Hormontherapie beim Mammakarzinom von Dr. med Bernhard Ost Warum Hormontherapie? In Deutschland erkranken jährlich rund 50.000 Frauen an Brustkrebs, 19.000 sterben jährlich daran. Seit langem ist bekannt, dass ein Zusammenhang zwischen Östrogenen und der Entstehung eines Mammakarzinoms besteht. Das heißt, das weibliche Geschlechtshormon Östrogen gibt den Krebszellen einen Wach
Induced breastfeedingNewsflash: Hea
AsiaViews, Edition: 19/VII/August2010
LIKE other new mums, Sal y (not her real name) shared a fulfil ing breastfeeding relationship with her newborn baby.
But unlike them, she did not go through pregnancy and the painful process of childbirth. Sal y adopted her son Andrew four years ago,when he was just two weeks old. The names have been changed to protect their identities.
When Sal y held him in her arms for the first time, she knew for certain that she would treat Andrew like her own. So she made thedecision to breastfeed him.
"I've never felt like I was an adoptive mum, so like any biological mother, I wanted to give him the best. Through breastfeeding, I wasable to build that mother-and-child bond with my baby," said Sal y, who is in her early 40s.
To induce lactation, she consulted a doctor and a lactation consultant, and took a combination of medication. It was a tough process, but she was "mental y prepared".
Said Sal y: "I strongly wanted to breastfeed my baby. Realising the benefits of breastfeeding helped me to overcome al difficulties." Such cases are rare in Singapore. But lactation experts Today spoke to said it is possible to induce lactation.
At KK Women's and Children's Hospital, lactation consultant Cynthia Pang, who is also the assistant director of nursing, said the hospital sees about two to three such cases each year. It saw five cases last year.
Betty Lee, a lactation consultant in private practice, said induced lactation is not new. The practice dates back to centuries ago. In somecountries, women do it to care for orphaned babies.
"Most of the adoptive mums we see choose this option to enhance the mother-child bonding. They also hope to provide breast milk to Features
build up the health and immunity of the baby," said Ms Pang.
According to Ms Lee, any breast milk a baby receives is nutritious, regardless of the source.
"Breast milk contains antibodies, nutrients and enzymes that aid a baby's development. The nutritional value of breast milk (from the natural or non-biological mother) is the same, although an adoptive mum may find it hard to produce sufficient milk to breastfeed 'Tricking' the body to produce milk
The main chal enge that adoptive mums face is to produce a good supply of breast milk and maintaining it.
Most natural mums who go through pregnancy and childbirth have no problems doing so, because the body natural y goes through "During pregnancy, progesterone and oestrogen are at high levels. These are the hormones which support the pregnancy. The breasts are also prepared for lactation at this point by increasing in size," explained Ms Lee.
When the baby is delivered, she continued, these hormones levels drop immediately. "This is when another hormone, prolactin, is released to activate the milk cel s in the breasts to produce milk." Women who attempt to induce lactation go through a process which mimics these hormonal changes.
If a woman knows when she wil be adopting a newborn, Ms Pang advised preparing four to five months in advance.
She said: "A combination of progesterone-oestrogen pil s and domperidone (a medication which triggers the milk hormones, prolactin) is used to prepare the mother's breast to produce milk." About six to eight weeks before the baby is due, the progesterone-oestrogen in the body is stopped. Domperidone continues to boost the milk hormones. This is also when the adoptive mum is encouraged to stimulate her milk production with a milk pump, said Ms Pang.
In the initial stages, Sal y used a lactation aid to provide additional milk for her baby. Most adoptive mums wil need to use this, said Ms A lactation aid is a supplementary nursing system which comprises a bottle containing formula. The milk is dispensed through two tiny tubes attached close to the nipples to provide additional milk to the baby during breastfeeding.
"The sucking reflex of the baby wil further stimulate the mother's own milk production," said Ms Pang.
No walk in the park
The process, warned lactation experts, can be an arduous one.
"The adoptive mum wil encounter more chal enges than a natural mum, especial y during the initial phase of stimulating milk supply," And sometimes, even after al that effort, Ms Lee said an adoptive mum may not be able to produce sufficient milk.
But for many adoptive mums, breastfeeding isn't just about providing their babies adequate nutrients.
"It's also the bonding and satisfaction they get from nursing their babies," said Ms Lee.
After three months, Sal y's perseverance paid off. The experience of final y producing breast milk "was very emotional and heart- Although she did not produce sufficient milk to breastfeed exclusively, she continued to nurse her baby until he was a year old.
"Now my boy is four years old, bright and bubbly. I have no regrets," she said.
How safe is induced lactation?
According to Dr Wee Horng Yen, consultant and director of KKH's KK Women Wel ness Centre, studies have shown that the progesterone-estrogen pil , which is also an oral contraceptive, is safe to use.
Furthermore, as the pil s are taken before lactation occurs, they wil not affect the baby. Studies looking at the long-term safety of domperidone, which stimulates the milk hormones, on mother and babies have also not shown conclusive evidence of harmful effects in Today 03 August 2010
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Progesterone testing pinpoints source of breeding problems Todd Byrem, Ph.D., Director, AntelBio In November we discussed a herd that was having breeding problems and Julie Ainsworth, NorthStar Cooperative’s Dairy Production Analyst was called in to assess the problem. With a pregnancy rate of just 15 percent and a first-service conception rate of only 22 percent, this herd was s