上海地区婴儿母亲返岗及工作场所母乳喂养支持状况研究

目的:了解上海地区婴儿母亲返岗工作及工作场所对母乳喂养的支持条件。方法:对上海市徐汇区和闵行区402位产后12～15个月的婴儿母亲进行问卷调查,对8位产后12个月的婴儿母亲进行个人深入访谈。结果:332位婴儿母亲在产后12个月前已返岗工作,返岗时间中位数为产后4.0个月,134位母亲由于返岗工作而停止母乳喂养。在198位返岗后仍继续母乳喂养的母亲中,15.7%的乳母工作6个月后仍能继续母乳喂养,83.3%的乳母能享受每天1 h的哺乳假,但该假对改善母乳喂养的实际帮助并不大;80.8%的乳母工作场所有冰箱可以存放乳汁,但乳母多半很难为哺乳或挤奶腾出时间、找到地方或携带工具;45.9%的母亲认为工作单位并非积极支持母乳喂养。结论:大部分婴儿母亲在产后12个月前已经返岗工作,多数因上班而停止母乳喂养;大部分婴儿母亲工作单位能遵守法定产假和哺乳假,仍有大部分工作单位缺乏支持母乳喂养的配套设施,缺乏支持母乳喂养的工作环境,因此亟待营造一个支持职业女性母乳喂养的工作环境。     

产后6个月内乳母营养摄入与哺乳的跟踪观察

对北京市城乡50名产后哺乳妇女6个月内营养素摄入量和乳汁分泌以及乳成分进行跟踪观察。结果表明:乳母的营养素摄入量在产后第1个月内除了钙以外均超过我国膳食营养素供给量(RDA),但第3和第6个月时都下降,尤以钙、维生素A及B_2明显。母乳的分泌量在产后前3个月,城乡分别为689g及803g,至6个月时下降,以城区的下降更明显,但都能接近或超过发达国家乳母的母乳分泌量。城区母乳中热能、蛋白质、脂肪和乳糖的含量均高于农村的,可能与城市乳母膳食质量较高有关。从母乳分泌量及其营养成分看,母乳喂养婴儿到3个月能满足婴儿营养的需要,而农村还可以维持到6个月。     

中断哺乳原因及中断哺乳对以后哺乳时间长短影响的分析

对３６１５名产妇产前至产后１５个月的随访资料进行分析,探讨母乳喂养中中断哺乳的情况及中断哺乳对哺乳时间长短的影响。结果表明,７．５％的对象曾中断过哺乳,绝大多数发生在产后６周内。中断的次数以１次居多,中断的天数大多在７天内,中断哺乳的主要原因是母亲或婴儿患病。中断哺乳的人数比例市区高于郊县,但郊县中断的天数相对较长。中断哺乳受产妇的年龄、文化程度、家庭收入、户口性质、职业、计划哺乳时间长短的影响。中断哺乳缩短了婴儿的生命表纯母乳和总母乳喂养时间。提示,要达到世界卫生组织提出的给出生婴儿至少４个月的纯母乳喂养的目标,减少产后早期中断哺乳的现象是必要的。     

陕南部分农村母亲的婴幼儿喂养知信行现况调查

目的：了解农村婴幼儿母乳喂养及辅食添加现状及影响因素,为进一步实施科学喂养、科学育儿,提高儿童健康水平提供科学依据。方法自拟调查问卷,随机抽取南郑县10个乡镇1000名1周岁婴幼儿母亲进行现场问卷调查,并对数据进行分析。结果母乳喂养率88．6％,6个月纯母乳喂养率31．2％,初乳喂养率66．3％,早开奶喂养率54．9％,其中部分农村母亲受家里老人观念的影响挤掉初乳占55％,母亲自认为奶水不足占48．8％,认为母乳营养不够该添加辅食了占51．2％,满4～6个月添加辅食率63．4％,满6个月以上添加辅食率仅占22．8％,添加辅食的种类以稀粥、菜汁、水果汁占的比例最大,为62．2％,而添加蛋黄比例为45．9％,动物类（肉、肝、鱼类）仅占5．9％。没有坚持母乳喂养的母亲主要是自认为母乳不足而过早加辅食;初乳挤掉主要是母亲认识不够,受旧观念影响;不添加动物类食物的母亲主要是认为孩子1岁以后才能消化。结论初乳喂养率、早期开奶率、6个月纯母乳喂养率及满6个月添加辅食率均偏低,辅食添加不合理且种类单一,动物性食物摄入严重不足;应加强妇幼保健、产儿科人员及婴幼儿母亲的培训,以更新相关知识及技能。     

