宝宝噎食急救 把握“黄金四分钟”

如何预防噎食

你以为噎食离你家宝宝很远？错了！进食的东西太大，或进食太快，都有可能造成噎食；而宝宝的喉咙发育不完全，发生噎食的概率比成人更高。那么，日常生活中如何预防宝宝噎食？下面一起来瞅瞅！

1、爸爸妈妈要特别注意食物的处理，如：肉应切碎、剁碎、撕碎或切片；水果可以捣碎或切成小片。另外，不要让5岁以下的孩子吃花生、瓜子、果冻等食物。

2、孩子吃饭时，家长不能逗孩子笑，更不能和孩子打打闹闹。正确的做法是让孩子安静、平静地吃饭，并避免刺激或惊吓孩子。

3、要培养孩子良好的就餐习惯，例如让其坐在饭桌上吃饭，拒绝边跑边吃。同时，要给孩子营造安静的就餐环境，以避免孩子情绪太急躁、激动或笑闹过度。

4、铅笔帽、橡皮头、绣花针、磁铁、塑料片等细小物品一定要放在孩子接触不到的地方。另外，家长要经常有意识地告诉孩子什么东西可以吃，什么东西不可以吃。

噎食的原因

当妈了，懂多点很有必要！所以，下面就跟着妈网百科一起来了解下噎食的原因吧！吃饭时大哭或大笑、边吃饭边玩耍……这些平常容易忽略的因素，都有可能召来噎食这一魔鬼哦。

1、给小孩吃花生、瓜子、果冻等食物

甜甜的果冻，香脆的瓜子和花生，这都是孩子们喜欢吃的食物，可稍不留神，这些东西就有可能成为噎住孩子的“危险食物”。原因是这些食物体积比较小，很容易噎到孩子。

2、小孩吃饭时大哭或大笑

孩子吃饭时，有些家长会为了哄孩子而逗他笑，或者吓唬孩子，以致于把孩子惹哭了。但这些都是十分危险的行为！如果孩子一边吃饭，一边玩耍说笑，食物就很有可能从咽门掉进气管里，造成噎食。

3、孩子边吃饭边玩耍

孩子在前边走，家长在后面追着给他喂饭，这估计是许多家庭里常见的景象。但Stop！快停止这危险的行为吧！孩子玩的时候嘴里含着食物，很容易发生食物误入气管的情况，轻者会出现剧烈的呛咳，重者则可能导致窒息。另外，孩子叼着小勺跑来跑去时如果摔倒了，小勺可能会刺伤孩子的口腔或咽喉。

4、细小物品没有摆放好

孩子对细小的东西比较感兴趣，一些能放进孩子嘴里的物品如果没有放好，孩子能轻易接触到，并且可能当作食物拿来吃掉。吃进去的这些东西不仅容易使孩子噎着，一旦被孩子吞进去了，后果可能会更严重。如果婴幼儿吞下圆滑的小物品，还能随大便排出；但如果吞下的是到尖锐物品，就很容易卡在食道或消化道内，只能通过手术取出，情况严重的还会有生命危险。 ...

噎食的后果

常言道：因噎废食。那么，噎食究竟会造成怎样严重的后果，以致于让人索性连饭也不吃了？下面一起来了解下吧！

噎食，即食物堵塞咽喉部或卡在食道的第一狭窄处，甚至误入气管，引起呼吸窒息。一旦发生噎食，如果不能在“黄金四分钟”内将堵塞物取出，那么噎食者便很可能会因为窒息而死亡。

99.9%的情况下，噎食是不会发生的。因为咽喉部有精确的进食反射功能，进食时会自动封闭气管，开放食管，食物便可通过咽喉部自然进入食道。但如果儿童吃饭时注意力不集中，还是很可能出现噎食的。

