Child Health Care
Chapter 3
The content of child health care
? Regular health surveillance
? Screening test
? Counseling and Anticipatory guidance
? Immunization
Recommendation for primary health care
Essential elements
?History,Initial/interval
?Measurements
?Sensory screening
?Developmental Assessment
?Physical examination
?Immunization
?Anticipatory guidance
Injury prevention
Violence prevention
Sleep positioning counseling
Nutrition counseling
?Dental referral
Schedule of health care visit
?Infancy 0-1yr
Prenatal Neonatal First week
1 mo 2 mo 4 mo
6 mo 9 mo 12 mo
?Early Childhood 1-4 yr
15 mo 18 mo
2 yr 3 yr 4 yr
?Middle Childhood 5-10yr
5 yr 6 yr
8 yr 10 yr
?Adolescence 11-21 yr
11 yr 12 yr 13 yr
14 yr 15 yr 16 yr
17 yr 18 yr 19 yr
20 yr 21 yr
Seven Stage
Fetal period Neonatal period
Infant age Toddle age
Preschool age School age
Adolescence
Fetal Period
From egg fertilized to birth,280 days
Perinatal Period
Gestation 28 wks to 1 week after birth
Physiological
character
Growth and
development
are dependent
on maternal
condition
Category of
Diseases
Rules of health care
?Congenital
malformation
?Intrauterine
growth
retardation
?Heredity and
genetic
disorders
?Premature
delivery
?Abortion
?Sufficient nutrition and
cheerful environment for
pregnant woman
?Abstain from smoking and
alcohol
?Prevent from infection
during pregnancy
?Taking medicine carefully
?Avoid to exposure on the
radiation and toxicity hazard
?Screening test before
delivery if necessary
Fetal Period
Neonatal Period
From birth to 28 days
Physiological
character
?Adapt to the
condition of
surroundings
(independent
living)
?Physiogiocal
functions are
immature
Category of
Diseases
Rules of health care
?Congenital
malformation
?Premature
?Pneumonia
?Birth injury
?Asphyxia
?Inherit and
genetic
diseases
?Intensify the health care of
prenatal and improve the
skill of deliver
?Pay more attention to the
nursing,feeding,warming
and prevention
?Establish the family visiting
program for neonate
?Screening tests for the PKU,
Hypothyroidism,CDH,and
neonatal hearing test,etc.
Neonatal Period
Infant period
From birth to 1 yr of age,
included neonatal period
Physiological
character
?Grow and
develop
promptly
?Relatively
high
requirement
of nutrition
?Antibodies
from
maternal
decrease
gradually
Category of
Diseases
Rules of health care
?Deficiency of
nutrition,
diarrhea
?Infectious
diseases
?Accident,
trauma
?Properly feeding (breast
feeding,supplementation,
weaning)
?Monitor the growth and
development and provide
anticipatory guidance
? Immunization
?Prevent from rickets and
anemia etc.
