Pay attention to the early and comprehensive development of infants and young children

Reporter Han Songyan

Early childhood is the period with the highest ratio of human capital input-output in the whole life cycle, and early childhood development not only determines the health status and development of individuals, but also profoundly affects national human resources and social and economic development
.
Good nurturing care and health management of infants and young children is an important measure
to achieve early childhood development.
In order to improve children's health, promote early childhood development, and strengthen infant and child care guidance, the General Office of the National Health Commission recently issued the Guidelines for Healthy Care and Care of Infants Under 3 Years Old (Trial) (hereinafter referred to as the Guidelines).

According to the relevant person in charge of the Department of Maternal and Child Health of the National Health Commission, the Guidelines are mainly composed of
three parts and four annexes.
First, the importance of healthy nurturing and care for infants and young children; The second is the basic concept of healthy parenting and care for infants and young children; The third is the consultation and guidance content of infant health care and care, including growth and development monitoring, nutrition and feeding, communication and play, life care guidance, injury prevention, prevention and control of common health problems and care
, a total of 3 parts.
There are also four attachments
, including the growth and development monitoring chart of children aged 0-3 years, the early warning sign screening form of children's psychological and behavioral development problems, the key points for adding complementary food for infants aged 6-24 months, and the key points for parent-child communication and play for infants and young children.

Scientific parenting and care

Infancy and early childhood are a critical period for children's growth and development, when the brain and body develop
rapidly.
Providing good nurturing care and health management for infants and young children will help children achieve comprehensive development in physical, psychological and social abilities, lay the foundation for children's healthy growth in the future, and help prevent the occurrence of
cardiovascular and cerebrovascular diseases, diabetes, depression and other diseases in adulthood.

According to the relevant person in charge of the Department of Maternal and Child Health of the National Health Commission, the Guidelines focus on the critical stage of 0-3 years old, and strengthen medical institutions to guide caregivers to master scientific parenting concepts and knowledge through parenting risk screening and consultation guidance, parent classes, parent-child activities, follow-up visits, etc.
, to provide infants and young children with good parenting care and health management, and lay the foundation
for children's healthy growth in the future.

Parents are the first responsible for infant care and health management
.
The Guidelines clearly require that caregivers should regularly take infants and young children to undergo health examinations for children aged 0-6 years old under the national basic public health service project, and detect health problems such as wasting, overweight, obesity, stunting, anemia, vitamin D deficiency, rickets, eye diseases, hearing impairment and caries as soon as possible, find out the causes, and intervene in a timely manner
.
Accept the guidance of child health care personnel in medical institutions, learn to master children's growth and development knowledge and skills, and continuously improve scientific parenting ability
.
At the same time, we should take the initiative to pay attention to our own health, conduct regular physical examinations, timely detect and alleviate parenting anxiety, and maintain physical and mental health
.

Scientific parenting care and health management are important guarantees
for promoting the healthy growth of infants and young children.
The Guidelines emphasize that caregivers should learn and master various skills and methods of parenting care and health management, and grow up with children in parenting practice; Through guidance, caregivers can understand and identify common health problems of infants and young children, and master corresponding home care skills; Follow the laws and characteristics of infant growth and development, respect individual characteristics and differences, provide scientific nurturing care for infants and young children, and promote early childhood development
.
If an infant develops its first baby tooth, cleaning should begin as soon as it
develops.
Caregivers can choose gauze, finger braces toothbrushes, and children's regular toothbrushes to clean the teeth
of infants and young children morning and evening.
Children's fluoride toothpaste is recommended to be the size of a grain of
rice.
Feed plain water or clean your mouth
after each meal.
Try to avoid sugary diets between meals, and drink mainly white water
.
Caregivers should not chew food before feeding it to infants and young children, should not share eating utensils with infants and young children, and infant feeding utensils should be cleaned and disinfected
frequently.

According to the Parenting Framework – Promoting Early Childhood Development, jointly issued by UNICEF and the World Health Organization, nurturing and care includes five elements
: good health, adequate nutrition, responsive care, early learning opportunities, and safety and security 。 Based on the five elements of parenting and care put forward in the "Parenting and Care Framework - Promoting Early Child Development", the Guidelines clarify the key points of consultation from six aspects, including growth and development monitoring, nutrition and feeding, communication and play, life care, injury prevention, prevention and control of common health problems and care, and require child health care personnel to provide consultation and guidance to infant caregivers, improve their parenting and care skills, and promote the comprehensive development of children's physical, psychological and social adaptability in early childhood
。

Pay attention to nutritional feeding

Adequate nutrition and good feeding are the guarantee
for promoting physical growth, functional maturity and brain development of infants and young children.
Developing good eating habits is an important part of cultivating a healthy lifestyle for infants and young children, and can lay the foundation for
a healthy lifestyle in adulthood.
For infant nutrition and feeding, the Guidelines summarize the basic knowledge and operational skills of breastfeeding, complementary food addition, reasonable diet, eating behavior, etc.
, and guide caregivers to provide scientific nutritional feeding care for infants and young children, prevent the occurrence of nutritional diseases in children, and promote the healthy growth
of children.

