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. Utami
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No Lactiferous Sinuses
Conventionally described dr. Utami Roeslilactiferous SpA IBCLC FABM sinuses do not exist 4
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65% of glandular tissue within 30 mm of nipple
Glandular tissuedr. is found closer to the nipple Utami Roesli SpA IBCLC FABM
Roesli SpA IBCLC FABM Subcutaneous fat dr. isUtami minimal at the base of the nipple
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Ratio of glandular to fatty tissue is 2:1
The ratio of glandular to fatty tissue is not equal, but dr. Utami Roesli SpA IBCLC FABM rather 2 : 1
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Ductal network not always radial or symmetrical
dr. Utami Roesli SpA IBCLC FABM The ductal network is not always radial or symmetrical
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4 -18 ducts exiting the nipple (average of 9)
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 10
STAGE OF LACTATION
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Reflek PROLACTIN
Rangsangan putting saat menyusu menghambat Dopamine (Prolactin Inhibiting Factor ); Hipophise Anterior mengeluarkan Prolaktin dr. Utami Roesli SpA IBCLC FABM Prolaktine merangsang sel sel dinding alveoli untuk membuat ASI
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PROLACTIN 13
Reflek Oksitosin - Pengaliran ASI- Reflek Kasih Sayang Reflek Let Down Milk EjectionRefleks
Isapan bayi merangsang serabut syaraf menjalar melalui syaraf mammary afferent ke hyphothalamus; 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
Memandikan
Bermain
Sendawa
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REFLEXES IN NEWBORN
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POSISI MENYUSUI
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HOLD THE BABY BEHIND THE BACK AND SHOULDER NOT ONLY TKE HEAD ALLOW BABYS HEAD TO FALL BACK ONTO YOUR WRIST & FOREARM SNUGGLE THE BABY FROM UNDERNEATH TURN BABYS BODY TO FACE YOU
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Badan bayi tidak menghadap badan ibu. Hanya bahu yang ditompang oleh tangan ibu. Leher bayi terputar Badan ibu condong kedepan
dr. Utami Roesli SpA IBCLC FABM 22
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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 IBCLC FABM 27 SpA Pipi menggelembung
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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
Signs of Poor Attachment : Only the nipple is in babys mouth, not the underlying breast tissue The lactiferous ducts are outside the babys mouth, his tongue can not reach The tongue is inside his mouth not pressing on the lactiferous sinuses
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NIPPLE CONFUSION Introducing artificial teats to a breastfed infant may begin a process of inadequate suckling at the breast , because the action of mouth, tongue, mandible different from breast to bottle It can lead to total refusal of the breast
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DAFTAR PUSTAKA 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. American Academy of Pediatrics. Breastfeeding and the Use of Human Milk. Pediatrics.; 1997: 100: 1035-1039. Bhandari N et al. Effect of community-based promotion of exclusive Breastfeeding on diarrhoeal illness and growth: a cluster randomised controlled trial Lancet 2003: 26; 361 (9367):1418-23 Birch E el al. Breastfeeding and Optimal Visual Development. J Pediatr Ophthalmol. Strabismus1993; 30 : 33-38 Black R F et al : The Support of Breastfeeding.Lactation Specialist Self- Study Series.Module 1. Jones and Bartlett Pub. Boston. Toronto London 1998 Black R F et al : The Science of Breastfeeding .Lactation Specialist Self- Study Series.Module 3. Jones and Bartlett Pub. Boston. Toronto London 1998 Black R F et al : The Management of Breastfeeding.Lactation Specialist Self- Study Series.Module 4. Jones and Bartlett Pub. Boston. Toronto London 1998 Bouwstra H et al . Exclusive breastfeeding of healthy term infants for at least 6 weeks improves neurological condition J Nutr 2003; 133 ( 12): 4243-3 Chantry CL : Colostrum :Liquid Gold ABM News and Views 2002: vol 8, no 4 Cohen R Comperation of Maternal Absenteeist and Infant Ilness Rates among Breastfeeding and Formula Feed Women in two Corporations. American Journal of Health Promotion 1995, 10 ( 2 ): 148-53 Honwood U, Fergusson DM, Breastfeeding and later cognitive and academic outcomes. Pediatrics : 101: p.e9; 1998 Howie PW. MBBS, MSc and Begum S. MBBS,MSc Protective effect of Breastfeeding against infection. BNJ, 1990 ,300: 11-16 Laurence R Breastfeeding. A Guide for Medical Profession. 5th ed. St.Louis, MO: CV Mosby: 1999 Lucas A, Morley R, Cole TJ, Lister G, Leeson-Payne C. Breast milk and subsequent intelligence quotient in children born preterm. Lancet 1992 : 339 .261-264 Mortensen EL et al. The Association Between Duration of Breastfeeding and Adult Intelligence . JAMA, 2002, 287 (18): 23652371 Oddy WH . Breastfeeding protects againts illness and Infection in Infant and Children Breastfeeding Review 2001: 9(2):11-18 Rogan WJ, Gladen BC, Breastfeeding and cognitive development. Early Human Development 1993: 31: 181-193 Riva E, Agostoni C, Trojan S, Luoti D, Fiori L, Giovannini M; Early Breastfeeding is linked to higher IQ scores in dietary treated PKU children. Acta Paediatr1996, 83 : 56-58 Tobolic TJ: Fathers Day : Understanding and Supporting the Father in the Triad. 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 , including 50 302 Women with Breast Cancer and 96 973 Women without the Disease. Lancet 2002 ; 360: 187-95 Victora CG, Barros .WHO Collaborative Study Team on the Role of Breastfeeding on the Prevention of Infant Mortality. Effect of Breastfeeding on Infant and child mortality due to Infectious diseases in less developed countries: a pooled analysis.Lancet
2000: 355; 451-55
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