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This article states that about 3–13 % of infants display symptoms of functional constipation. These symptoms may cause parents to worry, and drive them to seek medical advice. Functional constipation is often observed in infants, especially when switching from breast milk to artificial feeding or to solid food. In this case, the younger the child, the higher the risk of anatomical or organic causes, although the incidence of functional constipation reaches 97 % of all cases of constipations in children. This article discusses the feasibility and effectiveness of diet therapy and medical treatment of functional constipation.

Two hundred [200] mothers consecutively attending Al-Fateh Paediatric Hospital, Benghazi in 1992 were interviewed. The majority of women were under 30 years of age, had primary or no education, were housewives, had no experience of pregnancy wastage or child loss, used no contraception, had one to three living children, had information about breast-feeding from the mother-in-law, a relative or a neighbour, considered breast-feeding a natural way, nutritionally superior and hygienic, and practised mixed feeding. The reasons for introducing artificial feeding were maternal in 49.7% of cases, filial [related to the baby] in 36.5% and due to social pressure in 13.8%. Measures for successful breast-feeding are emphasized

Background: Breast milk has nutritional, anti-allergic, anti-infective, defensive, developmental, psychological and socio-economic proprieties for both mother and infant. So, exclusive breast-feeding (EBF) is a unique source of feeding during the first six months of an infant’s life. Though the numerous proprieties of breast milk, the median duration of EBF in Egypt is 1.8 months making the identification of risk factors a high priority. The aim was to assess factors affecting mothers' choice of artificial feeding postpartum and during the first six months of infant life. Design; A descriptive cross –sectional exploratory was used. Sample: A purposive sample of 365 mothers were chosen. Tools: I- Socio demographic questionnaire. II- Anthropometric measurements. III- Factors of artificial feeding questionnaire. Results; the rate of EBF is very low as 80% of mothers gave artificial feeding, while only 20% gave mixed feeding. Artificial feeding was associated significantly with socio demographic characteristics as 44.7 % are in age group 20 - < 30 years and 30.1% are read and write. Regarding maternal factors, 60 % of the mothers have insufficient time. Likewise, 85.2 % of the mothers have feeling of need to teach infant to eat and 74.8 % of them had previous experience of artificial feeding. Regarding feeding practices, 70 % gave babies pre-lacteal fluids. Conclusion; Timely initiation and pattern of breastfeeding at Minia is unsatisfactory as 80 % of the participant mothers did not apply WHO recommendations attributed significantly to specific socio-demographic characteristics of infant/ mother, maternal, environmental, infant and health care services factors. Recommendations; Pre natal and post natal education of mothers to achieve longer duration of breast feeding and overcoming maternal, infant and environmental barriers. Provide continuous training of health care providers on EBF importance at all levels.

Mother’s milk is the most suitable product for feeding a newborn baby, its uniqueness is obvious. However, there are situations when breastfeeding is not possible at all or its volume is limited, so under certain circumstances mothers are forced to partially supplement or completely feed the child with an artificial formula. Although the composition of the ingredients in most modern formula feeds is similar, there are nevertheless differences in their composition and in the processing of the ingredients in the formula. In addition, the child may have individual taste preferences as well as unexpected negative reactions to any adapted milk formula. This review presents the achievements of recent years in creating adapted goat’s milk-based formulas for feeding newborns and first-year infants. Goat’s milk-based formulas have a number of advantages over cow’s milk-based formulas. One of the representatives of modern artificial formulas are those containing goat’s milk, which is characterized by low α-s1-casein genotype and high β-lactoglobulin content, which provides easier protein digestibility, contributes to more comfortable digestion and better absorption. Knowledge of the biological and nutritional value of goat milk, taking into account the peculiarities of the gastrointestinal tract of newborns and their needs, made it possible to develop and introduce into the goat’s milk-based formula the DigestX lipid complex, which is a complex of vegetable oils with a high content of palmitic acid in the sn-2-position in the triglyceride molecule, which is similar to breast milk. Goat’s milk, compared to cow’s milk, contains 4-6 times more oligosaccharides, which retain their beneficial properties in the production of artificial goat’s milk formula.Recent scientific literature data is presented, including that from the standpoint of evidence-based medicine, proving the effectiveness and safety of artificial goat’s milk-based formulas. The necessity of consulting mothers, psychological support and practical assistance not only in breastfeeding, but also in artificial feeding is substantiated.

