Ungawuthatha ngempela umuthi kadokotela ukukhulisa ukutholakala kobisi lwakho?

Imfundo Yezempilo

Lokhu kuyingxenye yochungechunge lokuncelisa ibele ukweseka iNyanga Kazwelonke Yoncelisayo (Agasti). Thola ukumbozwa okuphelele lapha .

Ukuncelisa ingane ibele kuvame ukubizwa ngokuthi yindlela yemvelo yokondla ingane, kodwa ngenxa yokuthi into engokwemvelo akusho ukuthi kulula. Eqinisweni, ukuncelisa kungaba nzima kakhulu: izingqinamba, izingono eziqhekekile, ama-engorgement, kanye nobisi oluncane konke kuhlupha amasonto okuqala nezinyanga zokuncelisa.

Kuzo zonke lezi zinkinga, ukutholakala kobisi oluncane kungenzeka ukuthi kuyinkinga kakhulu-ngakho-ke kuyaqondakala ukuthi kungani omama abaningi abasha bephendukela ezinhlotsheni ezahlukahlukene amasu okwenza ubisi oluningi , kufaka phakathi ukucela udokotela wabo imithi kadokotela enamahemuhemu kuyo ukwandisa ukutholakala kobisi .

E-United States, kunesidakamizwa esisodwa kuphela esivunyelwe i-FDA sokusebenzisa ukwesekwa kwe-lactation: i-metoclopramide, igama lomkhiqizo Reglan . (Abantu baseCanada bavame ukunikezwa i-domperidone esikhundleni salokho, kodwa kunjalo akuvunyelwe ukuthengiswa e-U.S. ngenxa yokukhathazeka ngemiphumela engemihle.) Ngokusho kukaChristine Masterson, MD, umphathi wezinsizakalo zabesifazane nezingane Summit Medical Group eNew Jersey, i-metoclopramide yisidakamizwa esivame ukusetshenziselwa ukwelapha okuhlukahlukene izingqinamba emathunjini ; kwenzeka nje ukuthi omunye wemiphumela emibi yalesi sidakamizwa ukukhiqizwa kobisi okwandisiwe.

IMetoclopramide icisha ikhemikhali ebuchosheni ebizwa nge-dopamine, evumela ukuphakama kweprolactin, kusho uDkt Masterson. (IProlactin iyi- i-hormone ekhuthaza ukukhiqizwa kobisi .) Ingahluka kakhulu ekutheni isebenza kangakanani ekunceliseni ibele, yize ezinye iziguli zingathola ukwanda kwamaphesenti angama-50 kuye kwayi-100 ekunikezelweni kobisi.

Ngakho-ke yini inkinga yokusebenzisa uReglan ukuncelisa ibele? Empeleni, uDkt Masterson uthi baningi. Kokunye, ukusetshenziswa kwe-metoclopramide yokukhiqiza ubisi akufundwe kahle. Okwesibili, akukho okubonisa ngokusobala mayelana nomthamo wokukhiqizwa kobisi kuqhathaniswa nezimpawu ze-GI. Futhi ekugcineni, ngoba i-metoclopramide idlula obisini lwebele, kungaba nemiphumela emibi kubo bobabili umama futhi ingane.

Ukuhlungwa kwesidakamizwa egazini lengane kungahluka kakhulu, kepha kungaba ngamaphesenti ayishumi esikali sikamama, uDkt Masterson wembula. Lokhu kungathinta ipheshana le-GI yengane: kubangele ukwakheka kwegesi okwengeziwe nokungakhululeki esiswini noma ukuguqula ukuhamba kwabo kwamathumbu kuhudo.

Njengokungathandeki lokho enganeni, imiphumela emibi kumama ingaba mibi kakhulu. UDkt Masterson uthi ngaphezu kwezinkinga ezifanayo ze-GI, ikhanda, ukukhathala, umlomo owomile, nokuqinisekile ukuphazamiseka kokuhamba , abesifazane bangaphinde bathole ukuthi i-metoclopramide ibangela noma yenze izimpawu zokukhathazeka nokudangala zibe zimbi kakhulu. Ngesikhathi lapho omama besengozini enkulu ekushintsheni kwemizwelo okulethwa ngamahomoni abeletha ngemuva kokubeletha kanye nengcindezi yokondla usana ubusuku nemini, umuthi onengozi enkulu yokudangala kungenzeka kungabi yisinqumo esihle kakhulu.

