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Πονάει ο θηλασμός; Και ναι και όχι….

Οι γυναίκες που δεν πονούν καθόλου κατά τη διάρκεια των πρώτων ημερών του θηλασμού είναι μάλλον τόσες, όσες και οι γυναίκες που λένε ότι έχουν την εμπειρία του οργασμού κατά τη διάρκεια του τοκετού τους, δηλαδή ελάχιστες.  Όλοι έχουμε ακούσει τις τρομερές ιστορίες πόνου των θηλών και του στήθους και κανείς δεν πιστεύει τις γυναίκες που λένε ότι δεν πόνεσαν ποτέ κατά τη διάρκεια του θηλασμού.

Ο πόνος λοιπόν είναι συνηθισμένο φαινόμενο, αλλά είναι φυσιολογικό; 

Σύμφωνα με τον ειδικό του θηλασμού Δρ. Jack Newman:“Αν και μια κάποια ευαισθησία είναι συνηθισμένη τις πρώτες μέρες, αυτή θα πρέπει να διαρκεί μόνο για λίγες μέρες και δεν θα πρέπει ποτέ να είναι τόσο δυνατός πόνος ώστε η μητέρα να φοβάται να θηλάσει. Κάθε πόνος που είναι περισσότερο από μέτριος, είναι αφύσικος και σχεδόν πάντα οφείλεται στην κακή πρόσληψη του στήθους από το μωρό”.

 Οι μητέρες που το έχουν περάσει θα σας πουν ότι απλώς χρειάζεται κάποιος χρόνος για να σκληραγωγηθούν οι θηλές. Κάποιοι άλλοι λένε ότι δεν υπάρχει τέτοιο πράγμα, δηλαδή «σκληραγώγηση θηλών» και ότι αν πονάμε κάτι δεν πάει καλά και χρειάζεται να το διορθώσουμε όσο το δυνατόν γρηγορότερα.

Η αλήθεια βρίσκεται νομίζω κάπου στην μέση. Δεν πιστεύω ότι χρειάζεται οπωσδήποτε χρόνος για να σκληραγωγηθούν οι θηλές, αλλά πιστεύω ότι κάθε ζευγάρι θηλασμού (μητέρα – μωρό) χρειάζεται χρόνο για να μάθει ο ένας τον άλλο και να βελτιώσουν την τεχνική τους. Και  πιστεύω ότι χρειάζεται να αναρωτιόμαστε «γιατί πονάει η μητέρα» και «τι μπορούμε να κάνουμε για να εξαλειφθεί ο πόνος».

Ανακαλύπτοντας την αιτία του πόνου

Εκτός από την μέτρια ευαισθησία για την οποία μιλάει ο Δρ Newman, ο πόνος που αισθανόμαστε κατά τη διάρκεια του θηλασμού συνήθως έχει μια αιτία. Και όπως λέει και η Kelly Bonyata IBCLC: «Μην ξεχνάτε ότι το πιο σημαντικό που μπορείτε να κάνετε για να θεραπευτεί ο πόνος, είναι να βρείτε την αιτία του προβλήματος».

Η πλειοψηφία των γυναικών αισθάνονται κάποιον πόνο κατά τις πρώτες εβδομάδες του θηλασμού, καθώς το μωρό μαθαίνει να πιάνει σωστά το στήθος, καθώς η μητέρα μαθαίνει πώς να το κάνει σωστά, καθώς οι θηλές της συνηθίζουν τον πολύωρο ερεθισμό και καθώς το στόμα του μωρού μεγαλώνει.

