A WIDELY IGNORED SHIFT IN BREASTFEEDING母乳喂养中一个被普遍忽视的转变

As a followup to the recent post on breast compression, I would like to point out that how a baby latches on, is also very important to increasing the breastmilk intake by the baby.

作为对我最近发表的关于乳房按压这篇文章的跟进，我想强调宝宝的含乳姿势对于增加他的母乳摄入量也是非常重要的。

 

There is a shift in breastfeeding that should have occurred a long time ago. A shift to the asymmetric. An asymmetric latch. Knowing how to achieve an asymmetric latch is crucial to helping mothers with breastfeeding and increasing the breastmilk intake by the baby. Showing mothers what an asymmetric latch looks like is one of the first things we do at our clinic when helping mothers with breastfeeding. Together with breast compression, it is a foundation for everything else we do.
母乳喂养中有一个应该是很久以前发生的转变，那是一个不对称的转变，也就是不对称的含乳姿势。了解如何实现不对称的含乳，对于帮助母亲进行母乳喂养并增加宝宝的母乳摄入量至关重要。向妈妈展示什么是不对称的含乳是我们在诊所里帮助她们进行母乳喂养的首要任务之一。不对称含乳与乳房按压一起，是我们做其他所有事情的基础。

 

Why does it make a difference? The deeper (or better) the baby’s latch on the breast, the better; better, from the point of view of mother’s having pain or not, and how well the baby gets breastmilk. Pain during breastfeeding is a sign the mother needs help; so if breastfeeding hurts, almost always, the baby´s latch is not as good as it could be. Even Candida (“thrush”, “yeast”) infections are due to an underlying problem, since Candida does not grow on normal skin; the damage of the skin from a poor latch comes first and needs to be fixed if we are to provide a permanent solution to Candida or nipple pain of any kind. As well, the better the latch, the more breastmilk the baby will get from the breast.
不对称的含乳为什么会让母乳喂养有所不同呢？宝宝在乳房上含乳越深，效果越好。这个“好”是从母亲是否感觉疼痛和宝宝得到乳汁的情况这两个角度来看的。哺乳期间的疼痛是母亲需要帮助的一个信号；如果妈妈的乳房因为哺乳而疼痛，通常因为宝宝的含乳姿势不够好，即使母亲感染了念珠菌（“鹅口疮”，“酵母菌”）也是由于一个潜在的因素，念珠菌不会在健康的皮肤表面上繁殖；妈妈在感染之前应该出现了由不良含乳姿势造成的皮肤破损。如果我们要为念珠菌感染或其它任何类型的乳头疼痛提供永久的解决方案，首先需要解决的是由不良含乳造成的皮肤损伤。同样的，宝宝的含乳姿势越好，就能够从乳房得到更多的乳汁。

 

The experience of my time in Africa provided me with an interesting insight: one of the things I noticed back many years ago was that the mothers were often latching the baby on with what I would consider a poor latch. I discussed this with the person in charge of teaching for the Baby Friendly Hospital Initiative, wondering why, if it were so important, as I believed then as did she, why mothers we were seeing had babies with really poor latches and yet neither the mother nor the baby had problems with breastfeeding. True, sore nipples, even there, were considered “normal”. I pointed out to her that we were seeing many mothers breastfeeding without problems of poor weight gain in the babies despite what I (and she) would have considered a poor latch. I didn’t anticipate her answer: “Yes, quite right, but the mothers in this area are said to have their milk drying up very early, usually within the first 4 months”.
我在非洲的经历让我得到一个有趣的发现：许多年前我就注意到一个现象，那里的母亲们经常用一种我认为糟糕的姿势让宝宝含乳。我和一位在“爱婴医院倡议”负责教学的工作人员讨论过这件事，我想知道的是，如果含乳姿势真如我们两个都认为的那样重要，为什么即使我们看到的母亲们让宝宝的含乳姿势如此糟糕，然而母亲和宝宝在母乳喂养方面却没有出现什么问题？ 真的，乳头疼痛在那里甚至被认为是“正常的”。 我向她指出，即使我（和她）认为婴儿的含乳姿势有问题，但我们看到许多母亲母乳喂养她们的宝宝并没有出现体重增长不良的问题。我没有预料到她的答案会是：“是，太对了。但是据说这个地区的母亲们很早就没有奶了，通常在产后头4个月内”。

 