噎食的表现

如果宝宝发生噎食，那么爸爸妈妈一定要把握好“黄金四分钟”，展开急救。然而，宝宝噎食有哪些表现？下面一起来看看！

1、进食时突然不能说话，并出现窒息痛苦表情；

2、患儿通常会用手按住颈部或胸前，并用手抠口腔；

3、如为部分气管阻塞，会出现剧烈咳嗽、咳嗽间有哮鸣音等表现。

噎食怎么急救

意外随时会发生，危险也无处不在！万一宝宝不小心被食物噎到了，爸爸妈妈应该怎么急救？下面一起来备课吧！

一旦孩子发生噎食，爸爸妈妈应把握“黄金四分钟”急救。如果4分钟内不能将噎住的异物取出，那么孩子就会有窒息的危险。

对于神志清楚的噎食儿童，要敦促其主动用力咳嗽，通过咳嗽产生的气流将堵塞物排出，或者形成可以保持呼吸的空隙。在噎食儿童自救的同时，家长要让其坐好并且上身前倾，然后在孩子的背后两肩胛之间以手掌快速有力地拍击4下。

对于神志不清的噎食儿童，应由一个人倒提其双脚，然后斜抱住身体，另一个人一边用一根手指压下孩子的舌头，一边在孩子的背后两肩胛之间以手掌根部快速有力地拍击4下。

如果是被月饼馅等黏稠的食物噎住，还可让患儿侧卧，以食指沿喉咙的内壁轻轻伸入喉咙深处，掏出或夹出食物。

最后，在家自行急救的同时别忘了拨打急救电话哦。

Media Use by Children Younger Than 2 Years

Abstract

In 1999, the American Academy of Pediatrics (AAP) issued a policy statement addressing media use in children. The purpose of that statement was to educate parents about the effects that media—both the amount and the content—may have on children. In one part of that statement, the AAP recommended that “pediatricians should urge parents to avoid television viewing for children under the age of two years.” The wording of the policy specifically discouraged media use in this age group, although it is frequently misquoted by media outlets as no media exposure in this age group. The AAP believed that there were significantly more potential negative effects of media than positive ones for this age group and, thus, advised families to thoughtfully consider media use for infants. This policy statement reaffirms the 1999 statement with respect to media use in infants and children younger than 2 years and provides updated research findings to support it. This statement addresses (1) the lack of evidence supporting educational or developmental benefits for media use by children younger than 2 years, (2) the potential adverse health and developmental effects of media use by children younger than 2 years, and (3) adverse effects of parental media use (background media) on children younger than 2 years.

• media
• development
• infants
• young children
• television
• screen time

INTRODUCTION

From built-in DVD players in minivans to smart cell phone technology, today's children have more access to electronic media than those of any previous generation. As predicted in the 1999 American Academy of Pediatrics (AAP) policy statement,¹ industry has also targeted those in the 0- to 2-year age group (and their parents) as key consumers of electronic media. Educational DVDs/videos, television programs, and even entire cable networks are geared toward this age group.

Currently, 90% of parents report that their children younger than 2 years watch some form of electronic media.² By 3 years, almost one-third of children have a television in their bedroom.³ Parents report that they view television as a peacekeeper and a safe activity for their children while they are preparing dinner, getting ready for work, or doing household chores.³ Many parents report feeling better knowing that the programming their children watch has been described as educational. Parents who believe that educational television is “very important for healthy development” are twice as likely to have the television on all or most of the time.⁴

Some children are watching television programs or recorded programs (DVDs/videos) intended for their viewing, termed “foreground media.” Others are exposed to programs intended for adults, termed “background media,” because the television is on while they are present in the room. Some children are exposed to 4 hours or more of televised programs per day. Other children may be watching a 30-minute DVD while a parent is just taking a shower or preparing dinner. Some children are watching shows with parents or siblings, and some are watching alone. On average, children younger than 2 years watch televised programs 1 to 2 hours/day.² Fourteen percent of children aged 6 to 23 months watch 2 or more hours/day of media.³

Some media industry executives claim that educational media programs are meant to be watched by both the parent and the child to facilitate social interactions and the learning process.⁵ However, it is not clear whether this happens in the real world. In fact, it seems that audible television is associated with decreased parent-child interactions.⁶ Although a leading survey of family media use has reported that 40% of parents watch with their child all the time and 28% watch with their child most of the time, parents also report that they avoid co-viewing because their child's media time provides an opportunity for them to do other things.³

Although there is equal access to media among children of different socioeconomic groups, the amount of media consumption is unequal. Children who live in homes with lower socioeconomic status and children with single mothers or mothers with less than a high school education are spending more time in front of a screen on a daily basis.^3,7 Another study found no association between family income and early childhood media use but did find a relationship between lower parental education and higher levels of media use in early childhood.⁸

This revised policy statement addresses the past 10 years of research on the effect of media on young children, clarifies the rationale for the position of the AAP on media use by children younger than 2 years, and provides updated recommendations for families, clinicians, and researchers. For the purposes of this policy statement, the term “media” refers to television programs, prerecorded videos, Web-based programming, and DVDs viewed on either traditional or new screen technologies.

