Abstract: Objective To find out the effects of complementary-food-making education courses on food exchanges during complementary feeding in preterm infants,so as to explore a feasible and effective guiding mode. Methods Preterm infants born in Foshan Women and Children Hospital were enrolled in this study from June to December 2017,with 76 infants in intervention group[12 infants with gestational age (GA)＜32 weeks,20 infants with GA 32-34 weeks,44 infants with GA＞34 weeks]and 191 infants in control group (48 infants with GA＜32 weeks,34 infants with GA 32-34 weeks,109 infants with GA＞34 weeks).The control group received routine complementary feeding education at the corrected age of 4,7 and 10 months,while the intervention group participated in complementary-food-making education courses additionally at the corresponding age.All infants were followed up to the corrected age of 18 months,then the differences on food conversion,physical indexes and nutrients indicators between the two groups were compared. Results 1) For preterm with GA＞34 weeks,the first time for introducing complementary food and starches was later in the intervention group,while the first time for introducing solid food was earlier,the proportions of first introducing complementary food earlier than 4 months old,changing back to low energy density food,introducing semisolid food later than 9 months old,and introducing solid food later than 12 month-old were lower in the intervention group,but the proportions of "face-to-face feeding" and "infants self-feeding allowed" were higher(P<0.05).2) For preterm infants with GA＜32 weeks,the intervention group introduced mashed food later for the first time,the proportions of the first introducing complementary food earlier than 4 months old,and changing back to low energy density food were less(P<0.05).3) The increase of weight and the serum iron level at the corrected age of 18 months in the intervention groups were significantly higher than those in control group(P<0.05). Conclusion Complementary-food-making education courses can positively facilitate introducing complementary food and converting food textures at a more appropriate time,promote responsive feeding,improve growth and iron storage for the preterm.

Key words: preterm, food exchanges, complementary feeding guide, responsive feeding, physical growth

摘要： 目的 探讨实操式辅食制作课程指导早产儿食物转换的效果,旨在探索出一种有效可行的指导模式。方法 选取2017年6-12月佛山市妇幼保健院出生的267例早产儿为研究对象。76人为干预组(胎龄<32周12人、32~34周20人、>34周44人)和191人为对照组(<32周48人、32~34周34人、>34周109人),对照组于纠正4、7、10月龄予以门诊宣教,干预组相应月龄在对照组基础上予实操式辅食制作指导。随访至纠正18月龄,比较两组食物转换情况、体格发育、营养素指标的差异。结果 1)>34周早产儿干预组较对照组首次引入辅食及谷薯类食物晚,引入条块食物早,小于纠正4月首次引入辅食、引入泥糊食物后转为能量密度低流质食物、超过纠正9月引入颗粒食物、超过纠正12月引入条块食物比例低,顺应喂养行为中“面对面喂食”及“允许自行进食”的比例高(P<0.05)。2)<32周早产儿干预组较对照组首次引入泥糊食物晚,小于纠正4月首次引入辅食、引入泥糊食物后转为能量密度低流质食物比例低(P<0.05)。3)纠正18月龄时干预组的体重增幅、血清铁水平均高于对照组(P<0.05)。结论 实操式辅食制作课程能促进早产儿适时引入辅食及转换食物性状,促进顺应喂养及体重增长,提高血清铁水平。

关键词: 早产儿, 食物转换, 辅食指导, 顺应喂养, 体格发育