《千金》论云∶小儿宜用父故絮,女用母故絮为衣,勿用新绵及过浓,令壮热生
疮,发痫。又令筋骨缓弱。宜时见风日为佳。
乳者,奶也。哺者,食也。乳后不得便与食,哺后不得便与乳。小儿脾胃弱,
乳食相并,难以克化。周岁以上,必成乳癖、食癖,作热作疼,疳病从此始。丹溪
曰∶小儿肠胃薄窄,一切酸咸甜辣、鱼肉水果,湿面煎炒,俱是发热难化之物,皆
宜禁绝。只与熟菜白粥。非唯无病,且不纵口,可以养德。妇人无知,唯务姑息。
畏其啼哭,无所不与。积成痼疾,虽悔何及。乳母尤宜谨节。饮食下咽,乳汁便通。
情欲中动,乳脉便应。儿得此乳,疾病立至。不吐则泻,不疮则热。惊搐夜啼,口
糜腹痛诸疾,所由来矣。病之初来,其溺必少,便须询问,随证治母,可消患于未
形也。乳母亦不宜用狐臭、瘿 、喘嗽、疥癣、头疮、聋哑、 鼻、痫证之人。
《肘后》云∶儿生三日,宜助谷神。碎米作饮如乳,与儿大豆许,令咽之。频与三豆许。三七日可哺。
《千金》云∶儿哺早,不胜谷气,令头面体生疮,愈而复发, 羸难养。一月后,
虽哺勿多。不嗜食,勿强与之。宝鉴云∶儿五十日,可哺如枣核。百日弹丸。早晚
二哺。莫当风解衣澡浴,及带哭而乳,冒冷而哺。又不可在神佛驴马畔及各房异户,皆令儿为病。
钱乙云∶惜儿过当,三两岁犹未饮食,致脾胃弱,一生多病。半年后,宜煎陈
米稀粥时与之。十月后,渐与稠粥助中气,自然易养少病。
《外台》崔氏∶初哺儿,用平定成日,丑、寅、辰、巳、酉日吉。男忌戊、己,女忌丙、丁日。
小儿四、五岁,当断乳而不肯断者,(宜画眉膏。)断后,肉食宜少少渐进,则无疳癖之患。
田氏曰∶大凡小儿过暖生热,热极生风。提抱生痈,喂饲生癖。盛夏浴后,勿
即乳儿,儿啼勿即与乳,令儿成胃毒,或秋成痢。浴后良久,身体燥,儿啼后,俟
气息平,方可乳。盛啼即乳,多令气逆成呃。
《千金》论曰∶乳儿勿过饱,饱则溢而吐。若乳来多猛,取出 后再乳,或先捏
去宿汁乳之。乳母欲寐,当以臂枕儿头与乳平。母欲睡熟,即夺其乳。恐其不知饱
足,亦成呕吐。父母交合,儿卧于侧,或惊起,勿与乳。盖气乱未定,亦能害儿。
《颅囟经》曰∶夏不去热乳,令儿呕吐。冬不去寒乳,令儿泻痢。侵早乳儿,皆
须捏去宿乳。乳汁勿投于地。虫蚁食之,令乳无汁。宜沃东壁上。
张涣曰∶乳母须每日三时摸儿项后风池。若壮热者,即须熨之,使微汗即愈。
(风池在头项筋两辕之边。)切不可妄针灸,亦不可辄吐下。盖针灸伤儿经络,吐下动儿脏腑也。
婴儿半岁,尻骨已成,乳母当教儿学坐。二百日外,掌骨成,教令地上匍匐。
三百日,膑骨成,教令独立。周岁,膝骨成,教令行步。此皆一定之法。世人惜儿,
怀抱过时,柔痿筋骨,为害非浅。
《千金方》论述说:小儿适宜用父亲旧时的棉絮做衣服,女儿则用母亲旧时的棉絮做衣服,不要使用新棉花以及过厚的棉衣,以免导致身体壮热、生疮,甚至引发癫痫。又会使筋骨松弛软弱。适宜时常让小儿接触风和阳光为佳。
“乳”指的是奶,“哺”指的是食物。喂奶后不能立刻喂食,喂食后不能立刻喂奶。小儿脾胃虚弱,乳汁和食物同时进入体内,难以消化。满周岁以后,必然形成乳癖(因乳汁停滞形成的积块)、食癖(因食物停滞形成的积块),出现发热疼痛,疳病(小儿慢性消耗性疾病)也就从此开始。朱丹溪说:小儿肠胃薄弱狭窄,一切酸咸甜辣、鱼肉水果、湿面煎炒的食物,都是容易发热且难消化的东西,都应当禁止食用。只给吃熟菜和白粥。这不仅能无病,而且能防止放纵口腹之欲,可以培养品德。妇人无知,只知道一味姑息纵容。害怕孩子啼哭,什么都给。久而久之积成顽固疾病,即使后悔也来不及了。乳母尤其应当谨慎节制饮食。饮食咽下后,乳汁就会通畅传递。情欲冲动时,乳脉就会响应。婴儿得到这种乳汁,疾病立即到来。不是呕吐就是腹泻,不是生疮就是发热。惊风抽搐、夜间啼哭、口腔糜烂腹痛等各种疾病,就是这样产生的。疾病刚发生时,小便一定少,必须询问清楚,根据症状治疗乳母,可以在隐患未显现时就消除它。乳母也不宜选用患有狐臭、瘿瘤(甲状腺肿大)、喘咳、疥癣、头疮、聋哑、鼻渊(鼻窦炎)、癫痫等疾病的人。
《肘后备急方》说:婴儿出生三天,应当帮助建立谷神(脾胃功能)。将碎米煮成如乳汁般的流质饮料,给婴儿吃大豆大小的量,让其咽下。频繁给予三颗豆子的量。到三七二十一天时可以开始喂食固体食物。
《千金方》说:婴儿过早添加辅食,无法承受谷气,会导致头面部及全身生疮,痊愈后又复发,身体瘦弱难以养育。一个月后,虽然可以喂食也不要过多。如果不爱吃,不要强迫喂食。《铜人腧穴针灸图经》说:婴儿五十天,可以喂食像枣核大小的食物。一百天时像弹丸大小。早晚各喂两次。不要在风口处解开衣服洗澡,也不要带着哭声喂奶,不要在受冷时喂食。也不要在神佛、驴马旁边以及各个房间不同门户的地方,都会导致婴儿生病。