LOST IN TRANSLATION: CAN CHILDREN LEARN FROM MEDIA?

Research has found that certain high-quality programs have educational benefits for children older than 2 years. Children who watch these programs have improved social skills, language skills, and even school readiness.⁹ However, the educational merit of media for children younger than 2 years remains unproven despite the fact that three-quarters of the top-selling infant videos make explicit or implicit educational claims.⁵ To be beneficial, children need to understand the content of programs and pay attention to it. Children older than 2 years and those younger than 2 years are at different levels of cognitive development and process information differently.¹⁰ In fact, 2 studies have found that watching a program such as “Sesame Street” has a negative effect on language for children younger than 2 years,^11,12 and 2 studies have found no evidence of benefit.^13,14 There is a paucity of research on this topic, but the existing literature suggests that media use does not promote language skills in this age group.

Young children have difficulty discriminating between events on a video and the same information presented by a live person, which is referred to as “video deficit.”^15,–,17 Children 12 to 18 months of age are more likely to learn from a live presentation than from a televised one and are also more likely to remember the information from a live presentation afterward.¹⁸ These studies have only been performed on noncommercial videos. Some studies have found that children 1 to 2 years of age can remember an event on video if the screen demonstration repeats several times.¹⁹ Two studies have shown that infants as young as 12 months learn emotional responses after media viewing.^20,21 One longitudinal study performed has thus far found that children younger than 2 years who watch television have no statistical improvement in their cognitive development compared with their nonviewing peers by 3 years of age.²²

Children aged 12 months and younger do not follow sequential screen shots or a program's dialogue.^23,24 Other research has found that children younger than 18 months do not pay much attention to televised programs.²⁵ However, there are significant individual differences in attention to and interest in television in this age group that depend on content, setting, and whether a parent is watching with the child.²⁶ A developmental shift in attention to televised programs occurs between 1.5 and 2.5 years of age.^24,25

Children progress through developmental milestones on a continuum. Where each individual child is on that continuum determines what that child is capable of learning from a televised program. Some 18- to 24-month-olds might be capable of learning from media, but others might not. Other variables that influence a child's ability to learn are the content of the program, the amount of television watched, and whether a parent is watching with the child.^13,27

Despite the explicit or implicit marketing claims of educational programs for infants, whether they are actually learning something from these programs is questionable. More research is needed to determine if early television exposure has any long-term effects on learning.

SECONDHAND TELEVISION: FOREGROUND VERSUS BACKGROUND MEDIA

Many families have reported that they have a television on at least 6 hours/day or that a television is “always on” as background noise.²⁸ Thirty-nine percent of families with infants and young children have a television on constantly.²⁹ When a parent has an adult television program on, children are often in the room; 61% are there at least some of the time, including 29% who are there all or most of the time.³

Young children may not be paying close attention to a televised program that they cannot understand, but their parents are watching. It might be background media to the child, but it is foreground media to the parent. It distracts the parent and decreases parent-child interaction.^30,31 Infant vocabulary growth is directly related to the amount of “talk time” or the amount of time parents spend speaking to them.³² Heavy television use in a household can interfere with a child's language development simply because parents likely spend less time talking to the child.³³

Even if the program is not intended for the child to watch, research has found that children play and interact less with adults when a television is on, perhaps because the adult's attention is focused on the television program. A study that examined 12-, 24-, and 36-month-olds found that background television not only reduced the length of time that a child played but also that it reduced the child's focused attention during play.³⁴ Children stop to look at a televised program, halt their ongoing play, and move on to a different activity after the interruption.³⁴ Although most research has been performed on adolescents, study results suggest that background media might interfere with cognitive processing, memory, and reading comprehension.^4,34,–,36 Only 1 research study, conducted in 1996, resulted in evidence to the contrary. In that study, 10-month-old infants tuned out surrounding noise and concentrated more during play.³⁷

Background television has the direct effect of distracting a child and the indirect effect of taking a parent's attention away from the child. In addition, parents' media diet influences the media habits of their children.³

A GOOD USE OF TIME?

