. Experiment with different positions. The traditional cradle hold is the most popular position, but the football hold generally works better for women with larger breasts. In this position, the baby is tucked under your arm and you have better control of the baby's head as he latches on, as well as more freedom of arm movement. Be sure to use lots of pillows to bring the baby up to your level, rather than having to lean over him. You also want to support your back with pillows as well. Raising your knees with a footstool also helps (Medela's Nursing Stool is ideal for this). It is difficult to learn how to position your baby by reading a book, so spend some time at La Leche League meetings if you have the opportunity. You'll get the chance to see real live babies in action in a comfortable situation where only other mothers are present. Medela has an excellent video called "Breastfeeding Your Baby: A Mother's Guide: Positioning" that shows a variety of nursing positions. It's available from many LLL group libraries, and in our area, Blockbuster Video offers it free as a public service. You may find it useful to "practice" different positions before your baby arrives, using a baby doll or stuffed animal. While this isn't the same as nursing a real live wiggly baby, it can give you an idea of how to use pillows for support, and help you get a feel for which positions might be most comfortable for you.
  3. Make sure to support the breast while nursing. Using the "C" hold is often effective. The optimal C hold involves using your outside hand (the one on the same side you're nursing from) to support your breast. Put your palm gently under the breast, with your thumb curved around the top and side, forming a "C". Be sure to keep your finger and thumb well behind the areola, because if your fingers are in the way, your baby can't compress the milk sinuses effectively. This can cause soreness as well as keeping him from obtaining the hind milk that he needs to grow. Some mothers find that rolling up a washcloth and placing it under the breast during the feeding provides extra support. You may need additional support only while you are getting the baby latched on, or you may need to support the breast throughout the entire feeding. Once your baby is older and has better muscle control, you may find that you don't need as much support as you do in the beginning.
  4. Pay careful attention to latch on. You need to make sure that your baby takes a good portion of the areola (the dark area surrounding the nipple) into his mouth, and not just the nipple. Milk is stored behind the areola in pockets (lactiferous sinuses) and the baby has to compress these pockets in order to breastfeed effectively. Babies have tiny little rosebud mouths, and if your areola is large (some are the size of a saucer), then you need to make sure he opens wide (like a yawn) before you pull him in to you to latch on. Most of the areola should be covered, but it's not necessary for him to take all of it in his mouth.
  5. Gently massage your breasts while you are nursing. Large breasted women have more tissue that can become engorged or lumpy, and massage can help insure that the milk ducts are being emptied adequately.
  6. Set up a nursing station in the areas where you will be spending a lot of time (usually bedroom and living room). Get all the supplies you will need together so you don't have to move once you get settled: pillows, diapers, wipes, change of clothes, towel or cloth diaper for leaks or spit up, nursing pads, change of crib bedding, bottle of water, remote control, book to read, etc. A comfortable recliner is a wonderful investment. You will spend many hours nursing in it, and you deserve to be as comfortable as possible!
  7. Try to find a way to nurse while you are sleeping with your baby. Newborn babies nurse a LOT during the night, and you will get a lot more rest if you can learn to nurse comfortably while lying down. Many mothers find this the most difficult position to master, but in my experience, large breasted women find it easier than women with small breasts. The article on "Nursing After a Caesarean Section" has info on nursing lying down, and so does the Medela video.
  8. Nursing discreetly in public can be challenging for all mothers, but especially for women with larger breasts. If the football hold works best for you, you can use your diaper bag to rest the baby on (instead of a pillow). The article "Nursing Discreetly" has more tips on how to nurse in public without drawing a crowd. I personally have strong feelings about nursing mothers not feeding their babies in bathrooms, and there are lots of other options if you feel the same way. You have to do whatever is comfortable for you personally, but it is possible to nurse when you are out and about if you learn some basic tips to make it easier. 
  9. Good breast hygiene is important, because women with large breasts are more likely to have problems with skin irritation or infections due to the folds of skin underneath their breasts. Many skin problems such as yeast and heat rash are aggravated by moisture, and the area under the breast is prone to these infections. Wash your breasts daily with water (not soap) and dry them thoroughly, paying special attention to the area underneath the breast. You may want to use your hair dryer on the cool setting to make sure the area is completely dry, especially during warm weather.
  10. Many people make the assumption that mothers with large breasts will make more milk, have more oversupply problems, and leak more than the average woman. This is simply not true. Some women produce more milk and some leak more than others, but it isn't related to the size of the breasts. If you do experience a problem with an overabundance of milk, see the article on "Oversupply: Too Much Milk" for some solutions. 
  11. If you choose to use a breast pump, you should be aware that the breastshields and flanges (the funnel shaped pieces that fit over your nipple/areola) are designed for the "average" sized breast. Women with very large breasts or areolas may need a larger flange. Medela makes a PersonalFit flange kit that comes with two different size flanges for larger breasts, and this makes it possible for women with all sizes and shapes of nipples to pump comfortably and efficiently.
Nursing a baby can present special challenges for the mother who is amply endowed, but with preparation and practice, there is no reason why you can't have a very successful breastfeeding experience regardless of the size or shape of your breasts.