Κάποιοι το αποκαλούν «σκληραγώγηση θηλής», αλλά εγώ πιστεύω ότι είναι περισσότερο το ότι η μαμά και το μωρό μαθαίνουν να θηλάζουν. Και όπως συμβαίνει γενικά στη ζωή, κάποιοι μαθαίνουν πιο γρήγορα από κάποιους άλλους. Κι αυτός είναι ο λόγος που κάποιες γυναίκες χρειάζονται περισσότερο χρόνο για να ξεπεράσουν τελείως τον πόνο, απ’ ότι κάποιες άλλες. Αλλά όπως με  όλα τα προβλήματα που μένουν αδιάγνωστα, τα προβλήματα θηλασμού που μένουν αδιάγνωστα δεν ξεπερνιούνται από μόνα τους. Μόνο αν βρούμε την πηγή του προβλήματος, συνήθως μπορούμε να κάνουμε κάτι για να το διορθώσουμε.

Εάν ο πόνος που αισθανόμαστε είναι δυνατός ή μέτριος που όμως δεν καλυτερεύει όσο περνούν οι μέρες, αξίζει να επισκεφθούμε έναν πιστοποιημένο σύμβουλο θηλασμού ή να καλέσουμε μία σύμβουλο της La Leche. Η πιο συνηθισμένη αιτία είναι η λάθος προσκόλληση του μωρού στο στήθος, το οποίο δεν είναι πάντα εύκολο να επιτευχθεί και όχι πάντα εύκολο να διορθωθεί. Ξέρω πώς είναι η σωστή προσκόλληση στο στήθος και πώς είναι η αίσθηση αυτή, αλλά μου πήρε πολύ καιρό για να το μάθω.

Όταν ο γιος μου δεν μπορούσε να πιάσει σωστά, αλλά και αργότερα, που έπιανε σωστά αλλά εγώ πονούσα, ευχόμουν μέσα μου να μπορούσα να δανειστώ ένα άλλο μωρό και να το θηλάσω για ένα λεπτό, ώστε να καταλάβω ποια είναι η αίσθηση της σωστής προσκόλλησης. Δεν ξέρω εάν έφταιγε ο δικός μου τρόπος ή του μωρού, τα στήθη μου, οι θηλές μου ή το στόμα του. Το μόνο που ξέρω είναι ότι ήταν απογοητευτικό και πολύ επώδυνο.

Εκτός όμως από την σωστή προσκόλληση, υπάρχουν κι άλλα θέματα που μπορεί να προκαλούν πόνο κατά το θηλασμό. Ακριβώς όπως ένας κοντός αχίλλειος τένοντας εμποδίζει κάποια παιδιά από το να περπατήσουν σωστά, έτσι κι ένας κοντός χαλινός μπορεί να εμποδίσει κάποια παιδιά από το να θηλάσουν σωστά και μπορεί να προκαλέσουν μεγάλο πόνο στις μητέρες τους. Η μαμά μπορεί να κάνει τα πάντα σωστά, αλλά ο πόνος δεν μειώνεται καθόλου, εκτός κι αν διαγνωστεί το πρόβλημα και διορθωθεί.

Άλλες αιτίες πόνου και ενόχλησης είναι το πέτρωμα, η μυκητίαση, το δάγκωμα, οι φραγμένοι πόροι, η μαστίτιδα, ο θηλασμός μετά από εγχείρηση, μια νέα εγκυμοσύνη, η ωορηξία, το έντονο αντανακλαστικό εκροής γάλακτος και άλλα.

Θα το ξαναπώ: η ανακάλυψη της αιτίας του προβλήματος, είναι το πιο σημαντικό πράγμα που μπορείτε να κάνετε για να μειωθεί ο πόνος και να αποφύγετε περισσότερα προβλήματα στο μέλλον.

Σταματώντας τον πόνο

Το να βρεθεί η αιτία του προβλήματος είναι το πρώτο βήμα, αλλά όχι το τελευταίο. Υπάρχουν πολλά πράγματα που μπορούμε να κάνουμε για να ανακουφίσουμε τον πόνο του στήθους ή/και να θεραπεύσουμε τις πληγωμένες θηλές, ανάλογα πάντα με το πρόβλημα.

Σημαντική υπενθύμιση: εάν οι θηλές σας είναι ήδη πληγωμένες, θα πονούν ακόμα κι αν τα κάνετε όλα σωστά.