? Arrange appropriate time
schedule and train to good
habit
Infant period
Toddler period
From 1 yr to 3 yr of age
Physiological
character
?growth rate
slow down
?Intelligence
develop
promptly
?The range of
walk extends
gradually
?Inability to
avoid danger
?Immune
functions still
lower
Category of
Diseases
Rules of health care
?Diarrhea
?Accident
（ Trauma,
toxicosis）
?Infectious and
contagious
diseases
?Properly feeding
(supplementation,weaning)
?To monitor the growth and
development and provide
anticipatory guidance
?Immunization
?To arrange appropriate time
schedule and train to good
habit
?To avoid accidents
Toddler period
Preschool age
From 3 yrs to 6 yrs of age
Physiological
character
?Somatic
growth gain
up steadily
? Intelligence
develop
much more
maturely
?Immune
functions
matured
continually
Category of
Diseases
Rules of health care
?Trauma and
injury
?Infectious
diseases
?Allergy and
rheumatoid
diseases come
forth
?Attention education and
training
?Physical exercises
?Physical examination
punctually
?Prevent from infectious
diseases and accidents
Preschool period
School Age
From 6 yrs to 12 yrs of age
Physiological
character
?The maturity
of systems
and organs
approach
what in
adulthood
except for
reproduction
system
?The burden
of study
increase
observably
Category of
Diseases
Rules of health care
?The mortality
of acute and
severe diseases
decrease
significantly
?Decayed tooth
?Myopia
?Allergy and
rheumatic
diseases
?Sufficient nutrition and
exercises
?Planning the schedule of
work and rest,training good
behavior
?Appropriate facilities for
preventing from Myopia,
Decayed tooth
School age
Adolescence
Girls,11 – 18 yrs of age
Boys,13 – 20 yrs of age
Individual variation
2 – 4 yrs
Physiological
character
?The reproduction
system develops
promptly
?Anthropometrics
growth promote
rapidly again
?Instable
coordinate
regulation of
Nervo-endocrine
system
Category of
Diseases
Rules of health care
?The emotion
uncertain
?Goiter
?Hypertension
?Education of physiological
and psychological knowledge
?Guiding and steering gently
Adolescence
Chapter 4
Childhood Nutrition
Nutritional requirements
? Aim,To live,to grow and thrive
? the Core of food supply,Balance diet
? Under intake,nutritional deficiency diseases
? Over intake,toxicity or obesity
Classification of nutrients
(2000 Chinese DRIs)
?Energy
?Macronutrients
protein,fat,carbohydrates
?Micronutrients,Minerals,Vitamins
?Other diet’s components
Dietary fiber,water,and others.
Function
?Basal metabolism,50-60%
?Requirement for growth
20-30%
?Food dynamic action
7-8 %
?Requirement for physical
activity,15-20Kcal/kg/d
?Energy lost in excreta
10 %
Food sources Requirement
?Protein
9~15%
?Carbohydrate
45~55%
?Fat 35~45%
?1g protein
= 4 Kcal
?1g Carbohydrate
= 4 kcal
?1g fat
= 9 kcal
? <1yr,
110 kcal/kg/d
?>1 yr,
Reduce
10 cal/kg/d
every 3 yr
Energy
Function
?composition body tissues.
?Important role in body
growth and maintenance
Food sources Requirement
?Milk production,
egg,fish,meat,
bean etc.
?The quality of
animal protein is
better than plant
protein
? Breast
feeding
2g/kg/d
?cow milk
feeding
3.5g/kg/d
?Plant protein
feeding
4g/kg/d
Macronutrients - Protein
Nine essential amino acids,histidine,isoleucine,leucine,lysine
methionine,phenylalanine,threonine,tryptophan,and valine
Conditional essential amino acids,cystine,taurine,arginine
Function
?Energy storage
?Provide essential fatty acid
?As a solvent for the fat
soluble vitamins
Food sources Requirement
?Animal fat,meat,
milk production,
plant oil,plant
? <6y,
3-6g/kg/d
? >6y,
2.5g/kg/d
Macronutrients - Fat
Fatty acid
saturated fat,fats of animal origin (except human milk)
polyunsaturated fat,fats of vegetable origin
Function
?To supply energy
Food sources Requirement
?cereal,fruit,
legume,vegetable
? Infant
10-12g/kg/d
?Children
12-15g/kg/d
Macronutrients - Carbohydrate
three groups,
Mono - saccharides,disaccharides,polysaccharides
Function Food source
Micronutrients
Essential components Animal and plant
of body tissue foodMinerals
Body physiological function Meat,liver,
Promote body growth vegetables,fruitsVitamins
? Iron deficiency is the common nutritional deficiency
? Most vitamins cannot be synthesized in the body and
must be supplied in the diet
?Addition of vitamin D to milk is mandated by law
Function
?the principal constituent
for most tissue.
