Tema: Dojenje beba sa Down sindromom

[sumonja]

Nazalost tekst je na engleskom...

Istrajte u dojenju i pored svih "tehnickih" problema!

Ukoliko Vam bude lakse lezite sa bebom ali nju postavite na blago kosu ravan kako bi lako gutala.
Ukoliko je potrebno pomozite se vestackom "sikom" od silikona. Mozda Vam nece poci od ruke da je naucite brzo da sisa, ako nema razvijen instikt sisanja i gutanja. Odrzavajte mlako sto je duze moguce i uvek joj prvo ponudite prirodno mleko u neogranicenoj kolicini i sto cesce kako bi ojacala muskulaturu na licu . To ce joj osim za sisanje pomoci i kasnije kao vezba za govor.
Drzite se uvek istog tajminga kako bi od prvog dana stekla naviku i ritam dana.

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About one baby in every 850 is born with Down Syndrome. These babies have 47 chromosomes in each body cell, instead of the usual 46, but the exact reason why this occurs is not yet known. Fortunately, much progress has been made in recent years and continues to be made in the care and education of children with Down Syndrome. Breastfeeding can be an important step in the early care of these babies.
 
"Breastfeeding helped with my bonding to James initially when my world was turned upside down by his arrival."
 
The extent to which children are affected by Down Syndrome varies widely. These children achieve the milestones of child development, but more slowly than the average.
 
You may be experiencing mixed emotions - this is very natural as you wonder what lies ahead for you and your baby. A branch of the Down Syndrome Association or your doctor will be able to provide you with information on access to Early Intervention Programmes in your state and will be able to put you in touch with other parents of children with Down Syndrome. Many people find this contact very supportive.
 
"The best solution is to talk to other mums who have actually experienced your situation."
 
 
BENEFITS OF BREASTFEEDING
Breastmilk provides the best possible nutrition for all babies and encourages a close bond between mother and baby. Babies with Down Syndrome generally have poor muscle tone and are prone to respiratory infections. This means that there are added benefits in breastfeeding these babies. The actions involved in breastfeeding will help improve muscle tone in the lips, mouth and tongue, which are involved in speech development. The protection provided by the antibodies in breastmilk will help lessen the incidence of respiratory infections which occur because of very narrow nasal passages and more respiratory secretions than usual. Alternating sides in breastfeeding ensures equal left/right visual stimulation. While it may take some time and patience to establish breastfeeding, the efforts required are worthwhile and rewarding.
 
"I was encouraged by the Early Intervention Centre to breastfeed because it helps with lip closure and can discourage tongue thrusting as the child gets older."
 
 
BREASTFEEDING INFORMATION
A good knowledge of how breastfeeding works will help you establish breastfeeding more easily. ABA has recently published a full length booklet entitled Breastfeeding Your Baby with Down Syndrome. It contains lots of new material, plus mothers' anecdotes, photos and suggestions. Headings include: attachment, use of lactations aids, sleepiness, slow weight gain, hospitalisation, twins, adjusting to the diagnosis and introducing other foods. There is also a section of messages from other parents. It is also suggested that you read ABA's basic breastfeeding booklet - An Introduction to Breastfeeding, or the book Breastfeeding...naturally. These booklets and book can be purchased online from the Mothers Direct web site. See also the further reading suggestions at the end of this page.
 
You may like to contact your local ABA breastfeeding counsellor, a lactation consultant or your early childhood nurse (Maternal & Child Health Nurse). Many maternity units in large hospitals employ lactation consultants, while others work in private practice. As well as supporting you with breastfeeding, they may be able to put you in contact with another mother who has breastfed a baby like yours. For details on how to contact ABA please see the contact section of this web site or check your local telephone directory.
 
The following is additional to the basic breastfeeding information available in An Introduction to Breastfeeding and aims to help particularly with your special baby.
 
