影响陕西渭南农村小儿喂养的因素

目的 :了解小儿喂养的影响因素。方法 :分别对陕西省富平、澄城两县农村的围产保健质量和母亲喂养行为进行对比研究。结果 :经统计学检验 ,两县有显著性差异 (P <0 .0 5 )。结论 :围产保健质量与母亲喂养行为关系紧密 ,应重视农村社区围产保健工作 ,加强母乳喂养及辅食添加新知识的健康教育。     

顺义区0～2岁婴幼儿家长营养与喂养认知调查分析

目的 调查笔者所在区儿童喂养状况及家长认知水平,找出存在的问题,以有目的地指导家长合理喂养.方法 儿童保健门诊医生采用自行设计的调查问卷对就诊的329名儿童进行问卷调查,然后对调查结果进行统计学分析.结果 91.2%采用纯母乳喂养或混合喂养,但45.9%的母亲学过正确母乳喂养的姿势并按要求去做,当母乳不足时,83.7%的母亲会选择添加奶粉或辅食;近半数家长在辅食添加及婴幼儿饮食习惯培养上存在误区或不够重视.结论 今后婴幼儿喂养健康教育应更加侧重于喂养技术,即母乳喂养实施方法、辅食添加及进食技能培养的注意事项.     

北京石景山区婴幼儿母乳喂养与辅食添加情况分析

[目的]了解石景山区婴幼儿喂养情况,以便更好地指导儿童保健工作.[方法]在全区13个中心保健科固定的保健门诊日由儿保医师对保健体检的4～17个月龄婴幼儿母亲或喂养人进行问答式调查.调查结果入机应用SPSS10.0统计软件进行分析.[结果]①四个月内完全母乳喂养、部分母乳喂养及人工喂养率分别为56.7%、31.3%及12%;人工喂养主要原因(占66%)是母乳量少、始于新生儿期的占76.6%,干扰母乳喂养的有些因素是可以避免的;辅食早加率23.9%,早加辅食行为与喂养方式关系密切.②辅食开始添加的时间74%选择4～6个月;开始添加的品种80.4%为蛋黄或米粉;但肉豆类6～8个月添加率不足30%,8月龄后未添加率近20%,且应用频数低,以1～3次/周主.[结论]母乳喂养工作仍有待加强,母乳喂养指导的同时不可忽视辅食添加的指导.     

浙江省三门县婴儿母乳喂养与辅食添加情况分析

目的了解浙江省三门县婴儿喂养状况,为更好地指导儿童保健工作提供参考。方法在固定的保健门诊日由儿保医师对保健体检的4～12个月龄婴儿母亲或喂养人进行问卷调查,并对调查结果进行分析。结果4个月内全母乳喂养、部分母乳喂养及人工喂养率分别为53.9%、32.7%和13.4%,人工喂养的主要原因是母乳不足或产后无母乳(45.5%);6个月龄婴儿谷类、果/蔬类、蛋类、肉类、鱼虾类和豆制品的添加率分别为95.7%、83.6%、80.5%、29.6%、32.0%和31.5%;各类辅食首次添加时间集中在4～6月龄。结论4个月龄婴儿的母乳喂养率较低,辅食添加不平衡,提高母乳喂养率、改善辅食添加仍是儿童保健工作的重点。     

重庆市南岸区婴儿喂养及影响因素分析

【目的】 了解重庆市南岸区婴儿母乳喂养及辅食添加现状,并探索其影响因素,为加强科学喂养提供依据。 【方法】 通过整群随机抽样方式抽取两社区卫生服务中心,对来两中心进行儿童保健的0~12月婴儿母亲或看护人进行婴儿喂养及其影响因素调查。采用非条件Logistic回归分别分析母乳喂养和辅食添加影响因素。 【结果】 <4月婴儿母乳喂养率为76.56%,纯母乳喂养率占45.63%。4~6月婴儿喂养方式以部分母乳喂养和人工喂养为主,分别为52.8%、42.23%;7月~和10~12月,婴儿喂养方式以人工喂养为主,分别占69.66%、87.00%。辅食添加基本从4月龄开始,米粉/米糕和菜泥/果泥添加率分别在5、6月龄达到最高,分别为84%、84.5%;到7月以后粥/面条、碎菜/水果、蛋类和肉类添加率逐渐增加,到12月时基本能达到90%左右。辅食添加顺序大致为米粉/米糕、菜泥/果泥、碎菜/水果、蛋黄、粥/面条、蛋羹、肉类。 【结论】 该区婴儿母乳喂养情况有待改善,辅食添加情况可观。妇幼保健等相关部门应做好普及科学喂养知识的宣传工作,提高人群母乳喂养意识,从而改善婴儿母乳喂养情况和辅食添加行为。     

