Section 3
Health Care for Children

Health care for children is an important part of Chinese medicine pediatrics,and its main task is to study the regular patterns of the growth and development of children of all ages and its influencing factors,to feed and nurse children reasonably with the “ zhì wèi bìng ” concept (to treat disease before it arises) as the core,to enhance children’s physique,to prevent and manage pediatric diseases,and to promote the healthy growth of children.

Prenatal Care

Fetus in the mother,relying solely on the maternal blood to support the growth and development,is closely related to the maternal health and nutrition status.Prenatal care,or “ yăng tāi hù tāi ” “ tāi yăng tāi jiào ” in ancient China,has always been the first step for children’s health and has a profound impact on the postnatal constitution,intelligence,acquired diseases and life.

1.Conserving the Essential qi Before Conception Fetal health care starts with spouse selection.Those who are close relatives,or have similar blood relationship are not allowed to get married,otherwise,they will make future generations frail and the incidence of genetic diseases increases.Before marriage,it is advisable and should be popularized to have premarital examination and genetic counseling to make sure whether there is a disease or diseases unsuitable for marriage and procreation.The appropriate age for marriage is 24 years in males and 21 in females when the kidney yin and kidney yang are in balance,and they reach their peak maturity.It is conductive to fetal birth for the couple to have qi and blood sufficient,and renal yin and renal yang substantial through health care,regulation of qi,blood,yin and yang.

2.Regulating the Diet The growth and development of the fetus relies completely on nourishment from the mother’s qi and blood.Sufficient qi and blood in spleen and stomach as the source of generation and transformation guarantees the growth and development of the fetus.Pregnant women’s diet should be nutritious and easy to digest.Pregnant women should take food regularly and quantitatively.For pregnant women of different constitutions,the diet of different attributes can be corrected by cooling or warming.Avoid excessive cold,sweet,hot,fatty,greasy,spicy and fried food that may cause fetal cold,fetal heat,or fetal fat.Pregnant women should also stop unhealthy habits and give up smoking and drinking.

3.Adapting to Temperature After a woman becomes pregnant,her blood nourishes the fetus,so her qi and blood are relatively insufficient,and defensive qi is weakened.She tends to be sweaty and susceptible to external pathogenic attacks.Ten-month pregnancy will see different seasons with great climate changes.Pregnant women should pay more attention to the temperature changing than ordinary people,adapting to changes in temperature.Wear loose-fitting clothes for tights and corsets will hinder the blood circulation.Cotton goods is the first choice for pregnant women,since they are warm,comfortable,breathable,and moisture-absorbing; keep away from materials of fabric stiffness,no moisture absorption,or even sensitizing.

4.Preventing External Pathogenic Attack During pregnancy a variety of infectious diseases,especially viral infections,including rubella virus,influenza virus,cytomegalovirus,herpes simplex virus,varicella virus,and hepatitis virus,may cause congenital malformation,miscarriage or premature birth.For example,pregnant women infected with rubella virus at the early stage of pregnancy can cause congenital cataracts,congenital heart disease,deafness,microcephalia and intelligent underdevelopment,which are called congenital rubella syndrome.Therefore,it was said in Important Formulas Worth a Thousand Gold Pieces for Emergency ( Bèi Jí Qiān Jīn Yào Fāng ,备急千金要方) that fetus of three months old will grow with the changes of environment,and their intrinsic quality are not fully developed.The most attention should be paid to the prevention of pathogenic factors and the maintenance of the fetus.

5.Avoiding Trauma During pregnancy,pregnant women should guard against various traumas to protect themselves and the fetus.In ancient China, A Collection of Childbirth ( Chăn Jí ,产集) formulated 12 commandments: do not climb high,do not exert all the strength,do not walk too fast,do not sit on one side,do not overbend the back,do not fetch objects from high places,and so on.Pregnant women should guard against falling injuries,pay attention to protect the abdomen,avoid extrusion and collision,stay away from noise,and avoid exposure to radiation.At the same time,sexual intercourse should be controlled during pregnancy.Excessive sexual activities may impair the kidney and disturb the fetal qi leading to abortion or premature delivery.Especially in the first 3 months and the last 1.5 months of pregnancy,sexual intercourses should be avoided.

