Penerapan Pijat Oksitosin dan Marmet untuk Meningkatkan Produksi ASI Ibu Nifas

Breastmilk is needed by babies because of its vitamins that are needed for the growth of the baby's brain which is undergoing rapid development from the age of 0-6 months to the age of 2 years, what if the baby is malnourished then the cells in the baby will shrink to 15% up to 20%, Unfortunately, many postpartum mothers cannot express breast milk properly and smoothly. Breastfeeding is a very closely related interaction between mechanical, nervous, and hormonal stimuli that affect the release of oxytocin. This study aims to determine the effect of oxytocin massage and market technique on breast milk production in postpartum mothers. This research uses a quasi-experimental design, with pre and post-test design. The number of samples was 20 respondents with purposive sampling. Data analysis in this study "Wilcoxon" the results the mean pre and post-test for oxytocin massage were 4.7 with a p-value 0.005 and the Marmet technique had a mean value of 4.5 with a p-value 0.004. In conclusion, oxytocin massage was more effective than the marmet technique on postpartum mother's milk production at the Health Center.

Breastfeeding and factors associated to feeding in babies with cleft palate

Breastfeeding can be affected in babies with cleft palate, due to various factors associated with feeding. The objective of the study was to relate the time of breastfeeding and the time to express breast milk with factors associated with feeding in babies between 0 and 6 months with cleft palate. Electronic records of care of 36 babies with cleft palate from a public hospital in Chile were reviewed. Sociodemographic characteristics of the mother and father, perinatal and postnatal antecedents of the babies and general characteristics of feeding up to 6 months were extracted. The data were compared with the Mann-Whitney U test and relationships were established with the Pearson and Spearman correlations. In the time of direct breastfeeding (days), significant differences were observed in: the babies who used a nasogastric tube (p = 0.009), the indication to express breast milk (p = 0.017), the presence of manual extraction of breast milk (p = 0.005) and the presence of electrical extraction of breast milk (p = 0.002). In addition, a positive correlation (p = <.001; r = 0.538) was recorded between the time of direct breastfeeding and the time of expressed breast milk. It is concluded that the longer the breastfeeding time, the longer the breast milk extraction time. Meanwhile, the time of breastfeeding was influenced by the use of a nasogastric tube, the expression of breast milk as a personal option, and the manual and electrical expression of breast milk.

PREGNANCY AND CORONAVIRUS DISEASE 19

As Coronavirus disease 2019 (COVID 19) is declared a global pandemic. Management of expecting mothers and newborn care becomes a great challenge to the physicians and their family. They should follow same guidelines as the general population to avoid exposure to the virus as much as possible. Pregnancy does not seem to increase the risk of infection nor accelerate its natural history or the severity of illness. Routine prenatal-antenatal care should be home monitored and tele-medicine encouraged as much as possible. Women with comorbidities or at high risk of infection such as recent history of travel, from a containment zone, history of primary or secondary contact should be closely monitored for symptoms. RT PCR is recommended prior to labour or one day prior to elective surgery. Supportive treatment is important in infected patients. Low molecular weight heparin can be used for thromboprophylaxis in severe illness. Data on use of Remdesivir, hydroxychloroquine, Lopinavir-Ritonavir are limited. There is limited data on placental transmission of the virus. Newborn should also be immediately be tested following delivery of a COVID19 pregnant women. If newborn is found to be negative, strict hygienic measures according to CDC should be followed to express breast milk. According to WHO, breast milk banks are a safe alternative. Few mothers may prefer to give formula feeds, which can be administered by healthy care givers. There is limited data regarding transmission of virus through breast milk.

Pharmacokinetics of Dapivirine Transfer into Blood Plasma, Breast Milk, and Cervicovaginal Fluid of Lactating Women Using the Dapivirine Vaginal Ring

Breastfeeding (BF) women are an important population for biomedicalHIV prevention strategies, but they are rarely included in trials. The 25-mg dapivirinevaginal ring (VR) reduced women’s risk of sexually transmitted HIV infection in twophase 3 trials conducted in Africa. We conducted a phase 1, open-label study (MTN-029/IPM 039) of dapivirine VR use among lactating women in Pittsburgh, PA, andBirmingham, AL, USA. MTN-029/IPM 039 enrolled 16 healthy adult women who hadalready weaned their infants but were still able to express breast milk. Women wereinstructed to use the VR continuously for 14 days and provided milk, plasma, andcervicovaginal fluid (CVF) samples for pharmacological analysis. No infants were exposedto the drug, but infant dosage was estimated according to FDA guidance. Adverseevents (AEs) were collected at all contacts. The study was completed with100% participant retention. Median dapivirine concentrations were 676 pg/ml inbreast milk, 327 pg/ml in plasma (milk/plasma ratio ?2.0), and 36.25 ng/mg in CVF.Six participants experienced 10 total AEs, none of which required VR discontinuation.The estimated mean daily infant dosage was 74.3 ng/kg/day. In this first studyof dapivirine exposure during lactation, dapivirine VR use was associated with lowerconcentrations of detectable dapivirine in milk and plasma than in CVF samples anda favorable safety profile. Estimated daily levels of infant dapivirine exposure werealso low. Additional studies are needed to evaluate longer periods of dapivirine VRuse among BF mother-infant pairs living in regions with higher incidence of sexuallytransmitted HIV infection. (This study has been registered at ClinicalTrials.gov underregistration no. NCT02808949.)