Prof. Carmichael says that doctors deal with less digestive disorders in breastfed babies than they do in formula-fed babies.

The objective of this study was to investigate the effects of maternal breastfeeding, artificial feeding, types of introduction of complementary food introduction and the use of bottle and pacifier on lip /tongue pressure and maximum molar bite force of school children. Thirty-five healthy children with mixed dentition (20 boys and 15 girls), aged 6-10 years, participated in this study. The children were evaluated based on anthropometry, electronic scale and portable stadiometer, feeding practices (breastfeeding, artificial feeding, introduction of complementary food), bottle and pacifier use, tongue and lips strength and molar bite force. The results were submitted to ANOVA (p

According to the Rome IV revision criteria, functional gastrointestinal disorders are defined as “disorders of the gut-brain axis interaction”. The expression of symptoms of functional gastrointestinal disorders varies from mild to extremely severe. Their presence causes anxiety of parents, can contribute to a decrease in quality of life, and lead to the formation of immediate and long-term consequences in the form of children’s health disorders. Often, mothers stop breastfeeding their babies, and numerous replacements of formulas are made. The recommendations include behavioral therapy and parental education as the first line of therapy. For correction of nutrition in children with functional gastrointestinal disorders, in the absence of data for intolerance of cow’s or goat’s milk proteins formulas based on goat’s milk may be recommended. In natural goat milk there are 14 kinds of oligosaccharides, and 5 of them are identical to breast milk oligosaccharides. The main serum protein of goat milk is α -lactalbumin. The dominating casein fraction of goat milk as well as breast milk is s-casein. Relatively high content of albumins contributes to the formation of softer, smaller clots and small loose flakes. On the Russian market, goat milk based formulas include products that meet all standards established for infant formulas. The article contains data on goat milk mixtures with an updated formula of protein component. All the formulas of this mixture have reduced the total amount of protein and increased the content of whey protein fraction. Instead of palm oil coconut oil was added to the mixture, while the fat component has not changed its structure, maintaining 42% beta-palmitate, doubled the content of docosahexaenoic acid. The lactose content has been increased, which makes the carbohydrate profile of the mixes closer to breast milk, where the lactose content reaches 95%. In accordance with modern requirements, there were changes in vitamin and mineral composition of formulas, the content of vitamins D3, C, B6, calcium and iron was increased. The effectiveness of this mixture has been studied in young children with functional disorders of the gastrointestinal tract. By the 4th week of taking the mixture, the number of children suffering from colic decreased by 42%, and regurgitation by 30%, there was an improvement in stool consistency. The mixture can be recommended not only for healthy children, but also for children with functional gastrointestinal disorders.

