Ukuphathwa Kokunakekelwa Kwababelethisi Kwabomama Abangadli Imifino
Ukudla imifino kukhethwa kakhulu ngabesifazane abaseminyakeni yokuzala ngenxa yezizathu zempilo, zokuziphatha, zenkolo, kanye nezemvelo. Emsebenzini wokubeletha, omama abadla imifino—kungakhathaliseki ukuthi basadla imikhiqizo ethile yezilwane noma bagwema ngokuphelele yonke imikhiqizo yezilwane—badinga indlela ehleliwe, yomuntu ngamunye, futhi esekelwe ebufakazini yokunakekela. Ukugxila okuyinhloko ukuqinisekisa ukuthi izidingo zokudla okunempilo ziyahlangatshezwa, ukuqapha ukukhula komntwana kanye nesimo sikamama, kanye nokuvimbela ukuntuleka kwezakhamzimba ezincane ezibeka izingozi ngesikhathi sokukhulelwa, ukubeletha, kanye nesikhathi sokubeletha. Lesi sihloko sixoxa ngokuphathwa kokunakekelwa kokubeletha komama abadla imifino kusukela ekuhlolweni kuya ekuhlolweni, okuhlanganisa imfundo, ukwelulekwa, kanye nokudluliselwa lapho kudingeka.
1. Imiqondo eyisisekelo yokudla imifino kanye nemiphumela yayo ekukhulelweni
Abantu abadla imifino abalona iqembu elifanayo. Ngokuvamile kunezindlela eziningana: abantu abadla imifino ye-lacto-ovo (abadla ubisi namaqanda), abantu abadla imifino ye-lacto (ubisi), abantu abadla imifino ye-ovo (amaqanda), abantu abadla imifino ye-pescatarians (inhlanzi), kanye nabantu abadla imifino ye-vegan (ngaphandle kwayo yonke imikhiqizo yezilwane). Ngesikhathi sokukhulelwa, ukudla kwemifino kungasekela imiphumela emihle uma kuhlelwe kahle. Kodwa-ke, ingozi yokuntuleka kokudla okuthile—ikakhulukazi i-iron, i-vitamin B12, i-vitamin D, i-calcium, i-zinc, i-iodine, kanye nama-fatty acid e-omega-3 (DHA/EPA)—kufanele ilindelwe.
Ngokombono wokubeletha, imigomo yokunakekelwa iwukugcina impilo kamama, ukusekela ukukhula nokukhula komntwana osanda kuzalwa, ukunciphisa ingozi yokuntuleka kwegazi kanye nezinkinga zokukhula, nokuqinisekisa ukulungela ukuncelisa kanye nokululama ngemva kokubeletha. Isihluthulelo sempumelelo ukuxhumana okuhlonipha izinqumo zesiguli, okungahluleli, futhi kuthuthukisa uhlelo olungokoqobo oluvumelana nesimo sezenhlalo kanye nokufinyelela kokudla.
2. Ukuhlolwa kokuqala ekunakekelweni kwababelethisi
Ukuhlolwa komama abadla imifino kufanele kuqale ekuvakasheni kokuqala kwangaphambi kokubeletha futhi kubuyekezwe njalo. Izingxenye zokuhlola zifaka:
1) Umlando wezempilo yokubeletha kanye nowempilo jikelele: ukulingana, umlando we-anemia, izinkinga zokukhulelwa kwangaphambilini, izifo ezingamahlalakhona (i-hypothyroidism, isifo sikashukela, izinkinga zesisu), ukusetshenziswa kwemithi kanye nezithasiselo, kanye nokungezwani nokudla.