?an aqueous medium for
body metabolism
Food sources Requirement
?Milk,soup and
water
? <1y
150ml/kg/d
?1-3y
100ml/kg/d
?4-6y
80ml/kg/d
? Reduce
10ml/kg/3 yrs
Other diet components - water
Loss of water:
? Loss in urine,and in fecal
? Loss from lungs and skin (insensible water loss)
Function
?Soluble fiber
delay GI transit
delay glucose absorption
lower blood cholesterol
?Insoluble fiber
accelerate GI transit
increase fecal weight
slow starch hydrolysis
delay glucose absorption
Food sources Requirement
?Fruits( apple,
citrus),oats,
barley,legumes
? Wheat bran,
whole-grain
breads,cereals,
vegetables
?Not available
Other diet components
– dietary fiber
Key issues on Childhood Nutrition
? Calories should be the first item to be
evaluated in assessing a dietary history
? A well-balance diet
? Interaction of carbohydrate,fat and protein
? both energy and protein are insufficiency may
result in malnutrition
Evaluation of Nutrition status
? Clinical examination
Birth history; feeding history,clinic symptom & sign
? Dietary intake investigation
24 hrs inquiring method
? Anthropometric assessment
W/A,H/A,W/H,Growth curve
? Laboratory assessment
Blood sample,urine sample
Infant
feeding
Digestive system
anatomic physiological characteristic
Mouth
Cheek fatty mat; Hypogenesis of saliva gland
Amylase deficiency
Oesophagus
Hypogenesis of oesophageal wall muscle and bounce
fiber
Stomach
Position; Cardia & pylori constrictor; Stomach
capacity
Intestines
6 times of body’s length
Pancreas
<3 mo,the activity of amylase is lower
Liver
quite larger
Intestinal bacterium group
Breast feeding,lactobacillus
Cow-milk feeding,Escherichia Coli,
Normal stool
Fetal stool Breast feeding Cow milk feeding
Color Dark green Gold Straw yellow
Character Slimy Slimy & Soft Hard
Odor No odor Acid odor Protein
decomposed odor
Time Not surely ? 4-5 times,1-2 times
or constipation
Breast feeding
Breast is best
Human milk is for humans
Cow milk is for cows
Composition of breast milk
Colostrums Transitional breast milk Mature milk Terminal stage milk
Period 1 week 2 wks -1 mo 2-9months >10 months
character
?Dense,yellow
?Few fat
?High globin
?Highest fat
?Drop of
protein and
mineral
?Protein 1.2g%
?Fat 3.5g%
?Lactose 7.5g%
Decline of
amount and
nutrients
Advantage of breast feeding
? Better nutritional qualities
?Easily digested
? Protein,whey proteins (lactalbumin and lactoglobulins)
account for 2/3
? Fat,unsaturated fatty acids,linoleic acid,rich in lipase
? Lactose,higher concentrations
?Low renal solute load
?Favorable calcium to phosphate ratio
Ensure calcium absorption
?More iron,zinc content
Advantage of breast feeding
? Anti-infective properties
? Secretory Ig A
? Lysozyme (溶菌酶 ）
? Phagocytic cells （ 吞噬细胞 ）
? Iron-binding protein Lactoferrin （ 乳铁蛋白 ）
? Low-polysaccharid
? Zinc
? Vitamin B12
? Bifidus factor （ 双歧因子 ）
Advantage of breast feeding
? Psychologic benefit
? Promotes maternal-infant bonding
? Gain a sense of security
? Constitute the foundation for the development of all
human social relationships and communications
? others
? Economy,convenience
? Lack of contamination
Advantage of breast feeding
? Benefit for the mother
? Stimulation,by sucking,of oxytocin secretions,
which fosters uterine contractions and hastens
postpartum uterine involution
? Possible decreased risk of postpartum
thromboembolism (血栓栓塞） and breast cancer
? Emotional satisfaction and sense of fulfillment
Artificial Feeding
?Milk production in
common use
fresh cow’s milk,sheep’s milk,
infant formula,yoghourt,
exhalation milk
? Soya formula,Soya
milk,rice flour
? Feeding schedule
avoid overfeeding
Mixed Feeding
? supple the
inadequate of breast
feeding
? substitute of breast
feeding
Nutrients and energy daily requirement for infants
Energy
(kcal)
Water
(ml/kg)
Protein
(g/kg)
fat
(g/k
g)
Carbohyd
rate
(g/kg)
Calcium
(mg)
Iron
(mg)
Zinc
(mg)
Vitamin
A
IU
B1
mg
B2
mg
C
mg
D
mgIU
E
mg
110 150 1.7-4.0 4-6 10-12 500 15 5 1000 0.5 0.5 50 500 5
以后
每年
减 25
％
15% 35％ 50％
Energy:
100ml fresh milk include 66 kcal
5% sugary milk 86 kcal
8% sugary milk 98 kcal
Example,6 months infant,WT 7kg
?Energy daily requirement,110?7＝ 770kcal,be
equal to 770ml ml
?Liquid daily requirement,150ml?7=1050ml,
still need to supply water 280ml.
