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我国继续母乳喂养，满6月龄起添加辅食继续

发布日期：2022-06-05 12:01:04编辑：佚名

本指南所称7～24月龄婴幼儿是指满6月龄（出生180天）后至2周岁（满24月龄）的婴幼儿。

对于7～24月龄婴幼儿，母乳仍然是重要的营养来源，但单一的母乳喂养已经不能完全满足其对能量以及营养素的需求，必须引入其他营养丰富的食物。与此同时，7～24月龄婴幼儿胃肠道等消化器官的发育、感知觉以及认知行为能力的发展，也需要其有机会通过接触、感受和尝试，逐步体验和适应多样化的食物，从被动接受喂养转变到自主进食。这一过程从婴儿7月龄开始，到24月龄时完成。这一年龄段婴幼儿的特殊性还在于，父母及喂养者的喂养行为对其营养和饮食行为有显著的影响。顺应婴幼儿需求喂养，有助于健康饮食习惯的形成，并具有长期而深远的影响。

7～24月龄婴幼儿处于1000日机遇窗口期的第三阶段，适宜的营养和喂养不仅关系到近期的生长发育，也关系到长期的健康。针对我国7～24月龄婴幼儿营养和喂养的需求，以及可能出现的问题，基于目前已有的证据，同时参考WHO等的相关建议，提出7～24月龄婴幼儿的喂养指南。

【推荐条目】

1. 继续母乳喂养，满6月龄起添加辅食。

2. 从富含铁的泥糊状食物开始，逐步添加达到食物多样。

3. 提倡顺应喂养，鼓励但不强迫进食。

4. 辅食不加调味品，尽量减少糖和盐的摄入。

5. 注重饮食卫生和进食安全。

6. 定期监测体格指标，追求健康生长。

1. 继续母乳喂养，满6月龄起添加辅食

1. 继续母乳喂养，满6月龄起添加辅食

【提要】

母乳仍然可以为满6月龄（出生180天）后婴幼儿提供部分能量，优质蛋白质、钙等重要营养素，以及各种免疫保护因子等。继续母乳喂养也仍然有助于促进母子间的亲密连接，促进婴幼儿发育。因此7～24月龄婴幼儿应继续母乳喂养。不能母乳喂养或母乳不足时，需要以配方奶作为母乳的补充。

婴儿满6月龄时，胃肠道等消化器官已相对发育完善，可消化母乳以外的多样化食物。同时，婴儿的口腔运动功能，味觉、嗅觉、触觉等感知觉，以及心理、认知和行为能力也已准备好接受新的食物。此时开始添加辅食，不仅能满足婴儿的营养需求，也能满足其心理需求，并促进其感知觉、心理及认知和行为能力的发展。

【关键推荐】

1.婴儿满6月龄后仍需继续母乳喂养，并逐渐引入各种食物。

2.辅食是指除母乳和/或配方奶以外的其他各种性状的食物。

3.有特殊需要时须在医生的指导下调整辅食添加时间。

4.不能母乳喂养或母乳不足的婴幼儿，应选择配方奶作为母乳的补充。

2. 从富铁泥糊状食物开始，逐步添加达到食物多样

【提要】

7～12月龄婴儿所需能量约1/3～1/2来自辅食，13～24月龄幼儿约1/2~2/3的能量来自辅食，而母乳喂养的婴幼儿来自辅食的铁更高达99%。因而婴儿最先添加的辅食应该是富铁的高能量食物，如强化铁的婴儿米粉、肉泥等。在此基础上逐渐引入其他不同种类的食物以提供不同的营养素。

辅食添加的原则：每次只添加一种新食物，由少到多、由稀到稠、由细到粗，循序渐进。从一种富铁泥糊状食物开始，如强化铁的婴儿米粉、肉泥等，逐渐增加食物种类，逐渐过渡到半固体或固体食物，如烂面、肉末、碎菜、水果粒等。每引入一种新的食物应适应2～3天，密切观察是否出现呕吐、腹泻、皮疹等不良反应，适应一种食物后再添加其他新的食物。