Tuesday, September 20, 2011

Baru nak join..Insentif tunai untuk setiap trafik ke blog denaihati

Hai pa kabar semua, untuk pengetahuan kawan tiba2 pulak ummi ada hati mau menjoin YG INI INSENTIF TUNAI UNTUK SETIAP TRAFIK KE BLOG DENAIHATI haa ni lah ceritanya sesaja menjoin, mau memeriahkan blog ku ini, sambil meriah sambil2 lah juga mau dapat wang komisyen :). Kalau ada kawan-kawan yang berminat (untuk yg ada blog lah ya) apa salahnya kan? caranya mudah saja


Kalau ada sesiapa yg sudah join Nuffnang tu haa sama lah konsepnya, antara syarat yang ditetapkan oleh pihak DENAIHATI ialah seperti berikut:-

PERTAMA:  Insentif ini untuk 10 blog yang memberi top link referrer mengikut pengiraan
KEDUA: Insentif ini akan dibayar setiap bulan bermula 1/7/2011 sehingga 31/12/2011.
KETIGA: 1 trafik yang disumbangkan ke blog denaihati akan dibayar RM0.02. (wah ni yg best kalau 1000 trafik yg kita sumbangkan leh dapat rm20, kalau 3000 trafik dapatlah kita rm60 dan begitulah selanjutnya :) )

apa-apa pun pada sesiapa yg mempunyai blog tu haa apa lagi, jom lah join sambil berblog tu sambil dapat duit kan.
apa pun kalau kengkawan masih tak faham bolehlah berkunjung ke SINI


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Friday, September 16, 2011

Darah Tinggi Semasa Hamil

Tekanan darah tinggi adalah salah satu sebab mengapa wanita hamil dimasukkan ke hospital. Hypertension bermaksud tekanan darah tinggi manakala hypotension pula bermaksud tekanan darah rendah. Hypotension adalah normal semasa mengandung semasa awal dan pertengahan kehamilan dan sesuatu yang tidak perlu dirisaukan.

Kenapa Tekanan Darah Tinggi Merbahaya?

Punca utama mengapa wanita mengalami darah tinggi semasa hamil ialah disebabkan satu keadaan yang dinamakan pre-eclapmsia yang boleh menjurus kepada ECLMAPSIA, satu penyakit darah tinggi yang sangat serius. Pre-eclampsia dan eclampsia adalah salah satu punca utama kematian ibu dan bayi semasa hamil. 5-10% wanita yang mengandung anak sulung akan mengalami eclampsia.

 

Jenis-jenis Darah Tinggi

Penyakit darah tinggi kronik

Ia adalah penyakit darah tinggi yang wanita alami semasa wanita masih belum hamil lagi. Ia lebih kerap berlaku kepada mereka yang berusia dan wanita tersebut mungkin mempunyai sejarah keluarga yang juga mempunyai darah tinggi.
Penyakit darah tinggi kronik mungkin boleh mmenjadi lebih teruk sewaktu lewat kehamilan dan selalunya doktor akan memberikan pauntauan yang teliti terhadap tekanan darah selepas trimester kedua. Beberapa jenis ubat darah tinggi yang digunakan agak selamat semasa hamil dan selalunya doktor akan menukar ubat yang biasa dimakan sebelum hamil kepada yang lebih sesuai untuk wanita hamil.

Tekanan darah tinggi disebabkan oleh kehamilan (PIH)

Ia terjadi cuma semasa hamil dan hilang sebaik sahaja wanita melahirkan. Sebahagian kecil dari wanita ini akan mengalami eclampsia tetapi agak sukar untuk menentukan siapa yang lebih berisiko. Juga segelintir mereka yang mengalami PIH ini akan mendapat mendapat tekanan darah tinggi akhirnya semasa lebih berusia.