6.Alternating Work with Rest Pregnant women are advised to alternate and balance work with rest.Moderate physical activities can stretch the body to ensure that qi and blood move smoothly to promote normal development of the fetus and ensure a smooth delivery.Pregnant women should avoid overwork,heavy physical labor and strenuous exercise for fear of damaging fetus qi leading to abortion or premature delivery.Generally speaking,pregnant women should rest during the first 1–3 months and also beware of injuries caused by overstraining in order to secure the fetus.During 4–7 months,pregnant women may do more physical activities in order to promote the circulation of Qi and blood and to meet the needs of the rapid growth of the fetus in this period.

7.Regulating Mental States The ancient physicians summarized the experience of fetal education and claimed that women in pregnancy should “regulate the mind,harmonize the emotions,control the desires,keep everything clean and quiet”,namely,they should maintain emotional stability and peace of mind,enjoy the elegant music and healthy entertainment,which can cultivate the tastes of pregnant women,and what’s more,is conducive to the growth of the fetus.Excessive emotions of pregnant women are not only harmful to their health,but also influence the normal development of the fetus because of the disorder of qi and blood.

8.Being cautious in Medication Pregnant women should be very careful in medication.No medication when there is no disease present; if pregnant women were in need of treatment,doctors should select medicines carefully and withdraw them immediately after the problem is resolved.Some powerful medicines that may damage an embryo should be contraindicated.Ancient doctors divided medicinals that are contraindicated for pregnancy into the following three categories: toxin medicinals such as wū tóu (Aconitum), fù z Aconiti Lateralis Radix Praeparata), nán xīng (Arisaematis Rhizoma), yě gé (toxicodendron), shu yín (Hydrargyrum), qīng fěn (mercurous chloride), qiān fěn (Lead powder), pī shí (arsenic trioxide), liú huáng (Sulphur), xióng huáng (Realgar), bān máo (Mylabris), wú gōng (Scolopendra) and so on; blood-breaking medicinals such as shu zhì (Hirudo), méng chóng (Tabanus), gàn qī (Resina Toxicodendri), shè xiāng (Moschus,generally use artificial one), qú mài (Herba Dianthi) and so on; expelling and purging medicinals such as bā dòu (fructus Crotonis), qiān niú z Semen Pharbitidis), dà j Radix Knoxiae), yán huā (Flos Genkwa), zào jiá (Fructus Gleditsiae), lí lú (Radix et Rhizoma Veratri Nigri), dōng kuí z fructus Malvae)and so on.If used in pregnant women,these medicinals may cause toxicosis and damage the fetus,leading to early death,disability or malformation,etc.A variety of synthetic chemicals should be applied more carefully.

9.Regular Prenatal Examination Highrisk mothers in particular need prenatal screening.Terminate the pregnancy if there is something abnormal.Try to reduce pregnancy complications,prevent miscarriage,premature birth,and abnormal birth.

Neonatal Health Care

When a child is born,qi and blood are deficient, zang-fu organs are delicate and immature,stomach qi is just beginning to grow,yin and yang are not in harmony,and the bones are not yet fully developed.Due to lack of adaptability,adjustability and resistance,infants are susceptible to various diseases.What’s more,the conditions may change so rapidly that improper care will result in death in early infancy.Therefore,neonatal health care,especially within 1 week after birth,must be highly valued.

1.Cleaning the Mouth and the Eyes After newborns are delivered,it is necessary to clean and nurse immediately the mucous membrane of the skin.Sterile gauze is applied into the mouth,gently wiping out the debris,including mucus,blood,amniotic fluid and meconium,lest the children swallow it with a cry,and even inhale it into the airway.At the same time,debris should be removed from the eyes and the ears.

2.Omphalotomy and Cord Care The umbilical cord needs to be cut immediately after birth.Strict sterilization is necessary,and the end of umbilical cord should be manipulated with dry aseptic,covered with a sterile dressing.After the omphalotomy,the umbilicus should be kept clean and dry,allowing the umbilical cord to fall off in a few days.In the meantime,protect the umbilicus from sewage,urine and other grimes.It is also necessary to protect the umbilicus while taking a bath to avoid neonatal tetanus,umbilical dampness,umbilical sores and other diseases.