2) Umlando wokudla kanye nezindlela zokudla: uhlobo lokudla imifino olulandelwayo, ubude bokudla, izizathu zokukhetha, ukudla njalo, izinhlobo ezahlukene zamaprotheni emifino, ukudla ukudla okuqinisiwe (isb. ubisi lwemifino/okusanhlamvu okuqinisiwe), imikhuba yokuphuza itiye/ikhofi (ethinta ukumuncwa kwensimbi), kanye nezithiyo ezifana nokucasuka, ukuhlanza noma ukuzonda ukudla.
3) Isimo sokudla okunempilo kanye ne-anthropometry: isisindo sangaphambi kokukhulelwa (uma sikhona), i-BMI, ukukhuluphala ngokweminyaka yokukhulelwa, ukujikeleza kwengalo ephakathi nendawo (i-MUAC) uma kudingeka, kanye nezimpawu zomtholampilo zokuntuleka (ubumpunga, ukukhathala, ukulahleka kwezinwele, i-glossitis, i-paresthesia).
4) Ukuhlolwa ngokomzimba nokusekelayo: I-Hb/hematocrit yokuhlola i-anemia, i-ferritin uma ikhona ukuhlola izindawo ezigciniwe zensimbi, amazinga e-vitamin B12 kanye nama-25(OH)D ezimweni ezithile (isib. izimpawu zemizwa, umlando we-veganism eqinile, ukuchayeka okuncane elangeni), ukuhlolwa komchamo okuvamile, kanye nokuqapha ukukhula kombungu (TFU, i-ultrasound njengoba kubonisiwe).
Ukuhlolwa okuphelele kuvumela umbelethisi ukuthi athuthukise uhlelo oluthile lokungenelela, njengokuqinisa imithombo yamaprotheni, ukulungisa ukwengeza, noma ukuthumela umuntu onesifo sokulahlekelwa yigazi esimaphakathi kuya kwesikhulu.
3. Ukuxilongwa/izinkinga zokubeletha ezivame ukwenzeka
Kwabomama abadla imifino kuphela, ezinye zezinkinga ezivame ukutholakala zifaka:
– I-anemia yokuntuleka kwensimbi ngenxa yokuntuleka kwensimbi noma ukumuncwa kwayo okungaphansi kokufanele.
– Ukuntuleka kwe-Vitamin B12, ikakhulukazi kubantu abadla imifino kuphela, okungaholela ekuntulekeni kwegazi okungapheli kanye nezinkinga zezinzwa.
– Ukudla amaprotheni akwanele uma ukudla kungalingani noma ukukhetha ukudla kulinganiselwe.
– Ukuntuleka kwe-calcium ne-vitamin D kuthinta impilo yamathambo kamama kanye nezidingo zomntwana osanda kuzalwa.
– Ukudla okuphansi kwe-omega-3 (i-DHA/EPA) okudlala indima ekuthuthukisweni kobuchopho kanye ne-retina yengane esanda kuzalwa.
– Ukuntuleka kwe-iodine okubalulekile ekusebenzeni kwe-thyroid kanye nokuthuthukiswa kwezinzwa ze-fetus.
Ukuxilongwa kokubeletha akusho ngaso sonke isikhathi ukuthi kuyisifo; kuvame ukukhombisa "ingozi" noma "inkinga engaba khona" engavinjelwa ngokufundisa nokuqapha.
4. Ukuhlela kanye nokungenelela okuyinhloko
a. Ukwelulekwa okuhlelekile kokudla okunempilo
Ababelethisi badinga ukusiza omama ukuba bahlakulele ukudla okulinganiselayo okusekelwe kulezi zimiso ezilandelayo: amandla anele, amaprotheni anele, okucebile ngezakhamzimba ezincane, futhi okulula ukukulandela. Imithombo yamaprotheni enconyiwe esekwe ezitshalweni ifaka phakathi i-tempeh, i-tofu, ubhontshisi, udali, ubhontshisi we-mung, i-edamame, neminye imikhiqizo yesoya. Kwabadla imifino ye-lacto-ovo, amaqanda nobisi kungaba imithombo yamaprotheni ne-vitamin B12.
