MANAGEMEN LAKTASI

Roesli Indonesian Breast feeding Center

. Utami

dr. Utami Roesli SpA IBCLC FABM

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Anatomy of the Lactating Breast

Sir Astley Cooper

Wax cast of the ductal network of a lactating breast (1840)

dr. Utami Roesli SpA IBCLC FABM

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New View: what has changed?
New Old
No branching of ducts until deep in the breast Branching of ducts close to the nipple

• Ducts branch closer to the nipple

dr. Utami Roesli SpA IBCLC FABM

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Utami Roeslilactiferous SpA IBCLC FABM sinuses do not exist 4 .New View: what has changed? Old Lactiferous Sinuses New No Lactiferous Sinuses • Conventionally described dr.

New View: what has changed? Old Even distribution of glandular tissue New 65% of glandular tissue within 30 mm of nipple • Glandular tissuedr. is found closer to the nipple Utami Roesli SpA IBCLC FABM 5 .

New View: what has changed? New Old Substantial subcutaneous fat near the nipple Minimal subcutaneous fat near the nipple Roesli SpA IBCLC FABM • Subcutaneous fat dr. isUtami minimal at the base of the nipple 6 .

but dr.New View: what has changed? Old Even ratio (1 : 1) of glandular to fatty tissue New Ratio of glandular to fatty tissue is 2:1 • The ratio of glandular to fatty tissue is not equal. Utami Roesli SpA IBCLC FABM rather 2 : 1 7 .

Utami Roesli SpA IBCLC FABM • The ductal network is not always radial or symmetrical 8 .New View: what has changed? Old Ductal network depicted as radial and symmetrical New Ductal network not always radial or symmetrical dr.

New View: what has changed? Old 15 – 20 ducts exiting at the nipple New 4 -18 ducts exiting the nipple (average of 9) • Fewer ducts exiting the nipple than previously thought dr. Utami Roesli SpA IBCLC FABM 9 .

Utami Roesli SpA IBCLC FABM 10 .Alveoli Berbentuk anggur Bila dirangsang Prolaktin Sel dinding Alveoli akan mebuat ASI Ductus Lactiferous Menyalurkan ASIke ujung puting Otot polos Myoepithel Otot mengelilingi Alveoli Bila dirangsang Hormon Oksitosin . otot akan mengkerut menyemprotkan ASI didalam alveoli kedalam Saluran Payudara keluar pada ujung putting dr.

Utami Roesli SpA IBCLC FABM 11 .STAGE OF LACTATION With the arrival of transitional milk dr.

Reflek PROLACTIN • Rangsangan putting saat menyusu menghambat Dopamine “ (Prolactin Inhibiting Factor ). Utami Roesli SpA IBCLC FABM • Prolaktine merangsang sel sel dinding alveoli untuk membuat ASI 12 . Hipophise Anterior mengeluarkan Prolaktin dr.

dr. Utami Roesli SpA IBCLC FABM PROLACTIN 13 .

merangsang Hyphopise Posterior mengeluarkan Hormon Oxytocin • Oksitosin merangsang myoepithelial cells yang mengeliling alveoli untuk dr. Utami Roesli SpA IBCLC FABM 14 berkontraksi mengalirkan ASI keluar alveoli ke ductus lactiferous ( let-down or .Reflek Oksitosin .Pengaliran ASI.Reflek Kasih Sayang Reflek “ Let Down” – Milk EjectionRefleks • Isapan bayi merangsang serabut syaraf menjalar melalui syaraf mammary afferent ke hyphothalamus.

Takut payudara berubah dan gemuk 2. Takut ASI tidak cukup 4. Malu menyusui 7. cemas. marah. Ibu bekerja 3. Ibu sedih.HAL YANG MENGURANGI OKSITOSIN 1. Utami Roesli SpA IBCLC FABM 15 . keluarga kurang mendukung dr. Suami. kesal. bingung 6. Ibu kesakitan 5.

Utami Roesli SpA IBCLC FABM 4 Sendawa 16 .Melihat. memikir Bayi HAL YANG MENINGKATKAN OKSITOSIN Ganti popok Pijat Bayi Memandikan Ibu Tenang Bergurau 2 Bermain dr.

Utami Roesli SpA IBCLC FABM 17 .REFLEXES IN NEWBORN dr.

POSISI MENYUSUI CROSS dr.CRADLE Utami Roesli SpA IBCLC FABM 18 .

