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新生兒喂養(yǎng)：應(yīng)按時(shí)兼按需

出處：網(wǎng)絡(luò)收集 日期：2024-07-18 10:54:13 編輯：胖虎愛撩妹
　　美國(guó)醫(yī)學(xué)會(huì)、美國(guó)兒科學(xué)會(huì)、世界衛(wèi)生組織以及其他有關(guān)新生兒護(hù)理的專業(yè)性機(jī)構(gòu)一致倡導(dǎo)母乳喂養(yǎng)。世界衛(wèi)生組織建議嬰兒在4~6個(gè)月前應(yīng)全母乳喂養(yǎng)，因?yàn)槟溉橹械娜樘?、蛋白質(zhì)（乳清和酪蛋白）、脂肪極易為嬰兒所消化，母乳中也富含嬰兒生長(zhǎng)發(fā)育所需要的維生素、礦物質(zhì)等，母乳喂養(yǎng)的嬰兒在以后添加輔食時(shí)很少發(fā)生食物過敏反應(yīng)，母乳可為嬰兒提供酶和抗體，這是配方奶無法比擬的。
 
    母乳喂養(yǎng)不僅對(duì)嬰兒有利，對(duì)喂乳的婦女也有好處。如哺乳期消耗熱量多，不易發(fā)胖，有助于子宮收縮，加快體形恢復(fù)等。母乳喂養(yǎng)簡(jiǎn)單、方便、廉價(jià)。但母乳喂養(yǎng)也有不利的一面，每隔2~3小時(shí)喂一次奶，這使一部分喂乳期媽媽感到“捆得太緊”。尤其是對(duì)那些離家去上班或時(shí)常外出的媽媽們來說非常不方便。還有那些由于疾病等原因暫時(shí)不能喂乳的媽媽，在這期間需要將乳汁擠出來?xiàng)壍簦彩遣环奖愕?。早產(chǎn)兒可能不會(huì)吞咽或吸吮，多數(shù)是將母乳擠出后通過喂奶管直接送入胃中，因此也不便母乳喂養(yǎng)。人工喂養(yǎng)嬰兒應(yīng)注意以下幾個(gè)問題：1）家中應(yīng)有備份的配方奶；2）不要用過期奶粉或包裝已經(jīng)破損的奶粉；3）奶瓶和奶嘴應(yīng)保持清潔無菌；4）嬰兒喝剩的奶室溫存放1小時(shí)以上應(yīng)扔掉；5）調(diào)制好的配方奶在冰箱中存放不應(yīng)超過24小時(shí)；6）不要用微波爐熱奶，以免局部過熱的奶水燙傷嬰兒口腔。
 
    母乳喂養(yǎng)一般每隔2小時(shí)喂一次奶，每個(gè)奶頭的吸吮時(shí)間約為10~15分鐘；人工喂養(yǎng)的喂奶間隔可以稍長(zhǎng)一些，每次約2~3盎司，愛睡覺的新生兒應(yīng)按時(shí)喚醒喂奶。如果新生兒不哭不鬧，每天換6次尿布，睡眠好，體重正常，這說明奶量足夠。新生兒也知道饑飽，當(dāng)已經(jīng)吃飽時(shí)他就會(huì)停止吸吮或吸吮速度放慢。過飽會(huì)表現(xiàn)為溢奶、大便增多。喂養(yǎng)不足的新生兒主要表現(xiàn)為小臉不胖、皮膚皺折、喂完奶后嬰兒還是像沒吃飽似的。
1~3個(gè)月嬰兒喂養(yǎng)：數(shù)尿布
 
   這個(gè)年齡段的嬰兒有3~6周的快速生長(zhǎng)階段。在此期間應(yīng)注意多喂奶，保證營(yíng)養(yǎng)，以滿足其生長(zhǎng)發(fā)育的需要。判斷嬰兒是否吃飽的方法有兩種：一是監(jiān)測(cè)體重；一般來講，人工喂養(yǎng)的嬰兒體重增加的速度大于母乳喂養(yǎng)的嬰兒。二是數(shù)每天換下幾塊尿布；平均不應(yīng)少于6塊。人工喂養(yǎng)的嬰兒一般每隔4小時(shí)喂一次奶，而母乳喂養(yǎng)的嬰兒應(yīng)多喂幾次，因?yàn)槟溉橐紫?/div>
 