3.Bathing and Clothing Feces and blood should be removed from the infant’s skin with sterile gauze shortly after birth,and bathe the baby the next day.The bathing water should be boiled and used when it is slightly higher than the child’s body temperature.When bathing,gently clean the child’s body surface,and do not put the baby into the water,so as not to wet the navel.When taking a bath,the careful and gentle movement is needed to prevent external wind-cold attacks.The buttocks should be washed frequently to maintain the skin clean and dry and avoid diaper rash.

When the baby is born,keep it warm,especially for the fetus with a weak constitution and in cold seasons.In summer,heatstroke prevention is necessary,and the ambient temperature must not be too high in case of summer heat stroke.

The newborn should wear clothes made from light-colored soft cotton with absorbent properties.Infant clothing must be simple,easy to put on and take off,loose and not impeding limb activity,without buttons and elastic bands,so as not to damage the delicate skin.The diaper should be soft and absorbent,and should not be wrapped in plastic or rubber.

4.Early Lactation Infants should suck breasts as early as possible after birth and mothers are encouraged to breastfeed as needed.Generally full-term newborns have stronger sucking ability,and the swallowing function is basically perfect.Early lactation is helpful to promote the secretion of breast milk and plays an important role in the success of breast-feeding,and it can also nourish the newborns with milk at an early stage.

5.Disease Prevention Record the birth score,body temperature,respiration,heart rate,body weight and length in newborns after delivery,pay attention to sleep,crying,sucking,urine,stool,skin and so on in order to find out the early manifestations of various diseases of newborn.Rooming-in is advocated.A newborn’s room should be regularly ventilated,maintaining air fresh.Newborns should have their own exclusive utensils and appliances,and their tableware should be disinfected after use.Mothers should wash their hands before breast-feeding and nursing.Minimize family visits and kisses and avoid cross infection.Avoid neonatal asphyxia caused by heavy clothes wrapping the head,by incorrect breastfeeding,or from obstructing the newborn’s mouth and nose.Inoculate on time the BCG vaccine and hepatitis B vaccine,and screen the congenital genetic metabolic diseases as required.

Infant Health Care

Physical growth and development are particularly rapid in infancy,and rational feeding is especially important.During this period,much importance should be attached to feeding,nursing,and vaccination etc.

1.Feeding

There are three ways of infant feeding:exclusive breastfeeding,artificial feeding,and mixed feeding.

a.Breastfeeding　Mother’s breast milk is the best natural food for infants,which provides the energy and nutrients needed for the first few months of life.Breast milk also meets half or more of the baby’s nutritional needs during the second half of the year before the age of 1,and breast milk provides 1/3 nutrition during the year of the baby’s 2 years old.Within 6 months after birth,the breastfed (not feeding the baby any food or drink other than breast milk) is called exclusive breastfeeding.The advantages of breastfeeding are:

●　Meeting the nutritional needs of infants.Breast milk contains a variety of nutrients suitable for digestion and absorption of infants,and the proportion is appropriate.

●　Enhancing immunity.Breast milk contains a variety of immune factors,functioning as promoting the infant immunity and reducing diseases.

●　Being convenient and easy.The temperature of the breast milk is appropriate for infants.Breastfeeding is also uncontaminated,time saving,convenient and economical.

●　Promoting the emotional communication between mother and baby.Breastfed infants frequently contact their mother’s skin and receive caressing,which is conducive to the development of psychological and social adaptability of infants,and it is easy to observe changes in children and take care of them at any time.

●　Mother breastfeeding after lactation can produce prolactin,and promote uterine contraction and recovery; it also can inhibit ovulation,conducive to family planning.In addition,breastfeeding can reduce the risk of breast cancer and ovarian tumors.

