Wah selain soy formula muahal..
gizinya juga ga se-sempurna ASI kan??
Be wise ya...
Ini terjemahan dari artikel AAP Updates Its Stance on Soy Formula
www.familydoctor.org
Diterjemahkan Oleh Shanty
*Sekolah Dokter Keluarga Amerika *
mempersembahkan Kesehatan Anak
www.familydoctor.org
Banyak orang tua menganggap bahwa formula memainkan peranan dalam menyebabkan rasa mulas dan kerewelan pada bayi – dan bahwa mengganti formula susu sapi menjadi formula berdasar kedelai (terbuat dari protein kacang kedelai) akan banyak membantu. Tetapi bukan itu masalahnya, menurut laporan klinis baru oleh Sekolah Ilmu Kesehatan Anak Amerika (SIKAA) yang meninjau kembali keadaan 10 tahun pengaturan formula kedelai.
Walaupun banyak orang tua berpikir formula kedelai merupakan alternatif nyata untuk bayi yang alergi susu sapi, fakta bahwa 10% hingga 14% bayi dengan alergi susu sapi juga mempunyai alergi protein kedelai menyebabkan perlunya pertimbangan formula hipoalergenik, menurut SIKAA. Formula hipoalergenik juga harus diberikan pada bayi yang mempunyai reaksi gastrointenstinal berat (rasa sakit pada perut diikuti diare berdarah) terhadap susu sapi, karena kira-kira 30% hingga 64% bayi juga memiliki reaksi yang serupa terhadap kedelai.
Mengingat bahwa kebanyakan bayi di Amerika Utara meminum beberapa jenis formula bayi sejak usia 2 bulan, dengan formula kedelai mencapai hampir seperempat dari penjualan formula Amerika Serikat, kelompok dokter anak ingin menjelaskan bahwa sebenarnya hanya ada sedikit sekali alasan untuk memberikan formula kedelai pada bayi daripada formula susu sapi – walaupun keduanya mengandung nutrisi yang diperlukan oleh bayi.
Menurut SIKAA, bayi yang diberi asupan formula yang harus diberi fomula kedelai hanyalah bayi dengan kondisi sebagai berikut:
•Orang tua yang vegetarian garis keras (vegetarian yang tidak memakan daging merah, unggas, ikan, atau produk apapun yang berasal dari binatang seperti telur atau produk olahan susu).
•Diagnosis nyata ketidaktoleranan laktosa, yang sebenarnya jarang pada bayi, tetapi lebih umum terdapat pada anak-anak dan orang dewasa. Berbeda dengan alergi terhadap susu sapi, ketidaktoleranan laktosa merupakan ketidakmampuan mencerna laktosa gula yang ditemukan dalam susu sapi dan formula susu sapi bayi. Sehingga, bayi bisa diberi formula kedelai karena “bebas laktosa”
•Galaktosemia bawaan (di mana bayi kekurangan enzim yang mengubah galaktosa – satu dari dua gula yang ditemukan dalam laktosa – menjadi glukosa, gula yang dapat digunakan tubuh. Jika anak-anak ini mengonsumsi ASI, susu sapi, atau produk olahan susu lainnya, galaktosa dapat berkembang dalam sistem dan merusak sel-sel dan organ tubuh, menyebabkan kebutaan, keterbelakangan mental berat, gangguan pertumbuhan, dan bahkan kematian.
•Laporan SIKAA juga mengacu pada perhatian mengenai “pitoestrogen” yang ditemukan dalam formula kedelai, termasuk tipe estrogen yang disebut “isoflavon” (ditemukan dalam polong-polongan seperti kacang polong dan kacang lentil, tetapi konsentrasi paling tinggi terdapat dalam kacang kedelai). Yang mereka temukan: “tidak ada bukti pasti dari populasi binatang, manusia dewasa, atau bayi bahwa diet isoflavon kedelai secara buruk dapat mempengaruhi perkembangan manusia, reproduksi, atau fungsi endokrin.”
