儿科学之小儿营养与喂养

,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,Children nutrition and feeding,武汉科技大学儿科学教研室李圭华,小儿营养和喂养,第五章第一、二节,1,目的要求,熟悉小儿物质代谢特点及营养需要量,掌握婴儿喂养及辅食添加原则,了解小儿营养状况评价,2,Purpose and requirement,To be familiar with characteristics of energy metabolism and nutrition requirement of children.,To master breast feeding and principle of supplementary food.,To understand the evaluation of status of childhood nutrition,3,小 儿 营 养,Children nutrition,4,基础代谢,(basal metabolism),生长发育,(growth and development),食物特殊动力作用,(specific dynamic action),活动所需,(Bodily activity),排泄损失,(loss in the excreta),小儿能量需要,5,婴幼儿基础代谢相对较成人高,10,15,生长发育所需能量为小儿所特有,随小儿年龄增大,活动量增大,所需能量增加,年龄越小,蛋白质供给量相对越多,年龄越小,相对总能量需要越大,小儿物质代谢的特点,Characteristics of metabolism in children,6,能量来源,(,婴儿,),Energy source,7,蛋白质,(Protein),：生命的物质基础,宏量营养素 脂肪,(fat),：供能,碳水化合物,(Carbohydrate),：供能,营养素,8,维生素,矿物质,(Mineral),膳食纤维,(food fiber),水,(water),营养素,微量营养素,脂溶性维生素,(Fat-soluble vitamin),水溶性维生素,(Water-soluble vitamin,),9,小儿每日需能量和需水量表,The daily energy and water requirement in children,年龄,能量,（,Kcal/kg,d,）,水,（,ml/kg,d,）,Ages energy water,1,岁,110,150,1,3,岁,100 125,4,6,岁,90 100,7,9,岁,80 75,10,12,岁,70 75,13,15,岁,60 50,16,19,岁,50 50,成人,40,45 40,50,每,增,3,岁,减,10,每,增,3,岁,减,25,10,小 儿 喂 养,Children feeding,11,母乳喂养,Breast feeding,12,1989,年发布,8,月,1,日,-7,日为世界母乳喂养周,5,月,20,日被定为母乳喂养宣传日,13,促进母乳喂养的重要措施,-,爱婴医院的建立,1992,年,3,月世界第一所爱婴医院,-,菲律宾法培拉医院诞生,1992,年,12,月我国有,21,所医院首批被批准为爱婴医院,14,初乳,c,olostrum,产后,4,天内的乳汁,the first 5 days after delivery,色黄粘稠、脂肪少、免疫球蛋白多,富含,牛磺酸、,免疫因子,(,如,:,初乳小球,),含维生素、微量元素锌等,15-45ml/,次，,250-500ml/d,15,过渡乳,transitional milk,产后,5,10,天,脂肪高、蛋白及矿物质减少,成熟乳,Mature milk,11,天,9,月，量,700-1000ml/d,晚乳,Late milk,10,个月以后,量及营养成分减少,16,母乳与牛乳成分的比较,成份,Ingredient,(100g),母乳,human milk,牛乳,cow,s milk,蛋白质,Protein,(g)0.9 3.3,酪蛋白,Casein,0.4 2.7,白蛋白,Albumin,0.4 0.4,不饱和脂肪酸,(%)8.0 2.0,Unsaturated fatty acid,乳糖,Lactose,(g),7.0 4.8,矿物质,Minerals,(mg),200.0 800.0,钙,Calcium,34.0 117.0,磷,phosphorus,15.0 92.0,免疫成分,immunologic factor,丰富 缺乏,17,母乳喂养优点,advantages of breast feeding,降低婴儿死亡率及患病率,减少营养不良的危险性,营养素及比例适合,免疫因子,不易污染,不易过敏,18,母乳喂养优点,advantages of breast feeding,经济、方便、省时省力,增进母婴感情，便于观察护理,母乳喂养对婴儿的社会化有着促进作用,其它,促进母亲康复,有利于计划生育,减少乳母患肿瘤的机会,19,开奶：正常为生后半小时,喂奶：按需哺乳 母婴同室,断奶：,10-12,月,母乳喂养方法,The technique of breast feeding,20,喂养姿势,the posture,21,母乳喂养注意事项,The noticed proceeding of breast feeding,孕母树立信心、良好心情,保持乳头的清洁,按需哺乳、母婴同室,不轻易添加乳制品,母哺乳期间慎用药物,断奶前先加辅食，避免在夏季或生病时断奶,22,母乳喂养注意事项,The contraindications of breast feeding,母患慢性消耗性疾病,diabetes,hyperthyroidism,重症心脏病、肾脏病,heart or kidney diseases,乳头裂伤、乳腺炎,cracking of the nipples mastitis,母患精神病、癫痫,epilepsy,母患急、慢性传染病,infectious diseases,禁忌证,23,人工喂养,(Artificial feeding),24,牛乳：,最常用,牛乳成分相对较接近母乳,Its ingredients is very close to the breast milk.,来源广,Its source is extensive.,价格便宜,The price is cheaper.,牛乳,母乳,Cows milk Human,25,弥补牛乳的缺点,稀释,煮沸,加糖,全脂奶粉配全脂奶,Full cream milk powders,按体积,1:4,按重量,1:7,配方奶,Formula milk powders,26,部分母乳喂养,(Partial breast feeding),补授法,代授法,27,辅食的添加,Supplemental diet,目的,Intent,补充乳类营养素的不足,supplement the deficits of nutrients.,为断奶作准备,prepare for the ablactation,培养良好的习惯,develop the good habits of diets,.,28,辅食的添加,Supplemental diet,原则,Principles,顺序,Gradation,29,幼儿膳食,Toddlers nutrition,供给足够的能量和优质蛋白,蛋白质：脂肪：碳水化合物,1,：,1.2,：,4,食物宜细、软、烂、碎,每日三餐二点,忌食花生瓜子等,30,营养状况评价,临床询问,(clinic enquiry),.,营养调查,(nutrition survey),膳食调查,(dietary survey),体格检查,(physical examination),实验室检查,(laboratory examination),31,思考题,母乳喂养儿和人工喂养儿粪便中主要 是什么细菌,?,母乳喂养有何优点,?,早产儿能进行母乳喂养吗,?,患乙肝的母亲能对婴儿哺乳吗,?,32,thank you!,33,