Assessment of nutrition education during pregnancy through child care period.

目的：明确孕期育儿期间母婴营养教育的必要内容。方法：1)对产科机构孕期育儿妇女进行营养教育的纵向研究。2)儿科机构育儿期间对母亲的营养教育情况调查。3)对夜班母亲进行营养教育的情况调查。4)对产科、儿科护士进行营养教育和营养指导的访谈调查。结果：1)尽管孕妇认识到孕期营养的重要性和必要性，但孕中期的饮食行为与孕前相比无明显变化。相比之下，他们认为饮食行为的改善与怀孕后期胎儿的发育有关。尽管他们试图更改…的一部分更多的进食行为，这些仍然是不够的或可取的。虽然孕妇对分娩和哺乳很感兴趣，但她们并没有考虑到保育期的长期营养。2)4个月以前，母亲对自己出生后的饮食行为不太感兴趣。他们做饭时考虑到了食物的余量，只当晚餐用。至于早餐和午餐，他们主要是做主食。只有8.0%的母亲在早餐和午餐时会同时做主菜和配菜。他们觉得做断奶食品有很多困难，需要人帮忙做。3)与对照组(即家庭主妇或白天工作)相比，深夜工作的母亲更倾向于在夜间与家人一起在户外用餐和娱乐设施。他们对儿童进食不足和日常节律被打破感到焦虑，需要对进食的支持和日常节奏的调整。早餐率在不同组之间没有差异。对于工作到深夜的母亲，结合生活节奏进行营养教育是必要的。4)产科护士的营养教育和营养指导主要是孕期保健、产后康复支持和哺乳期饮食指导。与其他作品相比，他们觉得做这件事很困难。提炼出的困难因素是如何评价膳食，如何继续和改进营养指导，营养教育和营养指导知识有限，不足以回答孕妇的问题。孕前、孕中、孕后的营养教育需要一个具体、通俗易懂的工具。儿科护士的营养教育和营养指导主要集中在儿童膳食、断奶饮食、体检时两餐间进食、疾病期间进餐等。提炼出的困难因素有：母亲对进餐兴趣不高，如何评价母婴的不同故事，如何仅靠文字教育，母亲S对哺乳和奶类知识了解有限。讨论与结论：孕期营养教育和营养指导应具体化，并包括可用于育儿期间的预期内容。它应该在怀孕期间一直持续到育儿期。我们揭示了营养指导的具体内容，包括日常节律，并制作了孕前、孕中和孕后营养指导的工具，其中包括如何教育妇女和母亲。较少

Purpose : The purpose of this research is to clarify a necessary content of the nutrition education to mother and child during pregnancy through child care period.Methods : 1)Longitudinal study on nutrition education to women during pregnancy through child care period in obstetrics facilities. 2)Investigation on nutrition education to mothers during child care period in pediatrics facilities. 3)Investigation on nutrition education to mothers who work late at night. 4)Interview investigation concerning nutrition education and nourishment guidance to nurses who work for obstetrics or pediatrics departmentResults : 1) Eating behavior was not changed in the middle term of pregnancy compared with before pregnancy, even though the pregnant women recognized the importance and the necessity of the nourishment during pregnancy. In contrast, they thought an improvement of eating behavior in consideration with their fetal growth in the late term of pregnancy. Although they tried to change a part … More of eating behavior, those were still not sufficient or preferable. Although pregnant women had an interest to the birth and lactation, they didn't think about long-term nourishment through child care period. 2) Mothers had a little interest to their own eating behavior after birth until 4 months. They cooked in consideration with the meal balance only for supper. As to breakfast and lunch, they cooked staple food mostly. There were only 8.0% of mothers who had been cooking both main and side dishes in breakfast and lunch. They felt lots of difficulties to cook weaning foods and required a support to do. 3) Mothers who worked late at night tended to take meal outside and amusement facilities at nighttime frequently with their family compared with the control (i. e., housewives or working daytime). They were anxious about insufficient meal for children and broken daily rhythm and required a support for meal and adjustment of daily rhythm. Lack-of-breakfast rate was not different between groups. The nutrition education in consideration with the life rhythm is necessary for mothers who worked late at night. 4) The nutrition education and nourishment guidance of nurses who worked for obstetrics department was mainly the health care during pregnancy, the recovery support after birth, and the dietary instruction on lactation. They felt difficulties to do it compared with other works. The extracted factors for the difficulties were how to evaluate the meal, how to continue and improve the nourishment guidance, and the limited knowledge of the nutrition education and nourishment guidance, which were not enough to answer the question of pregnant women. They required a concrete and comprehensible tool for the nutrition education before, during and after pregnancy. The nutrition education and nourishment guidance of nurses who worked for pediatrics department was mainly the meal for children, weaning food, eating between meals at the time of medical check up, and the meal during diseases. The extracted factors for the difficulties were mother's poor interest for the meal, how to evaluate different stories from mother and child, how to educate them only by the words, and mother,s limited knowledge of lactation and milk.Discussion and conclusions : Nutrition education and the nourishment guidance during pregnancy should be concrete and include anticipated content that can be used for the child care period. It should continue during pregnancy through child care period. We revealed a concrete content of nourishment guidance including daily rhythm, and we made a tool for that before, during and after pregnancy, which included how to educate women and mothers. Less