钱乙说:过分爱惜孩子,到了两三岁还不让进食,导致脾胃虚弱,一生多病。半年后,应当煎煮陈米稀粥时常给孩子喝。十个月后,逐渐给予稠粥以助中气,自然容易养育且少病。
《外台秘要》记载崔氏的观点:刚开始给婴儿添加辅食时,应选择平定之日,丑、寅、辰、巳、酉日为吉利。男孩忌讳戊、己日,女孩忌讳丙、丁日。
小儿四、五岁时,应当断奶但不肯断的,(适宜使用画眉膏辅助断奶)。断奶后,肉类食物应少量逐渐增加,这样就不会有疳癖的祸患。
田氏说:大凡小儿穿得过暖产生内热,热极生风。抱持过多生痈疽,喂养不当生积癖。盛夏洗澡后,不要立刻喂奶,婴儿啼哭时不要立刻喂奶,否则会导致婴儿形成胃毒,或者秋天变成痢疾。洗澡后很久,身体干燥,婴儿啼哭后,等到气息平稳,才可以喂奶。剧烈啼哭时立刻喂奶,多会导致气逆形成呃逆。
《千金方》论述说:喂奶不要让婴儿过饱,过饱则会溢出而呕吐。如果乳汁来得又多又猛,应先挤出一些再喂,或者先捏去存留的陈旧乳汁再喂。乳母想睡觉时,应当用手臂枕着婴儿的头使其与乳房持平。如果母亲想睡熟,就要把乳头夺出来。恐怕婴儿不知道吃饱,也会造成呕吐。父母行房事时,婴儿睡在旁边,或者惊醒起来,不要喂奶。因为此时气机紊乱未定,也能伤害婴儿。
《颅囟经》说:夏天不除去热气的乳汁就喂,会导致婴儿呕吐。冬天不除去寒气的乳汁就喂,会导致婴儿泻痢。清晨喂奶,都必须捏去存留的陈旧乳汁。乳汁不要滴在地上。虫蚁吃了乳汁,会导致乳母无乳汁分泌。适宜泼在东边的墙壁上。
张涣说:乳母必须每天三个时辰抚摸婴儿项后的风池穴。如果出现壮热,就必须熨烫该处,使微微出汗即可痊愈。(风池穴位于头项部筋脉两侧的凹陷处。)切不可胡乱针灸,也不可随意使用催吐或泻下的方法。因为针灸会损伤婴儿的经络,催吐和泻下会扰动婴儿的脏腑。
婴儿半岁时,骶骨已经长成,乳母应当教婴儿学习坐立。二百天以后,掌骨长成,教令在地下爬行。三百天时,髌骨长成,教令独立站立。周岁时,膝骨长成,教令行走迈步。这都是固定的法则。世人爱惜孩子,怀抱时间过长,导致筋骨柔弱萎缩,危害非浅。
The *Qianjin Fang* (Essential Prescriptions Worth a Thousand Gold) discusses: Infants are suitable for wearing clothes made from the father's old cotton wadding, and daughters should use the mother's old cotton wadding. Do not use new cotton or overly thick clothing, as this may cause intense heat, sores, and even epilepsy. It may also lead to laxity and weakness of muscles and bones. It is best for infants to be exposed to wind and sunlight regularly.
"Ru" (Breast milk/Nursing) refers to milk; "Bu" (Complementary feeding/Solid food) refers to food. After nursing, one must not immediately give food; after giving food, one must not immediately nurse. Infants have weak spleen and stomach; if milk and food enter the body simultaneously, they are difficult to digest. After reaching one year of age, "Ru Pi" (Milk accumulation/patency due to milk stasis) and "Shi Pi" (Food accumulation/patency due to food stasis) will inevitably form, causing fever and pain, and "Gan disease" (Pediatric malnutrition syndrome) begins from here. Zhu Danxi said: Infants' intestines and stomachs are thin and narrow. All sour, salty, sweet, spicy foods, meat, fish, fruits, wet flour, fried, and roasted items are substances that easily generate heat and are hard to digest; all should be strictly prohibited. Only provide cooked vegetables and white rice porridge. This not only prevents illness but also prevents indulgence in taste, thereby cultivating virtue. Women who lack knowledge often indulge in excessive leniency. Fearing the infant's crying, they give everything. Over time, this accumulates into chronic diseases, and regret comes too late. The lactating mother especially should exercise caution and moderation in diet. Once food is swallowed, breast milk flows freely. When sexual desire arises, the breast meridians respond. If the infant receives such milk, disease arrives immediately. It results either in vomiting or diarrhea, either in sores or fever. Diseases such as convulsions, night crying, oral thrush, and abdominal pain originate from this. At the onset of illness, urine output is necessarily low; one must inquire carefully and treat the mother according to symptoms, eliminating the隐患 (hidden danger) before it manifests. Lactating mothers should not be chosen from those suffering from bromhidrosis (fox odor), goiter (Ying Liu), asthma/cough, scabies/tinea capitis, scalp sores, deafness/muteness, rhinorrhea (Bi Yuan), or epilepsy.
The *Zhou Hou Bei Ji Fang* (Handbook of Prescriptions for Emergencies) states: On the third day after birth, one should assist the "Gu Shen" (Grain Spirit, referring to Spleen/Stomach function). Grind rice into a drink resembling milk, give the infant an amount the size of a soybean to swallow. Repeat frequently with amounts the size of three beans. By twenty-one days (3x7), solid feeding can begin.