196例母乳喂养情况分析

我市各医院于1994年下半年先后创建了爱婴医院,实现产后纯母乳喂养率达90％以上,但随着月龄的增长,纯母乳喂养有迅速递减的倾向。现将196例42天及3个月来门诊健康检查的乳母喂养情况进行分析.1 对象和方法.询问乳母喂养情况,结合小儿体格发育评价同时观察乳房充盈情况。2 结果.42天纯母乳喂养152例,占77.55％;混合喂养44例,占22.45％;3个月纯母乳喂养110例,占56.12％;混合喂养86例,占43.88％,     

成都市产褥期妇女饮食行为现况调查

正哺乳期妇女膳食营养质量与乳母健康和婴儿生长发育密切相关,同时也是临床上产后保健门诊的工作重点。随着我国居民生活水平提高,合理健康饮食观念也越来越受居民重视,哺乳期妇女膳食营养质量更是备受关注。产褥期是哺乳期的重要阶段,产褥期的膳食质量将直接影响乳母营养状况和能否成功实现母乳喂养。研究显示,目前我国哺乳期妇女食物选择及摄入量仍不容乐观~([1-4]),成都地处经济欠发达的中国西南部,缺乏     

103名哺乳期妇女营养知识调查

哺乳期妇女的营养状况不仅关系到乳母自身健康，而且对乳汁的分泌、婴儿的生长发育都有密切的关系。随着人们生活水平的提高和计划生育政策的落实。合理营养、促进健康的膳食结构已人们所接受。但由于受传统观念、饮食习惯等影响，加之营养知识缺乏等因素，哺乳期特别产后一个月的营养问题并没有明显的改善。为了解哺乳期妇女营养知识水平。指导其合理营养，提高母乳喂养质量。于2003年2～5月对济南市部分哺乳期妇女营养知识水平进行了调查。     

患了性病，还能给孩子哺乳吗

我的孩子3个月大,出生后一直用母乳喂养。最近我因白带增多,排尿时出现不适到医院检查,医生诊断为“非淋球菌性尿道炎”。听说有些性病病原体可通过乳汁传给孩子,那么我还能继续给孩子哺乳吗?乳母患性病之后能否继续哺乳,主要取决于乳母所患性病的种类、母乳乳汁中是否含有病原体、长期哺乳的密切接触能否传染疾病、乳母在治疗时使用的抗生素能否造成婴儿的伤害等因素。     

亚热带地区哺乳妇女能量需要量的观察

以同地区的53名非哺乳育龄妇女作对照,对262名产后0～6月乳母的体重、皮脂、上臂围、基础代谢率(BMR)、能量消耗和摄入量分别进行横向和纵向观察。结果表明,产后乳母体重和皮脂厚度逐渐下降,至第4个月基本稳定,平均减重4.2kg,估计孕期的贮脂大部分已消耗。上臂围无明显变化(P>0.05)。乳母的BMR在产后第1周较高(P<0.01),1～6月无明显变化(P<0.05),但比对照组高4～20％(P<0.05)。乳母在同一标准活动耗能与对照组接近(P>0.05)。轻体力劳动乳母日均活动耗能8.360MJ,估计泌乳耗能为2.807MJ/d。乳母能量摄入量比对照组多2.259MJ/d。作者认为,亚热带产后0～6月乳母在正常哺乳情况下,头4个月每日能量需要量应在平日消耗量基础上增加1.883MJ(450kcal),后雨月增加2.720MJ(650kcal),或整个阶段平均增加2.092MJ/d(500kcal/d),但此值仍需按泌乳量和正常体重变化加以调节。     