Indlela esizala ngayo inomthelela endleleni esizizwa ngayo ngemuva siyabeletha, kusho umeluleki we-lactation ozinze eNew York ULeigh Anne O'Connor , IBCLC. Uma ngabe wazala inselele, nge-c-section ehleliwe noma engahlelwanga [noma okunye ukungenelela okungalindelekile], ukuncelisa ibele nakho kuzoba yinselele.

OKUSHIWO: Ukusekelwa kungasiza kanjani omama ngesikhathi sokuncelisa ibele

Lezi zinto ezihlanganisiwe zingadala iresiphi ye- ukucindezeleka kwangemva kokubeletha , noma ngabe umama omusha unomlando wokudangala noma cha (yize amathuba engaphezulu uma enawo); U-O'Connor uthi ubone abesifazane abaningi kakhulu bezwa izimpawu zokukhathazeka nokudangala ngenkathi bethatha i-metoclopramide ukuze bazizwe bekhululekile ukuyincoma ezigulini zakhe.

Esikhundleni salokho, ugcizelela ukubaluleka kokuthola ukwesekwa ezinsukwini zokuqala zokuncelisa. Indawo enhle ukuqala ngokuhlolwa okuphelele kwe-lactation kusuka ku Umeluleki We-Lactation Certified International Board (IBCLC), engaveza ukuthi ungumama noma cha ngempela inokunikezwa okuphansi (imvamisa kunenye inkinga elungiswa kalula ezenza inkinga yokuphakela). Noma ukunikezwa kukamama kuphansi impela, ukusebenza ne-IBCLC kungakhomba imbangela-futhi kumise enkambweni yokulungisa inkinga nokwakha isisekelo esiqinile sokuncelisa ikusasa.

Abantu abaningi bafuna ukuncelisa, kepha abaqondi ukuthi uhlelo lwethu lokunakekelwa kwezempilo alwenzelwanga ukuxhasa noma ukufundisa abantu ukuthi lubukeka kanjani ngempela nokuthi yiziphi izithiyo, kusho u-O'Connor. Abantu bazizwa njengokwehluleka uma kungahambi kahle zisuka.

Lokho kusho ukuthi, kunezimo ezithile lapho umuthi ofana ne-metoclopramide yokwandisa ukutholakala kobisi ungafaneleka. Ngokusho kukaDkt. Masterson no-O'Connor, abantu abangahlomula ngokusebenzisa iReglan ekunceliseni ibele bafaka:

• abesifazane abanamazinga aphansi ngokwemvelo we-prolactin;
• abesifazane abaye bathola noma yiluphi uhlobo lokuhlinzwa kwamabele, kufaka phakathi ukunciphisa;
• abesifazane abane-herpes esebenzayo noma i-HIV;
• abesifazane abane webele hypoplasia ;
• nomama bokutholwa abafuna ukuncelisa ingane yabo yokutholwa.

Ngokuvamile, kungcono ukubhekana nezizathu ngani ukuncelisa ibele akusebenzi esikhundleni sokuthembela kumuthi kadokotela ukuxazulula inkinga. UDkt Masterson uthi omama abasha kufanele bahlale bondlekile futhi benamanzi amaningi, balale ngokwanele, babhekane nengcindezi yabo, futhi bazungeze abantu abasekelanayo, abancelisayo abancelisayo.

Kepha ngokungafani no-O'Connor, yena kuyakwenza isethula i-metoclopramide njengenketho ezigulini zayo ezilwela ukuncelisa-inqobo nje uma zingenawo umlando wezinkinga ze-GI noma ukudangala.

Uma othile eza kimi ekhononda ngokuncelisa ibele, ngiyaye ngithi [Reglan] ngoba ukusungula ukuncelisa kubaluleke kakhulu emasontweni amabili kuya kwamathathu okuqala ngemuva kokuzalwa, kuchaza uDkt Masterson. Uma uyisebenzisela [kuze] amasonto ayi-12 — kungasekho — ngethemba ukuthi ukuncelisa kwakho kuzosungulwa kangcono futhi ngeke udinge ukukhushulwa okwengeziwe.

Uma unenkinga yokuncelisa ibele, ungathola i-IBCLC endaweni yangakini lapha . Uma wena noma othandekayo uhlangabezana nezimpawu zokucindezeleka kwangemva kokubeletha, funa usizo kumhlinzeki wezempilo yengqondo ngokushesha.