重庆城市户口和流动户口婴幼儿喂养行为及相关因素分析

目的:了解重庆城市户口和流动户口婴幼儿喂养行为及相关因素,以便更好地指导儿童保健工作。方法:对2004～2006年期间在本院儿童保健中心保健门诊就诊的4～12月龄婴幼儿进行体格检查,对其母亲或喂养人进行问卷式调查。结果:城市户口婴幼儿的喂养优于流动户口,但4月龄内纯母乳喂养比例均较低,辅食添加时间不合理,营养素含量低;城市家长除断奶时间外,对其他喂养知识的掌握均较郊区家长好;母亲文化程度越高,对科学喂养知识的掌握越好;喂养行为主要受家长喂养知识及态度的影响。结论:家长喂养知识不足是造成婴幼儿喂养不当的重要因素,应积极宣传和普及科学喂养知识。     

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。     

邹城市农村母乳喂养现状及对策

本文介绍了对邹城市农村母乳喂养现状的调查结果。重点调查了开奶时间、添加辅食时间、断奶时间和育龄妇女母乳喂养知识了解程度。其结果表明,母乳喂养率较高(90%以上),但以旧法喂养为主,喂养质量不高,大多数母亲缺乏母乳喂养知识。为此,提出了普及母乳喂养知识,提高母乳喂养质量的措施。     

拉萨农村藏族婴幼儿母亲喂养知识和行为调查

目的了解西藏自治区拉萨市农村藏族婴幼儿母亲喂养知识和行为,为指导婴幼儿科学喂养提供依据。方法采用自行设计调查表对抽取的拉萨市城关区3个农业乡共386名藏族0～24月龄婴幼儿母亲的喂养知识和行为进行调查。结果 386名农村藏族婴幼儿母亲的母乳喂养率为88.6%;从出生至4月龄,80%婴幼儿主要添加的辅食为糌粑糊;至6月龄时,60%婴幼儿添加的主要辅食为酥油茶,鸡蛋、肉类、蔬菜和水果的添加比例30%;至12月龄后,50%的婴幼儿开始添加鸡蛋、肉类、蔬菜和水果,但肉类的添加仅60%左右;有关婴幼儿喂养知识的7个问题中,除哺乳时两侧乳房应经常更换的回答正确率为85.9%外,其他6个问题的回答正确率均50%;在婴幼儿日常照料行为的2个问题中,61.9%的母亲能够经常带孩子晒太阳,77.2%的孩子外表看起来干净。结论拉萨市农村地区婴幼儿母亲喂养知识普遍欠缺,辅食添加不合理。     

陕南贫困农村地区婴幼儿喂养行为及风险因素分析

目的研究中国集中连片贫困农村地区婴幼儿喂养行为及其风险因素。方法 2013年在陕南秦巴山区开展贫困农村婴幼儿喂养行为调研,采用结构化问卷,选取1765名6~12月龄婴幼儿及其主要监护人为调查对象,收集婴幼儿喂养行为、孕产妇和儿童早期健康管理服务参与情况、婴幼儿及其家庭基本情况等信息,使用logistic模型分析婴幼儿喂养行为的风险因素。结果孕产妇和儿童早期营养教育能促进婴幼儿微量营养素补充(OR=1.413,P0.01),但与婴幼儿母乳喂养及辅食添加行为是否符合世界卫生组织标准间没有显著关系;低出生体重、第一胎和母亲不是第一监护人是科学母乳喂养婴幼儿的风险因素(均P0.01);年龄小、第一胎和妈妈教育年限≤9年是给婴幼儿科学添加辅食的风险因素(均P0.01)。结论陕南贫困农村地区婴幼儿母乳喂养和辅食添加不科学问题仍较普遍,孕产妇和儿童早期营养教育效果有限。     

沂源县农村婴儿喂养状况调查

目的:调查淄博市沂源县农村0～12个月婴儿喂养状况了解科学喂养率,为制定相关干预措施提供依据。方法:以2011年7～12月到沂源县妇幼保健院参与系统化保健的沂源县农村0～12个月婴儿为调查对象,对其主要看护人进行问卷调查。结果:1 675例0～6个月婴儿中纯母乳喂养率55.8%;补充维生素D 886例,补充率为52.9%;在441例添加辅食者中首选蛋黄251例,占56.9%;家长参加婴儿喂养讲座713例,占42.6%;参加喂养讲座可有效提高婴儿维生素D补充率。1617例7～12个月婴儿添加辅食1 542例,占95.3%;补充维生素D 634例,补充率为39.2%;首选辅食为蛋黄872例,占53.9%;参加喂养讲座可有效提高科学添加辅食的比率。结论:有组织、有规律地进行健康知识讲座是提高农村小儿科学喂养率、保障小儿健康的重要途径。     