BREASTFEEDING HINTS
Babies with Down Syndrome tend to have poor muscle tone and so may have trouble grasping the nipple and attaching themselves correctly to the breast. Some may have trouble coordinating sucking, swallowing and breathing and may gulp and choke as they feed. They may get less milk for their efforts and tire quickly. This can and will improve with time and patience ... the exercise of breastfeeding itself will improve muscle tone.
 
ENCOURAGING YOUR BABY TO SUCK
To encourage sucking, it is suggested you try the following simple exercises several times a day, particularly before feeds:
    stroke gently around your baby's mouth and cheek,
    circle the lips with your clean finger, popping it in and out of the mouth and gently stroking the tongue so that your baby begins to suck on your finger,
    put your clean finger in your baby's mouth and rub the gums (upper and lower and on both sides) gently from the front to the back of the mouth and the roof of his mouth from front to back,
    gently stroke in a downward motion on the outside of the throat to encourage the swallowing reflex,
    if sucking problems persist, you may find it helpful to consult a lactation consultant, a physiotherapist, a speech pathologist or your medical adviser.
 
WHEN TO FEED YOUR BABY
Learn to recognise the signs that your baby is starting to wake (eye movements behind the lids, mouth and body movements). Your baby may be very sleepy; he may need to be woken for feeds and stimulated to keep him awake while he feeds. Babies will feed better if they are awake and hungry and not crying. Crying is a late sign of hunger and if your baby is distressed, it may be difficult for him to attach properly to the breast. He may tire quickly, so will need to feed when he has the energy to do so.
 
You can wake your baby by:
    unwrapping him, talking to him and moving him around,
    changing his nappy, rubbing the soles of his feet vigorously, patting his legs with a cool cloth (however in cold climates this may not be practical and you may find other methods more suitable),
    by using a method known as the Doll's Eye Technique. This involves laying your baby on your lap with his legs towards your stomach. Support his head and body on your hands and arms, then sit him up by bending him at the waist. Lay him down again while talking to him. Lift him again and repeat this until he opens his eyes and keeps them open. Then put him to your breast,
    you may need to burp your baby and swap him to the other breast several times during a feed to keep him roused.
"The most successful way to wake him was to give him a shower. He enjoyed the showers and would always feed well afterwards."
 
However, some babies do not feed well if woken. If you find this is a problem with your baby, it may be better to wait until he wakes of his own accord and try to ensure that he has a substantial feed then.
 
"I truly found it impossible to wake him, or keep him awake, when he didn't want to be."
 
MILK SUPPLY
Breastfeeding depends on the principle of supply and demand, so frequent feeds will help you establish and maintain a good supply, and will help your baby get sufficient milk. Whenever practical, let your baby feed for as long as he wants. This will ensure he receives plenty of milk and also stimulate your milk supply.
 
If your baby is not feeding well, you will need to express to help build up and maintain your milk supply until your baby feeds strongly enough to achieve that himself. The milk you express can be offered to him in a cup or spoon. (It is best not to introduce a bottle at first if you can avoid it, so that your baby is not confused by the two different sucking techniques.) The milk which is available at the end of a feed, is especially rich in kilojoules, so if your baby's weight gain is of concern, you may like to express this milk and offer it to him, as well as his feeds at the breast.
 
ATTACHING YOUR BABY TO YOUR BREAST
Start your milk flowing before you put your baby to the breast, so that he will not have to spend energy sucking with little result. Gentle hand expression, rolling your nipple between your thumb and forefinger, gentle massage and perhaps a warm face washer on the breast will encourage your milk to let down and also soften the areola to make it easier for him to attach.
 
It is important that your baby is well positioned at your breast and that his body is well supported. If he uses as little energy as possible to hold his head and neck up, this will allow him to use his energy for feeding. You can use pillows to hold him up high enough so that his head is level with or slightly above your nipple. Using an extra pillow to raise his buttocks to near the level of his head, may help if low muscle tone is causing sucking problems. Having his throat and the back of his neck higher than your nipple, will help avoid gulping and choking, a problem for some babies with Down Syndrome.
 
"In the early weeks Rebeka would make gaspy, choky noises during feeds. After some trial and error, a more upright feeding position seemed to minimize this."
 