Children younger than 5 years who watch television spend less time in creative play and less time interacting with parents or siblings.³⁸ For every hour of television that a child younger than 2 years watches alone, he or she spends an additional 52 minutes less time per day interacting with a parent or sibling. For every hour of television, there is 9% less time on weekdays and 11% less time on weekends spent in creative play for a child younger than 2 years.

Does television displace more developmentally valuable playtime? No research exists at this point to know whether a child would find better things to do with his or her time if all screens were turned off, although evidence suggests that the child would hear more adult speech and talk more.⁶ Heavy media use is defined as the television being on always or most of the time. Heavy media use may be a sign of parenting style, so one cannot assume that parents will spend developmentally nurturing time with their child with the television off.³⁸

Heavy media use in a household does not seem to affect the amount of time a child of any age plays outside.⁴ However, children who live in households with heavy media use spend between 25% (for 3- to 4-year-olds) and 38% (for 5- to 6-year-olds) less time being read to or reading.^3,4 These children have a lower likelihood of being able to read compared with their peers from households with low media use.⁴ What is known is that unstructured playtime is critical to learning problem-solving skills and fostering creativity.³⁹

HEALTH CONSEQUENCES

Media use has been associated with obesity, sleep issues, aggressive behaviors, and attention issues in preschool- and school-aged children.^1,40 Studies are lacking on the health effects in children younger than 2 years. One area of concern, however, is media's effect on sleep. Television is part of the bedtime routine for many children. In 1 survey, 19% of parents of children younger than 1 year reported that their children have a television in their bedrooms. Twenty-nine percent of children 2 to 3 years of age have a television in their bedroom, and 30% of parents have reported that watching a television program enabled their children to fall asleep.³ Although parents perceive a televised program to be a calming sleep aid, some programs actually increase bedtime resistance, delay the onset of sleep, cause anxiety about falling asleep, and shorten sleep duration.⁴¹ Specifically, in children younger than 3 years, television viewing is associated with irregular sleep schedules.⁴² Poor sleep habits have adverse effects on mood, behavior, and learning. Although the effects of media on infants' cognitive and emotional development are still being explored, there are ample reasons to be concerned.

DEVELOPMENTAL CONSEQUENCES

Since 1999, 3 studies have evaluated the effects of heavy television use on language development in children 8 to 16 months of age. In the short-term, children younger than 2 years who watch more television or videos have expressive language delays,^12,43,44 and children younger than 1 year with heavy television viewing who are watching alone have a significantly higher chance of having a language delay.⁴⁴ Although the long-term effects on language skills remain unknown, the evidence of short-term effects is concerning.

Two studies have examined infant media use and subsequent attention problems in school-aged children.^45,46 One of these studies found that the effects of television watching on infants' attention span varied with the content of the programming.

Research findings to date might suggest a correlation between television viewing and developmental problems, but they cannot show causality. Are infants with poor language skills placed in front of the television more? Are infants with shorter attention spans more attracted to screens? Does media exposure contribute to a delay in social or communication skills and diminished attentional capacity? Because these questions remain unanswered, more research is needed.

CONCLUSIONS AND RECOMMENDATIONS

This updated policy statement provides further evidence that media—both foreground and background—have potentially negative effects and no known positive effects for children younger than 2 years. Thus, the AAP reaffirms its recommendation to discourage media use in this age group. This statement also discourages the use of background television intended for adults when a young child is in the room. Although infant/toddler programming might be entertaining, it should not be marketed as or presumed by parents to be educational.

No longitudinal study has determined the long-term effects of media use on infants and children younger than 2 years. The AAP supports research to understand the consequences of early electronic media exposure.