Breast feeding and later psychosocial adjustment

The relationship between the duration of breast feeding and psychosocial outcomes measured between the ages of 15 and 18 years was examined in a birth cohort of 999 New Zealand children. During the period from birth to 1 year, information was collected on maternal breast-feeding practices. Between the ages of 15 and 18 years, sample members were assessed using a range of psychosocial measures, including measures of the quality of parent-child relationships, juvenile delinquency, substance abuse and mental health. Children who were breast fed for a longer duration were more likely to report higher levels of parental attachment and tended to perceive their mothers as being more caring and less overprotective towards them compared with bottle-fed children. No association was found between the extent of breast feeding and subsequent rates of juvenile offending, substance use and mental health in later life. Mothers who elected to breast feed were also more likely to be older, better educated, living with a partner, less likely to smoke during pregnancy, and to come from advantaged socio-economic backgrounds characterised by better living standards and a higher family income. Rates of breast feeding were also greater among mothers who gave birth to a first-born child of higher birthweight. After adjustment for these maternal and perinatal factors, the duration of breast feeding remained significantly associated with adolescent perceptions of maternal care, with increasing duration of breast feeding being associated with higher levels of perceived maternal care during childhood. It is concluded that: (a) it is unlikely that breast feeding is associated with reduced risks of psychiatric disorder in later life; (b) breast feeding may lead to closer parent-child relationships; and (c) it is unlikely that the association between breast feeding and cognitive development is mediated by intervening processes relating to improved psychosocial adjustment in breast-fed children.     

产科护理人员对妊娠合并症产妇母乳喂养认识的护理体会

目的：探讨产科护理人员对妊娠合并症产妇母乳喂养认识的护理措施及效果。方法我院70例妊娠合并症产妇参照母乳喂养认知度评量表对产妇的母乳喂养认知度进行调查统计,基于调查结果对产科护理人员进行专项知识培训,后按照数字抽签法将其随机分为研究组与对照组,每组35例,研究组合并症产妇围产期在常规护理的基础上行系统的健康教育与心理护理指导,对照组妊娠合并症产妇围产期仅行常规护理与健康宣讲,护理后对两组产妇进行母乳喂养知识认知度评量,统计对比两组产妇的母乳喂养落实效果。结果研究组总掌握率为91.4%,对照组为71.4%,高于对照组,组间比较差异显著（P〈0.05）;研究组母乳喂养率为94.3%,对照组为74.3%,高于对照组,组间比较差异有统计学意义（P〈0.05）。结论在常规护理指导的基础上对妊娠合并症产妇进行系统心理指导与健康教育干预,有助于提升产妇母乳喂养认知度与母乳喂养率,可以进行推广应用。     

不同性质助产机构分娩产妇围产保健获取情况比较

目的调查不同性质助产机构产妇的围产保健获取情况,分析在孕产妇系统管理方面存在的差距,明确围产保健工作重点。方法采用分层整群随机抽样方法,抽取2014年4~6月在广州市花都区妇幼保健机构、三级综合公立医院、一级综合公立医院和民营助产机构各一间住院分娩产妇共1406例,回顾性分析其围产保健获取情况。结果高危妊娠三级转诊得到较好落实,一级医院（27.61%）和民营医院（7.46%）高危壬辰比例明显低于妇幼保健机构（61.07%）和三级医院（53.65%）。妇幼保健机构分娩产妇围产保健获取情况整体优于其他医疗机构。民营医疗机构以流动人口为主,占72.03%,产妇围产保健获取比例较低。结论加强孕期保健宣教和流动人口管理,提高群众孕产期保健意识,针对不同性质助产机构产妇的特点,采取针对性措施,提高孕产妇的生殖保健水平。     

关于促进我国母乳喂养问题的讨论和建议

社会,特别是母亲的母乳喂养观念淡化,忽视了母乳喂养的重要性;医疗保健人员对促进母乳喂养的工作重视不够;有关保护妇女、儿童健康的立法不够,或有了立法,但实施不力;缺乏母乳喂养的必要的社会支持;产科及妇幼保健服务能力不足是我国母乳喂养率下降的主要原因。致使我国母乳喂养率自70年代以来出现了明显下降趋势,如北京市区的母乳喂养率由50年代的81％下降到1989年的13％;上海市1989年为15％;农村母乳喂养率也有较明显下降。提高我国母乳喂养率的主要措施为:加强有关母乳喂养的健康教育和技术培训;加强保护妇女、儿童健康的立法;建立和改善母乳喂养的社会支持条件;改善有关母乳喂养的保健服务水平;加强有关母乳喂养的科研工作;建立母乳喂养的监测和监督体制。以使我国的母乳喂养率尽快提高到WHO提出的指标。     