   嬰兒吃不飽時(shí)有下列表現(xiàn)：1）在一側(cè)乳頭吸吮不到10分鐘；2）臉瘦、皮膚皺折；3）喂完奶后仍像沒吃飽似的。發(fā)現(xiàn)上述表現(xiàn)時(shí)應(yīng)加大奶量。對(duì)母乳喂養(yǎng)的媽媽來說，應(yīng)注意休息，攝入有助于催乳或營(yíng)養(yǎng)好的膳食，盡量讓嬰兒多吸吮奶頭，這樣可刺激泌乳。人工喂養(yǎng)的嬰兒到2個(gè)月時(shí)，每次喂乳的量應(yīng)在4~5盎司，到滿3個(gè)月時(shí)，每次應(yīng)喂5~6盎司奶。如果喂奶后嬰兒溢奶，大便多，這是過飽的表現(xiàn)。
4~7個(gè)月嬰兒：挺舌反射與輔食
 
    這個(gè)年齡段的嬰兒多數(shù)已開始添加輔食。添加輔食的前提條件應(yīng)該是：1）嬰兒挺舌反射消失；這種反射的作用是防止外來異物進(jìn)入喉部，導(dǎo)致嬰兒窒息。所以，若反射不消失，喂入嬰兒口中的食物會(huì)被推出來。2）嬰兒應(yīng)能夠豎起腦袋；這時(shí)的嬰兒可以不會(huì)做，但腦袋必須豎起來，以便添加輔食。3）嬰兒應(yīng)對(duì)食物感興趣；當(dāng)懷抱嬰兒在飯桌旁就餐時(shí)，嬰兒凝視著飯菜，并會(huì)伸手去抓，這顯然到了該給他添加輔食的時(shí)候了。
 
    在如下幾種情況下，應(yīng)推遲添加輔食的時(shí)間：1）有家族性食物過敏史；2）早產(chǎn)兒；它的吸吮-吞咽-呼吸功能發(fā)育或協(xié)調(diào)需要較長(zhǎng)的時(shí)間。3）試圖添加輔食時(shí)嬰兒不予理睬。
 
    通常，首先添加的輔食是米湯，將湯匙放在嬰兒的嘴邊，讓嬰兒聞聞味或嘗一嘗。最初喂入嬰兒口中的米湯可能不多，多半被撒在嬰兒臉頰、圍嘴或其他地方。不過請(qǐng)不必著急，慢慢來。一旦嬰兒已適應(yīng)谷類輔食后，就應(yīng)添加蔬菜和水果了。因?yàn)槿藗兲焐珢鄢蕴鹗?，而過多的甜食又對(duì)孩子未來的牙齒不利，所以要盡量限制嬰兒的攝糖量，盡可能以胡蘿卜汁或土豆泥替代含糖量高的蔬菜或水果。
 
    在添加輔食的同時(shí)，要時(shí)刻注意嬰兒對(duì)食物有無過敏反應(yīng)。以下是食物過敏反應(yīng)的幾種可能表現(xiàn)：1）脹肚；2）嘴或肛門周圍出現(xiàn)皮疹；3）腹瀉；4）流鼻涕或流眼淚；5)異常不安或哭鬧。若出現(xiàn)上述任何現(xiàn)象，都應(yīng)停止添加輔食。
 
    有些輔時(shí)應(yīng)該推遲添加時(shí)間，有的甚至要推遲到1周歲以后。如，蛋清、牛奶、柑桔類水果和果汁、蜂蜜等。許多嬰兒對(duì)蛋清或牛奶過敏；柑桔類水果含酸量大，會(huì)加劇嬰兒尿布疹的疼痛；蜂蜜中含有孢子，可導(dǎo)致嬰兒肉毒中毒。
 
    由于當(dāng)今社會(huì)生活節(jié)奏的加快，很多父母由于工作忙，沒有時(shí)間為嬰兒做飯，因此到超市或商店買些嬰兒食品。在采購(gòu)時(shí)應(yīng)注意食品包裝或標(biāo)簽說明，要選擇包裝精巧、量小、衛(wèi)生安全和營(yíng)養(yǎng)保證的食品。買來后，用潔凈餐具從包裝器皿中分出一小部分到小碗中，不要直接從包裝器皿中取食物喂嬰兒，因?yàn)閶雰阂淮纬圆涣说脑?，由于?xì)菌的污染，回加速食品的變質(zhì)。開封后在1~2天內(nèi)若吃不完的話，最好將余下的部分扔掉。
 