Shumna T. Ye., Levchuk-Vorontsova T. O. Diagnostic possibilities of determination of osteogenesis disorders in children born with low body weight. Journal of Education, Health and Sport. 2020;10(9):937-951. eISSN 2391-8306. DOI http://dx.doi.org/10.12775/JEHS.2020.10.09.114 https://apcz.umk.pl/czasopisma/index.php/JEHS/article/view/JEHS.2020.10.09.114 https://zenodo.org/record/4064924 The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019. © The Authors 2020; This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 20.08.2020. Revised: 01.09.2020. Accepted: 30.09.2020. UDК 616.71-053.2-06:616-056.25]-07 DIAGNOSTIC POSSIBILITIES OF DETERMINATION OF OSTEOGENESIS DISORDERS IN CHILDREN BORN WITH LOW BODY WEIGHT T. Ye. Shumna, T. O. Levchuk-Vorontsova Zaporizhzhia State Medical University, Zaporizhzhia, Ukraine Shumna T. Yе., MD, PhD, DSc, Professor of the Department of Faculty Pediatry, Zaporizhzhia State Medical University, Ukraine; 28А, Novgorodskaia street, Zaporizhzhia, 69076; Tel .:+380978541809, e-mail: tshumnaya72@gmail.com ID orcid 0000-0003-4926-1271 Levchuk-Vorontsova T.O., MD, Assistant of the Department of Children Diseases, Zaporizhzhia State Medical University, Ukraine; 28А, Novgorodskaia street, Zaporizhzhia, 69076; Tel .: +380674352467, e-mail: tatyana0702@gmail.com ID orcid 0000-0003-0557-6714 Abstract The work aims at studying the bone tissue mineral density in children born with low body weight, taking into account the dependence on the nature of feeding and polymorphism of the C/A gene polymorphism of COL1A1_1 collagen gene (rs1107946). Materials and methods. The study involved 74 children. Of these, 29 children born with the body weight of 1500-1999 g were in the observation group I; 25 children weighing 2000-2499 g - group II; 20 children with the body weight at birth of 2500 g - group III (control group). All children were under inpatient treatment at the Municipal Non-Profit Enterprise "City Children Hospital no. 5" of Zaporizhia City Council. Data on the type of breastfeeding of a child aged under 1 year were analyzed for all children. The study of bone tissue mineral density was performed at the age of 12-15 months using an ultrasonic bone sonometer (densitometer) Sunlight MINIOMNI) BeamMed Ltd., Israel. The examination was conducted at the Department of Faculty Pediatrics of the Zaporizhia State Medical University. Analysis of the results was performed by non-parametric statistics methods using the Statistica 13 software package. Ordinal descriptive statistics was used to calculate the average Z-score indicators. The non-parametric statistical method "2 × 2 Table", the Chi-square (df = 1) was used to compare the frequencies of desitometry indicators in different groups. Results. In general, among the examined children according to densitometry data, there were no changes in the skeletal system (Z-score 0.48 ± 1.20) in 64.86% of cases, but there were osteopenia (Z-score -1.8 ± 0 , 53) in 27.03% and osteoporosis (Z-score -3.5 ± 0.96) in 8.11%. But in the further analysis by groups, the average Z-score indicator in children of the group I was 0.37 ± 2.06, in children of the group II - -0.08 ± 1.59 and in children of the group III - 0.47 ± 1, 69. But in children of the group I with body weight at birth 1500-1999g, osteopenia was registered in 34.48% of cases; the group II (2000-24999 g) - in 28.00% of cases; the group III (2500 g and more) - in 15.00% of cases. Osteoporosis was found only among children of the groups I and II. Children of the group I mainly received artificial and mixed feeding. Children of the group II received approximately the same amount of natural and artificial feeding, much less often mixed one, and 50% of children of the group III were on natural feeding. The Z-score indicators less than -1SD were found in children with AA and CA genotypes. Osteopenia was significantly less common in children with the AA genotype of the C/A gene polymorphism of COL1A1_1 collagen gene (rs1107946), who received natural or mixed feeding than in children who were exclusively on artificial feeding (p˂0.05). Among children with the AA genotype who were breastfed, there were changes in bone tissue (63.64% of children had osteopenia and 22.73% had osteoporosis). Among heterozygotes who were on artificial feeding, osteoporosis was found in 12.5%. Children with the CA genotype on mixed feeding had a decrease in bone tissue density (osteopenia) in 33.33% of cases. Children with AA genotype who were breastfed and had osteopenia, these were children weighing up to 2500 g (groups I and II). Children with osteopenia on mixed breastfeeding weighed at birth up to 2000 g. Osteopenia in children receiving artificial feeding was found in children of all 3 groups: 50.00% - group I, 28.57% - group II and 21, 43% - group III. Osteoporosis in breastfed children was found only among children of the groups I and II. Conclusions. According to densitometry data, among all examined children, there were no changes in the skeletal system (Z-score 0.48 ± 1.20) in 64.86%, osteopenia was registered (Z-score - 1.8 ± 0.53) in 27.03% and osteoporosis (Z-score -3.5 ± 0.96) was registered in 8.11%. But in children of the group I with body weight at birth of 1500-1999g, osteopenia was registered in 34.48% of cases; in the group II (2000-24999) in 28.00% of cases; in the group III (2500 g and more) in 15.00% of cases. Osteoporosis was found only among children born weighing up to 2500 g. Children of the group I mainly received artificial (62.07%) and mixed (34.48%) feeding. Children of the group II received approximately the same amount of natural (40.00%) and artificial (44.00%) feeding, much less often mixed one. In the control group III, 50% of children were breastfed. Regardless of the type of feeding, no changes in bone tissue were detected in children with the CC genotype of the C/A gene polymorphism of COL1A1_1 collagen gene (rs1107946). The Z-scores indicators less than -1 SD were found in children with the AA and CA genotypes, and only among children with the AA genotype of polymorphism, who received natural or mixed feeding, osteopenia occurred significantly less frequently (30.00%) than among children who had exclusively artificial feeding (63.64%). Osteoporosis was detected only in children with the AA genotype (12.5%) who were on artificial feeding. Key words: children born with low body weight; premature babies; densitometry; osteoporosis; osteopenia; breastfeeding; artificial feeding; mixed feeding; C/A gene polymorphism of COL1A1_1 collagen gene (rs1107946).