PENGETAHUAN DAN PERSEPSI WANITA USIA SUBUR TERHADAP RUANG LAKTASI DI INSTANSI PEMERINTAH WILAYAH KOTA DENPASAR TAHUN 2017

ABSTRAKTantangan dalam pemberian ASI salah satunya dihadapi oleh para ibu bekerja yang merasa kesulitan untuk memberikan ASI maupun memerah ASI pada waktu kerja, baik dikarenakan tidak adanya fasilitas, cuti melahirkan yang tidak fleksibel sampai tidak diberikannya kesempatan menyusui. Pada tahun 2013 telah diterbitkan Peraturan Menteri Kesehatan (Permenkes) nomor 15 tahun 2013 tentang tata acara penyediaan fasilitas khusus menyusui atau memerah air susu ibu seperti ruang laktasi. Tujuan dari penelitian ini adalah untuk mengetahui tingkat pengetahuan dan persepsi Wanita Usia Subur (WUS) yang bekerja terhadap ruang laktasi di instansi pemerintah wilayah Kota Denpasar tahun 2017. Penelitian ini merupakan penelitian deskriptif kuantitatif dengan rancangan cross-sectional. Sampel penelitian adalah 79 WUS yang bekerja. Pemilihan tempat kerja yaitu instansi pemerintah yang memiliki ruang laktasi di Wilayah Kota Denpasar dan pemilihan sampel secara stratified proportional random sampling. Pengumpulan data pengetahuan dan persepsi dilakukan dengan menggunakan kuesioner dan data dianalisis secara deskriptif. Hasil penelitian didapatkan 72,2% WUS memiliki pengetahuan baik, 27,8% memiliki pengetahuan cukup, dan tidak ada yang memiliki pengetahuan kurang. Untuk persepsi terhadap ruang laktasi didapatkan 64,6% WUS memiliki persepsi baik dan 35,4% memiliki persepsi kurang baik. Dapat disimpulkan bahwa sebagian besar WUS memiliki tingkat pengetahuan baik serta lebih dari setengah memiliki persepsi yang baik terhadap ruang laktasi. Disarankan agar menyediakan ruang laktasi sesuai dengan ketentuan serta mendukung ruang laktasi tersebut dengan meningkatkan peran tenaga kesehatan dan atasan tempat bekerja agar lebih mensosialisasikan pemanfaatan ruang laktasi.Kata Kunci: awareness, perception, lactation room, reproductive age women ABSTRACTWorking mothers faces challenges to provide exclusive breastfeedings due to limited facility to breastfed or to express breast milk within working hours, inflexible maternity leave and no breastfeeding time within working hours. In 2013, the Ministry of Health (MoH) adopted MoH regulation (Permenkes) No 15/2013 about standard procedure to provide breastfeeding or expressing breast milk facility, such those called as “ruang laktasi”/lactation room. This study aims to explore awareness and perception of reproductive age working women (WUS) on lactation room at governments institution in City of Denpasar in 2017. This was a descriptive quantitative study with cross-sectional design. Study sample were 79 WUS. Working places included on the study were those that have lactation room and samples were selected by stratified random sampling. Data on awareness and perception were collected using questionnaire and analysed with descriptive analysis. From the study, 72.2% WUS have good awareness, 27.8% have moderate awareness and none with low awareness. For the perception on lactation room, 64.6% WUS have good perception and 35.4% have lower perception on lactation room. It can be concluded that the majority of working women have good awareness, and more than half have good perception on lactation room. It is recommended to provide lactation room and to support improvement of lactation room by improving role of health workers and supervisors at work places to extend socialization of the lactation room.Keywords: pengetahuan, persepsi, ruang laktasi, WUS

Expression of Breast milk-an update

Breast feeding by sucking is the norm. However sometimes expression is the only way by which breast milk can be given to babies. There are many situations when expressing breast milk is useful and necessary to enable a mother to initiate or to continue breast feeding. Hand or breast pump are used to express breast milk. Hand expression is the most preferred method. There are some mechanical pumps though pumps cause discomfort and are usually ineffective. The Marmet technique of expressing breast milk with hand is a fabulous alternative to using a breast pump. Until recently hand expression of breast milk has been as underutilized skill. However, there are many benefits of knowing how to express milk from the breast without the use of expensive and cumbersome breast pumps. Expressed breast milk can be feed by spoon, cup and nasogastric tube. It is essential to collect and store breast milk properly to prevent the risk of bacterial overgrowth. Feeding with breast milk is quite safe if done properly. It is important for every woman to learn to express the milk. Certainly all health workers who take care for breastfeeding mothers should be able to teach the way of expression of breast milk. DOI: http://dx.doi.org/10.3329/jssmc.v4i2.14422 J Shaheed Suhrawardy Med Coll, 2012;4(2):62-64

Increasing Breast Milk Production for Premature Infants With a Relaxation/Imagery Audiotape

Many women whose premature infants are hospitalized in a newborn intensive care unit choose to express breast milk for their babies. Yet anxiety, fatigue, and emotional stress are powerful inhibitors of lactation. To facilitate the breast-feeding experience, intervention mothers were given a 20-minute audio cassette tape based on relaxation and visual imagery techniques. At a single follow-up expression of milk at the hospital approximately 1 week after enrollment, they expressed 63% more breast milk than a randomized group of control mothers. The fat content of the breast milk in the two groups was not significantly different. Among a small group of mothers whose infants were receiving mechanical ventilation, the increase in milk volume compared with that of control mothers was 121%. Longer-term effects of the relaxation/ imagery approach (such as extending the duration of breast-feeding or reducing parental stress after hospital discharge) and the physiologic basis for the increased volume of expressed milk (improved milk production v more efficient milk ejection) are appropriate topics for future research.