ASI ( Air Susu Ibu )

– more fresh… HEALTHIER and free –

Mengenai ASI

From: Aan Surahman
To: sehat@yahoogroups.com
Sent: Tuesday, January 03, 2006 9:43 AM
Subject: [sehat] [Tanya]mengenai ASI

para sahabat , senasib seperjuangan SPS

Saya pernah Baca Artikel mengenai ASI ,,kalau tidak salah kirimannya Ibu
Luluk Lely Soraya..
dan saya pernah kirim kan pertanyaan lewat ( japri ).. mengenai ASi .

Saya Menikah Sudah 7 tahun dan anak saya sekarang baru  14 bulan. mungkin
kami termasuk
telat mempunyai anak , padahal kami tidak memakai alat kontrasepsi(kb) dan
memang ada
masalah diantara kami mengenai fungsi reproduksi nya ..dan sudah diobati (
sembuuh )
pakai dokter spesialis kandungan dan andrologi

yang saya tanyakan '''
1 . apakah benar mitos ASI bisa menghambat kehamilan ,, karena anak saya
laki-laki
minum asi nya banyak ,  kebetulan produksi asi nya banyak karena isteri saya
minum
susu menyusui dan minum suplemen kalsium dan makannya pun banyak.
saya ada rencana tambah anak lagi maklum kejar setoran...
mungkin ada yang kurang berkenan karena tulisan ini , saya sepertinya
terlalu ambisi
ingin tambah anak tanpa memikirkan perkembangan bayi 14 bulan  .. mohon maAF

2...TAMBAHAN MENGENAI ASI ....memang benar sekali apa kata di dalam artikel
yang ditulis''
dikutip oleh ibu L L soraya . anak saya seperti nya jarang sekali sakit
dibandingkan dengan seusianya
yang pakai ss formula,,,usia 10 bulan+25 hari sudah bisa jalan  ,,, gigi
sudah 7 buah.
memang berat badannya tidak seberat yang pakai ss formula , anak saya lebih
ringan tapi
dalam batasan normal versi ksm..grafik.padahal asupan makan kurang ,,anak
saya termasuk susah makan
tapi ASI nya sehari banyak sekali...

tolong kasih pencerahan mengenai mitos nya

terimakasih
aansurahmanbapaknyamuhammadpascalfadhillah

Jawab :

From: Luluk Lely Soraya I
To: sehat@yahoogroups.com
Sent: Tuesday, January 03, 2006 10:29 AM
Subject: Re: [sehat] [Tanya]mengenai ASI

Dear Pak Aan,

ASI bisa menjadi alat kontrasepsi dan menghambat proses pembuahan ?!
Hmm casenya iya jika memang syarat2 dibawah ini  terpenuhi semua tanpa kecuali

1. Bayi < 6 bl
2. Ibu BELUM mendapatkan menstruasinya sejak ia melahirkan bayinya
3. Bayi mendapatkan ASI secara eksklusif (atau hampir eksklusif)
4. Paling tidak interval menyusui terakhir tidak lebih dari 6 jam (? ==>
masih dalam penelitian)

KB dg cara ini disebut juga dg Lactational Amenorrhea Method (LAM).
Dan semua persyaratan tsb adalah WAJIB.
Artinay gak boleh hanya salah satu saja.
Jikapun semuanya terpenuhi, tetap efektivitas LAM sbg alat kontrasepsi
tidak setinggi jika dikombinasikan dg alat kontrasepsi lainnya.

Nah sekrg dari casenya bapak, anak bapak sudah berusia 14 bl kan (artinya ya gak asi eksklusif lagi toh...asi hanay sbg pelengkap aja) ?!
Dan pastinya ibu dah menstruasi dari lama kan pak ?!
krn begitu ibu sudah mendapatkan mens nya setelah melahirkan, maka artinya juga ibu siap utk dibuahi dan hamil.
Krn semua hormon dan organ reproduksinya sudah siap.
Maka jelas case bahwa ASI dapat menghambat proses pembuahan atau sbg alat KB jenis LAM jelas gak tepat pak.
Artinya juga...jangan khawatir dg ibu menyusui kemudian ibu tidak dapat hamil lagi.
Kalau bapak kurang yakin dsbnay, saran saya coba bapak konsultasi lebih lanjut dg dokter.
Jadi mitos itu gak bener ya pak.
Memang nih di dunia ASI & menyusui buanyaaaakkk sekali mitos.
Yg parahnya lagi mostly mitos2 itu membuat para ibu & ayah jadi binun.