Prior to breastfeeding,nursing mothers should do some cleaning,including changing the baby’s diaper,washing hands and cleaning the nipple.The mother makes sure she is in a comfortable sitting and completely at ease,embracing the baby with one arm.The baby’s head and shoulder rest on the bend of her elbow on the feeding side,with the thumb and other four fingers of the other hand placed on and below the breast respectively for the purpose to raise the whole breast without nasal blockage while breastfeeding with the nipple and most areola of breast in the mouth.The suckling baby should be allowed to empty one breast first and then change to the other side.After feeding,sit the baby up with its head propped against the mother’s shoulder and gently pat its back to help it burp up air from its stomach in order to reduce milk regurgitation.

Mothers should carefully observe and feed the babies on demand.On-demanding feeding is individualized and based on each baby’s different needs.Feeding time is about 15–20 minutes and may bed extended or shortened accordingly.Mother suffering from acute and chronic infectious diseases,such as hepatitis,tuberculosis,severe heart,liver and kidney diseases,or too weak,should stop breastfeeding.

As infants grow up,breast milk cannot meet the needs of children’s growth and development.While the infant’s spleen and stomach function are gradually adapted to non-liquid food,breastfeeding may be stopped,but weaning time depends on the mother and the baby.Generally,food supplements may be added gradually from 4–6 months so that the spleen and stomach are gradually adapted to the general diet.Reduce the times of breastfeeding before weaning at 10–12 months.Avoid sudden weaning.It may be postponed if the breast milk is sufficient or if babies become ill or suffer from a scorching summer.

b.Artificial feeding　This refers to using formula milk,cow’s,goat’s or horse’s milk to feed infants under 4– 6 months of age who cannot receive breastfeeding for various reasons.

Bovine milk is the most commonly used milk substitute.Though it contains more protein than breast milk,it is mostly casein,which forms bigger clots in the stomach and is difficult for digestion; both unsaturated fatty acid and lactose content in milk are less than that of breast milk.The biggest difference is the lack of various immunologic factors in bovine milk.Therefore,infants with milk feeding have more chances to develop infectious diseases.In addition,the milk contains minerals 3 times as much as human milk,increasing the solute load in the kidneys of the baby and potentially damaging the kidneys in the baby.

As for other milks,the nutritional value of goat’s milk is roughly the same as bovine milk,but there is less folic acid so feeding with goat’s milk for a long time will cause megaloblastic anemia; horse milk contains less protein and fat with lower energy,so it should not be used for long term feeding.

Due to the difference in species,the nutrients contained in animal milk are not suitable for human infants.Therefore,formula milk should be the best choice for general artificial feeding and for infants weaned from breast milk.

Formula milk powder is a dairy product transformed from bovine milk,containing most of the nutrients similar to breast milk.It is well-tolerated by the infant’s digestive and kidney systems for reducing the content of casein and inorganic salt,while adding some fundamental nutrients such as whey protein,unsaturated fatty acid,lactose,and enhancing micronutrients such as nucleotide,vitamin A,vitamin D,carotene and iron,zinc and other trace elements.Formula milk powder should be chosen according to the age of the child.

If the baby has to be fed with animal milk instead of formula milk,it is not appropriate to use it directly.It must be modified.The milk formula consists of three steps: diluting,adding sugar and disinfecting.The dilution corresponds to the age of the children.For newborns under 2 weeks old,the ratio between milk and water should be 2 : 1,and then gradually change to 3 : 1 or 4 : 1.When infants are 1 month old,they can be given undiluted bovine milk.The amount of sugar added is 5–8 g per 100 mL,and the baby should take milk with sugar about 110 mL/kg and water 150 mL/kg every day.Boiling sterilization can reach the requirements,and can make the milk protein denaturizing,so it will not form bigger clots in the stomach.

c.Mixed feeding　Mixed feeding,or partial breastfeeding,refers to adding formula milk,bovine milk,goat’s milk or other substitutes when the mother’s milk is insufficient.There are two kinds of mixed feeding methods:supplemental feeding and breast-bottle-feeding.Supplemental feeding refers to feeding the child as usual,breastfeeding followed by adding a certain amount of milk-substitute until the baby is satisfied.This feeding method can maintain the secretion of breast milk because of constant sucking stimulation,so it is superior to the breast-bottle-feeding that refers to feeding the child with milk or milk substitutes instead of breast milk one or more times a day.To achieve lactation success,the mother must persist with breastfeeding,no less than 3 times a day,maintaining at night in particular,otherwise,breast milk secretion will quickly reduce.

d.Adding complementary food　Supplementary feeding should be added to the infants at any given age,regardless of breast-feeding,artificial feeding or mixed feeding.The principle of adding complementary foods: offer them gradually when the infant is healthy with normal digestive function,from less to more,thin to thick,fine to coarse,one to many.The order of complementary food adding can refer to table 3–2.