Aquaculture is currently the foundation of the world's animal protein provider. The sustainability of this sector is greatly influenced by business governance which must prioritize environmentally friendly aspects. Nutrient enrichment waste and the spread of fish and other aquatic organisms are significant issues present in aquaculture systems throughout the world today, especially intensive aquaculture. The purpose of writing this article is to provide an overview of biofloc as a solution in overcoming environmental problems for a sustainable future aquaculture. Intensive aquaculture applies high density maintenance and artificial feeding. The system leads to environmental problems because a large amount of waste produced contains solids and nutrients that accumulate into pollutants that cause eutrophication and toxins for aquatic organisms. Biofloc technology is a new approach to reduce the waste of aquaculture activities. In this system, heterotrophic bacteria and algae are grown together in flocks under controlled conditions with no or minimal water exchange. Biofloc is a nutrient package that can be utilized directly by farm animals. Biofloc also acts as biocontrol. Biofloc technology can help overcome problems in intensive aquaculture.

Relevance: immunotropic effects of cholecalciferol are caused by vitamin-D-induced synthesis of antimicrobial peptides (AMP), in particular р-defensins. There are very few studies in pediatric clinical practice confirming the effect of vitamin D availability on AMP synthesis. Aim: analysis of the correlation between vitamin D availability and AMP production and assessment of the effect of cholecalciferol medication intake on defensin synthesis in young children. Materials and methods : 108 healthy children aged 1 month to 3 years were examined, of which 34 (31.5%) were adequately provided with vitamin D (calcidiol level over 30 ng/ml), 40 (37.0%) with insufficiency (20 to 30 ng/ml), 27 (25.0%) with vitamin D deficiency (10 to 20 ng/ml) and 7 (6.5%) with severe deficit (less than 10 ng/ml). In the presence of hypovitaminose of vitamin D the monthly course of cholecalciferol in doses of 2000-4000 lU/day was prescribed for correction, and in normal provision -prophylactic administration of 1000 IU/day. The indices of 25(ON)D, β1- and β2-defensins were determined three times. Results. On natural feeding, the rates of β1-defensin are 2.3 times (p

The article presents data on the prevalence of infant colic, etiological factors, diagnostic criteria, differential diagnosis and therapy with justification of approaches to the choice of formula in children on artificial feeding. When choosing a formula, it is necessary to take into account the compositional features aimed at overcoming the functional immaturity of the gastrointestinal tract, enteric nervous system, and the ongoing formation of the intestinal microbiome – the presence of a partially hydrolyzed protein, a reduced lactose content, the presence of prebiotics (fructooligosaccharides) and probiotics. The formula Similac Comfort is fully compliant. This formula additionally contains oligosaccharide of the breast milk 2 fucosillactose (2’-FL), 0.2 g / l – identical to that found in breast milk, which has proven positive effects in the form of an immunomodulating effect, anti-infectious effect, is involved in the regulation of growth and maturation of intestinal epithelial cells, in the development of the nervous system.

The aim of this work was to study the level of nutritional knowledge of mothers about breast and artificial feeding, sources of nutritional knowledge of mothers was also studied. This cross-sectional study was conducted on 200 mothers, selected randomly from urban and rural areas in Sharkia Governorate, Egypt during the period from March to May, 2019. All mothers filled a questionnaire to evaluate their knowledge about breast and artificial feeding. The results showed that the highest percentage of working and housewives mothers (50.0 and 53.1%) were aged 25-32 years old, respectively. About 65.8 and 46.3% of the working mother and housewives mothers were from urban area, respectively. The majority of working mothers were educated. The results revealed that the majority of working and housewives mothers (97.5 and 92.1%) were married. The results indicated that the children sex was 63.2% male and 36.8% female for working mothers. Whereas, they were 46.9% male and 53.1% female for housewives. It is obvious that the 57.9% of working mothers had children their age were (576-850) days. Whereas, the highest proportion of housewives (37.7%) had children their age was 25-300 days. The results indicated that the percentage of good nutrition children was 97.5 and 89.5% of housewives and working mothers, respectively. The results declared that the working and housewives mothers get nutritional knowledge by percent 63.2 and 46.3% from visiting doctor, respectively. The results illustrated that the highest percentage of working and housewives mothers (84.2 and 60.5%) had low level of general knowledge about breast feeding. Also, most of working and housewives mothers (76.3 and 62.3%) had low level of general knowledge about artificial feeding. It can be concluded that the most of subjects had low level of knowledge about breast and artificial feeding. Therefore, the recommendions are the use of programs to raise awareness for mothers about breast and artificial feeding.

