Introduction & Infant Feeding YANG FAN Associated-Professor of Pediatrics

What is Pediatrics?

Facilitate optimal health and well-being for children and their family Focus on the growth and development of children Focus on the prevention of diseases of children Focus on the treatment of diseases of children

Preventive Pediatrics Developmental Pediatrics Clinical Pediatrics

Aims Raise child’s physical endowment Decrease the morbidity and mortality rate Improve the living quality of the children

Under 1y 1. perinatal conditions intrauterine growth retardation respiratory distress syndrome 2. congenital malformation 3. sudden infant death syndrome 4. pneumonia 5. gastrointestinal disorders Major causes of death

1 ～ 4y 1. accidental injuries 2. congenital malformation 3. malignant neoplasms 5 ～ 14y 1. accidental injuries 2. malignant neoplasms

Rank order of death of children under 5 in developing country,2002 rankCause of deathcases （thousand） constitution（％） 1Perinatal death Lower respiratory infection diarrhea malaria measles Birth defect HIV/AIDS pertussis tetanus PEM

The infant mortality rate (IMR) is the ratio of the number of deaths among children less than one year old during a given year to the number of live births during the same year.

The death of an infant is often dependent on external factors, especially in developing countries. Poor water quality, an inadequate food supply, substandard health services, and a high level of infectious diseases such as malaria all contribute to a high IMR.

The IMR is therefore considered a good indicator of the level of health in a community The current worldwide average is just under sixty per thousand live births

IMR for selected regions and countries, 1998 Region or country IMR per thousand live births SOURCE: UNICEF (2000) The State of the World's Children. Singapore 5 Norway 5 Sweden 5 Japan 6 Finland 6 Australia 6 Austria 6 France 6 UK 6 Netherlands 6 Cuba 7 USA 7 Liberia 157 Afghanistan 165 Haiti 169 Angola 170 Sierra Leone 182

Infant Mortality Rate YearInfant Mortality Data Source Rate(‰) Before liberation 200 Before 1949About 200 其中：市 120 左右 of which: CityAbout Reported by Most Cities and Counties in 19 Covinces (Beijing and etc) Retrospective Survey on Tumor Death in China The 3rd National Population Census The Surveillance Region of Maternal and Child Health The Surveillance Region of Maternal and Child Health The Surveillance Region of Maternal and Child Health

GOBI-FFF UNICEF--United Nations International Children’s Emergency Fund G-- Growth monitoring O-- Oral rehydration treatment B-- Breast feeding I -- Immunization F -- Food nutrition F -- Family planning F -- Female education

Characteristics of pediatrics preclinical medicine

Physiology HR: 1m-1y： bpm >8y: 70-90bpm BR: neonate: 40-45bpm >8y: 18-20bpm BP (mmHg): SBP: = age ×2+80

Pathology Pneumococcal infection Vitamin D deficiency

clinical medicine disease pattern clinical manifestation

Age Period Birth 28day 1y 2y 3y 6y 12y 18y Neonatal Infant Period Toddler Age Preschool School Age Adolescence

Childhood Age Staging Fetal period first trimester of pregnancy first 12 weeks second semester of pregnancy 13~28weeks third semester of pregnancy 29~40weeks

mother ’ s medical history (chronic medical conditions, medications taken during pregnancy thalidomide event ) smoking, dietary habits occupational exposures to chemicals infections

ToRCH infection： T Toxoplasma R Rubella C Cytomegalovirus, CMV H Herpes virus O Others

Neonatal period the first 28 days of life experience great changes from inside uterus to outside the functions are not mature the diseases usually caused by maladjustment high mortality rate

Infancy From birth to 1 year old The most rapid growth period High incidence of malnutrition, dyspepsia, infectious diseases, etc immunization

Toddler’s age from 1 to 3 years old Intelligence development is very fast high incidence of accidental injury

Preschool period from 3 to 6/7 years old School age from 6/7 to preadolescence

Adolescence develop second sexual character growth acceleration individual differences

Immunizations Routine immunization dramatically decreased morbidity and mortality from a variety of infectious diseases Active immunization attenuated or inactivated organisms, their components, or their products

VACCINES Hepatitis B Bacille Calmette--Guerin BCG Diphtheria Pertussis Tetanus DPT Poliomyelitis Measels Measels Mumps Rubella MMR

Immunization schedule age <1d 1 m <2 m 2 m 3 m 4 m 5 m 6 m 8 m vaccine HB 1 HB 2 BCG Polio 1 Polio 2 DPT 1 Polio 3 DPT 2 DPT 3 HB 3 Measles