产后早开奶，母乳才会足

怀孕期间，孕妇的乳房比怀孕前增大2～3倍，乳腺的导管、腺泡都处于分泌的准备状态，一旦分娩，乳汁就开始分泌。通过婴儿的吮吸刺激乳母体内的催乳素和催产素，可使乳汁大量分泌。所以，现在主张早开奶，目的就是加强刺激。营养良好的母亲，分娩第二天就可以分泌100毫升的乳汁，到第二周可以达到500毫升，以后会逐渐增加到800毫升甚至850毫升。而营养不良的母亲，乳汁分泌就少。乳汁里的所有营养都是通过母亲膳食得来的，要维持乳汁的正常分泌和质量恒定，就要保证营养。如果乳汁营养不足，就要动用乳母体内的营养素，如果乳母再欠缺营养，乳汁的分泌量就会更少。所以，哺乳期间乳母应注意加强营养。乳母在选择食物时，要合理调配膳食。     

巴彦淖尔市城区产褥期妇女膳食状况调查

目的:调查分析巴彦淖尔市城区产褥期妇女的膳食状况。方法:采用随机整群抽样方式,抽取巴彦淖尔市城区1周岁以内儿童的母亲共482名作为研究对象,采用自行设计的产褥期调查问卷进行逐一入户问卷调查。结果:共回收有效问卷468份。468名产褥期妇女以顺产为主(57.5%);饮食主要由妈妈提供(63.5%);鱼虾禽畜肉油脂类摄入过多,蔬菜水果奶制品类摄入过少;蛋白质、胆固醇摄入过多(分别为理想摄入量的118.3%、441.3%),维生素C、膳食纤维摄入过少(分别为目标值的16.6%、27.0%);摄入奶制品在产妇年龄和营养保健知识来源中有统计学意义(P<0.05)。结论:巴彦淖尔市城区产褥期妇女膳食结构不合理,动物性食物摄入过多,植物性食物摄入过少,部分营养素摄入不足,应适当调整膳食结构,以保证产褥期妇女的营养均衡。     

Carotenoid composition and content of legumes, tubers and roots by HPLC

A survey was carried out in the district of Kemaman, Terengganu, Malaysia to study infant feeding practices in rural and semi-urban communities. A total of 593 mothers were interviewed and their socio-demographic information recorded. Data on infant feeding practices were collected from mothers who had children up to 15 months of age. Among breast-feeding mothers (n =157), 42.0 % fed their babies for less than 3 months and 58.0% bottle fed for more than 6 months. Sixteen children were found to be fed on sweetened condensed milk with 62.5% of them for the first 3 months. Among those who breast fed their babies, 40.1% were found to have bottle fed at one time or another. The majority of breast feeding mothers belonged to the groups having incomplete primary schooling or completed primary education only and household income below RM600 per month. A substantial number of breast fed babies were given weaning foods in the form of porridge mixture (rice + egg, rice + vegetables, rice + meat, rice+ fish and cereals) between the age of 0 - 3 months. The findings of this study concluded that although breast-feeding is widely practiced, however, their duration has dwindled, and early introduction of solid foods is widespread.     

Changes in food consumption patterns in Bahrain

Changes in food consumption in Bahrain can be identified particularly in the second half of seventies with the wake of oil boom. The consumption of traditional foods such as fish and dates have declined, while that of processed foods, fat, eggs, meat, poultry and milk products have risen. The daily per capita intake of animal protein and fat have increased at the expense of carbohydrates. Some factors responsible for this change are increasing income and literacy, food price fluctuations, food subsidy policy, the influence of immigrant food habits, influence of mass media and the changing structure of households. The change in dietary intake has associated with change in health and nutritional problems in the country.     

Determining iron bio-availability with a constant heme iron value

Iron deficiency is the most common and widespread nutritional disorder in the world. Consuming foods rich in dietary iron (high in both content and availability) is an effective way to alleviate iron deficiency. Iron from animal foods is more bio-available than iron from plant sources. This is due to the heme iron content in animal foods. According to the Monsen model, an average of 40% of total iron in meat, fish and poultry is in the heme form. Although the Monsen model can provide a generally good estimate of the heme iron content in animal products, recent research has suggested that the constant 40% value of heme iron is either an under- or over-estimation, depending on the source of the food. During this study a review was performed on the heme iron content of meat, fish and poultry, and comparisons are made with reference to the Monsen model. The aim of this study was to investigate whether using the constant 40% value for heme iron is adequate in describing the bio-availability of total iron in a particular food.     

