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13 Apr 2016
嬰兒便便知健康
註冊中醫師 彭明慧
正常嬰兒糞便的味道一般為甘酸味,毫無惡臭。嬰幼兒糞便的次數和性質反映著胃腸道的生理與病理狀態,故糞便檢查極為重要。正常大便含水分80%,其餘為黏液、細菌和食物的殘渣等。
【外觀】
嬰兒在出生首數天的大便稱作胎糞。胎糞的顏色一般是由墨綠色至近乎黑色,質地是十分黏稠。它是嬰兒在母體內時腸道積存的物質包括了羊水、脫落的皮膚細胞及其他身體的新陳代謝物等。這些色黑質黏的大便會緊黏在嬰兒的臀部。然而,若初生兒大便不通,中醫則稱此為「鎖肛」,意指嬰兒於出生後首數天內不排糞便而言。
常見證候:
胎熱壅結,大便不通:嬰兒出生後,首三天不排糞便,不食乳,煩擾多啼,哭聲宏亮,面赤唇燥,肚腹脹滿,小便短赤,指紋紫滯。
胎稟不足,大便不通:嬰兒出生後,首三天無糞便,神疲氣怯,哭聲低微,面色蒼白,指紋隱淡。
嬰兒在出生從第三至四天開始,由於胎糞在此時已大致完全排出體外,而且嬰兒的脾胃功能也開始啟動,隨著餵哺的次數和份量開始增多,他們大便的顏色便會開始變化:
全母乳餵哺的嬰兒大便顏色通常都比較淺,由淺黃色、芥末黃色至橙色不等;而質地會較稀軟一點,一般都沒有渣滓成分。
飲用配方奶粉的嬰兒大便顏色通常會較深,由黃色、褐色至綠色不等;外觀通常比較「成形」,偶爾大便中會有一粒粒碎屑狀物體。這是由於奶粉中的其中成份或始終尚未完全能讓嬰兒能完全消化和吸收。
【次數】
嬰兒大便的也是會隨着他們的年齡和飲食而有所不同。初生嬰兒的大便次數會較多;到了大約一個月後,大便的次數便會開始減少,之後會維持一個較穩定的次數,直至開始進食固體食物時,大便的次數或會再次改變。
純母乳餵哺的嬰兒:於初生時期可以每吃一頓就大便一次,甚至兩次。以他們平均每天(二十四小時計)餵食母乳十至十二次來計算,他們每天可以有十至十多次大便。
飲用配方奶粉的嬰兒:他們大便次數一般會較少。這是因為配方比較難消化,所以逗留在腸道的時間會較長,以一天平均飲用配方六至八次的嬰兒來說,大便的次數可以由一至五、六次不等,亦有些嬰兒兩三天才有一次大便。
【顏色】
灰白色:
若嬰兒的皮膚同時出現發黃,甚至連「眼白」也帶黃,這些是黃疸的現象,可能是因為肝膽功能出現問題,也可能是先天性膽管結構異常。
柏油色:
胃腸道上部出血。
帶血絲、黏液和膿液:
可以是發熱的症狀,又或是患上細菌性腸胃炎的症狀,多見於痢疾、腸炎、腸息肉、腸套疊、肛裂等。
當嬰幼兒出現便秘現象時,中醫會認為是「脾常不足」,即消化吸收能力較弱時的症狀。因為0至1歲的嬰幼兒消化系統尚未發育熟成,又或是本身其脾胃天生較虛,當受到一些外來因素影響時,就容易有消化吸收不佳、排便不順的情況發生。
很多父母會擔心讓嬰幼兒喝中藥會過於太早,故此在此與大家分享一些簡單的推拿手法:
1. 瀉大腸(緩解便秘):
便秘屬大腸經有火、有偏燥熱的情況,故有便秘等症狀。
做法:沿嬰幼兒食指外側至虎口的這一段距離,從虎口往食指尖的方向去推動。
次數:每日約可推拿約100至200次。
2 補脾經(健脾固本):
增強體內代謝作用,針對大便不硬但虛弱無力解便,體瘦乏力的便秘情況。
做法:將嬰幼兒的大拇指伸直,順時針旋轉推動拇指螺紋面,並由大拇指螺紋面自拇指尖向指跟方向直線內推動。
次數:每日約可推拿約200至300次。
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