Tetapi SIKAA menekankan bahwa formula kedelai tidak diciptakan atau direkomendasikan untuk bayi prematur. Apa artinya bagi Anda? Semua organisasi kesehatan utama setuju bahwa ASI adalah bentuk nutrisi terbaik untuk bayi setidaknya pada enam bulan pertama. Kemudian, jika ibu dan bayi bersedia, idealnya menyusui dilanjutkan bahkan setelah memperkenalkan makanan padat – hingga tahun pertama (bahkan setelahnya).
Walaupun susu sapi dan formula berdasar kedelai memberikan nutrisi yang dibutuhkan bayi, menyusui dipandang ideal karena:
•ASI lebih mudah dicerna dan secara alami mengandung semua vitamin dan mineral yang dibutuhkan oleh bayi.
•Studi menunjukkan bahwa ASI dapat menurunkan timbulnya atau keganasan diare, menurunkan angka infeksi pernapasan dan telinga.
•ASI memberikan perlindungan pada bayi terhadap diabetes, eksim, asma, dan sindrom kematian mendadak pada bayi (SIDS).
•Penelitian menunjukkan bahwa ASI menurunkan resiko ibu menyusui dari diabetes tipe 2 dan kanker rahim dan payudara.
Akan tetapi, ibu yang tidak dapat menyusui, atau memutuskan untuk tidak menyusui, formula bayi yang diperkuat oleh zat besi merupakan alternatif yang baik.
Bayi yang alergi terhadap protein dalam formula susu sapi (walaupun banyak anak umumnya kehilangan alergi susu pada usia 2 atau 3 tahun), gejala reaksi alergi meliputi:
•Muntah
•Diare
•Sakit perut
•Bintik merah
•Bahkan darah pada kotoran bayi
Jika alergi susu sapi merupakan penyebab ketidaknyamanan pada bayi Anda, dokter Anda mungkin merekomendasikan formula hipoalergenik (suatu formula protein terhidrolisasi secara ekstensif atau formula berdasar asam amino yang lebih mudah dicerna) bukan formula kedelai – karena banyak bayi tidak dapat menolerir formula berdasar kedelai atau susu sapi.
Namun beberapa bayi mungkin sama sekali tidak alergi terhaap susu sapi, tetapi malah memiliki ketidaktoleranan terhadap laktosa, yang cenderung berkembang dari waktu ke waktu dan dapat menyebabkan gejala seperti:
•Buang gas berlebihan
•Pembengkakan dan sakit abdominal
•Diare
Bayi juga dapat menjadi intoleran terhadap laktosa secara temporer setelah mengalami infeksi usus. Walaupun kebanyakan bayi memberikan reaksi baik ketika diberikan ASI atau formula susu sapi lagi setelah serangan diare, dalam beberapa kasus dokter mungkin merekomendasikan penggunaan formula kedelai atau formula bebas laktosa selama masa penyembuhan.
Sebelum membuat keputusan untuk beralih ke formula atas alasan apapun, pastikan untuk berkonsultasi dengan dokter Anda karena gejala-gejala ini dapat mengindikasikan sesuatu yang lain. Terlebih, harga formula hipoalergenik dapat mencapai hingga tiga kalinya formula susu sapi atau kedelai biasa, alasan lain untuk memastikan bayi Anda mempunyai alergi nyata terhadap protein susu sebelum berganti ke formula.
Ditinjau ulang oleh: Mary L. Gavin, MD
Tanggal peninjauan: May 2008
Sumber: "Penggunaan Formula Berdasar Protein Kedelai dalam Pemberian Makan Bayi," *Ilmu Kesehatan Anak*,
Mei 2008
Monday, December 22, 2008
Thursday, December 11, 2008
Jaundice
Jaundice
Reviewed by the BabyCenter Medical Advisory Board
Last updated: January 2005
I think my baby 's skin looks a little yellow. Is this normal?
Yes, about 50 to 60 percent of full-term babies have a yellowish cast to their skin — called jaundice — during their first week or two of life. In fact, virtually all newborn babies have some jaundice, but it's not always noticeable. For most babies, this is a temporary, harmless condition that will go away on its own or with mild treatment. But in rare cases, it can be very serious, so it's important to keep an eye on it.
What causes jaundice?