In the article, the authors cite modern data on the frequency of Caesarean section in obstetric practice, report the peculiarities of adaptation of children born by Caesarean section surgery, which is characterized by a high frequency of borderline conditions, pathological loss of body weight, functional disorders of the gastrointestinal tract, higher morbidity in the subsequent period. In addition, the authors note that mothers of these children are more likely to have hypogalactia, which is largely responsible for impaired adaptation in infants and their transfer to artificial feeding. Referring to the published works, the authors offer various options to improve the process of adaptation in this contingent of children.

Background.The prevalence of symptoms of life-threatening events in infants was previously studied using hospital data. However, not all parents in the event of such symptoms seek medical help in the hospital.Objective.Our aim was to identify the prevalence and risk factors of life-threatening events in infants in the first year of life.Methods.In the period from November 2017 to February 2018, we interviewed mothers who have children in their second year of life who are registered at children's outpatient clinics in Syktyvkar. Respondents noted episodes of absent, infrequent or irregular breathing, blanching or cyanosis of the skin, changes in muscle tone (hypo- or hypertonia), changes in the level of responses that occurred in infancy. The prevalence of symptoms of life-threatening events was estimated based on the total number of infants in the first year of life (n = 3088) who lived in Syktyvkar as of January 1, 2018.Results.At least one symptom of life-threatening events in infancy was reported by 43 (4.3%) of the 1001 mothers surveyed. The prevalence of symptoms was 429.5 [95% confidence interval (CI) 321–574] per 10,000 children of the corresponding age. Independent predictors of life-threatening events in children of the first year of life were sudden deaths of relatives under the age of 50 years [odds ratio (OR) 2.4; 95% CI 1.1–5.3], cases of pre-syncope or syncope in relatives (OR 4.4, 95% CI 2.1–9.0), artificial feeding of infants (OR 4.0, 95% CI 1.5–11.2). The sensitivity of the model, which took into account the presence of at least one of the three predictors, was 19% (8/43), specificity — 99% (2/958).Conclusion.The issue of the occurrence of life-threatening events in an infant can impact every 25th family. In every fifth infant, the occurrence of symptoms of life-threatening events can be predicted based on risk factors.

The purpose of the work was to evaluate the effectiveness of the elimination diet in infants with gastrointestinal manifestations of food allergy.Patients and methods. 84 children aged 2 months to 1 year were examined with gastrointestinal food allergy to cow's milk proteins. All children were prescribed an elimination diet with the exclusion of cow's milk proteins. An assessment was made of the regression of gastrointestinal symptoms on day 3, 7 and 14 of diet therapy and the determination of the concentration of eosinophilic cationic protein in serum. The general-clinical, immunological, allergological and statistical methods of research were used.Results. The purpose of the elimination diet with the exclusion of cow's milk proteins for nursing mothers and the use of mixtures with extensive hydrolysis of protein in the case of artificial feeding leads to a complete regression of gastrointestinal and skin symptoms in all examined children on the 14th day of diet therapy, which is further confirmed by the normalization of the concentration of eosinophilic cationic serum protein in diet therapy. Conclusions. Elimination of cow's milk proteins in infants with gastrointestinal food allergy results in complete regression of gastrointestinal and skin symptoms on day 14 of diet therapy, and determination of the concentration of eosinophilic cationic protein in serum can be used as an additional criterion for the effectiveness of diet therapy.

There is a lack of studies investigating the clinical benefits of prebiotic-supplemented infant formula. In this study, healthy infants that started, on medical recommendation, artificial feeding with one of 2 infant formulas containing 4 g/L of GOS/FOS (9:1) (IF4 group; n = 60) or 8 g/L of GOS/FOS (9:1) (IF8 group; n = 60) were followed for 30 days to the evaluation of growth and gastrointestinal symptoms. Exclusively breastfed infants (EBF; n = 60) were followed up as a reference. Both infant formulas supported adequate weight gain, however, IF4 formula promotes growth more similar to breastfed infants. There was no additional benefit of a dose higher than 4 g/L of GOS/FOS on gastrointestinal symptoms.