2.Nursing Care

a.Daily regimen It was said in Wan Family’s Secrets of Nursing Infants ( Wàn Shì Jiā Cáng Yù Yīng Mì Jué ,万氏家藏育婴秘诀) that “Babies should be brought outside to bathe the sunshine when it is pleasant and not windy,and be dressed according to the changes of climate.” Sunshine and fresh air are indispensable to the growth of infants.Children should be taken outdoors to strengthen the children’s physical constitution and increase their resistance to disease.Their clothes cannot be too warm,and the clothing should be loose.Being too tight may impede the circulation of qi and blood,affecting the growth and development.The children’s personal hygiene should be maintained adequately,such as changing the bedding and clothing regularly.Enough sleep is necessary.Sleep duration in children gradually shortens as they grow up.When organizing a regime for feeding and playing,this physiological feature should benoted in order to cultivate good sleeping habits at night with appropriate activities during the daytime.

b.Perception promotion　Infancy is an important period of development of the perception when vision,hearing,and discernibility are improved rapidly.The children should be trained to know the living environment from the near to the distant,promote the development of perception,and cultivate their observation ability.Parents should provide the children with space and opportunity to exercise and promote the development of their movements.Toilet training should be also practiced for infants.The development of language is a continuous and orderly process.Babies need to practice pronunciation first,and then feel the language and understand the language,and finally,use the language,that is,speak.The parents should actively cultivate their language ability.

c.Avoiding being terrified suddenly　Fear in the baby is a normal phenomenon in the process of growing up,but excessive shock can have a bad effect on the development of the baby.Adults’ loud snaps,things’ loud thump,even the city noise,are likely to frighten the baby.A frightened baby usually cries,restless at nights,low spirits,and so on.Therefore,parents need to be careful about the environment in which children live and try to avoid being frightened.

3.Disease Prevention

During the infant period,the zang-fu organs are delicate and the defensive qi is weakened.The immunity obtained from the mother body gradually disappears,while the acquired immunity has not yet come into being.It is prone to diseases of the spleen and stomach,lung diseases and infectious diseases.It is necessary to have a regular health examination and physical measurement for infants and to monitor their growth and development in order to identify problems early,take measures to prevent and treat malnutrition,obesity,nutritional iron deficiency anemia and vitamin D deficiency rickets and other diseases in a timely manner.Pay attention to diet hygiene,and reduce the incidence of spleen and stomach diseases.Prevent accidental injuries,such as foreign body aspiration,suffocation,poisoning,falling injuries etc.The infant has a higher susceptibility to various infectious diseases,and the immunization program for the infants under 1 year of age must be carried out in accordance with the prescribed procedures for immunization.

Toddlerhood Health Care

1.Diet Management Toddlerhood is a period when the children’s diet transforms from milk to a regular diet,and all the deciduous teeth are erupting successively,but their chewing ability is yet incomplete and spleen and stomach functions are still weak.Food for toddlers should be fine,soft,smashed,or minced.The food should be diversified.The major food should be cereal,with milk,fish,meat,eggs,bean products,vegetables,fruits and other foods,with meat and vegetables in fine matches.Cooking methods should also be diversified to enhance children’s appetite.Frequent eating,eating at night and drinking too much water will affect children’s appetite.Toddlers should be trained to develop good eating habits,having meals at fixed times and fixed quantities,eating without playing,or watching TV,not eating snacks,not being choosy in food.Train the children to correctly use tableware and have independent dining skills.While ensuring adequate nutrition supply,it is also important to prevent foot injury and diseases.