High levels of a pigment in the blood called bilirubin cause the skin to look yellow. When old red blood cells break down, one of the byproducts they create is bilirubin. Everyone's blood contains bilirubin, which is normally removed from the blood by the liver and then eliminated in the stool. Before your baby was born, your liver removed his bilirubin for him. Now it's just taking some time for his liver to take over the task — so the pigment builds up in his blood and his skin takes on the yellowish cast of jaundice.
This type of jaundice, called physiologic jaundice, usually appears on a baby's second or third day of life and disappears on its own within two weeks. (For premature babies, it peaks at five to seven days and may take up to two months to go away.) The yellow color tends to appear first in a baby's face, then move downward to his neck and chest and on down until, in extreme cases, it reaches his toes.
Is jaundice sometimes caused by breastfeeding?
If your baby is breastfeeding, it's possible for him to get jaundice if he doesn't get enough breast milk. That's because if your baby isn't taking in sufficient fluid, he may not be able to eliminate the excess bilirubin through his stools.
If this is the case for your baby, you'll want to discuss the feeding problem with your doctor. You may also want to work with a lactation consultant on breastfeeding. Once your baby is getting enough breast milk — through improved breastfeeding technique, more frequent feedings, or supplementation with formula — the jaundice will likely go away. The American Academy of Pediatrics (AAP) recommends that you breastfeed your baby at least eight to 12 times a day for the first several days.
Some babies develop something called "breast-milk jaundice" during their first few weeks. It's usually diagnosed at around 7 to 11 days of age. Although your baby may be nursing well and gaining weight normally, something in the breast milk interferes with his liver's ability to process bilirubin. This often happens along with physiologic jaundice, and it can go on for several weeks or even months. It's pretty common in exclusively breastfed babies, though, and is generally considered harmless. If your baby's bilirubin levels get too high, your practitioner may recommend that you stop nursing for a day or two to bring them down. (You can use a breast pump to maintain your milk supply during this time, and once the bilirubin is down, you can begin breastfeeding again.)
What's the danger?
Again, in the vast majority of cases, jaundice isn't anything to worry about. But if a baby's bilirubin levels get too high — because his jaundice goes without any treatment and the levels continue to rise — it can cause permanent damage to the nervous system. A very small percentage of jaundiced newborns develop a condition called kernicterus, which can result in deafness, delayed development, or a form of cerebral palsy.
Are some babies more prone to jaundice than others?
Yes, a baby is more likely to have noticeable jaundice if he:
• has a sibling who had jaundice
• had bruises at birth (the red blood cells that are part of the bruises are broken down and produce bilirubin as a byproduct)
• was born prematurely, because his immature liver may not be able to handle the bilirubin levels.
Are there tests for jaundice?
Your medical team will examine your baby for jaundice at birth. Ideally, they should also look at him three to five days after birth, when his bilirubin levels are likely to be highest. If there's any concern that your baby is jaundiced, his doctor may do a skin test or blood test to check his bilirubin levels. (She will definitely do the test if your baby appears jaundiced in the first 24 hours, because jaundice that appears then is more likely to be a problem.)
If you leave the hospital soon after your baby's birth, though, you and your baby may be home by the time jaundice shows up, and you may be the first to notice it. Here's how to check for jaundice: Take your baby into a room with plenty of natural or fluorescent light. If your child is fair-skinned, gently press your finger to his forehead, nose, or chest, and look for a yellow tinge to the skin as the pressure is released. If your child has dark skin, check for yellowness in his gums or the whites of his eyes.
Should I call my baby's doctor?
Yes, talk with his doctor if your baby's skin is yellowish, especially if the whites of his eyes, his tummy, or his arms or legs are yellow. Also call the doctor if your baby is jaundiced and becomes hard to wake or fussy, or doesn't want to eat, and if he has even a mild case of jaundice for over three weeks.
When is jaundice considered serious?
If your baby develops jaundice in the first 24 hours after birth, it's always considered serious and he'll need close monitoring and treatment. This type of jaundice is uncommon, though, and is usually due to a blood-type incompatibility between mom and the baby. If your blood type is O or Rh-negative, it may be incompatible with your baby's blood type. During your first prenatal appointment, your practitioner probably checked your blood type to see if you were at risk for this, but there's no way to know for sure until your baby is born and you find out what his blood type is.