Pre-eclampsia (PE)

Pre-Eclampsia(PE) adalah penyakit yang unik semasa hamil. Ia bukan sahaja penyakit yang melibatkan tekanan darah tinggi malahan ia akan memberi kesan kepada buah pinggang, otak dan organ-organ penting yang lain dalam badan.
Buah pinggang merupakan organ yang pertama mendapat komplikasi dari penyakit ini. Cara untuk mengetahui yang penyakit tersebut dalam peringkat yang agak serius ialah dengan membuat ujian air kencing. Sekiranya terdapat banyak protin didalam urin bermakna wanita sudah mendapat pre-eclampsia. Semakin banyak protin yang terdapat dalam urin semakin teruk keadaan pesakit tersebut.
Sekiranya PE tidak dirawat dengan segera, ia akan menjadi serius dengan cepat dan eclampsia akan berlaku. Ini terjadi apabila wanita mula mendapat sawan. Sekiranya tekanan darah menjadi terlalu tinggi dan dia belum melahirkan, kemungkinan besar bayi juga akan mendapat komplikasi dan mungkin boleh meninggal didalam rahim. Terdapat juga risiko stroke terhadap ibu sekiranya tekanan darah tidak dapat dikawal.

Penyebab Pre-Eclampsia

Ia tidak diketahui bagaimana penyakit ini terjadi. Banyak hormon yang terlibat tetapi penyebab sebenar masih menjadi tanda-tanya. Tetapi pakar perubatan mendapati ia mungkin berkaitan dengan uri. Pakar mendapati, uri tidak membentuk secara normal dengan salur darah tidak menjadi nipis dan lembut sebagaimana yang sepatutnya.
Pembentukkan uri yang tidak normal boleh berlaku seawal 18-20 minggu kehamilan. Terdapat juga darah beku, menyebabkan salur darah tersumbat didalam uri dan ini menjelaskan kenapa bayi wanita yang mempunayai pre-eclampsia lebih kecil dari biasa. Buat masa ini terdapat banyak penyelidikan sedang dijalankan untuk mengetahui punca sebenar mengapa ia terjadi dan bagaimana ia boleh dicegah.

Apa yang menyebabkan PE lebih kerap terjadi?

Keadaan berikut boleh diri anda lebih berisiko untuk mendapat PE tetapi perlu diingat, ia boleh terjadi kepada sesiapa sahaja.
  • Ia sering terjadi kepada kandungan sulung
  • Mempunyai PE pada kandungan sebelumnya
  • Berumur kurang dari 20 atau lebih dari 35
  • Migrane
  • Mempunyai ahli keluarga dekat keluarga yang mempunyai PE
  • Mempunyai hypertension kronik
  • Terlalu kurus
  • Terlalu rendah
  • Kandungan kembar
  • SLE
  • Kandungan molar 
Di bulan-bulan terakhir kehamilan, wanita hamil mungkin akan mengalami masalah kesukaran tidur, tidak selesa dan bangun ditengah malam.
Kerana disebabkan berlakunya perubahan fizikal dengan perut yang semakin membesar, ramai wanita yang sebelumnya tidak mengalami kesukaran tidur diawal mengandung, mendapati mereka tidak mendapat tidur yang diakhir kehamilan.
Banyak masalah yang boleh menganggu tidur seperti:
  • Kaki kejang
  • Sukar untuk bernafas
  • Sering buang air kecil diwaktu malam
  • Bayi yang terlalu aktif, yang sering menendang pada bahagian ibu yang sensitif
  • Susah untuk menukar posisi badan semasa tidur disebabkan oleh bayi yang semakin membesar
  • Sakit belakang terutamanya pada bahagian bawah tulang belakang
  • Mengigau lebih dari biasa
  • Mimpi ngeri yang sukar dilupa
  • Merasa risau tentang kelahiran yang bakal mendatang
  • Bimbang tentang bayi samada ia normal atau tidak
  • Semua ini adalah masalah yang biasa terjadi semasa mengandung

Bagaimana saya boleh mendapat tidur yang selesa?