伊犁察布查尔县婴儿代乳品、辅食添加现状及原因分析

目的 了解伊犁察布查尔地区6个月以内婴儿母乳喂养与辅食添加现状,分析影响婴儿过早添加辅食的可能因素。方法 队列研究方法,对伊犁察布察尔地区2008年出生的婴儿母亲进行问卷调查及产后6个月的逐月随访,样本量226例。结果 （1）婴儿出生时纯母乳喂养率是82.06%,3个月时纯母乳喂养率（72.81%）开始明显下降,4个月时纯母乳喂养率降到55.92%,6个月仅有43.09%的婴儿是纯母乳喂养。（2）婴儿1月、2月、3月、4月、6月时辅食添加率分别是16.4%、16.8%、20.8%、27.4%、41.6%,其中有27.4%的婴儿在4个月前已经开始添加了一种或一种以上的辅食,已添代乳品、水、水果蔬菜、谷类、蛋类的比例分别占62.9%、53.2%、27.4%、27.4%、35.5%;6个月时大部分婴儿未及时添加辅食,辅食添加率仅为41.6%,代乳品、水、水果蔬菜、谷类、蛋类的比例分别占77.7%、40.4%、42.6%、35.1%、57.4%。（3）代乳品添加中鲜牛奶的比例最高,4个月时已达82.1%,6个月时所占比例为84.9%。（4）婴儿辅食添加过旱的影响因素有：母亲年龄、孩子是否第一个、吸吮时间、孩子每天睡眠时间等。结论伊犁察布查尔地区纯母乳喂养率低;在辅食添加时间上存在较大的问题;加强少数民族母亲婴儿喂养知识的教育,重点在及时合理的添加辅食。     

Nutrients and contaminants in human milk from mothers on macrobiotic and omnivorous diets.

The effect of alternative dietary habits and prolonged lactation on the nutrient and contaminant concentrations in human milk was studied. The study sample consisted of mothers on macrobiotic diets, containing little or no diary products and meat, at 2-3 months postpartum (n = 9) and 9-13 months postpartum (n = 12), and mothers on omnivorous diets at 2-3 months postpartum (n = 10). Protein and zinc concentrations in breast-milk from macrobiotic mothers decreased with stage of lactation. After adjustment for stage of lactation, milk from macrobiotic mothers contained less calcium, magnesium and saturated fatty acids C15:0-C20:0, and more polyunsaturated fatty acids. Observed tendencies for lower protein and fat and higher lactose concentrations in the macrobiotic group were not statistically significant. Concentrations of vitamin B12, HCB and polychlorinated biphenyls (PCB 118, PCB 138, PCB 153 and PCB 180) were lower in the macrobiotic group. After adjustment for confounding variables, meat and fish consumption, but not dairy products, contributed to vitamin B12 concentrations. Meat and diary products strongly contributed to breast-milk concentrations of dieldrin and PCBs, fish to PCB 118, and smoking to DDT and dieldrin. Our findings suggest that breast-milk contamination could be reduced by abstinence from smoking and a moderate intake of animal products. However, risk of nutritional deficiencies rules out complete avoidance of meat, fish or diary products. Quantitative research on the effects of a reduced consumption of animal products, as well as smoking, on breast-milk contamination is warranted.     

Poor compliance with appropriate feeding practices in children under 2 y in Mexico

We evaluated breast-feeding and complementary feeding practices in Mexico, using data from a national probabilistic survey carried out in 17,716 households, with regional and urban-rural representation. Mothers of children <2 y old (n = 3,191) reported duration of breast-feeding and the ages of usual introduction of 7 food groups. The Kaplan-Meier method was used to estimate the median time of feeding events. Practices were analyzed by categories of ethnicity, housing condition, and place of residence (geographic region and degree of urbanization). We found that 86% of infants at 1 mo and 39% at 11 mo were breast-fed, whereas 60% at 1 mo and 8% at 6 mo were exclusively breast-fed. Early introduction (<6 mo) of water, nonhuman milk, nonnutritive liquids, and fruits and vegetables was reported for all categories studied. Also, early introduction of nutritive liquids, cereals and legumes, and animal foods other than milk occurred in all categories except rural areas and the indigenous population. Late introduction of solid foods was documented in large proportions of infants in rural areas and in poor families. Poorer, unemployed, and indigenous women, and those bearing males, had a significantly higher probability of feeding their infants as recommended by the WHO. Feeding practices were unrelated to attained growth when the influence of economic and social factors was considered. Results indicate the need to implement actions for the promotion of exclusive breast-feeding during the first 6 mo and of timely introduction of complementary foods thereafter.     