The introduction of supplementary food
The purpose of supplementary food
? To supply nutrient deficiency of breast milk
? To supply the inadequate of breast milk
? To prepare for weaning
? To train the oral motor function
The rules of supplementary food
?From little to large
?From watery to solid food
?From thin to thick
?From one food to multi-foods
Schedule for introduction
of solid foods
Age Feeding foods
3-4 months Cereals,e.g,baby rice
4-5 months Pureed fruit and vegetables,meat (e.g,chicken)
6-7 months
Able to chew,e.g,rusks
Introduce lumpy foods and variety of
tastes and textures,egg yolk
8-9 months Bread and butter,fruit,egg white
12 months ‘real’ food in small bits
Toddle Feeding
?Caloric needs decrease
?The function of digest has improved
?Providing an adequate diet
?The development of feeding skills,food
habits,and nutrition knowledge
谢 谢 ！
Chapter 3
The content of child health care
? Regular health surveillance
? Screening test
? Counseling and Anticipatory guidance
? Immunization
Recommendation for primary health care
Essential elements
?History,Initial/interval
?Measurements
?Sensory screening
?Developmental Assessment
?Physical examination
?Immunization
?Anticipatory guidance
Injury prevention
Violence prevention
Sleep positioning counseling
Nutrition counseling
?Dental referral
Schedule of health care visit
?Infancy 0-1yr
Prenatal Neonatal First week
1 mo 2 mo 4 mo
6 mo 9 mo 12 mo
?Early Childhood 1-4 yr
15 mo 18 mo
2 yr 3 yr 4 yr
?Middle Childhood 5-10yr
5 yr 6 yr
8 yr 10 yr
?Adolescence 11-21 yr
11 yr 12 yr 13 yr
14 yr 15 yr 16 yr
17 yr 18 yr 19 yr
20 yr 21 yr
Seven Stage
Fetal period Neonatal period
Infant age Toddle age
Preschool age School age
Adolescence
Fetal Period
From egg fertilized to birth,280 days
Perinatal Period
Gestation 28 wks to 1 week after birth
Physiological
character
Growth and
development
are dependent
on maternal
condition
Category of
Diseases
Rules of health care
?Congenital
malformation
?Intrauterine
growth
retardation
?Heredity and
genetic
disorders
?Premature
delivery
?Abortion
?Sufficient nutrition and
cheerful environment for
pregnant woman
?Abstain from smoking and
alcohol
?Prevent from infection
during pregnancy
?Taking medicine carefully
?Avoid to exposure on the
radiation and toxicity hazard
?Screening test before
delivery if necessary
Fetal Period
Neonatal Period
From birth to 28 days
Physiological
character
?Adapt to the
condition of
surroundings
(independent
living)
?Physiogiocal
functions are
immature
Category of
Diseases
Rules of health care
?Congenital
malformation
?Premature
?Pneumonia
?Birth injury
?Asphyxia
?Inherit and
genetic
diseases
?Intensify the health care of
prenatal and improve the
skill of deliver
?Pay more attention to the
nursing,feeding,warming
and prevention
?Establish the family visiting
program for neonate
?Screening tests for the PKU,
Hypothyroidism,CDH,and
neonatal hearing test,etc.