2.Daily Life Activities When learning to walk,children should be led by adults to prevent falling and given some freedom of activity to develop their motor skills.Young children are curious and thirsty for knowledge,and they have a desire to express themselves,ask questions,sing simple songs,read storybooks,and watch cartoons.Adults should satisfy these desires,talk to them,and encourage them to speak more so as to promote children’s language development.Combined with the characteristics of children’s age,cultivate them to develop good habits.It was stated in Oral Discussion of Pediatrics — Children’s Safeness and Health ( Huó Yòu K u Yì — Xi o Ér Cháng Ᾱn ,活幼口议·小儿常安)that “it is unnecessary to dress the children too many clothes or feed them too much food for the purpose of keeping them safe and sound.” These are all effective nursing experience of Chinese medicine.

3.Disease Prevention With the increase of children’s age,outdoor activities and exposure to foreigners are increasing,and all kinds of acute infectious diseases are prone to occur.It is necessary to train them to develop good hygiene practices and to correct their bad habits,such as sucking hands,grabbing food and sitting on the ground to play.Be sure to wash their hands before eating and after toilet.Rotten and contaminated food cannot be eaten.Clothes and beddings are changed frequently.The incidence of lung diseases and spleen diseases in childhood is high.Be cautious about living,dieting,personal hygiene,preventing exogenous diseases and reducing the incidence of diseases.Vaccination should be continued as a schedule of immunization procedures.Children are curious and restless and lack the ability to identify risks so much attention should be paid to foreign body inhalation,burns,electric shock,trauma,poisoning and other accidents.

Preschool Children’s Health Care

Preschool children are highly active,and their intelligence has been developed.They have a strong curiosity and thirst for knowledge.Although the incidence of the disease decreases with the increase of physical fitness,the health care workers should be done according to the characteristics of this period.

1.Physical Exercises Physical exercises should be arranged according to the characteristics of children at this period,to ensure that every day there is a certain amount of outdoor activities,in order to enhance children’s physique through games,physical exercises.

2.Preschool Education Since preschoolers are studious and inquiring,parents and caregivers should respond to their questions and patiently answer their questions and give them as much explanation as possible.Appropriate education methods and contents should be arranged according to the intelligent characteristics of the children of this age.Wan Quan,a doctor of Ming Dynasty,put forward an approach to learning that is “to teach them what they see”.In Secrets of Nursing Infants ( Yù Yīng Jiā Mì ,育婴家秘),it was stated that “when children learn to speak,teach them normal language,not vulgar words; when children learn to eat,teach them eating in good manners,not in a rude and absent-minded way ...; when communicate with children,teach them to be honest and not to deceive; teach them to greet and see off guests with respect not to retreat; teach them what they see,such as clothes,utensils,grain,and livestock; teach them the numbers,orientations,hours or days or years.In this way,the children will not get diseased.What’s more,they will obtain knowledge at an early stage”.

3.Disease Prevention During this period the incidence of diseases in children declines and their physical fitness is strengthened.It is high time to treat sick children who get diseased in infancy period.For example,for children with recurrent respiratory tract infection,differentiated regulation and reinforcement are needed to improve the physique and reduce the development of diseases; for those with asthma in remission,boost healthy qi and consolidate the root to control the incidence of asthma; for those with anorexia,adjust diet,regulate the spleen to help transport in order to increase their appetite;for those with malnutrition,take diet therapy and medical therapy to invigorate spleen and promote digestion so as to enhance their growth and development,etc.Physical examinations are conducted once or twice every year to monitor the growth and development,screen and correct myopia,saprodontia,iron deficiency anemia,and parasites,and so forth.

School Children’s Health Care

School-age children enter school when life and requirements are undergoing major changes.The main tasks of health care during this period are to ensure the physical and mental health and promote the all-round development of children.

1.All-around Development School-age children are in an important stage of growth and development,and the joint education of schools and families is an indispensable requirement for healthy growth of children.Parents and teachers should teach and guide the children through their own words and deeds,have the children develop to the correct target,and train fine qualities of high morality,responsibility,discipline,solidarity,self-respect and self-reliance.Ensure children’s diet full and balanced to meet the children’s physical growth,mental and intellectual development,learning and sports and other needs.Engage outdoor activities and physical exercises,and participate in systematic sports activities and some labor work.Children should be lively,active,an initiative in a study to promote the development of their creative thinking.Reduce the burden of excessive learning,and provide children with space to study independently and time for necessary activities.

