Kudlová E
Ustav hygieny a epidemiologie 1. LF UK, Praha.
Cas Lek Cesk. 2005;144(8):540-4; discussion 544-5.
During the last 15 years much effort with remarkable success has been devoted to the promotion and support of breast-feeding. Much less attention has been paid, until recently, to child nutrition during the period of transition from exclusively milk feeding to the family diet. The aim of presented study is to provide a qualitative review of information on feeding of children 6 - 24 months old available to parents from various sources and to compare it with the WHO recommendations based on the Global Strategy for Infant and Young Child Feeding.
Within the frame of field practice, students of the Charles University, 1st Medical Faculty conducted interviews with 273 mothers of children under 5 years old, focused interview with 19 paediatric general practitioners, gathered 42 promotion materials, identified and evaluated 16 relevant publications and 14 web sites. All practitioners interviewed provided information on the nutrition, recommend exclusive breast-feeding up to the age of 6 months and the appropriate introduction of complementary food but they probably did not promote sufficiently breast-feeding beyond six months. Review of various information sources revealed, as expected, certain variations in feeding recommendations, which is partially a consequence of their changes during the last decade. Most publications emphasise breast-feeding as the ideal nutrition for up to 6 months. Recommendations for breast-feeding beyond 6 months are inadequate. Complementary feeding recommendations are, with exceptions, common for breast-fed and non-breastfed children as well as for those who need to start complementary feeding before 6 months of age. Except for sporadic notes, publications do not deal with the safe food preparation and feeding during and after a common disease.
Consideration to all 10 areas of WHO guiding principles should be given. Also the clear formulation of breastfeeding recommendations, differentiation of information according to the target population, and recommendations based on the conditions of a thriving infant exclusively breast-fed for 6 months would contribute to the harmonization of information on the older infant and toddler nutrition with WHO recommendations.
在过去15年里，人们为促进和支持母乳喂养付出了巨大努力，并取得了显著成功。直到最近，从完全母乳喂养过渡到家庭饮食阶段的儿童营养问题才受到较少关注。本研究的目的是对父母可从各种来源获取的有关6至24个月儿童喂养的信息进行定性综述，并将其与基于《婴幼儿喂养全球战略》的世界卫生组织建议进行比较。
在实地实践框架内，查理大学第一医学院的学生对273名5岁以下儿童的母亲进行了访谈，对19名儿科全科医生进行了重点访谈，收集了42份宣传材料，识别并评估了16篇相关出版物和14个网站。所有接受访谈的从业者都提供了营养方面的信息，建议6个月以下婴儿纯母乳喂养，并适当引入辅食，但他们可能没有充分推广6个月以上的母乳喂养。对各种信息来源的综述显示，正如预期的那样，喂养建议存在一定差异，这部分是过去十年中这些建议变化的结果。大多数出版物强调母乳喂养是6个月以下婴儿的理想营养方式。关于6个月以上母乳喂养的建议并不充分。除个别情况外，母乳喂养和非母乳喂养儿童以及6个月前需要开始添加辅食的儿童的辅食添加建议是相同的。除了零星的记录外，出版物没有涉及常见疾病期间及之后安全的食物制备和喂养问题。
应考虑世界卫生组织指导原则的所有10个领域。此外，明确制定母乳喂养建议，根据目标人群区分信息，并基于6个月纯母乳喂养茁壮成长婴儿的情况提出建议，将有助于使有关较大婴儿和幼儿营养的信息与世界卫生组织的建议保持一致。