Ukungenelela okusebenzayo okunganikezwa:
– Hlanganisa imithombo yensimbi esekelwe ezitshalweni (isipinashi, ubhontshisi, i-tempeh) ne-vitamin C (amawolintshi, ama-guava, utamatisi) ukuze kwandiswe ukumuncwa.
– Nciphisa ukusetshenziswa kwetiye/ikhofi ngesikhathi sokudla ngoba ama-tannins angavimbela ukumuncwa kwensimbi.
– Sebenzisa ukudla okuqinisiwe uma kutholakala, njengokusanhlamvu okuqinisiwe kwe-calcium ne-B12 noma ubisi olusekelwe ezitshalweni.
– Hlela ukudla okulula okunomsoco ukuze ulwe nesicanucanu: isinkwa esithosiwe sikakolweni esigcwele nebhotela lamantongomane, iyogathi (uma ingenayo i-lactose), noma i-smoothie enezithelo namantongomane.
b. Ukwengezwa ngokwezidingo
Ngokuvamile, abesifazane abakhulelwe badinga ukwengezwa okuthile, kanti kubantu abadla imifino ezinye izithasiselo ziba zibaluleke kakhulu:
– I-Folic acid ngokwezindinganiso zangaphambi kokubeletha (ngokuvamile kusukela ngaphambi kokukhulelwa kuya ku-trimester yokuqala).
– I-ayini ngokwenqubomgomo yesevisi kanye nemiphumela yokuhlolwa kwe-Hb; umthamo ulungiswa uma kukhona i-anemia.
– I-Vitamin B12 ibalulekile kubantu abangadli inyama; ingatholakala ngezithasiselo ezivamile noma ngokuqinisa ukudla okulinganiselwe.
– I-Vitamin D ikakhulukazi uma kungekho ukuchayeka elangeni okwanele noma kunezici eziyingozi zokushoda.
– I-iodine ngosawoti oxutshwe ne-iodine noma izithasiselo ngokwezincomo zendawo.
– I-Omega-3 (DHA) ingacatshangelwa emithonjeni ye-algae (i-DHA esekelwe ku-algae) yabantu abangadli inyama.
Ababelethisi kudingeka baqinisekise ukuthi omama bayaqonda ukuthi bangathatha kanjani izithasiselo ngendlela efanele (isib., i-iron kufanele ithathwe ngokwehlukana ne-calcium) futhi baqaphe imiphumela emibi efana nokucanuzela noma ukuqunjelwa.
c. Ukuqapha okuqinile ngaphambi kokubeletha uma kukhona ingozi
Ukuqapha njalo kuhlanganisa umfutho wegazi, ukuvuvukala, ukukhuluphala, ukunyakaza kombungu, kanye nokukhula kombungu. Kwabomama abane-anemia, ukukhuluphala okunganele, noma ukudla okulinganiselwe kakhulu, ukuvama kokuhlolwa kungandiswa, ngokuhlolwa okuphindaphindiwe kwe-Hb ngemuva kokungenelela.
d. Ukusekelwa kwengqondo kanye nokuxhumana ngaphandle kokucwasa
Abanye omama abangadli inyama baye babhekana nokucwaswa emindenini yabo noma ezindaweni zokunakekelwa kwempilo. Ababelethisi badlala indima ekuqinisekiseni induduzo kamama, banikeze ulwazi olungakhethi, futhi bahilele umndeni uma kudingeka. Lokhu kusekelwa kubalulekile ngoba ukucindezeleka kungathinta ukuthobela imithetho kanye nenduduzo ngesikhathi sokukhulelwa.
e. Ukubambisana kanye nokudluliselwa kwabanye
Ukudluliselwa kudokotela noma kuchwepheshe wezokudla kuyadingeka uma:
- i-anemia ephakathi nendawo noma enzima kakhulu,
- ukwehlisa isisindo, i-hyperemesis, noma izinkinga zokudla,
- izinsolo zokuntuleka kwe-B12 kanye nezimpawu zezinzwa,
- izinkinga ze-thyroid noma ezinye izinkinga ze-metabolic.