Recommendations for Pediatricians

1. The AAP discourages media use by children younger than 2 years. Pediatricians should discuss these recommendations with parents.
2. The concept of setting “media limits” before 2 years of age should be discussed at health maintenance/well-child visits, because many parents are not aware of the AAP recommendations. It is important to set limits and create balance at an early age. Only 15% of parents report that their pediatrician discusses media use with them.³ Families should be encouraged to provide supervised independent play for infants and young children during times at which a parent cannot sit down and engage in play with the child. Simply having a young child play with nesting cups on the kitchen floor while a parent prepares dinner is useful playtime.
3. Pediatricians should explain to parents the importance of unstructured, unplugged play in allowing a child's mind to grow, problem-solve, think innovatively, and develop reasoning skills. Unstructured play occurs both independently and cooperatively with a parent or caregiver. The importance of parents sitting down to play with their children cannot be overstated.
4. Families should be strongly encouraged to sit down and read to their child to foster their child's cognitive and language development.

Recommendations for Parents

1. The AAP discourages media use by children younger than 2 years.
2. The AAP realizes that media exposure is a reality for many families in today's society. If parents choose to engage their young children with electronic media, they should have concrete strategies to manage it. Ideally, parents should review the content of what their child is watching and watch the program with their child.
3. Parents are discouraged from placing a television set in their child's bedroom.
4. Parents need to realize that their own media use can have a negative effect on their children. Television that is intended for adults and is on with a young child in the room is distracting for both the parent and the child.
5. Unstructured playtime is more valuable for the developing brain than any electronic media exposure. If a parent is not able to actively play with a child, that child should have solo playtime with an adult nearby. Even for infants as young as 4 months of age, solo play allows a child to think creatively, problem-solve, and accomplish tasks with minimal parent interaction. The parent can also learn something in the process of giving the child an opportunity to entertain himself or herself while remaining nearby.

Recommendations for Industry

1. Independent research should be performed to assess the educational claims made in advertising for infant media products.
2. The Federal Trade Commission should improve its standards for scientifically valid educational claims in product advertising.

Recommendations for Research

1. Researchers should conduct prospective, longitudinal studies to determine the long-term effects of early media exposure on children's future physical, mental, and social health.
2. The AAP supports the National Children's Study by the Eunice Kennedy Shriver National Institute of Child Health and Human Development to examine the effects of environmental influences on children.
3. The mission of the AAP is to attain optimal physical, mental, and social health and well-being for all infants, children, adolescents, and young adults. To this end, the AAP supports continued research to examine the influence of media in children's lives and will offer evidence-based guidance to its members and the public.

Lead Author

Ari Brown, MD

Council on Communications and Media Executive Committee, 2010–2011

Deborah Ann Mulligan, MD, Chairperson

Tanya Remer Altmann, MD

Ari Brown, MD

Dimitri A. Christakis, MD, MPH

Kathleen Clarke-Pearson, MD

Holly Lee Falik, MD

David L. Hill, MD

Marjorie J. Hogan, MD

Alanna Estin Levine, MD

Kathleen G. Nelson, MD

Gwenn Schurgin O'Keeffe, MD

Past Executive Committee Members

Benard P. Dreyer, MD

Gilbert L. Fuld, MD, Immediate Past Chairperson

Regina M. Milteer, MD

Donald L. Shifrin, MD

Victor C. Strasburger, MD

Liaisons

Michael Brody, MD

American Academy of Child and Adolescent Psychiatry

Brian Wilcox, PhD

American Psychological Association

Staff

Gina Ley Steiner

Veronica Laude Noland

Footnotes

• This document is copyrighted and is property of the American Academy of Pediatrics and its Board of Directors. All authors have filed conflict of interest statements with the American Academy of Pediatrics. Any conflicts have been resolved through a process approved by the Board of Directors. The American Academy of Pediatrics has neither solicited nor accepted any commercial involvement in the development of the content of this publication.
• All policy statements from the American Academy of Pediatrics automatically expire 5 years after publication unless reaffirmed, revised, or retired at or before that time.

• AAP —

  American Academy of Pediatrics

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• Copyright © 2011 by the American Academy of Pediatrics

Why to Avoid TV for Infants & Toddlers

​By: David L. Hill, MD, FAAP
Parents are often shocked when I tell them that pediatricians think it's a bad idea for children to watch TV or use mobile apps before age 18 months, because most toddlers already have. Surveys tell us that 92.2% of 1-year-olds have already used a mobile device, some starting as young as age 4 months.

