신생아수유계획 38 주이전에태어나거나임신주수에비해작은 신생아수유계획 (10 퍼센타일이하 ) Feeding Plan for Infants Born Before 38 weeks or Small for Gestational Age (Below 10th percentile) (Korean) 임신주수에비해작게태어난신생아는체중이하위 10 퍼센타일미만으로크기가 작습니다. 이러한신생아들은크게태어난아기보다젖을물고, 빨고, 삼키는데있어어려움이있습니다. 이런크기로태어난많은신생아들은몸집이커지기 전까지는수유를지속적이고일관되게하지못합니다. Infants born Small for Gestational Age are smaller in size with a weight below the 10 th percentile for the gestational age. These infants have more difficulty with latch, suck and swallow than a larger infant. Many infants born at this size are not able to consistently feed well until they get bigger. 후기조산아는임신 34 와 0/7 주에서 36 과 6/7 주에태어납니다. 이런아기들은 미숙아로, 만삭아보다잠을더자려고하며, 젖을물고빨고삼키는데더큰 어려움을겪습니다. 이임신주수에태어난많은신생아들은만삭인 38 주에서 40 주사이가될때까지는수유를지속적으로잘하지못합니다. Late Preterm infants are born between 34 0/7 to 36 6/7 weeks gestation. These infants are immature, and may be sleepier and have more difficulty with latch, suck, and swallow than a full-term infant. Many infants born at this gestation are not able to consistently feed well until they reach full-term age between 38 to 40 weeks gestation. 조기만삭아는임신 37 과 0/7 주에서 37 과 6/7 주사이에태어납니다. 이들중 어떤신생아는젖을깊이물고, 힘차게빨아먹으며, 삼키는소리가들릴정도로 효율적인수유모습을보이지만, 또어떤아기들은후기조산아들과비슷한수유 양상을보입니다. 이플랜이아기에게적절한것인지를가늠하기위해서, 모유 수유상담가나간호사가수유할때와서지켜보고결정해줄것입니다. Early Term infants are born between 37 0/7 to 37 6/7. While some of these - 1 -
infants are able to demonstrate signs of effective feeding (deep latch, strong suck and audible swallows), others demonstrate feeding behaviors similar to late preterm infants. Your lactation consultant or nurse will assess a feeding to determine if this plan is appropriate for your infant. 아기가모유수유를충분히하고있는지어떻게알수있습니까? How do I know if my infant is breastfeeding enough? 아기가모유를충분히섭취하고있는지를알게해주는신호들은다음과같습니다 : Signs of adequate intake that let you know your infant is breastfeeding effectively are: - 2 -
나이 Age 생후-24 시간 Birth-24 hours 24-48 시간 24-48 hours 48-72 시간 48-72 hours 소변과대변 Urine and Stool 소변 1 회와대변 1 회 1 urine and 1 stool 소변 2 회와대변 2 회 2 urine and 2 stools 소변 3 회와대변 3 회 3 urine and 3 stools 체중감소 Weight loss 3% 미만 Less than 3 % 7% 미만 Less than 7% 7% 미만 Less than 7 % 다음의권장사항들은산모와후기조산아 / 조기만삭아가모유수유를 잘시작하는데도움이될것입니다. The following recommendations will help you and your Late Preterm/ Early Term infant get off to a good start with breastfeeding: 출산하자마자부터아기와살과살이맞닿는접촉을가능한한빨리하고, 그 후에도되도록자주하십시오.Practice skin to skin contact with your infant as soon as possible after birth, and as much as possible thereafter. 아기출생후한시간이내에모유수유를시도하십시오. Attempt breastfeeding within your infant s first hour of life. 아기가배고픈신호를보낼때마다수유를하십시오 ( 혀를내밀거나, 입술을 빨거나, 손을입으로가져감 ). 우는것은배고픔을알리는마지막신호입니다. Encourage your infant to feed whenever they are giving hunger cues (thrusting the tongue, licking lips, bringing hands to the mouth). Crying is a late sign of hunger. 아기가배고픈신호를보내지않는다면, 때로는깨워야만하는경우가있을 것입니다. 이것은후기조산아에게는흔히있는일입니다. 아기는 24 시간 동안에 8-12 회, 혹은 모유수유를해야만합니다. Sometimes, it may be necessary to wake your infant if they do not give hunger cues, which is not unusual in the late preterm infant. Your infant should be breastfed 8-12 times per 24-hour period, or every 2-3 hours. 다음의수유플랜은아기가충분한양의모유수유를하는데도움이될 - 3 -
것입니다 : The following feeding plan will help ensure your infant is getting enough milk: 젖이잘나오도록하기위해서유방을눌러주십시오. 삼키는소리가나는지잘 들어보십시오. Use breast compression to help increase the flow of milk from your breast. Listen for audible swallowing. 아기를깨워서모유수유를하십시오. 아기가젖을잘물고 적어도 10-15 분간젖을빨아야합니다. Wake your infant and offer breastfeeding every 2-3 hours. Your infant should latch well and suckle for at least 10-15 minutes. 아기가효율적으로수유하는모습을보일때까지는 ( 삼키는소리를내며젖을 힘차게빨때까지 ), 모유수유를한후에, 짜놓은모유나분유로보충수유를 해야만합니다. Your infant will need to be supplemented after breastfeeding with expressed breast milk or formula until they are able to demonstrate signs of effective feeding (strong suck with audible swallows). 