The *Qianjin Fang* states: Early introduction of complementary feeding overwhelms the infant's ability to handle "Gu Qi" (Grain Qi/Food energy), causing sores on the head, face, and body. These sores heal but recur, leading to emaciation and difficulty in nurturing. After one month, although feeding is permitted, do not overfeed. If the infant does not desire food, do not force it. The *Tong Ren Shu Xue Zhen Jiu Tu Jing* (Illustrated Manual of Acupoints) states: At fifty days, feed an amount the size of a date pit. At one hundred days, the size of a small ball. Feed twice daily, morning and evening. Do not undress and bathe in the wind, nor nurse while crying, nor feed when cold. Also, avoid locations near deities, Buddhas, donkeys, horses, or different rooms/households, as these can cause illness in the infant.
Qian Yi stated: Excessive doting leads to infants aged two or three still not eating, resulting in weak spleen and stomach and lifelong illness. After six months, boil old rice into thin porridge and offer it frequently. After ten months, gradually introduce thick porridge to support Middle Qi (Spleen/Stomach energy); naturally, the child becomes easier to raise and falls ill less.
Cui Shi, recorded in the *Wai Tai Mi Yao* (Important Essential Formulas Preserved by the Imperial Library): When first introducing complementary feeding, choose auspicious days: Chou, Yin, Chen, Si, and You days are favorable. Boys should avoid Wu and Ji days; girls should avoid Bing and Ding days.
When infants are four or five years old and refuse to wean, (use Huamei Gao/Plum Drawing Ointment to assist weaning). After weaning, meat should be introduced in very small amounts gradually, avoiding the risk of Gan and Pi syndromes.
Tian Shi said: Generally, infants overheated by excessive clothing develop internal heat; extreme heat generates Wind. Excessive carrying causes carbuncles; improper feeding causes food stagnation. After bathing in midsummer, do not nurse immediately. Do not nurse when the infant cries, as this may cause "Wei Du" (Stomach Toxicity) or dysentery in autumn. Wait until long after bathing when the body is dry, and after crying subsides and breathing stabilizes, then nurse. Nursing during intense crying often causes Qi rebellion and hiccups.
The *Qianjin Fang* discusses: Do not overfeed the infant; overfeeding causes overflow and vomiting. If milk flow is too vigorous, extract some first before nursing, or pinch out retained old milk before nursing. If the lactating mother feels sleepy, she should prop the infant's head with her arm to align with the breast. If the mother falls into deep sleep, remove the nipple. Otherwise, the infant may not realize satiety, leading to vomiting. During parental intercourse, if the infant is sleeping nearby or wakes up startled, do not nurse. The Qi is chaotic and unsettled, which can harm the infant.
The *Lun Xin Jing* (Classic of the Cranial Fontanelle) states: In summer, nursing without removing hot milk causes vomiting. In winter, nursing without removing cold milk causes diarrhea and dysentery. For early morning nursing, one must always pinch out retained old milk. Do not drip milk on the ground. If insects and ants consume it, the lactating mother will cease producing milk. It is appropriate to splash it on the eastern wall.
Zhang Huan stated: The lactating mother must massage the Fengchi acupoint behind the infant's neck three times daily. If there is intense heat, moxibustion/warming should be applied to induce slight sweating for recovery. (Fengchi is located at the sides of the tendons in the head and neck junction.) One must absolutely not perform random acupuncture or moxibustion, nor arbitrarily use emetics or purgatives. Acupuncture and moxibustion damage the meridians, while emetics and purgatives disturb the Zang-Fu organs.
At half a year of age, the sacral bone is formed; the lactating mother should teach the infant to sit. After two hundred days, the palmar bones are formed; teach crawling on the ground. At three hundred days, the patellar bones are formed; teach standing independently. At one year, the knee bones are formed; teach walking. These are fixed principles. People who dote on their children hold them too long, leading to soft and atrophied muscles and bones, causing significant harm.