Sekiranya anda mendapat kekejangan pada kaki, tekankan kaki anda pada dinding atau berdiri pada kaki yang kejang boleh mengurangkan kekejangan. kekurangan kalsium boleh menyebabkan kekejangan berlaku lebih kerap, jadi pastikan anda mendapat cukup kalsium, seperti dengan meminum susu. Jantung yang selalu berdebar mungkin disebabkan oleh kekurangan darah (anemia). Pastikan anda memberitahu doktor tentang masalah ini dan mendapat suplemen zat besi yang secukupnya
Posisi yang terbaik untuk tidur semasa mengandung ialah dengan berbaring secara mengiring dengan lutut separuh membengkok. Ini membolehkan jantung anda bekerja dengan lebih baik kerana darah lebih senang mengalir ke jantung.
Sekiranya anda mengalami sakit belakang, cuba membuat experimen dengan meletakkan lebih bantal semasa berbaring. Seperti satu bantal dibawah perut, satu dicelah kedua kaki, satu bantal yang padat pada bahagian bawah belakang, atau satu bantal lagi pada bahagian kepala.
Selalu bangun untuk membuang air kecil diwaktu malam adalah biasa, kerana bayi yang semakin membesar semakin memberi tekanan pada pundi kencing, ini memang tidak dapat dielakkan tetapi, dengan mengurangkan minum air sebelum anda masuk tidur mungkin boleh membantu.
Kurangkan meminum miniman bercafin seperti teh, kopi dan minuman bergas kerana buah pinggang akan memproses lebih air kencing. Cuba tidur secara mengiring.
Sekiranya anda merasa tidak selesa pada bahagian ari-ari, anda mungkin mengalami jangkitan kuman pada bahagian pundi kencing. Jumpalah dengan doktor untuk pemeriksaan lanjut.
Sekiranya ketakutan tentang kelahiran yang membuatkan anda merasa sukar tidur, sertailah kelas antenatal. Disini anda akan diberitahu tentang apa yang akan berlak semasa proses bersalin dan senaman yang perlu untuk membantu anda bersalin. Ia juga satu tempat untuk anda bertanyakan soalan
Berbincanglah dengan doktor sekiranya anda merasa takut. Perasaan takut tentang keadaan anak anda semasa lahir adalah sangat biasa.

Apa yang perlu saya lakukan sekiranya saya masih tidak dapat tidur?

Ingat, pil tidur memang tidak digalakan tetapi sekiranya sudah tiada jalan lain, ia tidak merbahaya sekiranya ia tidak mebuatkan anda merasa letih. Daripada duduk diatas katil tanpa berbuat apa-apa, adalah lebih memberikan kepuasan untuk bangun dan membuat sesuatu yang memberi berfaedah.
Bacalah buku, mendengar muzik, melayari internet, mandi, menonton  TV atau menjahit. Selepas membuat sesuatu yang memberikan kepuasan, anda akan merasa lebih senang untuk tidur.
Banyak wanita yang mendapat menafaat dari senaman ringkas dan mendengan muzik yang menyenangkan.  Sekiranya anda merasa letih disiang hari, cuba tidur sekejap.
Sekiranya anda masih tidak dapat tidur, jumpalah doktor yang dapat menolong anda.

(sumber: http://portal.alamhamil.com/)




Saturday, September 10, 2011

Al-Kisah tali pusat bayi baru lahir..

A Cord of Three Strands... 

 

Ummi dapat artikel ni dari sumber ini ianya ada perkaitan dengan pelahiran anak-anak Ummi yg mengalami ABO jaundis cerita berkenaannya di sini . Dan masa anak kedua kaisah lahir dengan ABO jaundis tidak terlalu lama (5 hari di wad dan pemeriksaan di klinik 2 or 3 kali - tidak sampai umurnya sebulan) berbanding adiknya Ifwat yg sangat lama tempoh ABO Jaundisnya (10 hari di wad dan pemeriksaan di klinik ibu dan anak mencecah umurnya sebulan!) - so kaitannya dengan menyegerakan pemotongan tali pusat bayi yg baru lahir atau sebaliknya- ummi jumpa artikel ni dan mahu menyimpannya - jawapan yg ummi cari ada di sini)- di artikel bawah ini.


The umbilical cord is an amazing object!

Often disregarded at birth, the most notoriety that it receives is when someone proudly exclaims "I cut the cord"!

There is so much more value to the umbilical cord than that, though, both in utero and after birth.

Normally, an umbilical cord has two arteries and one vein and, at term, is around 22-24 inches long. These are all wrapped up in a beautifully plump, purple, rich cord of three. Surrounding, insulating, and protecting everything is a substance called Wharton's Jelly. The arteries return deoxygenated, nutrient-depleted blood from babe to the placenta, where it will be reoxygenated and replenished with vital nutrients to be recirculated through the one vein back to babe again.