Neonatal Period
Infant period
From birth to 1 yr of age,
included neonatal period
Physiological
character
?Grow and
develop
promptly
?Relatively
high
requirement
of nutrition
?Antibodies
from
maternal
decrease
gradually
Category of
Diseases
Rules of health care
?Deficiency of
nutrition,
diarrhea
?Infectious
diseases
?Accident,
trauma
?Properly feeding (breast
feeding,supplementation,
weaning)
?Monitor the growth and
development and provide
anticipatory guidance
? Immunization
?Prevent from rickets and
anemia etc.
? Arrange appropriate time
schedule and train to good
habit
Infant period
Toddler period
From 1 yr to 3 yr of age
Physiological
character
?growth rate
slow down
?Intelligence
develop
promptly
?The range of
walk extends
gradually
?Inability to
avoid danger
?Immune
functions still
lower
Category of
Diseases
Rules of health care
?Diarrhea
?Accident
（ Trauma,
toxicosis）
?Infectious and
contagious
diseases
?Properly feeding
(supplementation,weaning)
?To monitor the growth and
development and provide
anticipatory guidance
?Immunization
?To arrange appropriate time
schedule and train to good
habit
?To avoid accidents
Toddler period
Preschool age
From 3 yrs to 6 yrs of age
Physiological
character
?Somatic
growth gain
up steadily
? Intelligence
develop
much more
maturely
?Immune
functions
matured
continually
Category of
Diseases
Rules of health care
?Trauma and
injury
?Infectious
diseases
?Allergy and
rheumatoid
diseases come
forth
?Attention education and
training
?Physical exercises
?Physical examination
punctually
?Prevent from infectious
diseases and accidents
Preschool period
School Age
From 6 yrs to 12 yrs of age
Physiological
character
?The maturity
of systems
and organs
approach
what in
adulthood
except for
reproduction
system
?The burden
of study
increase
observably
Category of
Diseases
Rules of health care
?The mortality
of acute and
severe diseases
decrease
significantly
?Decayed tooth
?Myopia
?Allergy and
rheumatic
diseases
?Sufficient nutrition and
exercises
?Planning the schedule of
work and rest,training good
behavior
?Appropriate facilities for
preventing from Myopia,
Decayed tooth
School age
Adolescence
Girls,11 – 18 yrs of age
Boys,13 – 20 yrs of age
Individual variation
2 – 4 yrs
Physiological
character
?The reproduction
system develops
promptly
?Anthropometrics
growth promote
rapidly again
?Instable
coordinate
regulation of
Nervo-endocrine
system
Category of
Diseases
Rules of health care
?The emotion
uncertain
?Goiter
?Hypertension
?Education of physiological
and psychological knowledge
?Guiding and steering gently
Adolescence
Chapter 4
Childhood Nutrition
Nutritional requirements
? Aim,To live,to grow and thrive
? the Core of food supply,Balance diet
? Under intake,nutritional deficiency diseases
? Over intake,toxicity or obesity
Classification of nutrients
(2000 Chinese DRIs)
?Energy
?Macronutrients
protein,fat,carbohydrates
?Micronutrients,Minerals,Vitamins
?Other diet’s components
Dietary fiber,water,and others.
Function
?Basal metabolism,50-60%
?Requirement for growth
20-30%
?Food dynamic action
7-8 %
?Requirement for physical
activity,15-20Kcal/kg/d
?Energy lost in excreta
10 %
Food sources Requirement
?Protein
9~15%
?Carbohydrate
45~55%
?Fat 35~45%
?1g protein
= 4 Kcal
?1g Carbohydrate
= 4 kcal
?1g fat
= 9 kcal
? <1yr,
110 kcal/kg/d
?>1 yr,
Reduce
10 cal/kg/d
every 3 yr
Energy
Function
?composition body tissues.