Semoga membantu ya.

Luluk
===============
http://www.bflrc.com/newman/overheads/BF%20and%20contraception2.htm

Breastfeeding and Contraception

First Principles

Breastfeeding is as good as combined contraceptive pills (about 2% failure
rate) if all the following conditions apply (no exceptions):

1. the baby is younger than 6 months

2. the mother has not yet had a normal menstrual period

3. the baby is exclusively breastfeeding (or near exclusively)

4. there is no prolonged period (greater than 6 hours?) when the baby does
not nurse

For those of little faith, breastfeeding can be combined with other
contraceptive methods. However, the "other methods" do not have to be the
pill.  the pill is often used because it is easy for the physician and too
often the needs of the couple are not taken into account or even discussed
breastfeeding is hardly ever a consideration in the equation
contraception is an intimate issue, and has complex and multiple facets
including:
the question of when to return to sexual relations, and what that might
entail
religious
understanding, sacrifice, compromise
a father might not want to use a condom
a mother might not want to have an iud inserted, or have to take the pill
it takes longer for a man to become a father than for a woman to become a
mother

Options:  abstinence
sexual activity other than intercourse
natural planning methods
non artificial methods (coitus interruptus)
barrier methods
IUD
progestin only pills
medroxyprogesterone injections (DepoProvera)
combined pills

When to start contraception?  Conception before about 4 weeks postpartum
must be extremely uncommon
there is virtually no risk of ovulation in the fully breastfeeding woman
up to about 6 weeks

If there is no option to the pill:  wait at least 6 weeks postpartum
use progestin only pills, which have not been shown to decrease milk supply
combined pills should not be used until at least the baby is feeding
other foods (not usually earlier than 4 months of age) so that a decrease
in the milk supply can be compensated by an intake in food

CAVEAT!!  Babies respond to milk flow, not the "amount of milk in the
breast". Thus, they may not breastfeed well, even if the decrease in
supply is relatively minor

progestin only pills  a little harder to use, and may result in pregnancy
if not taken consistently
they may result in menstrual irregularities, not usually a problem in the
first few months as women are amenorrheic anyway

Medroxyprogesterone (DepoProvera)?  in theory should not cause problems
Hartmann has theorized that the sensitization of alveolar cells to the
stimulating effect of prolactin happens in response to a fall in
progesterone levels
this might have great significance in situations where the injection is
given on hospital discharge
there have been anecdotal reports of women's milk supply decreasing with
progesterone and/or medroxyprogesterone injections
the manufacturer recommends waiting six weeks postpartum before giving
the injection

Suggestion:

If the mother is to be given medroxyprogesterone injections:

1. do not give injection on discharge from hospital

2. start progestin only pill at 6 weeks  if there is no obvious decrease
in milk supply after first cycle, give medroxyprogesterone
if there is, stop progestin only pill immediately and do not give
medroxyprogesterone

References:

1. WHO task force on oral contraceptives. Effects of hormonal
contraceptives on breastmilk composition and infant growth. Studies in
Family Planning. 1988;19:361-9

2. Fraser IS. A review of the use of progesteron-only minipills for
contraception during lactation. Reprod Fertil Dev 1991;3;245-54

3. Visness CM, Rivera R. Progestin only pill use and pill switching during
breastfeeding. Contraception 1995;51:279-81

4. Labbok M, Cooney K, Coly S. Guidlines: Breastfeeding, Family Planning
and the Lactation Amenorrhea Method. Washington, DC: Institute for
Reproductive Health, 1994

===================
http://www.fhi.org/en/RH/Pubs/factsheets/breastfeeding.htm

Is Breastfeeding an Effective Contraceptive?

Research has shown that breastfeeding suppresses fertility. Yet many women
know someone who became pregnant when breastfeeding -- or became pregnant
themselves during breastfeeding. Service providers are sometimes reluctant
to allow women to rely on breastfeeding for pregnancy protection, and have
in certain settings discouraged breastfeeding in favor of initiating a
modern method of contraception.