The Guidelines make it clear that breast milk is rich in nutrients, immunoactive substances and water, which can meet all the nutrients required for the growth and development of infants aged 0-6 months, help the brain development of infants and young children, reduce the risk of colds, pneumonia, diarrhea and other diseases in infants, reduce the occurrence of obesity, diabetes, cardiovascular and cerebrovascular diseases and other chronic diseases in adulthood, enhance parent-child relationship, and also reduce the risk
of postpartum hemorrhage, breast cancer and ovarian cancer in mothers.
Skin contact, early sucking, and early initiation
should be given as soon as possible after birth.
Infants under 6 months of age are exclusively breastfed and do not require the addition of water and other foods
.
Breastfeed as mother and baby, more than 8-10 times a day, so that the baby can consume enough milk
.
Adequate sucking by the baby is the most effective way
to promote milk production.
A mother's happy mood, adequate sleep and balanced nutrition are also important factors
in promoting lactation.
Persistent insufficiency should be managed
under the guidance of a physician's evaluation.
For breastfeeding of preterm infants, the Guidelines also suggest that breastfeeding is the preferred feeding method for preterm infants, and promote mother-to-mother feeding and kangaroo care
.
For premature infants with a gestational age of < 34 weeks, birth weight < 2000 grams, or slow weight gain, breast milk fortifiers
should be added to breast milk according to the doctor's guidance.

For the supplementation of micronutrients in infants and young children, the guidelines require that full-term infants be supplemented with 400 international vitamin D per day under the guidance of a doctor within a few days after birth to promote growth and development
.
Exclusively breastfed term infants or breastfed term infants aged 4 to 6 months can be given appropriate iron supplementation as needed to prevent the occurrence
of iron deficiency anemia.
Premature or low birth weight infants generally start within a few days after birth, under the guidance of a doctor, 800-1000 international vitamin D supplementation per day, 3 months later changed to 400 international per day; Starting 2 to 4 weeks after birth, iron supplementation is given at 2 mg/kg per day, including the content
of formula and breast milk fortifiers.
Supplement calcium, vitamin A and other nutrients
as appropriate.

Infants should be given complementary foods from 6 months onwards, and on the basis of reasonable addition of complementary foods, breastfeeding can continue until 2 years of age and above
.
Preterm infants should be given complementary foods
at the trimmed gestational age of 4 to 6 months.
The Guidelines make it clear that the principle of adding complementary foods for infants and young children is: only one new food is added each time, from a small amount to a large amount, from one to a variety to guide infants to gradually adapt; Start with an iron-rich pureed food, gradually increase the variety of foods, gradually transition to semi-solid or solid foods; Each time a new food is introduced, add a new food
after 2-3 days of adaptation.

Foods for complementary foods include cereals and potatoes, legumes and nuts, animal foods (fish, poultry, meat and offal), eggs, fruits and vegetables rich in vitamin A, other fruits and vegetables, milk and dairy products
.
The types of complementary foods added should not be less than 4 per day, and should include at least one animal food, one vegetable and one cereal potato food
.
The addition of complementary foods from 6 to 12 months of age is particularly important for infant growth and development, and special attention should be paid to the frequency and type
of addition.
The frequency and insufficient variety of complementary foods for infants and young children will obviously affect growth and development, resulting in health problems
such as anemia, low body weight, growth retardation, and mental retardation.
Infants aged 6-9 months need to add complementary food 1-2 times a
day.
For infants aged 9-12 months, the addition of complementary foods is increased to 2-3 times a
day.
Infants aged 12 to 24 months, while continuing to breastfeed, add 3 family food meals and 2 additional meals every day, and the average intake of foods other than breast milk per meal is 3/4 bowl to 1 whole bowl (250 ml bowl).

The Guidelines require that complementary foods for infants and young children should be prepared separately, using fresh, high-quality, pollution-free ingredients and clean water
.
Cooking should be steamed, boiled, stewed, simmered and other methods, ingredients should be completely removed from crusty, bone, thorns, cores, etc.
, beans or nuts should be fully ground
.
Infant complementary foods within 1 year old should maintain the original taste, without adding salt, sugar and condiments, and after 1 year old, complementary foods should be less salt and sugar
.
Encourage young children to try a variety of foods and avoid foods that have been pickled, marinated, grilled, and heavy foods that are heavy in oil, sweet, and spicy
.

The Guidelines emphasize the need for infants and young children to develop good eating habits
.
After the age of 1, children gradually transition to independent eating, and caregivers should create a relaxed and pleasant eating environment for children, and guide and not force children to eat
.
Arrange meals for young children to be with their families and encourage self-eating
.
Pay attention to hunger and satiety signals from young children and respond in a timely manner
.
Food is not used as a reward and punishment
.
Children do not watch TV, mobile phones and other electronic products when eating, each meal time is controlled at about 20 minutes, the longest should not exceed 30 minutes, and gradually develop regular meals and good eating habits
.

In addition, the Guidelines also require caregivers to pay attention to the prevention and control of nutritional diseases, including iron deficiency anemia, malnutrition, vitamin D deficiency rickets, etc
.
If infants are 6 months old, iron-rich foods should be added in time to prevent iron deficiency anemia
.
Iron deficiency anemia should be supplemented with iron in time according to medical advice
.
Complementary foods should be added reasonably to ensure the energy, protein and other nutrients
needed for the growth of infants and young children.
Those who have poor weight gain for two consecutive times or poor growth after 3-6 months of nutritional improvement need to go to a specialist clinic for consultation and treatment
.
Strengthen children's nutrition and feeding guidance, promote equal emphasis on eating and moving, and prevent and reduce overweight and obesity
in children.
The peak incidence of vitamin D deficiency rickets is 3-18 months old, infants and young children can start vitamin D supplementation a few days after birth, outdoor activities as soon as possible, fully expose body parts, can prevent the occurrence of rickets, the occurrence of vitamin D deficiency rickets should be treated
according to medical advice.

China Food News(Version 03, December 07, 2022)

(Responsible editor: Han Songyan).