kobieta karmi piersią Karmienie piersią a zajście w ciążę. Westend61/Getty Images

Czy odstawienie dziecka od piersi jest konieczne podczas drugiej ciąży? Wyjaśnia ginekolog

Spis treści:

Zobaczyłaś dwie kreski na teście ciążowym i już wiesz, że po raz kolejny zostaniesz mamą. Jeśli twoje starsze dziecko wciąż jest karmione piersią, może pojawić się dylemat, czy powinnaś je odstawić. Na to pytanie odpowiada ginekolog dr Ewa Kurowska.

Czy karmienie piersią chroni przed zajściem w ciążę? To pytanie zadaje sobie większość karmiących matek. Teoretycznie tak, występuje bowiem u nich tzw. niepłodność laktacyjna. Jej skuteczność zależy jednak od wielu czynników. Powrót płodności po porodzie jest kwestią indywidualną, a im rzadziej maluch przystawiany jest do piersi, tym szansa na zajście w ciążę wzrasta. Należy również pamiętać, że nawet jeśli u karmiącej mamy miesiączka jeszcze nie wróciła, to owulacja mogła się już pojawić (owulacja poprzedza krwawienie). Gdyby niepłodność laktacyjna była skutecznym środkiem antykoncepcyjnym, internet nie byłby pełen wpisów kobiet, które zaszły w drugą ciążę, karmiąc piersią.

Karmienie piersią podczas ciąży

Jeśli ponownie spodziewasz się dziecka, a nadal chcesz karmić piersią swoją starszą pociechę, mamy dobrą wiadomość: nie ma ku temu przeciwwskazań. – Jeżeli mama dalej chce karmić dziecko piersią, a ono tej piersi nie odrzuca, i jeśli kolejna ciąża przebiega podręcznikowo, to nie ma wskazań, by koniecznie odstawić dziecko od piersi – tłumaczy dr n. med. Ewa Kurowska, ginekolog ze Szpitala Medicover. Również Ministerstwo Zdrowia nie wymienia kolejnej ciąży wśród przeciwwskazań do karmienia piersią.

Jest jednak jedno „ale”. Dr Ewa Kurowska wyjaśnia, że proces laktacji wiąże się z wytwarzaniem hormonów, które mogą powodować skurcze macicy, więc gdyby w kolejnej ciąży kobieta karmiąca piersią odczuwała np. pobolewania w dole brzucha, powinna omówić to z lekarzem prowadzącym ciążę, który podejmie decyzję, czy należy zakończyć naturalne karmienie.

Pytam dr Ewę Kurowską, czy ciąża zagrożona jest wskazaniem do odstawienia starszaka od piersi. – Nie ma badań na ten temat, bo trudno byłoby przeprowadzić takie doświadczenie na kobietach w ciąży zagrożonej i do tego karmiących piersią. Dlatego do każdej pacjentki należy podejść indywidualnie. Ciąża zagrożona sugeruje, że może pojawić się poronienie albo poród przedwczesny. W takim przypadku karmienia piersią jako czynnik mogący wywoływać skurcze i napięcie macicy, z dużym prawdopodobieństwem powinien zostać wyeliminowany, ale ostateczną decyzję podejmuje lekarz – tłumaczy ginekolog.

Lekarz może zalecić ciężarnej pacjentce zakończenie naturalnego karmienia, jeśli:

Na jeszcze jedną kwestię zwraca uwagę dr Ewa Kurowska. Otóż gdy kobieta zajdzie w ciążę, skład jej pokarmu się zmieni, a z nim również jego smak. – Może się więc zdarzyć tak, że dziecko samo odrzuci pierś – zauważa lekarka. Ale uwaga: mitem jest przekonanie, że mleko ciężarnej stanie się kwaśne, za chude, bezwartościowe. Nic takiego się nie stanie. Nadal będzie bogatym w substancje odżywcze pokarmem.

– Generalnie u zdrowych ciężarnych kobiet, jeśli ciąża ma prawidłowy przebieg, droga do kontynuowania karmienia jest otwarta i ostateczna decyzja zależy od tego, jakie poglądy na ten temat ma mama i jak się czuje – sumuje dr Ewa Kurowska.

Jak długo karmić piersią?

Światowa Organizacja Zdrowia (WHO) zaleca karmić wyłącznie piersią przez pierwsze pół roku życia dziecka, a następnie kontynuować karmienie (jako uzupełnienie zróżnicowanej diety) do drugiego roku życia i dłużej. Autorytety medyczne nie podają górnej granicy, do której należy karmić piersią.

Ministerstwo Zdrowia wśród zalet naturalnego karmienia dla zdrowia dziecka wymienia m.in. zmniejszenie ryzyka infekcji (zwłaszcza ostrego zapalenia ucha środkowego i przewodu pokarmowego), zmniejszenie ryzyka rozwoju niektórych rodzajów nowotworów (w tym białaczki limfatycznej i szpikowej) oraz zmniejszenie ryzyka hospitalizacji w pierwszym roku życia. U dzieci karmionych piersią rzadziej występują nadwaga, otyłości, cukrzyca oraz inne choroby niezakaźne. Poza tym ssanie piersi sprzyja ćwiczeniu mięśni twarzy i jamy ustnej, co pozytywnie wpływa na rozwój mowy u dziecka.

U matek naturalne karmienie powoduje szybsze obkurczanie się macicy i redukuje ryzyko wystąpienia krwotoku poporodowego, a także niedokrwistości z powodu niedoboru żelaza. Zmniejsza również ryzyko zachorowania na raka sutka, jajników i osteoporozy.

Dr Ewa Kurowska podkreśla jednak, że mleko matki to nie woda. Oprócz substancji odżywczych zawiera również cukier. – Gdyby zapytać stomatologów dziecięcych, do kiedy powinno się karmić piersią, odpowiedzą, że karmienie naturalne powyżej roku staje się szkodliwe dla uzębienia małego dziecka. A nie znam mamy, która po wieczornym czy nocnym karmieniu piersią, myłaby dziecku zęby – mówi ginekolog. Zdaniem dr Kurowskiej trzeba pamiętać, że roczne dziecko (i starsze) samo wytwarza sobie bezcenne przeciwciała albo dostarcza sobie niezbędnych składników odżywczych wraz z dietą. Mama może więc po roku odstawić dziecko od piersi, bez obaw o zdrowie malucha.

Jeśli jednak zdecydujesz się kontynuować karmienie piersią podczas ciąży, a nawet po urodzeniu dziecka, nic nie stoi na przeszkodzie, byś karmiła… dwójkę dzieci. Piersi działają na zasadzie fabryki, a nie magazynu, co oznacza, że jeśli będziesz regularnie przystawiać maluchy, laktacja będzie pobudzana na bieżąco i mleka nie zabraknie. Pamiętaj jedynie, by najpierw nakarmić noworodka, dla którego twój pokarm to jedyne i bezcenne dla zdrowia oraz życia pożywienie.

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