Tandem ve Gebelikte Emzirmede Hemşirelik Yaklaşımı

Yıl 2022, Cilt: 9 Sayı: 1, 95 - 99, 11.04.2022

Hamide Coşkun Erçelik

https://doi.org/10.31125/hunhemsire.1102089

Öz

Emzirmenin anne ve bebek sağlığı açısından son derece önemli olduğu bilinmektedir. Türkiye’de anneler bebeklerini değişen sürelerde emzirmektedir. Ancak; emzirme döneminde yeniden gebe kalan anneler, emzirmenin sürdürülmesi konusunda kararsızlık yaşamakta ve çoğu zaman emzirmeyi sonlandırmaktadır. Bazı anneler ise, gebelikte emzirmeyi sürdürmekte ve doğum sonrasında hem yenidoğanı hem de büyük bebeği emzirmeye (tandem emzirme) devam etmektedir. Bu noktada; hemşirenin vereceği etkili bir eğitim, bakım ve danışmanlık hizmeti emzirmenin sürdürülmesi/sonlandırılması kararında anneye yardımcı olacaktır. Literatürde bu konuda araştırmalar olmasına karşın; emzirmenin koşulsuz önerilmesi veya reddedilmesini destekleyen çok az kanıt vardır. Bu sebeple hemşirelerin ve diğer sağlık profesyonellerinin anneleri nasıl bilgilendirecekleri ve yönlendirecekleri önem kazanmaktadır. Bu derleme, tandem ve gebelik döneminde emzirmenin anne ve çocuk sağlığına etkilerini hemşirelik yaklaşımıyla ele almak, hemşirelerin bu konuda farkındalıklarını artırmak ve emzirme eğitiminde kullanılabilecek kanıta dayalı öneriler sunmak amacıyla yazılmıştır.

Anahtar Kelimeler

Anne sütü, emzirme, gebelik, hemşirelik, tandem emzirme

Nursing Approach for Breastfeeding in Tandem and Pregnancy

Öz

The vital significance of breastfeeding for mothers and infants have been widely acknowledged. Mothers in Turkey breastfeed their babies for variable durations. However, breastfeeding mothers who get pregnant again are often uncertain about continuing breastfeeding, and in many cases, they stop doing so. Some mothers, on the other hand, continue breastfeeding while pregnant and they breastfeed both the newborn and the older baby (tandem breastfeeding) after delivery. In this regard, mothers will particularly benefit from the efficient education, care and counseling services to be provided by nurses. Despite a considerable number of studies on breastfeeding, little evidence has been reported whether or not mother should continue breastfeeding unconditionally. Therefore, it is of utmost importance for nurses and other medical personnel to inform and guide mothers properly. Consequently, this review aims to explore the influences of tandem breastfeeding and breastfeeding in pregnancy on maternal and child health with a nursing approach, to raise nurses’ awareness towards tandem breastfeeding and breastfeeding in pregnancy, and to present evidence-based suggestions that can be used in breastfeeding education.

