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新生儿喂养：应按时兼按需

发布日期：2024-07-18 10:54:13编辑：胖虎爱撩妹

　　美国医学会、美国儿科学会、世界卫生组织以及其他有关新生儿护理的专业性机构一致倡导母乳喂养。世界卫生组织建议婴儿在4~6个月前应全母乳喂养，因为母乳中的乳糖、蛋白质（乳清和酪蛋白）、脂肪极易为婴儿所消化，母乳中也富含婴儿生长发育所需要的维生素、矿物质等，母乳喂养的婴儿在以后添加辅食时很少发生食物过敏反应，母乳可为婴儿提供酶和抗体，这是配方奶无法比拟的。
 
    母乳喂养不仅对婴儿有利，对喂乳的妇女也有好处。如哺乳期消耗热量多，不易发胖，有助于子宫收缩，加快体形恢复等。母乳喂养简单、方便、廉价。但母乳喂养也有不利的一面，每隔2~3小时喂一次奶，这使一部分喂乳期妈妈感到“捆得太紧”。尤其是对那些离家去上班或时常外出的妈妈们来说非常不方便。还有那些由于疾病等原因暂时不能喂乳的妈妈，在这期间需要将乳汁挤出来弃掉，也是不方便的。早产儿可能不会吞咽或吸吮，多数是将母乳挤出后通过喂奶管直接送入胃中，因此也不便母乳喂养。人工喂养婴儿应注意以下几个问题：1）家中应有备份的配方奶；2）不要用过期奶粉或包装已经破损的奶粉；3）奶瓶和奶嘴应保持清洁无菌；4）婴儿喝剩的奶室温存放1小时以上应扔掉；5）调制好的配方奶在冰箱中存放不应超过24小时；6）不要用微波炉热奶，以免局部过热的奶水烫伤婴儿口腔。
 
    母乳喂养一般每隔2小时喂一次奶，每个奶头的吸吮时间约为10~15分钟；人工喂养的喂奶间隔可以稍长一些，每次约2~3盎司，爱睡觉的新生儿应按时唤醒喂奶。如果新生儿不哭不闹，每天换6次尿布，睡眠好，体重正常，这说明奶量足够。新生儿也知道饥饱，当已经吃饱时他就会停止吸吮或吸吮速度放慢。过饱会表现为溢奶、大便增多。喂养不足的新生儿主要表现为小脸不胖、皮肤皱折、喂完奶后婴儿还是像没吃饱似的。
1~3个月婴儿喂养：数尿布
 
   这个年龄段的婴儿有3~6周的快速生长阶段。在此期间应注意多喂奶，保证营养，以满足其生长发育的需要。判断婴儿是否吃饱的方法有两种：一是监测体重；一般来讲，人工喂养的婴儿体重增加的速度大于母乳喂养的婴儿。二是数每天换下几块尿布；平均不应少于6块。人工喂养的婴儿一般每隔4小时喂一次奶，而母乳喂养的婴儿应多喂几次，因为母乳易消化。
 
   婴儿吃不饱时有下列表现：1）在一侧乳头吸吮不到10分钟；2）脸瘦、皮肤皱折；3）喂完奶后仍像没吃饱似的。发现上述表现时应加大奶量。对母乳喂养的妈妈来说，应注意休息，摄入有助于催乳或营养好的膳食，尽量让婴儿多吸吮奶头，这样可刺激泌乳。人工喂养的婴儿到2个月时，每次喂乳的量应在4~5盎司，到满3个月时，每次应喂5~6盎司奶。如果喂奶后婴儿溢奶，大便多，这是过饱的表现。
4~7个月婴儿：挺舌反射与辅食
 
    这个年龄段的婴儿多数已开始添加辅食。添加辅食的前提条件应该是：1）婴儿挺舌反射消失；这种反射的作用是防止外来异物进入喉部，导致婴儿窒息。所以，若反射不消失，喂入婴儿口中的食物会被推出来。2）婴儿应能够竖起脑袋；这时的婴儿可以不会做，但脑袋必须竖起来，以便添加辅食。3）婴儿应对食物感兴趣；当怀抱婴儿在饭桌旁就餐时，婴儿凝视着饭菜，并会伸手去抓，这显然到了该给他添加辅食的时候了。
 
    在如下几种情况下，应推迟添加辅食的时间：1）有家族性食物过敏史；2）早产儿；它的吸吮-吞咽-呼吸功能发育或协调需要较长的时间。3）试图添加辅食时婴儿不予理睬。
 
    通常，首先添加的辅食是米汤，将汤匙放在婴儿的嘴边，让婴儿闻闻味或尝一尝。最初喂入婴儿口中的米汤可能不多，多半被撒在婴儿脸颊、围嘴或其他地方。不过请不必着急，慢慢来。一旦婴儿已适应谷类辅食后，就应添加蔬菜和水果了。因为人们天生偏爱吃甜食，而过多的甜食又对孩子未来的牙齿不利，所以要尽量限制婴儿的摄糖量，尽可能以胡萝卜汁或土豆泥替代含糖量高的蔬菜或水果。
 
