婴儿俯卧活动指南

doi:10.11852/zgetbjzz2024-0433

摘要/Abstract

摘要： 俯卧活动是指在成人的鼓励和看护下,婴儿清醒时俯卧并且不受限制地活动四肢和躯体。作为生命早期发育进程中婴儿能够移动身体前的一项重要身体活动方式,俯卧活动具有促进婴儿大运动和认知发展、预防位置性头颅畸形和超重肥胖等重要意义。近年来,世界卫生组织和全球多个国家发布的身体活动指南和共识对婴儿期俯卧活动做出了推荐,而我国尚无相关指南。首都儿科研究所联合运动科学、儿科学和儿童保健学领域的专家成立指南工作组,共同编写了《婴儿俯卧活动指南》。该指南是我国首个适用于1岁以下婴儿的俯卧活动指南,应用人群为婴幼儿养育照护相关从业人员和家长。《婴儿俯卧活动指南》遵循了婴儿运动发育规律,从俯卧活动指导原则、时间和频次、活动类型以及监测与评估等4个方面提出推荐,为婴儿科学和安全进行身体活动以满足其身体发育需求提供专业指导。

关键词: 俯卧活动, 身体活动, 指南, 婴儿

Abstract: Tummy time is defined as awake prone positioning with unrestricted movement of limbs, which is encouraged and supervised by adults. As one of the most important physical activities during early stages of life, tummy time plays a critical role in promoting gross motor and cognitive development, preventing plagiocephaly and decreasing overweight and obesity. Recently, the World Health Organization and many countries worldwide issued guidelines on tummy time for infants; however, there is no tummy time guideline in China. To fill in this gap, the Capital Institute of Pediatrics, together with experts from sports science, pediatrics and child health care, has jointly developed the Infancy Tummy Time Guideline. As the first tummy time guideline for infants under one year old in China, it aims to provide professional recommendations for both child care professionals and parents. The guideline raises recommendations from four aspects, including principles for tummy time, duration and frequency, types of tummy time activities, and monitoring and evaluation, which gives professional guidance on scientific and safe tummy time activities for infants to meet their developmental needs.

Key words: tummy time, physical activity, guideline, infants

中图分类号:

R179

吴琼, 王晓彤, 黄艺文, 张延峰, 杨玉凤, 张霆, 朱宗涵. 婴儿俯卧活动指南[J]. 中国儿童保健杂志, 2024, 32(8): 813-820.

WU Qiong, WANG Xiaotong, HUANG Yiwen, ZHANG Yanfeng, YANG Yufeng, ZHANG Ting, ZHU Zonghan. Infancy tummy time guideline[J]. Chinese Journal of Child Health Care, 2024, 32(8): 813-820.

