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INISIASI MENYUSU DINI

Diah Rumekti Hadiati


MFM Division
OBGYN Department
Sardjito Hospital, Yogyakarta

LATAR BELAKANG

Persentase IMD di Indonesia rendah (38%)


(BPS et al., 2003).

Jauh tertinggal dibandingkan negara-negara


berkembang lainnya: Oman (85%), Srilangka
(75%), Filipina (54%) dan Turki (54%)
(IBFAN Asia, 2007).

Statistics on Breastfeeding
Around the World
Region

Infants (< 6 months)


exclusively breastfed (2006)

Sub-Saharan Africa

30%

Middle East/North Africa

26%

South Asia

45%

East Asia/Pacific

32%

Latin America/Caribbean

Central Europe/Russian Republics,


and Baltic States
Industrialized Countries

Developing World

19%
*

37%

IMD berperan dalam menurunkan angka kematian


bayi sebesar 22% (Edmond et al.,2006).
IMD berhubungan erat dengan kesuksesan
pemberian ASI eksklusif (Chien et al., 2007)
IMD membuat ikatan kasih sayang (bonding) antara
ibu dan bayi menjadi lebih baik (Klaus,1998)

IMD meningkatkan kontraksi uterus sehingga


membantu mengurangi perdarahan pasca melahirkan
(Matthiesen et al, 2001)

Murray & Fisher (2002) dan Escamilla et al. (1996):


metode persalinan seksio sesarea merupakan
hambatan untuk IMD.
Chien et al. (2007) dan Victora et al. (1990): proporsi
IMD antara bayi yang lahir dengan metode
persalinan spontan vaginal dengan bayi yang lahir
dengan seksio sesarea adalah sama.

Angka tetap menyusui setelah 4


bulan

Opportunities to
Promote Breastfeeding

Preconception
Education in school systems
Pediatric and adolescent visits
Gynecologic visits
Breast examinations

Opportunities to
Promote Breastfeeding

Early pregnancy

Perform breast
examination.
Discuss normal
anatomy and
physiology.
Assess previous
surgeries, scars, biopsies.
Talk about previous breastfeeding
experiences.
Provide positive support for benefits
of breastfeeding.

Early Initiation of
Breastfeeding

Reduces infant deaths worldwide


Protects infants from early exposure
to bacteria and viruses
Increases maternal oxytocin important for
milk production and attachment
Helps prevent maternal blood loss

Protect the environment (keeping mother


and baby together), and the behavior
(breastfeeding) will follow.
Nils Bergman, MD

Protecting the Environment:


Appealing to Babys
Five Senses

Sight

Newborns are drawn to the face of


their mothers (Chilton 2003)
Newborns vision is most accurate
8-12 inches from mothers face (Meltzoff 1977)
Mutual gaze is the first communication
between mother and baby (Klaus 1998)

Protecting the Environment:


Appealing to Babys
Five Senses

Hearing

Baby begins hearing sounds at 25 weeks


gestation
Babies prefer high-pitched female voices,
and recognize the voices of their parents

(Klaus 1998)

Protecting the Environment:


Appealing to Babys
Five Senses

Smell

Infants are attracted to the smell of


amniotic fluid and prefer the scent
of their mothers breast
Infants find their mothers breast through
her breast scents

(Varendi 1997)

Protecting the Environment:


Appealing to Babys
Five Senses

Taste

Newborns prefer the


taste of amniotic
fluid and the flavor
of colostrum

(Matthiesen 2001)

Protecting the Environment:


Appealing to Babys
Five Senses

Touch

Babies are eagerly drawn to skin contact


with the mothers body
Touch increases production of growth
hormones and enhances the immune system

(Klaus 1998)

Skin-to-Skin Contact

Thoroughly dry
infant to prevent
temperature loss
Place infant prone
against mothers bare
chest
Place a blanket across
babys back and pull bed
covers over both mother
and baby

Value of Skin-to-Skin
Contact

Maintains body warmth (Gardner 1979)


Serves as a pain analgesic (Ludington-Hoe 2000)
Reduces infant crying (Christianssen 1995)
Improves maternal attachment (Feldman 2006)
Improves breastfeeding (Anderson 2003)
Lowers stress levels in mothers (Feldman 2006)

Skin-to-Skin Contact
Helps Babies Breastfeed
Placing babies back in their
natural habitat skin-to-skin
with mother allows babies
to use their energy reserves
to learn how to breastfeed.

Mothers dont breastfeed.


Babies breastfeed. The mothers
body is simply the habitat where
the baby feeds.
Nils Berman, MD

How Babies Move to the Breast


During the 1st Hour or Two

First 30 minutesbaby rests and gazes


at mother.
Baby begins smacking his lips and mouthing
his fingers.
Baby inches forward with his legs.
When he reaches the mothers breast bone,
he bounces his head into her chest.
After several attempts, baby latches at
the breast.

(Klaus 1998)

Ways to Welcome Baby


Softly

Provide an environment where mothers and


babies are together skin-to-skin immediately
after birth
Assess the newborn and provide medical care
while mother and baby are held skin-to-skin,
if possible
Delay infant bathing and other routine
procedures that can safely wait until after the
first breastfeed
Allow babies to self-attach
Give mothers lots of affirmation and praise

Opportunities to
Promote Breastfeeding

Prenatal visits
Provide appropriate literature,
resources.
Refer for prenatal and
breastfeeding classes.
Refer to pediatrician for
prenatal visit.
Avoid formula coupons or
products.

Opportunities to
Promote Breastfeeding

Peripartum/postpartum

Provide supportive
delivery environment.
Facilitate early
skin-to-skin contact.
Dry, warm, and place
on mothers abdomen.
Have trained professionals
to assist mother if needed.
Initiate breastfeeding within the
first hour after delivery.

Baby Friendly Hospital


Initiative 10 Steps
Hospital Policies to
Support Breastfeeding
1. Have a written breastfeeding policy that is
routinely communicated to all health care staff.
2. Train all health care staff in skills necessary to
implement this policy.
3. Inform all pregnant women about the benefits
and management of breastfeeding.
4. Help mothers initiate breastfeeding within
1 hour of birth.
5. Show mothers how to breastfeed and maintain
lactation, even if separated from infants.

Baby Friendly Hospital


Initiative 10 Steps
Hospital Policies to
Support Breastfeeding
6. Give newborn infants nothing other than
breastmilk, unless medically indicated.
7. Practice rooming-in 24 hours a day.
8. Encourage breastfeeding on demand.
9. Give no artificial nipples or pacifiers.
10. Foster the establishment of breastfeeding
support groups.

Community Support

Knowledgeable
physicians
Lactation
specialists
Hospital support
groups

The Breastfeeding
Friendly Doctors Office

Encourage women/staff to
breastfeed in the office.
Display pictures of breastfeeding
infants.
Avoid distributing infant formula
or coupons.

How Long to
Breastfeed?

Exclusively for
about the first
6 months of life
Continuing for
at least the first
year of life, with
addition of solids
Thereafter, for as
long as mutually
desired by mother and child

Photo Mary Boyd, MD, FAAP

Summary

Breastfeeding is preferred feeding


for almost all infants.
Mothers should be informed of the
benefits of breastfeeding.
Supplementation is rarely indicated
and interferes with successful lactation.
Breastfeeding should be actively
supported and promoted in the
medical community and society.
Women should feel comfortable
continuing to breastfeed for as
long as desired.

Breast Crawl WHO

World Breastfeeding
week

http://www.worldbreastfeedingweek.org

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