Wharton's Jelly is a substance that, when exposed to extreme changes in temperature, begins to expand and, as a result, occludes and collapses the vein and arteries... physiologically clamping the cord within an average of 5-20 minutes after birth. Wharton's Jelly contains a great many types of stem cells.

The umbilical cord is attached to the placenta 'on the maternal side'. The placenta (loosely translated as cake) is another amazing organ that allows for nutrient uptake, waste elimination and gas exchange via the mother's blood supply, which is then transferred to the fetal circulatory system via villi; thus, the maternal and fetal circulatory systems do not meld.

The umbilical cord is attached, on the fetal side, through the umbilicus (this will, after birth, become the navel). Within babe, while in utero, the umbilical vein continues on to the transverse fissure of the liver, where it splits. One of the two branches joins with a vein that carries blood directly into the liver. The other branch (ductus venosus) directs about 80% of the incoming blood to the left hepatic vein into the inferior vena cava, which carries blood towards the heart.

After birth, the umbilical vein and ductus venosus close up inside the newborn, becoming the round ligament of the liver and the ligamentum venosum. Part of each umbilical artery closes up while the remaining sections continue to work as part of the circulatory system.

Variations
Some of the variations that can occur with an umbilical cord include (but are not limited to):
  • Nuchal Cords - nuchal (neck) cords simply mean that the cord is wrapped around the neck. This occurs in about 25% of births. Most babies have no problems when born with the incidence of nuchal cord. The most common indicator of a nuchal cord is when babies heart rate (fetal heart tones or FHT) decrease during contractions, only to come back up after contractions. Rarely does this mean that a cesarean is indicated.
  • Single Umbilical Artery - This is occurs when an umbilical cord develops with only one artery, instead of two. Single umbilical arteries occur in about 1% of singleton and 5% of multiple pregnancies. Studies show that babies with single umbilical artery have an increased risk for birth defects. These birth defects can include heart, central nervous system and urinary-tract defects. Single umbilical artery in and of itself, though, does not mean that a baby will have a birth defect.
  • Knots - some knots occur when baby moves around in utero, others occur when a nuchal cord loops off of baby and into a knot. This occurs in about 1% of babies.
  • Cysts - the cysts are out-pockets that form on the cord. There are two types of cysts: true cysts (lined with cells and contain remnants of early embryonic material) and false cysts (fluid filled sacs that can be related to swelling of the Wharton's Jelly). Both types are sometimes associated with chromosomal or abdomenal defects. Cysts occur in about 3% of births.
To Clamp or Not To Clamp
There are good arguments that should be considered when deciding whether to immediately clamp and cut the cord or delay the procedure. A great discussion can be found here. An additional MUST READ can be found here! You will find, for better or worse, what my stance is on the issue of cord clamping by reading the information below.

"The placental blood normally belongs to the infant, and his/her failure to get this blood is equivalent to submitting the newborn to a severe hemorrhage at birth."
The newborn receives approximately 80-100cc of blood from the placenta within the first 3-5 minutes after birth. This additional blood flow opens the lungs and 'jump starts' the intestines and kidneys, preparing them for digestion and elimination.

When a newborn's cord is quickly clamped and cut, before the bolus of oxygenated blood is adequately transfused, it creates a crisis situation in some/many situations. Instead of supplying 80-100ccs of blood to the newborns intestines, survival dictates that the blood already within the newborn be directed to the heart, lungs, and brain to preserve life. Loss of needed blood results in some pathological symptoms of shock in the newborn - hypovolemia and/or hypoxia.
"Normal blood volume is not produced by a cord clamp ... Many neonatal morbidities such as the hyperviscosity syndrome, infant respiratory distress syndrome, anemia, and hypovolemia correlate with early clamping. To avoid injury in all deliveries, especially those of neonates at risk, the cord should not be clamped until placental transfusion is complete." - George M. Morley
If the cord is cut before the baby has a chance to take a few breaths in his own time, the transition to breathing will be in fear, panic, and distress. To force a newborn to breathe independent of the bodies timing (i.e. physiological clamping) is to add risk that the baby/newborn body may not be ready. In other words, creating a crisis where the child must immediately breathe - rather than allowing adequate and safe time. As long as the cord is pulsing, the newborn is receiving oxygen - why create an emergent situation?
"Early cord clamping may impede a successful transition and contribute to hypovolemic and hypoxic damage in vulnerable newborns." - Mercer JS and Skovgaard RL.
Some doctors argue that waiting to clamp and cut will put undue stress on the newborn and create complications like shock, jaundice, or other newborn complications. But, in fact, in 1993, a study by "Kinmond et al...found no increased jaundice, plethora, hyperviscosity, or polycythemia using this method. Yet fear of late clamping persists because physicians have been conditioned to believe that these complications are caused by placental over-transfusion. Cord stripping (allowing the baby to retrieve its own blood supply) has become tantamount to malpractice."