•HOLD THE BABY BEHIND THE BACK AND SHOULDER NOT ONLY TKE HEAD •ALLOW BABY’S HEAD TO FALL BACK ONTO YOUR WRIST & FOREARM •SNUGGLE THE BABY FROM UNDERNEATH •TURN BABY’S BODY TO FACE YOU CHIN TO BREAST CHEST TO CHEST dr. Utami Roesli SpA IBCLC FABM 19 .

Utami Roesli SpA IBCLC FABM 20 . Bahu dan lengan ibu tidak tegang dan dalam posisi natural dr.POSISI MENYUSUI YANG BENAR : Kunci Keberhasilan Pelekatan 1. hidung menjauhi payudara 3. dagu bayi melekat pd payudara. Letakkan kepala bayi di pertengahan lengan bawah 2. Posisikan bayi dari bawah . Dada bayi melekat pada dasar payudara (dada) ibu 5. Seluruh badan bayi menghadap ibu 4.

Utami Roesli SpA IBCLC FABM 21 .Dagu Bayi Menempel ke Payudara ibu CHIN TO BREAST Perut/dada bayi menempel pasadadadan perut ibu CHEST TO CHEST SELURUH BADAN BAYI MENGHADAP KE BADAN IBU HINGGA TELINGA BAYI PADA GARIS LURUS DG LENGAN BAYI LEHER BAYI LURUS PEGANG BELAKANG BAHU JANGAN KEPALA BAYI POSISI MENYUSUI yang BENAR: Kunci Keberhasilan PELEKATAN dr.

Leher bayi terputar Badan ibu condong kedepan dr.POSISI MENYUSUI YANG KURANG TEPAT Kepala bayi terletak di siku hingga bayi menunduk Badan bayi tidak menghadap badan ibu. Hanya bahu yang ditompang oleh tangan ibu. Utami Roesli SpA IBCLC FABM 22 .

ATTACHMENT : The Key to successful Breastfeeding • • • • • Position baby so the nipple is above baby’s top lip & opposite baby’s nose Tease baby’s bottom lip & chin with the breast & areola WAIT for baby to respond with wide open mouth. Push behind baby’s chest & shoulder. Utami Roesli SpA IBCLC FABM 23 . never behind baby’s head dr. tongue down QUICKLY bring baby onto the Breast.

Utami Roesli SpA IBCLC FABM 24 .PELEKATAN : Kunci Keberhasilan Menyusui • • • • • • Bayi datang dari arah bawah Hidung bayi berhadapan dengan puting susu Dagu bayi merupakan bagian terdepan melekat pd payudara (contact point) Puting diarahkan ke atas ke langit-langit bayi Telusuri langit-langit bayi dg puting sampai ada diantara uvula dan pangkal lidah Puting susu hanya 1/3 atau ¼ dari bagian “dot” jaringan payudara yang terbentuk dr.

CARA BAYI MENGELUARKAN ASI dr. Utami Roesli SpA IBCLC FABM 25 .

or flattened against his mother’s breast • More areola above the baby’s mouth then below • Breast look round during feeding dr.ON Signs of Good Attachment : • Baby’s chin touching the breast • His mouth wide open • His lower lip turned outwards • His cheeks round. Utami Roesli SpA IBCLC FABM 26 .GOOD ATTACHMENT / CORRECT LACH .

Utami Roesli IBCLC FABM 27 • SpA Pipi menggelembung • .TANDA PELEKATAN BENAR Areola bagian atas terlihat lebih banyak dari bagian bawah • Bibir atas terputar keluar keatas dan bibir bawah terputar keluar kebawah • Mulut terbuka lebar • Dagu melekat ke payudara dr.

Utami Roesli SpA IBCLC FABM 28 .dr.

Signs of Attachment : • He has taken much of the areola and the underlying tissue into his mouth • The lactiferous ductus are included in these underlying tissue • He has streched the breast tissue out to form a long “teat” • The nipple forms only about 1/3 of the “teat” • The baby is suckling from the breast not from the nipple GOOD ATTACHMENT / CORRECT LACH .ON 29 dr. Utami Roesli SpA IBCLC FABM .

POOR ATTACHMENT / LACH . Utami Roesli SpA IBCLC FABM 30 .ON • More areola below baby’s mouth than above it or the same amount • His mouth not wide open • His lower lip is turn in • His lips is pointing forwards or his lower lip turned in • Baby’s chin not touching the breast dr.

Signs of Poor Attachment : • Only the nipple is in baby’s mouth. Utami Roesli SpA IBCLC FABM 31 . not the underlying breast tissue • The lactiferous ducts are outside the baby’s mouth. his tongue can not reach • The tongue is inside his mouth not pressing on the lactiferous sinuses dr.