And we see this problem in Toronto as well. Mothers who started off with an abundant milk supply, around 3 or 4 months after birth have babies who start acting as if they are not getting fast enough flow of breastmilk. They pull at the breast, they are fussy at the breast and between feedings, they are frequently sucking their fingers much of the time, and they may even refuse to take the breast, especially during the day. And all this may occur despite the baby breastfeeding exclusively and even gaining weight well. Which makes it difficult for the mothers to believe their milk supply has decreased – this decrease being relative to the copious milk supply the mother had in the beginning.
而且我们在多伦多也遇到过这种问题。一开始母亲的奶量供应是充足的，在大约3到4个月之后，婴儿开始表现出他们好像没有得到足够快速的奶流。他们拉扯乳房，在吃奶的时候和两次哺乳的间隔都表现得很烦躁，大部分时间里宝宝经常吸吮自己的手指，甚至可能会拒绝接受妈妈的乳房，特别是在白天。所有这一切都可能会发生，即使宝宝是纯母乳喂养甚至体重增长情况不错。这让母亲们难以相信她们的奶量已经减少了——这种减少是相对于母亲在一开始时充足的奶量而言。

 

Because of continued good weight gain in many, the babies are diagnosed with “reflux”, or allergy to something in the mother’s milk. But these diagnoses can only be made if one does not look at the whole picture and watching to see if drinking from the breast or not. Watching the baby at the breast will verify that the baby is pulling, crying, popping off and on the breast when the flow of milk slows.
因为许多婴儿的体重增加情况持续良好，这类表现烦躁的婴儿往往被诊断为患有“胃食管返流症”或对母乳中某些成分过敏。但是这种诊断只有在一种情况下才会被做出，那就是接诊的医生没有了解到事情的全貌，也没有观察婴儿是否真的从母亲的乳房喝到了奶。观察宝宝吃奶的情况让我们能够确认：当乳汁流速减慢时，宝宝开始拉扯乳房、哭闹、嘴巴放开乳房然后又含上。

 

I commonly hear from mothers that they were told the baby’s latch was good. When we see the mothers and babies at the clinic, it is clear the baby’s latch could be much better and we show then how to make a shift to the asymmetric latch.
我经常听到母亲们说，别人告诉她们宝宝的含乳姿势很好。然而当我们在诊所看到母亲和婴儿时，很明显，宝宝的含乳姿势还有很大的改善空间。然后我们教给妈妈如何把含乳姿势转变成不对称的含乳。

 

With the asymmetric latch, the baby’s chin is in the breast, but the nose is not. The baby covers more of the areola with his lower lip than the upper lip. The photo below shows the opposite of the asymmetric latch. And why the asymmetric latch rather than the other?
不对称的含乳姿势让宝宝的下巴陷进乳房，但鼻子不会触碰到乳房。宝宝的下唇比上唇覆盖了更多的乳晕。下面的第一张图片展示了不对称的含乳，第二张图片是和不对称含乳相反的姿势。那么为什么不对称的含乳姿势比另一个更好

 

In the photo 1, the baby has an asymmetric latch, the chin is in the breast, the nose is not. In photo 2, the baby does the opposite – the nose touches the breast and the chin does not. In both cases, the baby has a deeper latch, or a “partial” deep latch; in photo 1, the baby has more of the breast where his lower jaw and gums, and the tongue are.
在图片1中，宝宝是不对称的含乳，下巴陷进乳房里，鼻子没有触碰到乳房。 在图片2中则相反——宝宝的鼻子触碰到乳房，下巴并没有。两种情形中婴儿都有一个较深的含乳，或者是“部分”较深的含乳；在图片1中，婴儿的下颚、牙龈和舌头共同含住了更多的乳房。

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

In photo 2, the baby has more of the breast where his maxilla (upper jaw) is. In photo 1, the baby’s lower jaw and tongue can stimulate the breast to release its milk, to stimulate rapid flow. In photo 2, the upper jaw does not move, so the stimulation of the breast is just not effective since the lower jaw and tongue are very shallowly attached to the breast

在图片2中，宝宝的上颌骨（上颚）接触到更多的乳房。在图片1中，宝宝的下颌和舌头可以刺激乳房排出乳汁并且刺激乳汁快速流动。在图片2中，宝宝的上颌不动，下颌和舌头非常浅地包裹住乳房，所以不能对乳房产生有效的刺激。

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

如需母乳喂养方面的帮助，可以向我们的诊所预