This paper is aimed to analyze Whiteleg shrimp’s (Penaeus vannamei’s) acoustic behavior collected in a farming pond. According to artificial feeding events, the chewing sound from shrimps is obtained by a passive acoustic recorder. The sound pressure level of the 1-minute segments between the two feedings is lower than that of after feeding, but higher than that of before feeding. There are two changing parts in the spectrum of several segments, in which one type has a low-frequency energy mainly in 2kHz, and the other has a high frequency energy in 4-15kHz. It is related to shrimps chewing behavior with a large number of ‘click’ signals. By analyzing the chewing sound from individual shrimp, time length of the signal is around 0.01s and the frequency range is about 4-15kHz. The behavior corresponding to the sound pressure level of 2kHz mentioned above has not been determined. In addition, from no-feeding data at night, there are also short-time ‘click’ signals, which are notably different from daytime’s data, and sometimes is concentrated on the low-frequency (about 4kHz) from the energy of the signal. Further research is needed to determine whether there is a relationship between the two low-frequency signals.

Objectives: to determine the prevalence and analyze the factors associated with newborns drinking tea in a birth cohort. Methods: A cross-sectional study with nested prospective cohort was conduct with 329 puerperal women and their newborns in Vitória da Conquista, Bahia. Sociodemographic and information about the newborn's diet and mothers/babies was obtained at a maternity and 30 days after birth, at home visits. The prevalence ratios (PR) and its respective confidence intervals (CI95%) were estimated with Poisson regression models according to the hierarchical conceptual model. Results: the prevalence of tea consumption up to 30 days of life was 34.6% (CI95%=29.7; 40.0%). The sociodemographic and maternal characteristics associated with the outcome were not having a partner (PR = 1.39; CI95%=1.03-1.88), more than eight years of schooling (PR=1.38; CI95%=1.03-1.84), lower income (PR=2.21; CI95%=1.31-3.73), primiparous (PR=1.48; CI95%=1.01-2.17) and does not have any experience with breastfeeding before (PR=2.25; CI95%=1.48-3.41). As for the child, there was a higher prevalence of tea consumption than among those who received artificial milk in the first month of life (PR= 2.10; CI95%=1.62-2.73). Conclusions: the offer of tea in the first month of life was high. Tea consumption was positively associated with sociodemographic, maternal and newborn feeding factors. Resumo Objetivos: determinar a prevalência e analisar fatores associados ao uso de chá em recém-nascidos em uma coorte de nascimento. Métodos: estudo transversal aninhado a uma coorte prospectiva conduzida em 329 puérperas e recém-nascidos em Vitória da Conquista, Bahia. Informações sociodemográficas, relativas à alimentação do recém-nascido e relacionadas aos pares mães-bebês foram obtidas na maternidade e aos 30 dias de nascimento, durante visita domiciliar. As razões de prevalência (RP) e seus respectivos intervalos de confiança (IC95%) foram estimados em modelos de regressão de Poisson conforme modelo conceitual hierárquico. Resultados: a prevalência do uso de chá até os 30 dias de vida foi de 34,6% (IC95%=29,7; 40,0%). As características sociodemográficas e maternas associadas ao desfecho foram não possuir companheiro (RP = 1,39; IC95%= 1,03-1,88), ter até oito anos de estudo (RP=1,38; IC95%= 1,03-1,84), menor renda (RP = 2,21; IC95%= 1,31-3,73), ser primípara (RP=1,48; IC95%= 1,01-2,17) e não possuir experiência anterior com amamentação (RP=2,25; IC95%= 1,48-3,41). Quanto à criança, houve maior prevalência de uso de chá entre as que receberam leite artificial no primeiro mês de vida (RP = 2,10; IC95%=1,62-2,73). Conclusões: a oferta do chá no primeiro mês de vida foi elevada. O uso do chá associou-se positivamente a fatores sociodemográficos, maternos e da alimentação do recém-nascido.