参考文献

[1] 朱宗涵. 生命最初 1000 天: 改变一生, 改变未来[J]. 中国儿童保健杂志, 2011,19(8):681-682.
Zhu ZH. The first 1000 days of life: Change the life, change thefuture[J]. Chin J Child Health Care, 2011,19(8):681-682.(in Chinese)
[2] Perszyk DR, Waxman SR. Linking language and cognition in infancy[J].Annu Rev Psychol, 2018, 69:231-250.
[3] Ilyka D, Johnson MH, Lloyd-Fox S. Infant social interactions and brain development: A systematic review[J]. Neurosci Biobehav Rev, 2021,130:448-469.
[4] Zeng N, Ayyub M, Sun H, et al. Effects of physical activity on motor skills and cognitive development in early childhood: A systematic review[J]. Biomed Res Int, 2017, 2017:2760716.
[5] Laurent CW, Burkart S, Andre C, et al. Physical activity, fitness, school readiness, and cognition in early childhood: A systematic review[J]. J Phys Act Health, 2021, 18(8):1004-1013.
[6] 王晓彤,常佳慧,刘爱华,等. 婴儿期俯卧活动的研究进展[J]. 中国儿童保健杂志,2023,31(1):58-61.
Wang XT, Chang JH, Liu AH, et al. Research advances in tummy time during infancy[J]. Chin J Child Health Care, 2023,31(1):58-61.(in Chinese)
[7] Hewitt L, Kerr E, Stanley RM, et al. Tummy time and infant health outcomes: A systematic review[J]. Pediatrics, 2020,145(6):e20192168.
[8] Wen LM,Baur LA, Simpson JM, et al. Effectiveness of an early intervention on infant feeding practices and "tummy time": A randomized controlled trial[J]. Arch Pediatr Adolesc Med, 2011,165(8):701-707.
[9] Zhang Z,Predy M, Hesketh KD, et al. Characteristics of tummy time and dose-response relationships with development in infants[J]. Eur J Pediatr, 2023, 182(1):113-121.
[10] Carson V, Zhang Z,Predy M, et al. Longitudinal associations between infant movement behaviours and development[J]. Int J Behav Nutr Phys Act, 2022,19(1):10.
[11] Majnemer A, Barr RG. Association between sleep position and early motor development[J]. J Pediatr, 2006, 149(5):623-629.
[12] Carson V, Zhang Z,Predy M, et al. Adherence to Canadian 24-hour movement guidelines among infants and associations with development: A longitudinal study[J]. Int J Behav Nutr Phys Act, 2022,19(1):154.
[13] Dudek-Shriber L, Zelazny S. The effects of prone positioning on the quality and acquisition of developmental milestones in four-month-old infants[J]. Pediatr Phys Ther, 2007, 19(1):48-55.
[14] Russell, DC,Kriel H, Joubert G,et al. Prone positioning and motor development in the first 6 weeks of life[J]. S Afr J Occup Ther, 2009, 39(1): 11-14.
[15] Monson RM,Deitz J, Kartin D. The relationship between awake positioning and motor performance among infants who slept supine[J]. Pediatr Phys Ther, 2003,15(4):196-203.
[16] 王佳悦,姜艳蕊,金志娟,等. 俯卧位时间对婴儿运动发育的影响[J]. 临床儿科杂志,2021,39(11):851-854.
Wang JY, Jiang YR, Jin ZJ, et al. Study on the effect of prone time on motor development ininfants[J]. J Clin Pediatr, 2021, 39(11): 851-854.(in Chinese)
[17] Senju A, Shimono M, Tsuji M, et al. Inability of infants to push up in the prone position and subsequent development[J]. Pediatr Int, 2018, 60(9):811-819.
[18] 张玉彩,李文婷,刘洪根. 俯卧位对新生儿胃肠功能障碍治疗的临床效果观察[J]. 中国妇幼保健,2006,21(6):790.
[19] Koren A, Kahn-D'angelo L, Reece SM, et al. Examining childhood obesity from infancy: The relationship between tummy time, infant BMI-Z, weight gain, and motor development-An exploratory study[J]. J Pediatr Health Care, 2019, 33(1):80-91.
[20] Graham JM. Tummy time is important[J]. Clin Pediatr (Phila), 2006, 45(2):119-121.
[21] vanVlimmeren LA, van der Graaf Y, Boere-Boonekamp MM, et al. Risk factors for deformational plagiocephaly at birth and at 7 weeks of age: A prospective cohort study[J]. Pediatrics, 2007,119(2):e408- e418.
[22] Kim EH, Kim KE,Jeon J, et al. Delayed motor development and infant obesity as risk factors for severe deformational plagiocephaly: A matched case-control study[J]. Front Pediatr, 2020, 8:582360.
[23] Hewitt L, Stanley RM,Okely AD. Correlates of tummy time in infants aged 0-12 months old: A systematic review[J]. Infant Behav Dev, 2017,49:310-321.
[24] Changing concepts of sudden infant death syndrome:Implications for infant sleeping environment and sleep position. American Academy of Pediatrics. Task force on infant sleep position and sudden infant death syndrome[J]. Pediatrics, 2000, 105(3 Pt 1):650-656.
[25] Loo BKG,Okely A, Taylor R, et al. Asia-pacific consensus statement on integrated 24-hour activity guidelines for the early years[J]. Lancet Reg Health West Pac, 2022, 32:100641.