Utami Roesli SpA IBCLC FABM 32 . because the action of mouth.1 NIPPLE CONFUSION Introducing artificial teats to a breastfed infant may begin a process of inadequate suckling at the breast . mandible different from breast to bottle It can lead to total refusal of the breast dr. tongue.

depan MAKANAN mereka di tangan kita EMAS ANAKHari DENGAN STANDAR IMD ASI Eksklusif 6bln MPASI makanan keluarga ASI sampai 2 tahun TERIMA KASIH LEBIH SEHAT Juga dari IQ LEBIH TINGGI EQ LEBIH BAIK SQ LEBIH BAIK SOLEH. Utami Roesli SpA IBCLC FABM 33 .SOLEHA anak-anak Mataram Lombaol dr.

Effect of Breastfeeding on Infant and child mortality due to Infectious diseases in less developed countries: a pooled analysis.Lactation Specialist Self. Breastfeeding and cognitive development.Module 3. Barros . Boston. 6. 83 : 56-58 Tobolic TJ: Father’s Day : Understanding and Supporting the Father in the Triad. 18. J Pediatr Ophthalmol. Agostoni C. 7.Study Series. 361 (9367):1418-23 Birch E el al.261-264 Mortensen EL et al. 5th ed. Lancet 1992 : 339 . Exclusive breastfeeding of healthy term infants for at least 6 weeks improves neurological condition J Nutr 2003. Pediatrics.Study Series. Toronto London 1998 Bouwstra H et al . A Guide for Medical Profession. Jones and Bartlett Pub. MBBS.Module 4.Lancet 2000: 355. 10 ( 2 ): 148-53 Honwood U. Trojan S. Morley R. 9. Lister G. Cole TJ. Effect of community-based promotion of exclusive Breastfeeding on diarrhoeal illness and growth: a cluster randomised controlled trial Lancet 2003: 26. American Journal of Health Promotion 1995. 8. 17. 360: 187-95 Victora CG. 15. 5. Giovannini M. Utami Roesli SpA IBCLC FABM 34 . The Association Between Duration of Breastfeeding and Adult Intelligence . 133 ( 12): 4243-3 Chantry CL : Colostrum :”Liquid Gold “ ABM News and Views 2002: vol 8. Gladen BC. Bhandari N et al. 14. Academic Breastfeeding Medicine News and Views 2003 vol 9 no 2 UNICEF Collaborative Group on Hormonal Factors in Breast Cancer : Breast Cancer and Breastfeeding : Collaborative Reanalysis of Individual Data from 47 Epidemiological Studies in 30 Countries . St. 451-55 dr. Strabismus1993. Breastfeeding protects againts illness and Infection in Infant and Children Breastfeeding Review 2001: 9(2):11-18 Rogan WJ.Louis. Jones and Bartlett Pub. 1998 Howie PW. Boston. 2. Toronto London 1998 Black R F et al : The Management of Breastfeeding. 19. 20.Module 1. 1990 . Toronto London 1998 Black R F et al : The Science of Breastfeeding . 1997: 100: 1035-1039. 11. 10. Early Breastfeeding is linked to higher IQ scores in dietary treated PKU children. BNJ. Leeson-Payne C.WHO Collaborative Study Team on the Role of Breastfeeding on the Prevention of Infant Mortality. American Academy of Pediatrics. MSc and Begum S.300: 11-16 Laurence R Breastfeeding. Fiori L. Breastfeeding and Optimal Visual Development.e9. Pediatrics : 101: p.DAFTAR PUSTAKA 1. Acta Paediatr1996.Lactation Specialist Self. Luoti D. MBBS. Fergusson DM. Early Human Development 1993: 31: 181-193 Riva E. 16. 13.Lactation Specialist Self. 287 (18): 23652371 Oddy WH . JAMA.MSc Protective effect of Breastfeeding against infection. 4..Study Series. Breastfeeding and later cognitive and academic outcomes. MO: CV Mosby: 1999 Lucas A. Jones and Bartlett Pub. 12. 30 : 33-38 Black R F et al : The Support of Breastfeeding. Breast milk and subsequent intelligence quotient in children born preterm. Boston. no 4 Cohen R Comperation of Maternal Absenteeist and Infant Ilness Rates among Breastfeeding and Formula Feed Women in two Corporations. 3. including 50 302 Women with Breast Cancer and 96 973 Women without the Disease. Lancet 2002 . Breastfeeding and the Use of Human Milk. 2002.

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