If your practitioner is concerned about incompatible blood types, she'll take a blood sample from your baby at birth to find out his blood type. (Some practitioners will wait to do the blood test until a baby shows signs of developing jaundice, since he may be fine even if your blood types aren't compatible.) She'll also do a "Coombs test" to see if an incompatibility has affected your baby's blood cells, causing him to become jaundiced. If the doctor determines that your baby does have a blood-type incompatibility and/or a positive Coombs test, she'll watch him closely for jaundice.
Jaundice during a baby's first 24 hours can also be caused by serious conditions such as liver, gallbladder, and intestinal disorders, an infection, excessive birth trauma, or extreme prematurity (birth before 28 weeks gestation).
How is jaundice treated?
Most jaundice needs no treatment, but when it does, phototherapy (light therapy) is considered very safe and effective: Placing your baby under blue "bililights" lights — naked in a bassinet, with his eyes covered — will often do the trick because ultraviolet light changes the bilirubin to a form that your baby can more easily dispose of in his urine. Another option involves wrapping your baby in a fiber-optic blanket called a bili-blanket or bili-pad. With a prescription from your doctor, you may be able to rent one of these blankets to treat your baby at home.
Phototherapy is usually effective, but if a baby develops a severe case of jaundice, or his bilirubin levels continue to rise despite phototherapy treatment, he may need to be admitted to the intensive care unit for a blood transfusion called an "exchange transfusion."
Something else you can do on your own to help reduce jaundice is make sure that your baby is getting plenty of breast milk or formula — so he'll have frequent bowel movements. If you have any concerns about jaundice, check with his doctor to make sure you're taking the right steps to get your baby back in the pink.
http://www.babycenter.com/0_jaundice_89.bc?page=1
Reviewed by the BabyCenter Medical Advisory Board
Last updated: January 2005
I think my baby 's skin looks a little yellow. Is this normal?
Yes, about 50 to 60 percent of full-term babies have a yellowish cast to their skin — called jaundice — during their first week or two of life. In fact, virtually all newborn babies have some jaundice, but it's not always noticeable. For most babies, this is a temporary, harmless condition that will go away on its own or with mild treatment. But in rare cases, it can be very serious, so it's important to keep an eye on it.
What causes jaundice?
High levels of a pigment in the blood called bilirubin cause the skin to look yellow. When old red blood cells break down, one of the byproducts they create is bilirubin. Everyone's blood contains bilirubin, which is normally removed from the blood by the liver and then eliminated in the stool. Before your baby was born, your liver removed his bilirubin for him. Now it's just taking some time for his liver to take over the task — so the pigment builds up in his blood and his skin takes on the yellowish cast of jaundice.
This type of jaundice, called physiologic jaundice, usually appears on a baby's second or third day of life and disappears on its own within two weeks. (For premature babies, it peaks at five to seven days and may take up to two months to go away.) The yellow color tends to appear first in a baby's face, then move downward to his neck and chest and on down until, in extreme cases, it reaches his toes.
Is jaundice sometimes caused by breastfeeding?
If your baby is breastfeeding, it's possible for him to get jaundice if he doesn't get enough breast milk. That's because if your baby isn't taking in sufficient fluid, he may not be able to eliminate the excess bilirubin through his stools.
If this is the case for your baby, you'll want to discuss the feeding problem with your doctor. You may also want to work with a lactation consultant on breastfeeding. Once your baby is getting enough breast milk — through improved breastfeeding technique, more frequent feedings, or supplementation with formula — the jaundice will likely go away. The American Academy of Pediatrics (AAP) recommends that you breastfeed your baby at least eight to 12 times a day for the first several days.
Some babies develop something called "breast-milk jaundice" during their first few weeks. It's usually diagnosed at around 7 to 11 days of age. Although your baby may be nursing well and gaining weight normally, something in the breast milk interferes with his liver's ability to process bilirubin. This often happens along with physiologic jaundice, and it can go on for several weeks or even months. It's pretty common in exclusively breastfed babies, though, and is generally considered harmless. If your baby's bilirubin levels get too high, your practitioner may recommend that you stop nursing for a day or two to bring them down. (You can use a breast pump to maintain your milk supply during this time, and once the bilirubin is down, you can begin breastfeeding again.)