You can hold your baby lying on his side across your lap, his chest facing yours, his lower arm around your waist, so that he does not have to turn his head to grasp the nipple. Some mothers use a Meh Tai sling to hold their baby's body in a "C" shape keeping his head and bottom tucked in.
 
Alternatively, you may like to use the "football hold": put a pillow at your side and another pillow across it and your lap. Rest your baby's bottom on the first pillow and support his back on your forearm while you cradle his head in your hand. You can try different feeding positions, till you find one that suits your baby.
 
Your baby may also be helped if you support your breast and his head while he feeds. Cup your hand under your breast, then slide it forward so that three fingers support your breast. Make a U shape with your thumb and first finger and support your baby's jaw in that U. This is called the Dancer Hand position.
 
To effectively breastfeed, your baby needs to take your nipple and as much as possible of your areola (the dark area around your nipple) into his mouth. You may find it helpful to gently press his chin down or to tickle his lower lip with your nipple or your finger as he latches on, so that he is encouraged to open his mouth widely enough. When your baby is properly attached and feeding from your breast, his lips will be turned out; not tucked in. His tongue will be over his lower gum and between his lip and your breast and will not hurt your nipple. If it does hurt, gently break the suction by putting your finger into the corner of his mouth, and try again.
 
Be sure your nipple is centred in your baby's mouth. His mouth needs to be directly opposite your nipple as he attaches, not above or below.
 
If your baby is having trouble sucking correctly, contact a lactation consultant, early childhood nurse (Maternal & Child Health Nurse), ABA breastfeeding counsellor or your medical adviser.
 
LOOKING AFTER YOURSELF
Feeding your baby will take a lot of time no matter which method you choose, so it is very important to take care of yourself. When you are at home with your baby, make sure that you have a comfortable place to sit so that you can relax while feeding. Move the phone close to you or ignore it so that you are not disturbed by calls.
 
Accept any offers of help with meals or housework. This is not always easy, but those who offer are genuinely wanting to help. This will free your time for caring for your baby.
 
"My son receives a disability allowance, so with this we have someone come to clean and iron once a week."
 
"The support of my mother in those early months was invaluable, because of the time needed for feeding and doing exercises, so that he would hold up his head, roll over, do all the other things you take for granted."
 
 
Nastavak sledi...

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IF YOUR BABY IS HOSPITALISED
Some babies with Down Syndrome need special care in hospital from birth. For some, this is because they are born prematurely, while for others it is because they have a specific medical problem. Your baby's doctor will tell you if this is needed and you should feel able to ask hospital staff any questions you may have and to discuss your baby's progress with them.
 
Some babies with Down Syndrome suffer from complications which require surgery later, when they are several months old. These babies usually go home with their mothers after birth, and then are re-admitted to hospital when necessary.
 
In either case it is usually possible to continue to breastfeed your baby.
 
If your baby is in a special care nursery, and not able to feed at the breast, you can still provide nourishment for him by expressing your milk. This will probably be fed to your baby via a tube into his stomach.
 
Expressing your milk for tube feeds will help to establish and maintain your milk supply. As his strength and health improves, you will be able to try some breastfeeds; slowly at first, then gradually building up to full feeds. ABA booklets - Expressing & Storing Breastmilk and Breastfeeding your Premature Baby contain suggestions that you may find helpful.
 
If your baby has to return to hospital for surgery, it is important to plan ahead if you intend to continue to breastfeed. Talk to hospital staff and your child's doctor, explaining that you are breastfeeding and see if you can be accommodated along with your baby.
 
Discuss with your baby's surgeon and anaesthetist, how long your baby will have to fast before surgery, and how soon afterwards he will be able to resume breastfeeds. Some mothers find they need to express their milk for a few days until their baby is well enough to feed at the breast again.
 
Expressing in this situation relieves the discomfort of overfull breasts and helps to maintain your milk supply.
 
If your baby has a heart condition requiring surgery, you will probably find that after surgery he is much stronger, and more able to stay awake for feeds.
 
