Borstvoeding
Inhoud
1. Back to the basics...............................................................................................................................3
1.1 Het begin......................................................................................................................................3
1.2 De 7 natuurwetten........................................................................................................................3
1.2.1 Wet 1.....................................................................................................................................3
1.2.2 Wet 2.....................................................................................................................................3
1.2.3 Wet 3.....................................................................................................................................4
1.2.4 Wet 4.....................................................................................................................................4
1.2.5 Wet 5.....................................................................................................................................5
1.2.6 Wet 6.....................................................................................................................................5
1.2.7 Wet 7.....................................................................................................................................5
1.3 Fysiologie van de lactatie..............................................................................................................5
1.4 Verstoring vh natuurlijke borstvoedingsproces............................................................................6
1.5 Always remember.........................................................................................................................6
2. Borstvoedingsbegeleiding door de vroedrouw: aandachtspunten opvolging thuis............................7
2.1 Borstvoedingsbegeleiding door de vroedvrouw...........................................................................7
2.1.1 Welke factoren belemmeren en/of bevorderen de BV-begeleiding do de vv?......................8
2.1.2 De discussie...........................................................................................................................9
2.1.3 De conclusie.........................................................................................................................10
2.1.4 Aanbevelingen voor de praktijk...........................................................................................10
2.2 Borstvoeding promoten..............................................................................................................10
2.3 Borstvoeding geven, een keuze?................................................................................................11
2.3.2 Ethisch.................................................................................................................................11
2.4 Aandachtspunten voor de opvolging ve borstvoeding thuis.......................................................12
2.5 Do’s and Dont’s...........................................................................................................................12
3. Problemen bij borstvoeding – als het anders loopt..........................................................................15
3.1 Inleiding......................................................................................................................................15
3.2 Tepelproblemen.........................................................................................................................16
3.2.1 Tepeltrauma........................................................................................................................17
3.2.2 Ankyloglossia.......................................................................................................................17
3.2.3 Fenomeen van Raynaud......................................................................................................20
3.3 Borstproblemen..........................................................................................................................21
3.3.1 Candida................................................................................................................................21
1
, 3.3.2 Mastitis................................................................................................................................22
3.3.3 Borstabces...........................................................................................................................23
3.4 BV en Covid-19...........................................................................................................................24
4. Bijvoeding, introductie vaste voeding en lang voeden.....................................................................25
4.1 Inleiding......................................................................................................................................25
4.2 Bijvoeding bij borstvoeding........................................................................................................26
4.3 Kunstvoeding..............................................................................................................................27
4.4 Introductie vaste voeding...........................................................................................................30
4.5 Stoppen met borstvoeding.........................................................................................................31
4.6 Relactatie....................................................................................................................................31
4.7 Borstvoeding en werken.............................................................................................................32
4.8 Langvoeden en tandemvoeden..................................................................................................33
4.9 Borstvoeding bij adoptie.............................................................................................................34
5. Medicatie en borstvoeding...............................................................................................................35
5.1 Transfer van medicatie naar moedermelk..................................................................................35
5.1.1 Principes v transfer..............................................................................................................35
5.1.2 Fysiochemische eigenschappen van de medicatie...............................................................35
5.1.3 Tips om de transfer van medicatie te beperken..................................................................37
5.1.4 Medicatie die de melkproductie afremt..............................................................................38
5.1.5 Medicatie die gegeven w wanneer parturiënt lactatie onderdrukt.....................................38
5.1.6 Tegenaangewezen medicatie..............................................................................................39
5.1.7 Enkele begrippen.................................................................................................................40
5.2 Evalueren van het risico..............................................................................................................40
5.3 Verder.........................................................................................................................................41
5.4 LAM............................................................................................................................................41
2
, 1. Back to the basics
Golden Hour: Het eerste uur pp
1.1 Het begin
9 fasen na geboorte: Moeder- & babygedrag:
1.2 De 7 natuurwetten
1.2.1 Wet 1
Wet 1: Moeders & baby’s zijn voorgeprogrammeerd om BV te
geven
Natuurlijk gedrag
o Breast Crawl
o Primitieve neonatale reflexen
o Hongersignalen
Biological nurturing
Natuurlijk moedergedrag
Oxytocine
Hoe werkt borstvoeding?
1.2.2 Wet 2
Wet 2: Het lichaam van de moeder is de natuurlijke habitat vd
pasgeborene
Skin-to-skin contact
Oxytocine
Voedingsreflexen
Indien geen skin-to-skin
o Lagere glycemie
o Minder goede thermoregulatie
o Meer AH-problemen
o Huilen meer
Voordelen:
o Betere neurologische ontwikkeling
o Meer BV
o Minder angst & stress
3
, o Betere hechting
Stressregulatie: PG kan stress niet reguleren Nood aan “veilige basis”
o Indien moeder / veilige basis weg: °Stress
o Verdedigingsmechanisme: huilen (protest, meer stresshormonen, maagdarmfuncties
vallen stil)
o °Wanhoop > Verdedigingsmechanisme: waakstand
Hartslag & T° dalen, AH vertraagt, groei vertraagt
Dragen baby
1.2.3 Wet 3
Wet 3: Een beter gevoel en betere flow in comfortzone
Goed aanhappen & aanleggen cruciaal
o “Lippenstifttepel”: BV dat pijn blijft doen
o Verkorte tongriem?
Verschillende houdingen
Regel van 3:
o Buik tegen buik (lichaam op 1 lijn)
o Neus thv tepel
o Mond wijd open: lipjes nr buiten, tepel
tepelhof in mond
Asymmetrisch aanhappen
Geen pijn ad tepels
Ademen – zuigen – slikken
Niet klakken, noch smakken, gn kuiltjes
Biological Nurturing
1.2.4 Wet 4
Wet 4: Meer borstvoeding in het begin betekent meer melk later
Hoe meer drinken > Hoe meer borsten gestimuleerd w
Maaginhoud PG: knikker – ei
Prolactinereceptortheorie
Kort, maar vaak voeden
Hongersignalen
Rooming-in
borsten /x?
Prolactinereceptortheorie: Elke keer dat
baby drinkt, Oxytocine toeschieten
4
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