In 1988, a group of scientists met in Bellagio, Italy to define a set of
guidelines that a woman could use to predict her return to fertility
during breastfeeding. The scientists reviewed data from studies regarding
return to fertility and determined that breastfeeding can provide up to
98% effective contraception if three criteria are met:
The mother has not experienced the return of her menstrual periods
(bleeding up to the 56th postpartum day is considered part of the
postpartum recovery process and is not counted as menstrual bleeding);
The mother is fully or nearly fully breastfeeding; and
The baby is less than six months old.
These guidelines later defined a new method of family planning called the
Lactational Amenorrhea Method or LAM. Clinical trials have shown that LAM
is at least as effective as the Bellagio scientists predicted it would be.
Fewer than 1% of LAM users in three clinical trials became pregnant when
all the three LAM criteria were met.

Efficacy of LAM Reported from Several Clinical Trials
Country Number of Women Studied Number of Pregnancies LAM Failure Rate
Chile 422 1 0.45%
Pakistan 391 1 0.58%
Philippines 485 2 0.96%

Of the three LAM criteria, the return of menses is the most important
indicator of fertility. The studies conducted by Family Health
International in Pakistan and the Philippines have shown that pregnancy is
rare even beyond six months and the end of full breastfeeding among women
who do not experience vaginal bleeding. Only 1.1% of the women in Pakistan
and 2.6% of the women in the Philippines conceived during 12 months of
lactational amenorrhea.

The pattern of breastfeeding exerts a strong effect on the resumption of
menstruation and fertility. However, defining what is meant by "full"
breastfeeding can be difficult. The following definitions are currently
being used by family planning counselors who are teaching LAM:
Full breastfeeding can be exclusive (no other liquid or solid is given to
the infant) or almost exclusive (vitamins, water, juice or ritualistic
feeds are given infrequently to the infant).
Nearly full breastfeeding means that the vast majority of feeds (at least
85%) are breastfeeds. There can be some supplementation with another
liquid or food, but supplementation never replaces or delays a breastfeed.
A mother can maximize the contraceptive effect she receives from
breastfeeding by following the guidelines for optimal breastfeeding
behaviors.

The Lactational Amenorrhea Method is, however, a temporary method of
family planning. To continue effective pregnancy protection, a woman who
uses LAM must be ready to switch to another family planning method when
any one of the LAM criteria changes. She should be made aware that:
Once her periods return, breastfeeding will no longer protect her from a
new pregnancy. She should consider any vaginal bleeding (after the 56th
postpartum day) to be a warning that her fertility is returning, even if
that bleeding does not resemble her regular menses.
If she starts to give the infant any food or drink on a regular basis or
experiences disruptions in her breastfeeding routine, such as returning to
work or ceasing to breastfeed at night, she is no longer protected from
pregnancy.
Once the infant is older than six months, the chance of becoming pregnant,
even before her periods return, is increased.
If any of these changes occur, a woman should choose another contraceptive
method if she wants to be protected from pregnancy. There is no need to
discontinue breastfeeding, however. Family planning methods that are
recommended for breastfeeding women include barrier methods, IUDs, male or
female sterilization, and hormonal methods that contain only progestin,
such as progestin-only pills ("minipills"), injectables and Norplant.
Contraceptive pills containing both estrogen and progestin (the most
common kind of birth control pill) have been associated with reduced
breastmilk production and should be considered a last-choice method.
Optimal Breastfeeding Behaviors for Child Health and Child Spacing
Begin breastfeeding as soon as possible after the child is born.
Breastfeed exclusively for the first six months.
After the first six months, when supplemental foods are introduced,
breastfeeding should precede supplemental feedings.
Breastfeed frequently, whenever the infant is hungry, day and night.
Continue breastfeeding even if the mother or the baby become ill.
Avoid using a bottle, pacifiers or other artificial nipples.
Continue to breastfeed up to two years and beyond.
Eat and drink sufficient quantities to satisfy the mother's hunger.
Conclusions
Breastfeeding is best for both mothers and babies and should be
encouraged. Breastfeeding can also provide natural, safe, effective
contraceptive protection, if certain conditions are met, for up to six
months postpartum. Women who are interested in using the natural
protection of breastfeeding should have access to information about LAM
and about other available family planning methods suitable for
breastfeeding women.

Source
Labbok M, Cooney K, Coly S. Guidelines: Breastfeeding, Family Planning and
the Lactational Amenorrhea Method-LAM. Washington, DC: Institute for
Reproductive Health. 1994.
return to index page

January 3, 2006 - Posted by | Q&A/ Sharing ASI

No comments yet.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

%d bloggers like this: