معكم عضو البورد الدولى للرضاعة الطبيعية(الجزء الثانى)

اهم سؤال
ما وزنه كل مرة اتوزن؟
ماعندي خلفيه وديته الدكتور قبل اسبوع تقريبا ماعلق على الوزن
هل راجعتى موضوع طريقة الامساك الصحيح للثدى
كيف تثقين فى نفسك
راجعته وبحاول اطبق طريقة الامساك
بس بصراحه ماعندي ثقة وكمان حاسه ان حليبي قل وانا لسه مارجعت العمل اجل كيف بعده
وهو الان بيطلع اي شيء اعطيه بصورة كبيرة و يرجع يطلب ويدور حليب وصدري ماعاد زي اول يتعبى حليب حتى لما اصحى من النوم الاقيه فاضي
وله الان 3 ايام مايتبرز ايش اعمله؟؟ ممكن من الحليب الصناعي انا بستعمل سيميلاك
ليش بتعطيله ببرونه مدام صدرك مليان؟
انا بعطيه الببرونه لما الاقي صدري فاضي اعصره مايخرج شيء وهو جدا معصب مايرضى يمص

كمان سؤال هل الحليب لما اشربه لازم يكون دافي ممكن اشرب الحليب الي بالعلب اسهل بس انه يكون بحرارة الغرفه مائل للبرودة؟؟

تعبتك يادكتورة بس دوامي يبدأ السبت و انا جدا قلقانه
ونسيت اقولك اني لازم اعطيله لهاية عشان لما يبكي وانا ماني موجودة يلهي شويه

واتفقت مع الشغاله انه تعطيله ببرونه كل ساعتين بس 60 مل بدل 90 الي مكتوب في علبة الحليب عبال ماارجع من الدوام

السلام عليكم دكتورة
عندي 6 أسئلة أتمنى من سعادتك التفضل بالإجابة على كل واحد منها
منفصلاً وبشكل مفصل إذا سمحتِ

س1
إذا رحت للصيدلي علشان أشتري كبسولات الثوم وحبة البركة ولقيت عنده أنواع مختلفة بتراكيز مختلفة
ماهو الأساس الذي بناءا عليه أستطيع تحديد واختيار النوع والتركيز المناسب لحالتي ؟

س2
هل كبسولات الثوم تطلع ريحتها بالجسم مثل الحلبة ؟


س3
رائحة الحلبة تضايق زوجي جدا
هل أقدر أستغنى عنها ؟
أو هل يوجد بديل للحلبة ويكون من غير رائحة ؟

س4
ماهو شكل القنطريون العنبري حتى أتمكن من معرفته إذا شاهدته عند العطار ؟
هل هو أوراق ناشفة أم سيقان أم بذور
ممكن توصفي لي بالضبط شكله وماهو أقرب شي يشبه له ؟

س5
دكتورة أخاف والله يزيد وزني على هالنظام اللي عطيتيني إياه ويصير من الصعب انزال الوزن الزائد خصوصا إن أغلب زيادتي في منطقة البطن (الكرش)
ليش ماتعطيني نظام ريجيم ومدر للحليب في نفس الوقت من الآن أفضل ؟


أخيرا دكتورة
عندي الثدي الأيمن حلمته غير بارزة ولقد عانت بنتي كثييييييييييييييرا في أول شهرين والحمدلله بعد معاناة حقيقية ، بنتي تعودت عليه نوعا ما
لكن المشكلة التي أواجهها منذ ولادتها عدم رغبتها بالحليب الذي يدر منه ولا أعلم مالسبب
علما بأنني إذا أجبرتها على الرضاعة منه ترضع لحد معين دون إفراغ كامل للثدي ومن ثم تستفرغه بعده مباشرة وأحيان بعده بفترة وهذه الحالة معها من الولادة وليومك هذا
بالرغم أنها ترضع بشكل عادي من الثدي الأيسر ذو الحلمة البارزة
جربت أن أدعها على راحتها في البداية بأن ترضع من واحد دون الآخر ولكن واجهتني مشكلة اختلاف حجم الثديين بشكل ملحووووووووظ جدا وأصبح شكله مقرف
سؤالي

س6
هل من الممكن أن يكون طعم الحليب في الثدي الأيسر يختلف عنه في الثدي الأيمن؟
ومالذي يتوجب علي فعله لحل تلك المشكلة ؟

شاكرة ومقدرة سرعة ردك
وجزاك الله عنا جميعا خير الجزاء

عندي ورم ليفي في الثدي الأيسر هل فيه ضرر من الإرضاع مع وجود الورم؟

هل لو أزلت الورم بعمليه جراحيه أستطيع الإرضاع من نفس الثدي بعد العمليه؟

As a paediatrician who deals now only with mothers and babies who are having difficulty with breastfeeding, I am very concerned about the warning about domperidone which was issued by the Federal Drug Administration in the US on June 7, 2004. It warns breastfeeding mothers about getting domperidone to enhance milk supply because it conceivably can cause cardiac arrhythmias.