2.Disease Prevention Morbidity of schoolage children further decreases,but much attention is needed to prevent and treat frequently encountered diseases during this period.Attention should be paid to changes in children’s mood and behavior,to avoid excessive mental stress,and to reduce the occurrence of mental and behavioral disorders.Education on the eye and oral health should be strengthened.Correct the chronic focus of a disease.Make sure the children maintain proper postures for sitting,standing and walking,and in addition to eye exercises,develop good habits of oral hygiene after meals,before sleep and after getting up in the morning,with eye exercises and other training methods,to prevent dental caries and myopia.The incidence of some autoimmune diseases such as asthma,rheumatic fever,allergic purpura,nephropathy syndrome is high in this period.Prevention and timely treatment of various infections are necessary,avoiding environmental pollution and allergens,reducing the incidence of diseases.Children also have to learn legal knowledge and traffic rules and prevent accidents.

Adolescent Health Care

Adolescence is a special period when the kidney qi is exuberant and they reach the second peak of growth and development.Physiological and psychological changes are great,and the healthcare has its special requirements.Healthcare in adolescence is of great significance for the smooth transition from children to adults with a healthy physical and mental state.

1.Physiological Health Care During adolescence,with rapid physique growth and large consumption of mental labor and physical exercise,it is necessary to increase the intake of various nutrients.Adolescents should be guided to choose adequate nutritious foods,maintain good eating habits,and avoid excessive indulgence in fast foods or addictions to any kind of food,especially for those girls for the pursuit of body shape.Be sure to have enough time for both sleep and physical exercise in order to attain the goal of all-round development.

During adolescence,girls’ menstruation come,instruction about menstrual health should be strengthened,such as having a stable and routine everyday life,avoiding the cold,strenuous exercise and heavy physical labor,paying attention to perineal hygiene,and avoiding sitz bath etc.Adolescent boys have their first spermatorrhea,and should also be taught to correctly handle.During this period it is important to prevent and treat frequently encountered diseases such as goiter,dysmenorrhea,irregular menstruation,tuberculosis,rheumatism,accidental trauma and any accidents.

2.Psychological Health Care Adolescence is the second peak in physical development.Not only have the weight and height increased greatly,but also the secondary sexual characteristics become more and more obvious.“Kidney qi is exuberant,and tiān guǐ (reproduction-stimulating essence) is produced”.The reproductive system develops quickly,with menstruation in girls and spermatorrhea in boys.Therefore,correct sex education should be carried out,good character and moral emotion should be cultivated and correct outlook on life should be established.Popularize the knowledge of adolescent health care including sexual physiology knowledge,clear up the confusion of teenagers,and resist the harmful effects of pornographic books and videos.Adolescent neuroendocrine regulation is not stable,which often leads to psychological,behavioral and mental instability,and at the same time,the physiological changes may cause discomfort or impulsion,environmental changes,and more contacts may bring about psychological problems about social adaption,such as inferiority,being impulsive and adventurous,and even suicide.According to its physiological,psychological and spiritual characteristics,education and guidance should be strengthened so that they can know themselves and correctly deal with the physiological changes of puberty.Tell them the dangers of smoking,alcohol abuse,and drug abuse.They should know how to understand society,adapt to society,correctly deal with interpersonal relations,enhance identification ability,and integrate smoothly into society.

QUESTIONS

1.What are the stages of child age? What are the characteristics of each stage?

2.Tell the methods of calculating the normal value of body weight,body length,and teeth in children and its clinical significance.

3.What is the importance of rational feeding for children’s growth and development? What are the usual ways of feeding children?

4.Brief emphasis on health care in the neonatal period.

5.What are the specific principles and order of complementary feeding in infancy? F6h9f8bcQ7tjPZpL3gJsFG1Rm/zzQUIpTC6DdXODaWIITen7Ztc3B4Zv8/qnCuiW