Khong nen lay trong luong cua con lam muc tieu phan dau

Huong dan nau an cho tre tai Trung tam Dinh duong TP.HCM - Anh: L.TH.H.

Theo so lieu cua Trung tam Dinh duong TP.HCM, co khoang 30-40% tre 2-3 tuoi bieng an. Da so tre bieng an la do cha me thieu kien thuc cham soc tre, cach cho tre an va lam thuc an cho tre. “O nhieu gia dinh, bua an cua tre tro thanh mot cuoc chien trien mien ma cac ben deu bi thuong ton” - bac si Nguyen Thi Kim Hung - giam doc Trung tam Dinh duong TP.HCM - da mo dau buoi trao doi voi TT nhu vay.

+ Thua bac si, vi sao tre lai bieng an?

- Nguyen nhan tre bieng an rat phuc tap, da dang va co nhieu. Tuy nhien, co mot so nguyen nhan co ban sau: tre bieng an do nguyen nhan tam ly xa hoi; do benh ly (tre sap benh, dang benh, vua benh xong; do bi trao nguoc, bi sut moi che vom an uong kho khan); do tre thieu sat, kem, lysin; cung co khi do bieng an bam sinh; do che do an khong hop ly, don dieu qua; bieng an do... cha me (cha me nghi la tre bieng an chu that su tre khong bieng an, hoac thay con minh nhe ky, an it hon con hang xom thi lo lang va ep con an).

Trong cac nguyen nhan tren, nguyen nhan tam ly xa hoi la quan trong nhat, thuong gap nhat. Do cuoc song hien qua nhieu cang thang, nhieu bac cha me di lam, ban biu suot ngay, it co thoi gian danh cho con cai khien tre bi thieu tinh thuong va dieu nay co the khien tre bi bieng an.

Can luu y rang neu an uong la vui ve, la thoi diem hap dan, la co hoi giao tiep thi se hinh thanh nhung thoi quen an uong tot sau nay cho tre. Con neu an uong la chuyen gi do lanh nhat, la bao luc, la du do mua chuoc, doa dam... thi tre khong the an ngon mieng duoc. Thuong nguoi lon gio du tro voi dua tre de ep buoc no an ma khong biet rang tuy tre chua biet noi hoac khong noi ra, nhung tre cam nhan duoc het nhung thai do va hanh vi nay cua cac bac cha me.

Do la nhung nguyen nhan ve mat tam ly xa hoi tao nen hanh vi an uong sai lech o tre. Khi thoi quen an uong nay keo dai thi be bat dau thieu chat, ma khi thieu chat thi cang lam tang su bieng an. Tu bieng an tre de roi vao suy dinh duong. Tu suy dinh duong tre lai de bi benh, ma khi benh lai tiep tuc bieng an hon nua.

+ Hien nay co thuoc gi de tang can cho tre khong, thua bac si?

- Den nay cac chuyen gia ve dinh duong tren the gioi van noi rang ai tim duoc thuoc that su chong bieng an se trao giai Nobel cho nguoi do. Nhung thuoc ma ai do dang dung cho tre khong phai la thuoc chong bieng an.

+ Viec dieu tri mot tre bieng an phai bat dau tu dau?

- Dieu tri mot dua be bieng an rat phuc tap. Muon dieu tri hieu qua, nguoi thay thuoc, chuyen gia dinh duong phai tim hieu ky o nhieu goc do de tim ra dau la nguyen nhan chinh khien tre bieng an. Nhieu khi cung phai cho tre uong thuoc de giai quyet tinh trang suc khoe, benh ly truc tiep. Tuy nhien do cung chi la dieu tri trieu chung, cai goc van la phai giai quyet nguyen nhan tam ly xa hoi, moi truong an uong...