The FDA has basically come up with a political statement. They seem really bothered because people were going around using a drug which they have not approved. The deaths (and I believe there were two) occurred with intravenous domperidone, which is never used any more and has never been used for enhancing milk supply. Domperidone was given intravenously in huge doses to patients who were sick with other problems as well, notably cancer for which they were getting chemotherapy. Domperidone was being used to decrease nausea and vomiting. Some patients were getting 1000 mg of domperidone every 4 hours intravenously, compared to our usual dose of 30 mg 3 times a day, taken by mouth. It is also likely that some of the chemotherapy drugs the patients would have received have cardiac side effects (for example, doxorubicin) and it was the combination of the huge doses of domperidone intravenously plus other drugs that caused the problem. Furthermore, unlike what the FDA has led people to believe, perhaps unintentionally, these are not new cases, but 2 decades old.

Why didn't they mention metoclopramide in their warning, which is far more dangerous (it can cause severe depression in oral doses, which domperidone does not) and is also being used off label to increase milk supply in the US, but which, on the other hand, is available and approved for gastric motility problems in the US? Can it be that they are not concerned about the danger but rather the threat to their authority? Here is part of a letter I received about metoclopramide and domperidone as a result of this to do about domperidone. “...my mother...is on domperidone for gastroparesis. She's 5 feet tall, and lost over 20 lbs...down to 82 lbs. And why is she on domperidone? Because she had depression and SEVERE panic attacks with the Reglan (metoclopramide). She was in and out of the senior psych ward all last spring. So my folks get domperidone from outside the US.”

Why didn't they mention the danger to diabetics, if they are so concerned, for whom some endocrinologists in the US are prescribing domperidone for gastric paresis? Why specifically for breastfeeding women? Why not specifically for diabetics who are at much greater risk of cardiac arrhythmias than women of reproductive age?

Why did this warning come out exactly on the day that the National Breastfeeding Campaign was to begin in the US?

I have used domperidone, in infants (for spitting up) but mostly to increase milk supply in women, in thousands of women, without any more than the occasional mother getting mild headaches or occasional menstrual irregularities or mild abdominal cramping as side effects. I cannot say the same for metoclopramide which I saw causing severe CNS side effects, aside from depression.

I have personally seen two children die of Stevens-Johnson Syndrome after taking Septra. If I have seen two, how many have actually occurred in the US and Canada? Why no such warnings on Septra? I have, as a medical resident, seen at least one person die and several get severely ill after taking ASA, from gastric bleeding. In overdose, many children have died and many have become seriously ill over the years because of ASA. Why no such warning on aspirin?

Many women have died and many more severely injured from taking the birth control pill. Why is it not banned?

The issue comes up about providing a drug for women in good health and that we should not be treating healthy women with a drug. I disagree. With all the talk about preventive medicine, when it actually comes down to trying to prevent illness, it is all lip service. The data are clear. Breastfeeding decreases the risk of breast cancer and type 2 diabetes in the mother. In the baby it decreases the risk of diabetes (type 1 and 2), obesity, hypertension, high LDL/HDL levels, otitis media, asthma, and allergies, gastroenteritis, and and in premature babies, necrotizing enterocolitis. The first 4 of these are all risk factors for atherosclerosis, the most significant degenerative disease in affluent societies and the biggest killer. The data are clear that breastfeeding results in better cognitive development in children. The data are less clear, but suggestive, that breastfeeding decreases the risk of certain cancers in children (Hodgkin's and non Hodgkin's lymphoma, breast cancer in later life), multiple sclerosis and inflammatory bowel disease.

Thus, we should do all that is reasonable to maintain and increase the success of woman who are breastfeeding. If this means that, in some cases, we use a drug that, in my experience of using it with thousands of women, is safe, with only minor side effects, we should have that option. Of course, there is no such thing as a drug which never causes side effects, and there are probably very few approved drugs (yes, even approved drugs) out there that haven't killed someone, but if one weighs the risk against the benefits, domperidone can do much good. I will continue to prescribe domperidone to women when I feel it will be useful. It's a shame, though, for women in the US to be deprived of this drug. The FDA says that it will monitor the border to make sure none gets through. Good for them. With heroine and cocaine getting through their borders as through a sieve, it's great that the US can now be sure that their borders are safe against an influx of the dreaded domperidone. What a waste of manpower! What a waste!

Questions? First look at the website nbci.ca or drjacknewman.com. If the information you need is not there, go to Contact Us and give us the information listed there in your email. Information is also available in Dr. Jack Newman’s Guide to Breastfeeding (called The Ultimate Breastfeeding Book of Answers in the USA); and/or our DVD, Dr. Jack Newman’s Visual Guide to Breastfeeding (available in French or with subtitles in Spanish, Portuguese and Italian); and/or The Latch Book and Other Keys to Breastfeeding Success; and/or L-eat Latch and Transfer Tool; and/or the GamePlan for Protecting and Supporting Breastfeeding in the First 24 Hours of Life and Beyond.

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