Ukubambisana kuqinisekisa ukuthi omama bathola ukwelashwa okufanele ngaphandle kokunganaki ukudla abakuthandayo.
5. Ukuphathwa ngesikhathi sokubeletha kanye nesikhathi sokubeletha
Ngesikhathi sokubeletha, izimiso zokunakekela zihlala zifana: ukuqapha isimo sikamama nesengane kanye nokulungiselela ukuphuma kwegazi, ikakhulukazi uma umama enesifo sokuntuleka kwegazi. Ababelethisi kudingeka bahlole isimo samanje se-hemoglobin (Hb) yowesifazane ngaphambi kokubeletha, bahlole izimpawu zokukhathala, futhi bakhe uhlelo lokopha kwegazi ngemva kokubeletha.
Ngesikhathi sokubeletha kanye nesokuncelisa, izidingo zamandla namaprotheni ziyanda. Abantu abadla imifino bangancelisa ngempumelelo, kodwa ukunaka i-B12, i-iodine, i-DHA, kanye ne-vitamin D kusabalulekile, njengoba kuthinta ikhwalithi yobisi lwebele kanye nesimo sokudla kwengane. Imfundo mayelana nokudla okusebenzayo, okunamaprotheni amaningi kanye nezakhamzimba ezincane kufanele iqhutshwe, njengokwandisa i-tempeh, amantongomane, kanye nemifino eluhlaza, kanye nokuqinisa okufanele. Uma umama edla imifino kuphela, ukwengezwa kwe-B12 kunconywa kakhulu ngesikhathi sokuncelisa.
6. Ukuhlolwa kanye nokubhalwa kwemibhalo yokunakekelwa
Ukuhlolwa kwenziwa ngokusebenzisa:
– ukuthuthukiswa kwezikhalazo (isib. ukuncipha kobuthakathaka/isiyezi),
– ukwanda kwe-Hb noma imingcele yelebhu,
- ukukhuluphala ngokwenhloso,
- imiphumela emihle yokuqapha ukukhula kwengane,
- ukuthobela kanye nokubekezelela izithasiselo.
Amadokhumenti kufanele afake uhlobo lwabantu abadla imifino, uhlelo lokudla, imfundo enikezwayo, imiphumela yokuhlolwa, kanye nokulandelela. Ukugcina amarekhodi ngendlela efanele kusiza ukuqinisekisa ukuqhubeka kokunakekelwa uma umama ethuthela kwesinye isikhungo noma enakekelwa esinye isisebenzi.
Isiphetho
Ukuphathwa kokunakekelwa kwababelethisi komama abadla imifino kugxila ekuvimbeleni ukuntuleka kokudla okunempilo kanye nokuqapha eduze ukuqinisekisa ukukhulelwa okunempilo. Ngokuhlolwa kokudla okunembile, ukwelulekwa okusebenzayo kokudla, ukungezelelwa okufanele (ikakhulukazi i-iron ne-vitamin B12), ukwesekwa kwengqondo, kanye nokubambisana kobungcweti, omama abadla imifino bangabhekana nokukhulelwa ngokuphephile, ukubeletha, kanye nesikhathi sokubeletha. Ukunakekelwa okusekelwe ebufakazini, okunenhlonipho kuyisihluthulelo sokufeza imiphumela emihle kakhulu kamama kanye nosana olusanda kuzalwa.
Uma ufisa, ngingalungisa lesi sihloko sibe amagama ayi-1000 ngqo (ngibala amagama ngokunembile), noma ngengeze ifomethi yokunakekelwa kokubeletha ephelele (i-SOAP/Varney) ikakhulukazi kwabesifazane abakhulelwe abangadli inyama.