Anahtar Kelimeler

Breast milk, breastfeeding, nursing, pregnancy, tandem breastfeeding

Kaynakça

• 1. World Health Organization. Breastfeeding [Internet]. 2018 [Erişim Tarihi 4 Nisan 2021]. Erişim adresi: https://www.who.int/news-room/facts-in-pictures/detail/breastfeeding
• 2. Victora CG, Bahl R, Barros AJ, França GV, Horton S, Krasevec J, et al. Breastfeeding in the 21st century: Epidemiology, mechanisms, and lifelong effect. The Lancet. 2016;387(10017):475-90.
• 3. Horta BL, Loret de Mola C, Victora CG. Breastfeeding and intelligence: A systematic review and meta-analysis. Acta Paediatr. 2015;104(467):14-9.
• 4. Hacettepe Üniversitesi Nüfus Etütleri Enstitüsü. 2018 Türkiye Nüfus ve Sağlık Araştırması, temel bulgular [Internet]. 2019 [Erişim Tarihi 4 Nisan 2021]. Erişim adresi: http://www.hips.hacettepe.edu.tr/tnsa2018/rapor/2018_TNSA_Ozet_Rapor.pdf
• 5. Anitasari B, RachmawatyI N, Permatasari H. Breastfeeding practices during pregnancy from the perspective of women in Makassar city. JHSP. 2019;3(3):1-8.
• 6. O’Rourke MP, Spatz DL. Women's experiences with tandem breastfeeding. MCN Am J Matern Child Nurs. 2019;44(4):220-7.
• 7. Molitoris J. Breastfeeding during pregnancy and its association with childhood malnutrition and pregnancy loss in low-and Middle-Income countries. Lund Papers İn Economic Demography. 2018;(3):1-81.
• 8. American Academy of Family Physicians. Family physicians supporting breastfeeding (Position paper) [Internet]. 2017 [Erişim Tarihi 4 Nisan 2021]. Erişim adresi: https://www.aafp.org/about/policies/all/breastfeeding-position-paper.html
• 9. Güler B, Bilgiç D, Okumuş H, Yağcan H. Gebelikte beslenme desteğine ilişkin güncel rehberlerin incelenmesi. DEUHFED. 2019;12(2):143-51.
• 10. Türk Jinekoloji ve Obstetrik Derneği. Uluslararası Jinekoloji ve Obstetri Federasyonu (FIGO) adölesan, gebelik öncesi ve maternal beslenme önerileri: “Önce beslenmeyi düşün.” IJGO. 2015;(4):41-55.
• 11. Ayrim A, Gunduz S, Akcal B, Kafali H. Breastfeeding throughout pregnancy in Turkish women. Breastfeed Med. 2014;9(3):157-60.
• 12. Şengül Ö, Sivaslıoğlu AA, Kokanali MK, Üstüner I, Avşar AF. The outcomes of the pregnancies of lactating women. Turk J Med Sci. 2013;43(2):251-4.
• 13. Shaaban OM, Abbas AM, Abdel Hafiz HA, Abdelrahman AS, Rashwan M, Othman ER. Effect of pregnancy-lactation overlap on the current pregnancy outcome in women with substandard nutrition: A prospective cohort study. Facts Views Vis Obgyn. 2015;7(4):213-21.
• 14. López-Fernández G, Barrios M, Goberna-Tricas J, Gómez-Benito J. Breastfeeding during pregnancy: A systematic review. Women Birth. 2017;30(6):292-300.
• 15. Sinkiewicz-Darol E, Bernatowicz-Łojko U, Łubiech K, Adamczyk I, Twarużek M, Baranowska B, et al. Tandem breastfeeding: A descriptive analysis of the nutritional value of milk when feeding a younger and older child. nutrients. 2021;13(1):277.
• 16. Yulia A, Johnson MR. Myometrial oxytocin receptor expression and intracellular pathways. Minerva Ginecol. 2014;66(3):267-80.
• 17. O’Donoghue K. Physiological changes in pregnancy. Baker PN, Kenny LC, editors. Obstetrics by ten teachers. 19th ed. London: Hodder Arnold; 2011. p.32.
• 18. Riordan J, Wambach K. Breastfeeding and human lactation. 4th ed. Sudbury, MA: Jones and Bartlett publishers; 2010. Chapter 3, Anotomy and physiology of lactation; p.79-109.
• 19. Madarshahian F, Hassanabadi M. A comparative study of breastfeeding during pregnancy: Impact on maternal and newborn outcomes. J Nurs Res. 2012;20(1):74-80.
• 20. Albadran MM. Effect of breastfeeding during pregnancy on the occurrence of miscarriage and preterm labour. Iraqi JMS. 2013;11(3):285-9.
• 21. Ishii H. Does breastfeeding induce spontaneous abortion? JOGR. 2009;35(5),864-8.
• 22. Molitoris J. Breast-feeding during pregnancy and the risk of miscarriage. Perspectives on sexual and reproductive health. 2019;51(3):153–63.
• 23. Pareja RG, Marquis GS, Penny ME, Dixon PM. A case-control study to examine the association between breastfeeding during late pregnancy and risk of a small‐for‐gestational‐age birth in Lima, Peru. Matern Child Nutr. 2015;11(2):190-201.
• 24. Marquis GS, Penny ME, Diaz JM, Marín RM. Postpartum consequences of an overlap of breastfeeding and pregnancy: Reduced breast milk intake and growth during early infancy. Pediatrics. 2002;109(4):56.
• 25. Cunniff A, Spatz D. Mothers’ weaning practices when infants breastfeed for more than one year. MCN Am J Matern Child Nurs. 2017;42(2):88–94.
• 26. Karamustafaoğlu Balcı B, Göynümer G. Pregnancy and puerperium during lactation. Perinatal Journal. 2015;23(3):194–200.
• 27. Tiwari S, Agarwal RK. Breastfeeding during/after next pregnancy. NIJP. 2012;1(1):2.