【关键推荐】

1.随母乳量减少，逐渐增加辅食量。

2.首先添加强化铁的婴儿米粉、肉泥等富铁的泥糊状食物。

3.每次只引入一种新的食物，逐步达到食物多样化。

4.从泥糊状食物开始，逐渐过渡到固体食物。

5.辅食应适量添加植物油。

3. 提倡顺应喂养，鼓励但不强迫进食

【提要】

随着婴幼儿生长发育，父母及喂养者应根据其营养需求的变化，感知觉，以及认知、行为和运动能力的发展，顺应婴幼儿的需要进行喂养，帮助婴幼儿逐步达到与家人一致的规律进餐模式，并学会自主进食，遵守必要的进餐礼仪。

父母及喂养者有责任为婴幼儿提供多样化，且与其发育水平相适应的食物，在喂养过程中应及时感知婴幼儿所发出的饥饿或饱足的信号，并作出恰当的回应。尊重婴幼儿对食物的选择，耐心鼓励和协助婴幼儿进食，但绝不强迫进食。

父母及喂养者还有责任为婴幼儿营造良好的进餐环境，保持进餐环境安静、愉悦，避免电视、玩具等对婴幼儿注意力的干扰。控制每餐时间不超过20分钟。父母及喂养者也应该是婴幼儿进食的好榜样。

【关键推荐】

1.耐心喂养，鼓励进食，但决不强迫喂养。

2.鼓励并协助婴幼儿自己进食，培养进餐兴趣。

3.进餐时不看电视、玩玩具，每次进餐时间不超过20分钟。

4.进餐时喂养者与婴幼儿应有充分的交流，不以食物作为奖励或惩罚。

5.父母应保持自身良好的进食习惯，成为婴幼儿的榜样。

4. 辅食不加调味品，尽量减少糖和盐的摄入

【提要】

辅食应保持原味，不加盐、糖以及刺激性调味品，保持淡口味。淡口味食物有利于提高婴幼儿对不同天然食物口味的接受度，减少偏食挑食的风险。淡口味食物也可减少婴幼儿盐和糖的摄入量，降低儿童期及成人期肥胖、糖尿病、高血压、心血管疾病的风险。

强调婴幼儿辅食不额外添加盐、糖及刺激性调味品，也是为了提醒父母在准备家庭食物时也应保持淡口味，即为适应婴幼儿的需要，也为保护全家人的健康。

【关键推荐】

1.婴幼儿辅食应单独制作。

2.保持食物原味，不需要额外加糖、盐及各种调味品。

3.1岁以后逐渐尝试淡口味的家庭膳食。

5. 注重饮食卫生和进食安全

【提要】

选择新鲜、优质、无污染的食物和清洁水制作辅食。制作辅食前须先洗手。制作辅食的餐具、场所应保持清洁。辅食应煮熟、煮透。制作的辅食应及时食用或妥善保存。进餐前洗手，保持餐具和进餐环境清洁、安全。

婴幼儿进食时一定要有成人看护，以防进食意外。整粒花生、坚果、果冻等食物不适合婴幼儿食用。

【关键推荐】

1.选择安全、优质、新鲜的食材。

2.制作过程始终保持清洁卫生，生熟分开。

3.不吃剩饭，妥善保存和处理剩余食物。

4.饭前洗手，进食时应有成人看护婴儿营养指南，并注意进食环境安全。

6. 定期监测体格指标，追求健康生长

【提要】

适度、平稳生长是最佳的生长模式。每3个月一次定期监测并评估7～24月龄婴幼儿的体格生长指标有助于判断其营养状况，并可根据体格生长指标的变化婴儿营养指南，及时调整营养和喂养。对于生长不良、超重肥胖，以及处于急慢性疾病期间的婴幼儿应增加监测次数。

【关键推荐】

1.体重、身长是反映婴幼儿营养状况的直观指标。

2.每3个月一次，定期测量身长、体重、头围等体格生长指标。

3.平稳生长是最佳的生长模式。

中国居民膳食指南修订专家委员会（妇幼人群指南修订专家工作组）

注: 相关实践应用和制定依据请参见专业版

联系信箱: cns@cnsoc.org

电 话: 010-83554781

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