    在添加辅食的同时，要时刻注意婴儿对食物有无过敏反应。以下是食物过敏反应的几种可能表现：1）胀肚；2）嘴或肛门周围出现皮疹；3）腹泻；4）流鼻涕或流眼泪；5)异常不安或哭闹。若出现上述任何现象，都应停止添加辅食。
 
    有些辅时应该推迟添加时间，有的甚至要推迟到1周岁以后。如，蛋清、牛奶、柑桔类水果和果汁、蜂蜜等。许多婴儿对蛋清或牛奶过敏；柑桔类水果含酸量大，会加剧婴儿尿布疹的疼痛；蜂蜜中含有孢子，可导致婴儿肉毒中毒。
 
    由于当今社会生活节奏的加快，很多父母由于工作忙，没有时间为婴儿做饭，因此到超市或商店买些婴儿食品。在采购时应注意食品包装或标签说明，要选择包装精巧、量小、卫生安全和营养保证的食品。买来后，用洁净餐具从包装器皿中分出一小部分到小碗中，不要直接从包装器皿中取食物喂婴儿，因为婴儿一次吃不了的话，由于细菌的污染，回加速食品的变质。开封后在1~2天内若吃不完的话，最好将余下的部分扔掉。
 
    如果在家里自己为婴儿做辅时，应注意以下两点：1）讲究卫生，防止食物传播疾病；2）选择合适的烹调方法，保证食品中的营养成分（维生素、矿物质）不被破坏。建议选用蒸、烤、微波炉加热等，尽量避免油炸和水煮。
 
    8~12个月婴儿：以手抓食
 
    这个年龄组的婴儿，单靠母乳或配方奶已不能满足发育对营养成分的需求，应辅以不同食品，也可以说婴儿一日三餐应坐到餐桌旁，同家庭中其他成员一起品尝“美味佳肴”。因此，家庭用餐应讲究质量，并在烹调时兼顾到婴儿的需要，食品中不宜放过多的糖、盐、脂肪等，餐桌上多一些新鲜蔬菜和水果，面包也要吃全麦粉的。
 
    8个月的婴儿已经会用手抓食物吃了，可将小块的鸡肉、香蕉、蛋黄、面包等放到他的旁边，让他自己抓着吃。但应防止食物卡在喉咙里，避免让他抓到圆而硬的食品，如苞米花、花生粒、糖块、葡萄或葡萄干等。
 
    8个月也是锻炼婴儿手握杯子能力的时候，买一个两边有把柄的带盖杯子，让他锻炼如何用杯子喝水。当然，不要让婴儿喝过多的水，以免影响饮食。
 
    这个年龄组的婴儿由于不是处于快速生长期，食欲会有所下降。婴儿可能对别的东西比对食物更感兴趣。只要他每天正常吃奶，并对他从未尝过的食品表示愿意品尝，就属正常，不会发生喂养方面的问题。
 
    1~2岁孩子：断奶期
 
    这个年龄组的孩子，一半以上的营养或热量仍然来源于母乳或配方奶，其余则由辅食补充。所以，家庭餐桌上的饭菜仍应照顾到孩子。盐、糖、脂肪等仍受限制，新鲜蔬菜、水果、食用瘦肉等要保证供应，全麦粉面包或粗粮仍是提倡的对象。
 
    1~2岁仍然不是快速生长期，所以，一般来讲，一日三餐，另加两顿加餐就已经足够了。由于年龄相对大了，消化道功能发育日趋成熟，你可以添加一些原来不敢给孩子添加的食品，象牛奶、蛋清、柑橘类水果等，但仍需注意食物过敏。让孩子喝奶可喝全脂奶，若生长发育良好，也可喝低脂或脱脂奶。将苞米花、糖块、果冻、葡萄或葡萄干、坚果等易引起孩子窒息的食品，放到孩子摸不到的地方。
 
    这个时期的孩子对饭菜要求不定，有时要求一顿一换样，有时却连续几天一直喜欢吃一种食品，所以很难做到平衡膳食。
 
    绝大多数孩子在这期间被强制断奶，断奶后要注意辅食的营养结构。一般来讲，每日分三次正餐、两次加餐共摄入1000卡热量就能保证孩子的营养。
 
    美国儿科学会认为，不管是母乳喂养还是人工喂养的婴儿，在6个月前都不需要补充微量元素氟。但从6个月以后至3岁这段时间内，如果饮水中严重缺氟（0.3ppm以下），就应注意补充氟。
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