매번모유수유를하고난후에, 적어도다음과같은추가량의수유를 시도하도록권장합니다 : After each breastfeeding session, we recommend that you offer your infant at least the following additional amounts of milk: 출생후 24 시간 First 24 hours of life 5-10 ml 5-10 ml Every 2-3 hours 최소한하루에 8 회 At least 8 times a day 출생후 25-48 시간 25-48 hours of life 10-30 ml 10-30 ml. Every 2-3 hours 최소한하루에 8 회 At least 8 times a day 출생후 49-72 시간 49-72 hours of life 15-30 ml 15-30 ml. Every 2-3 hours 최소한하루에 8 회 At least 8 times a day 출생후 73-96 시간 73-96 hours of life 30 ml 혹은그이상 30 ml. or more Every 2-3 hours 최소한하루에 8 회 At least 8 times a day 필요에따라양을늘리십시오 Increase as needed - 4 -
수유후에도아기가계속배고파보이면, 보충수유를더하십시오. If your infant still seems hungry after feeding, offer more supplement 아기의나이와수유전력에따라, 위의권장량을조절할필요가있을수 있습니다. 모유수유상담가, 간호사혹은의사의도움을받아서결정하시기 바랍니다. Depending on your infant s age and feeding history, the above volume recommendations may need to be adjusted. Your lactation consultant, nurse or health care provider can assist you in making this decision. 아기의상태와산모의개인적선호에따라, 숟가락, 컵, 보충수유도구나 속도를조절해주는우유병등을사용하여보충수유를할수있습니다. 어떤 수유방법이산모와아기에게가장좋을지를모유수유상담가나간호사와 상의하여결정하십시오. You may supplement your baby using a spoon, cup, supplemental nursing device or paced bottle method depending on your infant s condition and your personal preference. Please ask your lactation consultant or nurse to assist you in deciding which supplemental method is best for you and your infant. 매수유후, 성능좋은전동유축기로 15-20 분간유축하십시오. 이단계는엄마젖에서아기가직접모유수유를하기전까지충분한양의 모유를분비하는데반드시필요합니다. Pump your breasts with a quality double electric breast pump after every feeding for 15-20 minutes every 2-3 hours. This step is vital in order to establish an adequate supply of breast milk until your infant is transferring milk well directly from the breasts. 출산후첫 2 주는수유기간중에서아주 중요한 시기입니다. 호르몬의 변화에따라, 출산하고 72-96 시간이지나면 ( 약 3-4 일 ) 많은양의모유가 분비되기시작합니다. 이시기에엄마젖을자주잘비워주면, 모유분비량이 지속적으로늘어납니다. 만약에아기가모유수유에어려움을겪어서 2-3 시간 마다하는모유수유로엄마젖을완전히비울수가없다면, 2-3 시간간격으로 15-20 분동안유축기를사용하십시오. 이는아기에게줄충분한양의모유를 분비하고유지하는데반드시필요합니다. The first 2 weeks postpartum are - 5 -
a Critical time in lactation. As a result of hormonal changes, copious milk production begins around 72-96 hours after delivery (about 3-4 days). At this time, milk production continues to increase if milk is removed from your breasts frequently. If your infant is having breastfeeding difficulties and is not able to empty your breasts with feedings (every 2-3 hours), then it is vital that you use your breast pump for 15-20 minutes every 2-3 hours in order to establish and maintain enough breast milk to feed your infant. 퇴원후 1-2 일이내에, 아기의담당소아과의사를방문하여수유에관한 지속적인조언을받으십시오. See your infant s primary care provider within 1-2 days after discharge, for continued supplementation advice. 책임의한계와법적고지 : 본문서는미시간대학병원 (UMHS) 에서만든정보및 / 또는지침서류로, 여러분과동일한상태의전형적인환자를위해만들어졌습니다. 여기에는미시간대학교가직접창안하지않은온라인내용에관한링크가포함될수있는데, 이에대한책임은미시간대학교에서지지않습니다. 본문서, 건강상태혹은치료계획에대한질문이있다면, 반드시담당의료진과상담하십시오. 본문서가이를대체할수는없습니다. Disclaimer: This document contains information and/or instructional materials developed by the University of Michigan Health system (UMHS) for the typical patient with your condition. It may include links to online content that was not created by UMHS and for which UMHS does not assume responsibility. It does not replace medical advice from your healthcare provider if you have any questions about this document, your condition or your treatment plan. 번역 Translation: UMHS Interpreter Services 미시간대학병원의환자교육은 Creative Commons Attribution-NonCommercial-ShareAlike 3.0 Unported License 를통해인가받았습니다. 최종수정 2019/1/17 Patient Education by University of Michigan Health System is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 3.0 Unported License. Last Revised 1/17/2019-6 -