What's the danger?
Again, in the vast majority of cases, jaundice isn't anything to worry about. But if a baby's bilirubin levels get too high — because his jaundice goes without any treatment and the levels continue to rise — it can cause permanent damage to the nervous system. A very small percentage of jaundiced newborns develop a condition called kernicterus, which can result in deafness, delayed development, or a form of cerebral palsy.
Are some babies more prone to jaundice than others?
Yes, a baby is more likely to have noticeable jaundice if he:
• has a sibling who had jaundice
• had bruises at birth (the red blood cells that are part of the bruises are broken down and produce bilirubin as a byproduct)
• was born prematurely, because his immature liver may not be able to handle the bilirubin levels.
Are there tests for jaundice?
Your medical team will examine your baby for jaundice at birth. Ideally, they should also look at him three to five days after birth, when his bilirubin levels are likely to be highest. If there's any concern that your baby is jaundiced, his doctor may do a skin test or blood test to check his bilirubin levels. (She will definitely do the test if your baby appears jaundiced in the first 24 hours, because jaundice that appears then is more likely to be a problem.)
If you leave the hospital soon after your baby's birth, though, you and your baby may be home by the time jaundice shows up, and you may be the first to notice it. Here's how to check for jaundice: Take your baby into a room with plenty of natural or fluorescent light. If your child is fair-skinned, gently press your finger to his forehead, nose, or chest, and look for a yellow tinge to the skin as the pressure is released. If your child has dark skin, check for yellowness in his gums or the whites of his eyes.
Should I call my baby's doctor?
Yes, talk with his doctor if your baby's skin is yellowish, especially if the whites of his eyes, his tummy, or his arms or legs are yellow. Also call the doctor if your baby is jaundiced and becomes hard to wake or fussy, or doesn't want to eat, and if he has even a mild case of jaundice for over three weeks.
When is jaundice considered serious?
If your baby develops jaundice in the first 24 hours after birth, it's always considered serious and he'll need close monitoring and treatment. This type of jaundice is uncommon, though, and is usually due to a blood-type incompatibility between mom and the baby. If your blood type is O or Rh-negative, it may be incompatible with your baby's blood type. During your first prenatal appointment, your practitioner probably checked your blood type to see if you were at risk for this, but there's no way to know for sure until your baby is born and you find out what his blood type is.
If your practitioner is concerned about incompatible blood types, she'll take a blood sample from your baby at birth to find out his blood type. (Some practitioners will wait to do the blood test until a baby shows signs of developing jaundice, since he may be fine even if your blood types aren't compatible.) She'll also do a "Coombs test" to see if an incompatibility has affected your baby's blood cells, causing him to become jaundiced. If the doctor determines that your baby does have a blood-type incompatibility and/or a positive Coombs test, she'll watch him closely for jaundice.
Jaundice during a baby's first 24 hours can also be caused by serious conditions such as liver, gallbladder, and intestinal disorders, an infection, excessive birth trauma, or extreme prematurity (birth before 28 weeks gestation).
How is jaundice treated?
Most jaundice needs no treatment, but when it does, phototherapy (light therapy) is considered very safe and effective: Placing your baby under blue "bililights" lights — naked in a bassinet, with his eyes covered — will often do the trick because ultraviolet light changes the bilirubin to a form that your baby can more easily dispose of in his urine. Another option involves wrapping your baby in a fiber-optic blanket called a bili-blanket or bili-pad. With a prescription from your doctor, you may be able to rent one of these blankets to treat your baby at home.
Phototherapy is usually effective, but if a baby develops a severe case of jaundice, or his bilirubin levels continue to rise despite phototherapy treatment, he may need to be admitted to the intensive care unit for a blood transfusion called an "exchange transfusion."
Something else you can do on your own to help reduce jaundice is make sure that your baby is getting plenty of breast milk or formula — so he'll have frequent bowel movements. If you have any concerns about jaundice, check with his doctor to make sure you're taking the right steps to get your baby back in the pink.
http://www.babycenter.com/0_jaundice_89.bc?page=1
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