ABA's booklet Breastfeeding & Hospitalisation may be helpful.
 
Your local ABA group will have information for you about hiring electric breast pumps. Many mothers find electric pumps very helpful if they are expressing over a long period of time.
 

IN CONCLUSION:
When these suggestions are listed like this, they may seem rather daunting and you might feel that you face an impossibly difficult task in attempting to breastfeed your baby. Remember that it is unlikely that all situations here will apply to your baby. Try the suggestions that seem to suit your baby's needs, and use those that help. You will probably find your own ways of overcoming difficulties as you get to know your baby. Also remember that most difficulties will resolve as your baby learns to breastfeed. It is in the early days of establishing breastfeeding that your baby is most likely to need extra help. Breastfeeding your baby may not be easy at first, but as he grows he will become stronger and more able to feed effectively.
 
"I fed him for about 2 years. He weaned himself with a little encouragement from me, but it was a tranquil weaning and I remember well the last feed. I cried because, as I looked down at his little face, I knew I would never breastfeed another baby. I never felt any rejection for him and love him as much as my normal children. Whether this is because of the bonding breastfeeding is responsible for, I don't know, but I am willing to believe it could be so."
 
"The fact that I was able to breastfeed my exceptional baby in many ways helped me to come to terms with the whole situation to a certain degree, it helped bring everything back into equilibrium again."
 
"I would like to say that, in a mother's eyes, the imperfection fades and the child shines through and you see that, after all, he is a real little human being. Malcolm is loved by all the family."
 
(We refer to the baby as "he" to avoid confusion when referring to the mother as "she".)
 
The Australian Breastfeeding Association has produced this information page with assistance from the Down Syndrome Associations of Queensland, South Australia and Victoria.
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Babies born with Down Syndrome or other physical and mental challenges need the benefits of breast milk as much as, and maybe even more than, other babies. Building a healthy nursing relationship with a special-needs child may be difficult, but is beneficial to both the child and the mother.
 
      Steps:
1.     Try to nurse soon after your baby is born. You will face a lot of stress and conflicting emotions whether or not you were expecting a special-needs child. Focus, as early as possible and as best you can, on your baby's health and comfort.
 
2.     Provide as much colostrum and breast milk as possible for your baby. Babies with Down Syndrome are susceptible to infections, and your milk will help to boost your baby's immune system.
 
3.     Obtain a pump if your baby is reluctant to nurse or has low muscle tone and poor sucking ability. Build and maintain your milk supply by using the pump as often as necessary.
 
4.     Be patient: it may take a few weeks for your baby to learn to nurse. In the meantime, pump your milk for your baby and feed him through a supplemental nursing system (SNS), bottle, syringe, or other feeding system.
 
5.     Spend time with your baby skin-to-skin when you nurse him. This extra contact gives your baby the extra stimulation he needs to develop as fully as possible.
 
6.     Stimulate your baby to nurse even if he is sleepy or sluggish; this will help him gain weight.
 
7.     Carry your baby in a front carrier or sling to provide extra stimulation and easy nursing access.
 
8.     Get support. Your local La Leche League or other breastfeeding support group can help you and can recommend other groups that are specifically tailored to the needs of your child.
 
 
Tips:
 
Don't give up. Breastfeeding may not come easily to your baby, but it will help you to form a strong bond with each other and will give him extra protection from many of the challenges he may face.
    
 
If your baby needs extra support while nursing get a firm nursing pillow or some cushions to help you position him correctly and comfortably.
    
    
 
Warnings:   
 
If your baby has a large tongue he may have trouble latching on properly. Make sure his mouth opens wide to nurse; you may have to pull his chin down gently.   
    
 
Your baby may swallow more air than usual during feedings; burp him thoroughly and often, both during and after nursing sessions.   
    
 
Look after yourself. You will be under a lot of stress, and your baby and the rest of your family need you to stay healthy.   
 
Literatura:
http://www.breastfeeding.asn.au/bfinfo/down.html
http://www.ehow.com/how_5317_breast-feed-baby.html