    如果在家里自己為嬰兒做輔時(shí)，應(yīng)注意以下兩點(diǎn)：1）講究衛(wèi)生，防止食物傳播疾??；2）選擇合適的烹調(diào)方法，保證食品中的營(yíng)養(yǎng)成分（維生素、礦物質(zhì)）不被破壞。建議選用蒸、烤、微波爐加熱等，盡量避免油炸和水煮。
 
    8~12個(gè)月嬰兒：以手抓食
 
    這個(gè)年齡組的嬰兒，單靠母乳或配方奶已不能滿足發(fā)育對(duì)營(yíng)養(yǎng)成分的需求，應(yīng)輔以不同食品，也可以說嬰兒一日三餐應(yīng)坐到餐桌旁，同家庭中其他成員一起品嘗“美味佳肴”。因此，家庭用餐應(yīng)講究質(zhì)量，并在烹調(diào)時(shí)兼顧到嬰兒的需要，食品中不宜放過多的糖、鹽、脂肪等，餐桌上多一些新鮮蔬菜和水果，面包也要吃全麥粉的。
 
    8個(gè)月的嬰兒已經(jīng)會(huì)用手抓食物吃了，可將小塊的雞肉、香蕉、蛋黃、面包等放到他的旁邊，讓他自己抓著吃。但應(yīng)防止食物卡在喉嚨里，避免讓他抓到圓而硬的食品，如苞米花、花生粒、糖塊、葡萄或葡萄干等。
 
    8個(gè)月也是鍛煉嬰兒手握杯子能力的時(shí)候，買一個(gè)兩邊有把柄的帶蓋杯子，讓他鍛煉如何用杯子喝水。當(dāng)然，不要讓嬰兒喝過多的水，以免影響飲食。
 
    這個(gè)年齡組的嬰兒由于不是處于快速生長(zhǎng)期，食欲會(huì)有所下降。嬰兒可能對(duì)別的東西比對(duì)食物更感興趣。只要他每天正常吃奶，并對(duì)他從未嘗過的食品表示愿意品嘗，就屬正常，不會(huì)發(fā)生喂養(yǎng)方面的問題。
 
    1~2歲孩子：斷奶期
 
    這個(gè)年齡組的孩子，一半以上的營(yíng)養(yǎng)或熱量仍然來源于母乳或配方奶，其余則由輔食補(bǔ)充。所以，家庭餐桌上的飯菜仍應(yīng)照顧到孩子。鹽、糖、脂肪等仍受限制，新鮮蔬菜、水果、食用瘦肉等要保證供應(yīng)，全麥粉面包或粗糧仍是提倡的對(duì)象。
 
    1~2歲仍然不是快速生長(zhǎng)期，所以，一般來講，一日三餐，另加兩頓加餐就已經(jīng)足夠了。由于年齡相對(duì)大了，消化道功能發(fā)育日趨成熟，你可以添加一些原來不敢給孩子添加的食品，象牛奶、蛋清、柑橘類水果等，但仍需注意食物過敏。讓孩子喝奶可喝全脂奶，若生長(zhǎng)發(fā)育良好，也可喝低脂或脫脂奶。將苞米花、糖塊、果凍、葡萄或葡萄干、堅(jiān)果等易引起孩子窒息的食品，放到孩子摸不到的地方。
 
    這個(gè)時(shí)期的孩子對(duì)飯菜要求不定，有時(shí)要求一頓一換樣，有時(shí)卻連續(xù)幾天一直喜歡吃一種食品，所以很難做到平衡膳食。
 
    絕大多數(shù)孩子在這期間被強(qiáng)制斷奶，斷奶后要注意輔食的營(yíng)養(yǎng)結(jié)構(gòu)。一般來講，每日分三次正餐、兩次加餐共攝入1000卡熱量就能保證孩子的營(yíng)養(yǎng)。
 
    美國(guó)兒科學(xué)會(huì)認(rèn)為，不管是母乳喂養(yǎng)還是人工喂養(yǎng)的嬰兒，在6個(gè)月前都不需要補(bǔ)充微量元素氟。但從6個(gè)月以后至3歲這段時(shí)間內(nèi)，如果飲水中嚴(yán)重缺氟（0.3ppm以下），就應(yīng)注意補(bǔ)充氟。

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