Primary health care of the newborn baby

More than 50% of infant deaths in India occur during the neonatal period. High priority therefore needs to be given to improving the survival of newborns. A large number of neonatal deaths have their origin in the perinatal period and are mainly determined by the health and nutritional status of the mother, the quality of care during pregnancy and delivery, and the immediate care of the newborn at birth. Main causes of neonatal mortality are birth asphyxia, respiratory problems, and infections, especially tetanus. Most such deaths occur among low birthweight babies. Hypothermia, undernutrition, and mismanaged breast feeding may also indirectly contribute to neonatal mortality. Community-based studies have, however, demonstrated that most neonatal mortality can be affordably prevented through primary health care. Efforts are underway to expand the health care infrastructure, but the outreach of maternal and child health care remains unsatisfactory especially in rural areas.     

不同喂养婴儿方式对产妇产后体重变化的影响

目的 了解妇女生育后喂养方式对体重变化的影响.方法 对孕期和产后4～6个月的孕产妇进行纵向追踪调查,记录体重变化情况.根据产妇在4个月内喂养婴儿的方式分为基本纯母乳喂养组、混合喂养组和人工喂养组,比较各组体重变化情况.结果 产后4个月内基本纯母乳喂养率为63.8％.人工喂养组孕期增重和产后42d、产后4～6个月时体重减少值均显著高于基本纯母乳喂养组(P均＜0.01);产后4～6个月时,基本纯母乳喂养组妇女的体重和体重滞留量均显著低于人工喂养组(P均＜0.05).结论 妇女产后体重滞留与采用不同的喂养婴儿方式有关,进行母乳喂养婴儿的产妇产后体重恢复较慢,但是其孕期增重、产后体重和体重滞留量都较人工喂养者轻.因此,在加强产后纯母乳喂养宣传的同时,也要加强孕前保健知识的宣传.     

Poor maternal schooling is the main constraint to good child care practices in Accra

Life in urban areas presents special challenges for maternal child care practices. Data from a representative quantitative survey of households with children < 3 y of age in Accra, Ghana were used to test a number of hypothesized constraints to child care including various maternal (anthropometry, education, employment, marital status, age and ethnic group) and household-level factors (income, availability of food, quality of housing and asset ownership, availability of services, household size and crowding). Three care indices were created as follows: 1) a child feeding index; 2) a preventive health seeking index; and 3) a hygiene index. The first two indices were based on data from maternal recall; the hygiene index was based on spot-check observations of proxies of hygiene behaviors. Multivariate analyses (ordinary least-squares regression for the child feeding index and ordered probit for the two other indices) showed that maternal schooling was the most consistent constraint to all three categories of child care practices. None of the household-level characteristics were associated with child feeding practices, but household socioeconomic factors were associated with better preventive health seeking and hygiene behaviors. Thus, poor maternal schooling was a main constraint for child feeding, health seeking and hygiene practices in Accra, but the lack of household resources was a constraint only for health seeking and hygiene. The programmatic implications of these findings for interventions in nutrition education and behaviors in Accra are discussed.     

Breastfeeding: an appeal

Factors that hinder breast feeding include the lack of knowledge of health personnel about the uniqueness of breast milk and the ease with which they and mothers have accepted formula feeding. These factors prevailed in Europe and North America until the 1960s, and they prevail today in developing countries. It is crucial to persuade health workers of the merits of breast feeding in order to promote it. Baby milk formula was developed in 1919 to provide a substitute for infants afflicted by the lack of their mothers milk. The search for the perfect human milk formula continues, but formula feeding is an experiment whose long-term effects are unknown. Its putative benefits are convenience, creation of employment, decreased perinatal mortality in affluent societies, and increased weight gain of premature low-birth-weight babies. However, formula feeding encourages less frequent child-mother contact. Employment opportunities in the manufacture of formula milk are only generated in the developed countries. The decline in perinatal mortality in developed countries since the advent of bottle feeding has been attributable to better obstetric care and improved management of such conditions as respiratory distress syndrome in infants. Most of the weight gain associated with formula use is caused by water and solute retention, which may be harmful to immature kidneys. On the other hand, the indisputable benefits of breast feeding include 1) prevention of infant malnutrition in the poor and obesity in the affluent 2) reduction in infection owing to protective factors in breast milk 3) reduced exposure to foreign allergens leading to a lower incidence of atopic conditions 4) convenience 5) enhancing the emotional bond between mother and child; and 6) helping to regulate appetite and satiety. Developing countries need health workers who are committed to encouraging exclusive breast feeding for 4 months, followed by breast feeding with supplements for at least 12 months.