?Important role in body
growth and maintenance
Food sources Requirement
?Milk production,
egg,fish,meat,
bean etc.
?The quality of
animal protein is
better than plant
protein
? Breast
feeding
2g/kg/d
?cow milk
feeding
3.5g/kg/d
?Plant protein
feeding
4g/kg/d
Macronutrients - Protein
Nine essential amino acids,histidine,isoleucine,leucine,lysine
methionine,phenylalanine,threonine,tryptophan,and valine
Conditional essential amino acids,cystine,taurine,arginine
Function
?Energy storage
?Provide essential fatty acid
?As a solvent for the fat
soluble vitamins
Food sources Requirement
?Animal fat,meat,
milk production,
plant oil,plant
? <6y,
3-6g/kg/d
? >6y,
2.5g/kg/d
Macronutrients - Fat
Fatty acid
saturated fat,fats of animal origin (except human milk)
polyunsaturated fat,fats of vegetable origin
Function
?To supply energy
Food sources Requirement
?cereal,fruit,
legume,vegetable
? Infant
10-12g/kg/d
?Children
12-15g/kg/d
Macronutrients - Carbohydrate
three groups,
Mono - saccharides,disaccharides,polysaccharides
Function Food source
Micronutrients
Essential components Animal and plant
of body tissue foodMinerals
Body physiological function Meat,liver,
Promote body growth vegetables,fruitsVitamins
? Iron deficiency is the common nutritional deficiency
? Most vitamins cannot be synthesized in the body and
must be supplied in the diet
?Addition of vitamin D to milk is mandated by law
Function
?the principal constituent
for most tissue.
?an aqueous medium for
body metabolism
Food sources Requirement
?Milk,soup and
water
? <1y
150ml/kg/d
?1-3y
100ml/kg/d
?4-6y
80ml/kg/d
? Reduce
10ml/kg/3 yrs
Other diet components - water
Loss of water:
? Loss in urine,and in fecal
? Loss from lungs and skin (insensible water loss)
Function
?Soluble fiber
delay GI transit
delay glucose absorption
lower blood cholesterol
?Insoluble fiber
accelerate GI transit
increase fecal weight
slow starch hydrolysis
delay glucose absorption
Food sources Requirement
?Fruits( apple,
citrus),oats,
barley,legumes
? Wheat bran,
whole-grain
breads,cereals,
vegetables
?Not available
Other diet components
– dietary fiber
Key issues on Childhood Nutrition
? Calories should be the first item to be
evaluated in assessing a dietary history
? A well-balance diet
? Interaction of carbohydrate,fat and protein
? both energy and protein are insufficiency may
result in malnutrition
Evaluation of Nutrition status
? Clinical examination
Birth history; feeding history,clinic symptom & sign
? Dietary intake investigation
24 hrs inquiring method
? Anthropometric assessment
W/A,H/A,W/H,Growth curve
? Laboratory assessment
Blood sample,urine sample
Infant
feeding
Digestive system
anatomic physiological characteristic
Mouth
Cheek fatty mat; Hypogenesis of saliva gland
Amylase deficiency
Oesophagus
Hypogenesis of oesophageal wall muscle and bounce
fiber
Stomach
Position; Cardia & pylori constrictor; Stomach
capacity
Intestines
6 times of body’s length
Pancreas
<3 mo,the activity of amylase is lower
Liver
quite larger
Intestinal bacterium group
Breast feeding,lactobacillus
Cow-milk feeding,Escherichia Coli,
Normal stool
Fetal stool Breast feeding Cow milk feeding
Color Dark green Gold Straw yellow
Character Slimy Slimy & Soft Hard
Odor No odor Acid odor Protein
decomposed odor