Finally, I leave you with this: who claims right to that super-rich oxygenated blood? Of course, it is the baby's right to claim.

References:
Walsh, SZ, Maternal effects of early and late clamping of the umbilical cord, Lancet, May 11, 1968
Anne Frye, CPM, Holistic Midwifery: A Comprehensive Textbook for Midwives in Homebirth Practice, Labrys Press, 1998
George M. Morley, MB., CH. B "Cord Closure: Can Hasty Clamping Injure the Newborn?", OBG Management - July 1998
Gupta R, Ramji S. Effect of delayed cord clamping on iron stores in infants born to anemic mothers: a randomized controlled trial. Indian Pediatr 2002 Feb;39(2):130-5
Mercer JS and Skovgaard RL., Neonatal Transitional Physiology: A New Paradigm, J Perinat Neonat Nurs March 2002; 15:56-75.
Mercer, J, Bewley, S, Could early cord clamping harm neonatal stabilisation, Lancet, May 9, 2009
Dr. Sarah Buckley, Gentle Birth, Gentle Mothering, One Moon Press, 2005

Friday, September 9, 2011

Mencuba resepi nasi ayam

Bahan-bahan ( 6-8 orang )

  • Untuk rebus
  • -1 ekor ayam dipotong ikut suka besarnya (x potong pun boleh)
  • - 2 ulas bawang putih
  • - 2sm halia yg diketuk
  • Untuk perap
  • >1 sudu besar kicap pekat
  • >1 sudu besar sos tiram
  • >1cm halia
  • >2 ulas bawang putih
  • >sedikit kicap cair
  • Untuk nasi
  • - 5cwn beras
  • - 3 sudu besar butter
  • - 1cm halia- ditumbuk
  • - 4 ulas bawang putih -ditumbuk
  • - air rebusan ayam tadi secukupnya
  • - sedikit garam.
  • Bahan sos
  • > 5biji cili merah
  • > 5 ulas bawang putih
  • > 2cm halia
  • > 1 sudu teh cuka, garam, gula
  • > 1/2 cawan air
  • Untuk sup
  • @lebihan air rebusan ayam
  • @1 biji bawang besar kisar
  • @rempah sup
  • @garam
  • @daun sup yg dihiris.

Cara-cara

  1. Ayam dipotong ikut suka besarnya (x potong pun boleh)..bersihkan dan di lumur dengan 2 ulas bawang putih yg ditumbuk dan 2sm halia yg diketuk..dan rebus hingga empuk
  2. Toskan ayam dan perap dengan bahan-bahan untuk perap selama 15-20min. Goreng hingga garing.
  3. Basuh beras dan toskan. Panaskan butter, tumis halia dan bawang putih hingga garing. masukkan beras, terbit bau, masukkan air rebusan ayam secukupnya dan garam. Masak seperti biasa.
  4. Untuk sos-blendkan semua bahan diatas. boleh ditambah tomato sos/sos cili jika suka. Boleh juga dimasak sebentar (jika suka)
  5. Untuk sup- air rebusan ayam didihkan bersama bawang besar, rempah sup, garam dan daun sup tadi. 
resepi dari http://www.myresipi.com/top/detail/686

mau try dulu hari ni nanti dah siap msk baru amik gambar yek hehe



Thursday, September 8, 2011

blogger droid

Saja test, ok tak?
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Saturday, September 3, 2011

Avatar Ayu Raudhah

Saja buat avatar ni, bila sekali imbas ku rasa macam imbas si ayu raudhah pun ada hehe, mau bereksplorasi dengan avatar wajah anda? bah bulih bah sila klik sini ja BUAT AVATAR

ni 2nd time buat mcm ayu raudhah tak? hehe 


ni 1st time buat

Friday, September 2, 2011

Selamat Hari Raya 2011

SELAMAT HARI RAYA MAAF ZAHIR DAN BATIN 


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