O goc do tam ly xa hoi, ngoai viec mua nhung thuc an bo duong, che bien thuc an ngon va hap dan, con phai tao mot khong khi an uong vui ve, co hoi tiep xuc cho tre, ton trong so thich an uong cua tre. Khong nen lay trong luong cua con lam muc tieu phan dau, dieu do vua sai lam vua rat nguy hiem. Nhung tre khong map nhung khoe manh, hoat bat, thong minh van hon tre map map nhung cham chap, kem nhanh nhen...

+ Lam the nao de tre tang can tot, thua bac si?

- De tre co the tang can tot thi nang luong cung cap (do an thuc uong hang ngay cho tre) phai vuot nang luong tieu hao.

Muon tang nang luong cung cap co nhieu cach. Tang them bua, neu tre an qua it bua: 2-3 bua/ngay. O tre nho, ngoai bua an chinh be con phai duoc an them 2-3 bua phu. Nhung truoc bua an chinh mot tieng thi khong nen cho tre an uong gi het. Tang them thuc an vao tung bua an cho tre. Co the tre chi an het nua chen com, nhung co the cho tre an them mot qua trung luoc hoac cu khoai lang nho, chum nhan, vai cai banh, nua cai banh bao hay trai chuoi... Tang dau mo trong bua an chinh de tang nang luong cung cap cho tre. Hoac co the cho tre dung thuc pham cao nang luong nhu sua, bot dau cao nang luong (mot chen bot dau cao nang luong bang bon chen bot dau thong thuong).

Ngoai ra, cung co the khong tang cung cap nhung giam tieu hao thi tre cung tang can. Tre tieu hao nhieu nhat la khi van dong, bi cac benh lat vat nhu tieu chay, cam cum, viem hong, san lai nhieu. Vi vay, ngoai cung cap du nang luong phai thuong xuyen giu gin ve sinh cho tre, xo lai dinh ky (tre tren 2 tuoi xo lai hai lan/nam).

LE THANH HA

Thuoc “map” la thuoc gi? Thuoc “map” dau tien la thuoc chong viem glucocorticoid, goi tat la corticoid. Thuoc corticoid gom nhieu thuoc: dexamethason (goi nom na la “dexa” hay thuoc “hat dua”), prednison, prednisolon... Ve phuong dien chua benh, corticoid la thuoc dung de chong viem, giam dau, tri cac benh xuong khop, cac benh tu mien... chu khong bao gio duoc su dung lam cho map. Chinh co the co ve nhu map ra va tang trong khi uong thuoc nay lien tuc va keo dai - ma mot so nguoi tuong la beo tot - la bieu hien mot tac dung phu nguy hiem cua thuoc. Ngoai tac dung phu gay beo phi, thuoc con co mot so tac dung phu nguy hiem khac.. Thuoc “map” thu hai thuong duoc dung la cyproheptadin. Day la thuoc khang histamin tri di ung, co them tac dung kich thich su them an. Thuoc nay co tac dung gian tiep tri chung chan an, lam cho nguoi dung thuoc an nhieu hon. Tuy nhien, cyproheptadin chi kich thich su them an tam thoi (khi dang dung thuoc thi an ngon mieng, luc ngung se chan an tro lai) va co nhieu tac dung phu: gay buon ngu, khong dung cho phu nu co thai, dang cho con bu, tre em duoi 2 tuoi, nguoi gia suy nhuoc, nguoi bi tang nhan ap, u tuyen tien liet, loet ta trang. Doi voi tre em, thuoc co the gay con co giat. Dac biet, can luu y them ve thuoc “dong y” gia mao rat thuong hay tron tan duoc corticoid, cyproheptadin de tao ra tac dung truoc mat: an duoc, ngu duoc, map ra, neu co dau nhuc la giam dau nhuc ngay. Cac thuoc nay thuong duoc quang cao chu tri “mat huyet, tri gay yeu, thieu mau, bieng an, mat ngu...” nhung lau ngay khong sao luong het duoc tac hai cho suc khoe. TS.DS Nguyen Huu Duc (Dai hoc Y duoc TP.HCM)