Time Not surely ? 4-5 times,1-2 times
or constipation
Breast feeding
Breast is best
Human milk is for humans
Cow milk is for cows
Composition of breast milk
Colostrums Transitional breast milk Mature milk Terminal stage milk
Period 1 week 2 wks -1 mo 2-9months >10 months
character
?Dense,yellow
?Few fat
?High globin
?Highest fat
?Drop of
protein and
mineral
?Protein 1.2g%
?Fat 3.5g%
?Lactose 7.5g%
Decline of
amount and
nutrients
Advantage of breast feeding
? Better nutritional qualities
?Easily digested
? Protein,whey proteins (lactalbumin and lactoglobulins)
account for 2/3
? Fat,unsaturated fatty acids,linoleic acid,rich in lipase
? Lactose,higher concentrations
?Low renal solute load
?Favorable calcium to phosphate ratio
Ensure calcium absorption
?More iron,zinc content
Advantage of breast feeding
? Anti-infective properties
? Secretory Ig A
? Lysozyme (溶菌酶 ）
? Phagocytic cells （ 吞噬细胞 ）
? Iron-binding protein Lactoferrin （ 乳铁蛋白 ）
? Low-polysaccharid
? Zinc
? Vitamin B12
? Bifidus factor （ 双歧因子 ）
Advantage of breast feeding
? Psychologic benefit
? Promotes maternal-infant bonding
? Gain a sense of security
? Constitute the foundation for the development of all
human social relationships and communications
? others
? Economy,convenience
? Lack of contamination
Advantage of breast feeding
? Benefit for the mother
? Stimulation,by sucking,of oxytocin secretions,
which fosters uterine contractions and hastens
postpartum uterine involution
? Possible decreased risk of postpartum
thromboembolism (血栓栓塞） and breast cancer
? Emotional satisfaction and sense of fulfillment
Artificial Feeding
?Milk production in
common use
fresh cow’s milk,sheep’s milk,
infant formula,yoghourt,
exhalation milk
? Soya formula,Soya
milk,rice flour
? Feeding schedule
avoid overfeeding
Mixed Feeding
? supple the
inadequate of breast
feeding
? substitute of breast
feeding
Nutrients and energy daily requirement for infants
Energy
(kcal)
Water
(ml/kg)
Protein
(g/kg)
fat
(g/k
g)
Carbohyd
rate
(g/kg)
Calcium
(mg)
Iron
(mg)
Zinc
(mg)
Vitamin
A
IU
B1
mg
B2
mg
C
mg
D
mgIU
E
mg
110 150 1.7-4.0 4-6 10-12 500 15 5 1000 0.5 0.5 50 500 5
以后
每年
减 25
％
15% 35％ 50％
Energy:
100ml fresh milk include 66 kcal
5% sugary milk 86 kcal
8% sugary milk 98 kcal
Example,6 months infant,WT 7kg
?Energy daily requirement,110?7＝ 770kcal,be
equal to 770ml ml
?Liquid daily requirement,150ml?7=1050ml,
still need to supply water 280ml.
The introduction of supplementary food
The purpose of supplementary food
? To supply nutrient deficiency of breast milk
? To supply the inadequate of breast milk
? To prepare for weaning
? To train the oral motor function
The rules of supplementary food
?From little to large
?From watery to solid food
?From thin to thick
?From one food to multi-foods
Schedule for introduction
of solid foods
Age Feeding foods
3-4 months Cereals,e.g,baby rice
4-5 months Pureed fruit and vegetables,meat (e.g,chicken)
6-7 months
Able to chew,e.g,rusks
Introduce lumpy foods and variety of
tastes and textures,egg yolk
8-9 months Bread and butter,fruit,egg white
12 months ‘real’ food in small bits
Toddle Feeding
?Caloric needs decrease
?The function of digest has improved
?Providing an adequate diet
?The development of feeding skills,food
habits,and nutrition knowledge
谢 谢 ！