Sources of sodium, potassium, and energy in the diets of adolescents

Analysis of food diaries of 200 students in two boarding high schools indicated that 30% of their average daily sodium intake was contributed by bakery foods and ready-to-eat cereals. The next most important source of sodium (24%) was a category made up of food adjuncts, snack-type foods, soups, and beverages. The largest proportion of sodium in most foods had been added during food manufacture or preparation. Salt added at the table contributed less than 1% of the sodium in the diets of the teenagers. All students did not eat foods from all categories on their day of recording; 70% or more ate bakery products, dairy foods, food adjuncts, and meat, fish, poultry, and eggs. Changes in recipe formulations can decrease sodium content for a variety of bakery products, cereals, mixed dishes, snack-type foods, soups, and processed meats. It is therefore possible to make large reductions in dietary sodium without disturbing other nutrient values.     

Preliminary data from demographic and health surveys on infant feeding in 20 developing countries

This study describes infant feeding practices in developing countries, specifically complementary liquids and foods in the first year of life. Data were compiled from Demographic and Health Surveys conducted from 1999 to 2003. We analyzed data from those countries with available data, including results for child-level 24-h and 7-d food and fluid intakes. We used datasets from 20 countries with information on >35,000 infants categorized by age: 0-6 and 6-12 mo. For analysis, we grouped data for fluids other than breast milk as water, other milk (e.g., tinned, powdered, animal), infant formula, and other liquids (e.g., fruit juice, herbal tea, sugar water). All specific solid foods were grouped as any solid foods. We present data on breast-feeding and maternal-reported fluid and solid intake by infants in a 24-h period, for individual countries, and in a pooled analysis. Pooled data show that 96.6% of 0- to 6- and 87.9% of 6- to 12-mo-old infants were currently breast-fed. Reported feeding of other fluids was lower among 0- to 6-mo-olds than 6- to 12-mo-olds: water (45.9 vs. 87.4%), other milk products (11.9 vs. 29.6%), infant formula (9.0 vs. 15.1%), and other liquids (15.1 vs. 41.0%). Pooled analysis showed that 21.9% of mothers reported feeding 0- to 6-mo-old infants some type of solid food, and 80.1% of mothers reported feeding solids to 6- to 12-mo-olds. These survey data show that other milks, other liquids, and solid foods are each much more commonly fed throughout infancy than commercial infant formulas in the countries studied.     

Feeding practice among younger Tibetan children living at high altitudes

OBJECTIVE: Few published data are available on the feeding practice of younger children in Tibet. Our study investigated feeding pattern of younger Tibetan children. DESIGN AND SUBJECTS: The study was a cross-sectional survey conducted in Tibet. A sample of 1655 children younger than 36 months old and their mothers was obtained by stratified multistage cluster random sampling method. Mothers were interviewed to collect information on feeding practice by a designed family questionnaire including initial time and duration of breastfeeding and time, frequency and types of complementary foods introduced. RESULTS: Most of the children was ever or being breastfed at the time of interview. The median duration of breastfeeding was 26 months. The prevalence of almost exclusive breastfeeding for 4 months was 20.1%. Mothers' age and education, child's residence, and introduction of egg, fresh milk and milk powder were strongly associated with the duration of breastfeeding. The partial feeding was a main pattern in the first 6 months of life. Zanban and porridge were offered at about 1 month after birth. By 6th month, less than 25% of children were fed protein foods such as egg and meats and only near 20% of children were fed fresh vegetables. Bean products, fish and chicken were seldom offered to children. CONCLUSIONS: We conclude that although they were breastfed for long time, complementary feeding practice of Tibetan children was disadvantaged, especially of rural children. Improvement of monotonous complementary foods and timely introduction should be stressed in local programmatic nutritional interventions.