ASI ( Air Susu Ibu )

– more fresh… HEALTHIER and free –

Binggung Puting

From: Luluk Lely Soraya I
Sent: Monday, April 03, 2006 1:47 PM
Subject: Re: [sehat] Re: menyendoki ASI

Dear Mbak Galuh,

Memang betul bahwa gak semua bayi yg diberikan dot akan jadi bingung puting.
Tapi sekali lagi tidak semau bayi dpat spt itu.
Jika masalah bingung puting tidak menjadi problema dalam menyusui, maka saya
yakin mbak juga pasti setuju bahwa
para ahli laktasi gak akan repot dan pusing mikirin gimana cara mencegah
anak terkena bingung puting.

Jadi the last decision will be yours.
Dan memang baisanya begitu anak masuk usia > 3 bl ia relatif dapat memilih
apakah ia mau dg dot atau gak.
Juga termasuk relatif makin minim resiko bingung puting nya di usia tsb.

Ok saya repost ya artikel ttg nipple confusion utk jadi bahan pembelajaran
kita bersama.



There are some basic mechanical differences between how a baby gets milk
from a bottle and how a baby gets milk out of the breast. Giving bottles or
pacifiers to young, breastfeeding babies often leads to nipple confusion.
Baby tries to use the bottle-feeding technique on the breast and has
difficulty latching-on and sucking. Baby gets very frustrated, and so does
mother. Nipple confusion can even lead to baby refusing the breast. Here's
an explanation.

To get milk from the breast, baby must coordinate tongue and jaw movements
in a sucking motion that's unique to breastfeeding.

a.. When baby latches onto the breast, he opens his mouth wide and draws
the very stretchable nipple and areolar tissue far back into his mouth.
b.. The tongue holds the breast tissue against the roof of baby's mouth
while forming a trough beneath the nipple and areola.
c.. The gums compress the milk sinuses underneath the areola (the
pigmented area around the nipple) while the tongue rhythmically "milks" the
breast with a wave-like motion from front to back, drawing the milk from the
areola and the nipple.
d.. Since the nipple is far back in baby's mouth, it's not compressed by
the gums, so it's less likely to get sore.
Babies suck from a bottle entirely differently. Thanks to gravity, milk
flows from a bottle so easily that baby does not have to suck "correctly" to
get milk.

a.. He doesn't have to open his mouth as wide or correctly turn out the
lips to form a tight seal.
b.. The bottle nipple does not need to be far back into the mouth, nor is
the milking action of the tongue necessary.
c.. Baby can lazily gum the nubbin of the rubber and suck with only his
d.. When the milk comes out too fast, baby may thrust his tongue forward
and upward, to stop the flow from the nipple.
e.. Milk keeps on coming during feedings from bottles--whether or not baby
sucks--so there are no pauses to rest during bottle-feedings.
Problems occur when babies apply the lessons learned from bottle-feeding to
nursing at the breast. When you compare the illustration of sucking at an
artificial nipple with the illustration of sucking at the breast, you will
see that if baby sucks from the breast the same way he does the bottle, the
tongue and the gums will traumatize mother's nipple.

a.. Babies who get bottles soon after birth may thrust their tongue upward
during sucking and push the breast nipple out of their mouth.
b.. They don't open their mouths wide enough when latching-on, so they
suck only the tip of the nipple. They don't get enough milk, and mother's
nipples get sore.
c.. Baby becomes accustomed to the immediate flow of milk that comes from
the bottle; at the breast, babies have to suck for a minute or two to
stimulate mother's milk ejection reflex and get the milk flowing.
Does this mean that bottle-feeding is easier than breastfeeding? Yes, and
no. Bottles require less sucking finesse and less effort. However, studies
comparing premature infants during bottle-feedings and during breastfeedings
have shown that breastfeeding is actually less stressful.

a.. Babies' breathing and heart rate are more stable during feedings at
the breast.
b.. Babies have more control over the milk flow and can establish a more
regular rhythm of sucking, swallowing, and pausing.
c.. Feeding at the breast also requires less energy.

It is easier to prevent nipple confusion than to fix it--though it is a
problem that can be solved, should it occur (see below). Breastfed babies
should not be given artificial nipples during the first three to four weeks
when they are learning and perfecting their breastfeeding skills. Avoiding
artificial nipples means avoiding pacifiers as well as bottles. Supplements,
if medically necessary, can be given in ways that don't involve artificial
nipples. (See Alternatives to Bottles.)

Will it be more difficult to introduce the bottle later? Many mothers,
because they are going back to work or because they eventually plan to get
out for a few hours by themselves, want their breastfed babies to accept
feedings from bottles. They have heard stories of babies who adamantly
refused anything but the breast. Getting baby to accept a bottle at age two
or three months may take some patience, but most babies will catch on after
a few tries. (Babies can also be fed with alternatives to bottles when
mother is gone.) While introducing the bottle at one or two weeks of age may
insure that baby accepts the bottle later, you're taking a risk. Some babies
easily go back and forth between breast and bottle, but many others do not.
Don't jeopardize your breastfeeding relationship when it has barely begun.


When a baby who is getting bottles begins to balk at taking the breast,
nipple confusion is probably at the heart of the problem. Here's how to
re-teach a baby what to do at the breast:

a.. Banish bottles and pacifiers. Even if your baby will eventually have
to learn to use the bottle because you are returning to work, don't ask him
to learn both skills at the same time.
b.. If supplements are needed, they can be given in ways that don't use
artificial nipples. (See Alternatives to bottles.)
c.. Reacquaint baby with the pleasures of breastfeeding. Give her lots of
skin-to-skin contact. Carry her in a sling near the breast between feedings.
d.. Breastfeed when baby is calm, usually in the morning or upon awakening
from a nap. Don't wait until baby is ravenously hungry--she'll be in no mood
to try something new.
e.. Review the latch-on basics. Be sure that baby is positioned properly
in your arms. Wait until her mouth is wide open and her tongue is down
before latching her on to the breast.
f.. Show and tell. Open your mouth as you say "open" to baby during
latch-on. Even newborns can imitate adult facial expressions.
g.. Provide baby with instant gratification at the breast. Use a breast
pump or manual expression to stimulate your milk ejection reflex and get the
milk flowing before latching baby on. She'll be rewarded with a hearty flow
of milk after the first few sucks.
h.. Use an eyedropper or feeding syringe to drip milk into baby's mouth as
she latches on to the breast. (Get some help with this one.) This may
encourage baby to stay latched-on and to continue sucking.
i.. For more suggestions and support, get help from a La Leche League
Leader or a lactation consultant.
Babies often act puzzled or uncertain when they are re-introduced to the
breast. Be patient. Praise your baby for every tiny step she takes back to
breastfeeding. It may take a few days to woo baby back to the breast, but
you can do it.


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

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