[26] Tremblay MS,Chaput JP, Adamo KB, et al. Canadian 24-hour movement guidelines for the early years (0-4 years): An integration of physical activity, sedentary behaviour, and sleep[J]. BMC Public Health, 2017,17(Suppl 5):874.
[27] Draper CE,Tomaz SA, Biersteker L, et al. The south african 24-hour movement guidelines for birth to 5 years: An integration of physical activity, sitting behavior, screen time, and sleep[J]. J Phys Act Health, 2020,17(1):109-119.
[28] World Health Organization. Guidelines on physical activity, sedentarybehaviour and sleep for children under 5 years of age[EB/OL]. (2019-04-02) [2021-05-21]. https://www.who.int/publications/i/item/9789241550536
[29] Ministry of Health. Sitless, move more, sleep well: Active play guidelines for under-fives [EB/OL]. Wellington: Ministry of Health. 2017. (2017-05-31) [2022-05-01] https://www.health.govt.nz/publication/sit-less-move-more-sleep-well-active-play-guidelines-under-fives
[30] Alfawaz RA, Aljuraiban GS, AlMarzooqi MA, et al. The recommended amount of physical activity, sedentary behavior, and sleep duration for healthy Saudis: A joint consensus statement of the Saudi public health authority[J]. Ann Thorac Med, 2021, 16(3):239-244.
[31] Okely AD, Ghersi D, Hesketh KD, et al. A collaborative approach to adopting/adapting guidelines - The Australian 24-Hour Movement Guidelines for the early years (Birth to 5 years): An integration of physical activity, sedentary behavior, and sleep[J]. BMC Public Health, 2017, 17(Suppl 5):869.
[32] Reilly JJ, Hughes AR, Janssen X, et al. GRADE-ADOLOPMENT process to develop 24-hour movement behavior recommendations and physical activity guidelines for the under 5s in the United Kingdom, 2019[J]. J Phys Act Health, 2020, 17(1):101-108.
[33] College of Paediatrics & Child Health, Singapore Academy of Medicine, Singapore. Singapore Integrated 24-Hour Activity Guidelines for Early Childhood (0-6 years) [EB/OL]. (2021-10) [2023-12-01] https://www.cfps.org.sg/assets/1-Circular-for-GPs/7-CPCHS-Singapore-Integrated-24-Hr-Activity-Guidelines-for-Early-Childhood-2021-Main.pdf
[34] 《中国人群身体活动指南》编写委员会. 中国人群身体活动指南(2021)[J]. 中华流行病学杂志,2022,43(1):5-6.
Composing and Editorial Board of Physical Activity Guidelines for Chinese. Physical activity guidelines for Chinese (2021)[J]. Chin J Epidemiol, 2022, 43(1):5-6.(in Chinese)
[35] Huang Y, Wang X,Meng N, et al. Suboptimal status of tummy time for infants in early childhood education institutions in urban China: A cross-sectional study[J]. J Glob Health 2024;14:04048.
[36] Kadey HJ, Roane HS. Effects of access to a stimulating object on infant behavior during tummy time[J]. J Appl Behav Anal, 2012, 45(2):395-399.
[37] Silva BFVE, Sampaio SSS, Moura JR, et al. "I am afraid of positioning my baby in prone": Beliefs and knowledge about tummy time practice[J]. Int J Pediatr, 2023, 2023:4153523.
[38] Felzer-Kim IT, Erickson K, Adkins C, et al. Wakeful prone "tummy time" during infancy: How can we help parents[J]? Phys Occup Ther Pediatr, 2020, 40(6):651-668.
[39] Zhang Z,Predy M, Hesketh KD, et al. Demographic correlates of movement behaviors in infants: A longitudinal study[J]. J Phys Act Health, 2022, 19(3):177-185.
[40] Buchanan L,Xu H, Hewitt L, et al. A longitudinal analysis examining the associations of tummy time with active playtime, screen time, and sleep time[J]. J Phys Act Health, 2021,18(10):1215-1222.
[41] 0岁～6岁儿童发育行为评估量表:WS/T 580-2017[S]. 2017.
[42] 塔尼亚·奥尔特曼.美国儿科协会育儿百科[M]. 7版.唐亚, 译. 北京:北京科学技术出版社, 2020:190-250.
[43] 朱宗涵,李晓南. 0~6自然养育百科[M].北京:中国人口出版社, 2022 : 234-236.
[44] 藜海芪.实用儿童保健学[M].北京:人民卫生出版社,2016:195-197.
[45] Shull ER,Dowda M, McIver KL, et al. Behavioral, environmental, and demographic factors associated with objectively measured physical activity in infants[J]. Child Obes, 2022,18(7):466-475.
[46] Bruijns BA, Truelove S, Johnson AM, et al Infants' and toddlers' physical activity and sedentary time as measured by accelerometry: A systematic review and meta-analysis[J]. Int J Behav Nutr Phys Act, 2020,17(1):14.
[47] Hewitt L,Frohmuller C, Wen LM, et al. Effect of a multicomponent intervention in postnatal mothers' groups on meeting the Australian physical activity guidelines for infants: Protocol for a randomised controlled trial[J]. BMJ Open, 2022, 12(4):e054183.