Μπορεί να έχετε ακούσει για διόρθωση της στάσης, ψευδοθηλές, προστατευτικά θηλών, επιθέματα υγρής γέλης, λανολίνη, κεραλοιφή, αντλίες, ζεστά ή κρύα επιθέματα, αερισμό του στήθους, μαλάξεις, αντιμυκητισιακές αλοιφές, αντιβιοτικά, κλπ. Αυτά είναι μερικά από τα «όπλα» που χρησιμοποιούμε όταν θέλουμε να αντιμετωπίσουμε κάποιο πρόβλημα του στήθους ή των θηλών και καλό είναι να τα χρησιμοποιήσετε μόνο αν σας το συστήσει κάποιος ειδικός επί του θέματος.

Πολλές γυναίκες όμως δεν ξέρουν ούτε τα μισά από αυτά που πρέπει να κάνουν για να θεραπεύσουν τις πληγωμένες τους θηλές ή/και το πονεμένο τους στήθος, γιατί κανείς δεν τους τα είπε. Πολλές γυναίκες υποφέρουν πολύ περισσότερο απ’ όσο χρειάζεται. Και πολλές γυναίκες εγκαταλείπουν το θηλασμό εξαιτίας του πόνου, ενώ μπορούν να θεραπευτούν.

Ο πόνος στις θηλές είναι το πιο συνηθισμένο πρόβλημα που αντιμετωπίζουν οι γυναίκες που θηλάζουν και η πιο συνηθισμένη αιτία διακοπής του θηλασμού. Υπάρχουν τόσα εργαλεία και τόσοι τρόποι που μπορούν να βοηθήσουν τις μητέρες να ξεπεράσουν το πρόβλημα. Κι όμως, οι περισσότερες δεν τα καταφέρνουν, γιατί δεν τους ξέρουν.

Πώς να μιλήσουμε στην μητέρα που πονάει?

Ξέρω από πρώτο χέρι πόσο δύσκολος μπορεί να είναι ο θηλασμός και πόσο μπορεί να πονάει. Επίσης ξέρω πόσο ευάλωτες και απογοητευμένες μπορεί να είναι οι μητέρες όταν έρχονται αντιμέτωπες με τον πόνο. Και ξέρω ότι το να πω σε μια μαμά «κάνεις κάτι λάθος» δεν πρόκειται να την βοηθήσει, ούτε να της δώσει την αυτοπεποίθηση και την πίστη και την υποστήριξη που χρειάζεται από μένα.

Δουλεύοντας με μητέρες και μωρά τόσα χρόνια τώρα, έχω μάθει πόσο προσεκτικά πρέπει να διαλέγω τις λέξεις μου μερικές φορές. Έμαθα ότι όταν κάποια μητέρα μου κάνει μια ερώτηση, δεν πρέπει απλώς να απαντήσω την ερώτηση, αλλά πρέπει επίσης να την στηρίξω ψυχολογικά και να την επιβραβεύσω και να της δώσω την λύση διαβεβαιώνοντας την ότι όλα θα πάνε καλύτερα (γιατί στ’ αλήθεια πάνε όλα καλύτερα τελικά).

Ωστόσο, είναι δύσκολο. Δύσκολο να βρεθεί πάντα η ισορροπία ανάμεσα στην αλήθεια που πρέπει να μάθει η μητέρα και στο να μην τρομάξει από αυτήν και εγκαταλείψει το θηλασμό (γιατί πραγματικά γίνεται όλο και καλύτερος). Είναι επίσης δύσκολη η ισορροπία ανάμεσα στο χειρισμό αληθινών προβλημάτων θηλασμού και στο να μην ξεχνάμε να λέμε στις μητέρες πόσο σπουδαία δουλειά κάνουν θηλάζοντας τα μωρά τους.

Βίκυ Φαρδογιάννη – Πιστοποιημένη Σύμβουλος Θηλασμού IBCLC

http://www.thilasmos.com/?p=6152

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