Early Brain Development

I hear a lot of parents say, "But my baby likes it!" Infants may stare at the bright colors and motion on a screen, but their brains are incapable of making sense or meaning out of all those bizarre pictures.
It takes around 18 months for a baby's brain to develop to the point where the symbols on a screen come to represent their equivalents in the real world.
What infants and toddlers need most to learn is interaction with the people around them. That doesn't mean that they shouldn't video-chat with a distant grandparent or a deployed parent, but when it comes to day-to-day learning they need to touch things, shake them, throw them, and most of all to see the faces and hear the voices of those they love the most. Apps can teach toddlers to tap and swipe at a screen, but studies tell us that these skills don't translate into real-world learning. See Healthy Digital Media Use Habits for Babies, Toddlers & Preschoolers.

Where's the Harm?

So sure, babies and toddlers don't get anything out of watching TV, but if they seem to like it, where's the harm? If a little TV is what it takes for you to get dinner on the table, isn't it better for them than, say, starving? Yes, watching TV is better than starving, but it's worse than not watching TV. Good evidence suggests that screen viewing before age 18 months has lasting negative effects on children's language development, reading skills, and short term memory. It also contributes to problems with sleep and attention.
If "you are what you eat," then the brain is what it experiences, and video entertainment is like mental junk food for babies and toddlers.
The problem lies not only with what toddlers are doing while they're watching TV; it's what they aren't doing. Specifically, children are programmed to learn from interacting with other people. The dance of facial expressions, tone of voice, and body language between a toddler and parent is not only beautiful, it's so complex that researchers have to record these interactions on video and slow them down just to see everything that's going on. Whenever one party in this dance, child or parent, is watching TV, the exchange comes to a halt.
A toddler learns a lot more from banging pans on the floor while you cook dinner than he does from watching a screen for the same amount of time, because every now and then the two of you look at each other.
Just having the TV on in the background, even if "no one is watching it," is enough to delay language development. Normally a parent speaks about 940 words per hour when a toddler is around. With the television on, that number falls by 770! Fewer words means less learning.
Toddlers are also learning to pay attention for prolonged periods, and toddlers who watch more TV are more likely to have problems paying attention at age 7. Video programming is constantly changing, constantly interesting, and almost never forces a child to deal with anything more tedious than an infomercial.
After age 2 things change, at least somewhat. During the preschool years some children do learn some skills from educational TV. Well-designed shows can teach kids literacy, math, science, problem-solving, and prosocial behavior. Children get more out of interactive programs like Dora the Explorer and Sesame Street when they answer the characters' questions. Educational TV makes the biggest difference for children whose homes are the least intellectually stimulating.

What You Can Do:

Naturally, children learn more when they watch TV or use apps with a parent. Content matters, a lot. All programs educate kids about something, but stick with ones that are designed to teach children stuff they should actually know like language and math.
Regardless of content, cap your child's electronic entertainment time at 1 hour a day from age 18 months to age five.
Remember, too, TV is still TV whether you actually watch it on a TV screen or on a mobile phone or computer.

Additional Information & Resources:

• How to Make a Family Media Use Plan
• Language Delays in Toddlers: Information for Parents
• Parents of Young Children: Put Down Your Smartphones
• How Do Infants Learn? 
• Media and Young Minds (AAP Policy Statement)​

About Dr. Hill:

Pediatrician David Hill, MD, FAAP, is Vice President of Cape Fear Pediatrics in Wilmington, NC, and Adjunct Assistant Professor of Pediatrics at UNC Medical School. He serves on the executive committees of the North Carolina Pediatric Society and the American Academy of Pediatrics Council on Communications and the Media. Dr. Hill won the Independent Book Publishers Association Benjamin Franklin Award in 2013 for Dad To Dad: Parenting Like A Pro. He serves as a consultant on child care issues for local and national radio, television, and internet-based media. He lives in Wilmington, North Carolina with his wife, three children, and two step children.

Author

David L. Hill, MD, FAAP

Last Updated

10/21/2016

Source

American Academy of Pediatrics (Copyright © 2016)

The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.