Biogenic oil film is a natural surface slick that is mainly derived by sea flora and fauna. The often observation of the film near aquaculture facilities has raised awareness on the possibility of the linkage between the development of the film and the anthropogenic activities taking place on site (i.e. artificial feeding and liquid waste). This study aims to investigate the possibility of the detection of biogenic oil film on optical satellite images and discriminate it from other oceanographic phenomena. For the purposes of the study we have used a Sentinel-2 (S2) dataset consisted of 73 images for the year 2019 to detect the film on three aquaculture areas. An automatic procedure was developed on a Python based algorithm which included the following stages: (a) downloading images, (b) preprocessing the input data, (c) identifying dark formations in the adjacent fish farming area, (d) extracting attribute tables with the statistical characteristics of the formations (shape, area, etc.), (e) classification of formations as biogenic film or other (lookalike) and (f) extraction of biogenic film vectors. The developed algorithm was able to detect biogenic oil film successfully however some misleading results regarding the decision of true or false positive (biogenic oil film or lookalike) was evidenced. The efficiency of the algorithm was tested against manual classification with overall accuracy 82,6%. As further step the results of this study should be validated with in-situ measurements and further work is required to verify the results obtained by testing the methods in other sites.

Coronavirus disease 2019 (COVID‐19) results from severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2). The clinical features and subsequent medical treatment, combined with the impact of a global pandemic, require specific nutritional therapy in hospitalised adults. This document aims to provide Australian and New Zealand clinicians with guidance on managing critically and acutely unwell adult patients hospitalised with COVID‐19. These recommendations were developed using expert consensus, incorporating the documented clinical signs and metabolic processes associated with COVID‐19, the literature from other respiratory illnesses, in particular acute respiratory distress syndrome, and published guidelines for medical management of COVID‐19 and general nutrition and intensive care. Patients hospitalised with COVID‐19 are likely to have preexisting comorbidities, and the ensuing inflammatory response may result in increased metabolic demands, protein catabolism, and poor glycaemic control. Common medical interventions, including deep sedation, early mechanical ventilation, fluid restriction, and management in the prone position, may exacerbate gastrointestinal dysfunction and affect nutritional intake. Nutrition care should be tailored to pandemic capacity, with early gastric feeding commenced using an algorithm to provide nutrition for the first 5–7 days in lower‐nutritional‐risk patients and individualised care for high‐nutritional‐risk patients where capacity allows. Indirect calorimetry should be avoided owing to potential aerosol exposure and therefore infection risk to healthcare providers. Use of a volume‐controlled, higher‐protein enteral formula and gastric residual volume monitoring should be initiated. Careful monitoring, particularly after intensive care unit stay, is required to ensure appropriate nutrition delivery to prevent muscle deconditioning and aid recovery. The infectious nature of SARS‐CoV‐2 and the expected high volume of patient admissions will require contingency planning to optimise staffing resources including upskilling, ensure adequate nutrition supplies, facilitate remote consultations, and optimise food service management. These guidelines provide recommendations on how to manage the aforementioned aspects when providing nutrition support to patients during the SARS‐CoV‐2 pandemic.

Authors’ reply re: ’Maternal transmission of SARS-COV-2 to the neonate, and possible routes for such transmission: A systematic review and critical analysis (Response to BJOG-20-1416)Kate F Walker1, Keelin O’Donoghue2, Nicky Grace3, Jon Dorling4, Jeannette L Comeau4, Wentao Li5 Jim G Thornton11Division of Child Health, Obstetrics and Gynaecology, School of Medicine, University of Nottingham2The Irish Centre for Maternal and Child Health, University College Cork, Cork University Maternity Hospital, Cork, Ireland3 School of English, University of Nottingham4Department of Pediatrics, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada5Department of Obstetrics and Gynaecology, Monash University, Clayton, AustraliaThank you for the opportunity to comment on the letter by Dr Xue from Shanghai Jiao Tong University. We agree there are many weaknesses in the data we reviewed. Dr Xue has identified one. Others are the incomplete reporting of infant feeding and mother-child interactions, and the frequent lack of infant testing to confirm or refute the possibility of vertical transmission of COVID-19. Finally, although we simply provided summary totals, it would be statistically preferable to combine series using the Mantel-Haenszel method and calculate a relative risk. We judged that doing this in light of the uncertainties around the data which Dr Xue has identified, might give a spurious precision to our results. As he says, more work is needed. For now we think it remains reasonable to not regard COVID-19 in itself, as an indication for Caesarean, artificial feeding or separation, in the mother and baby’s interest.

This is a descriptive study aimed at assessing children’s complications related to fluid and electrolyte disorders. Data were collected in Babel Hospital for Maternal Children through a questionnaire model and data analysis by frequency and percentage, the results showed that (86%) of children lose their appetite, while (14%) They do not lose their appetite, results also show (72%) suffer from diarrhea, while (28%) do not suffer from diarrhea, as results show (20%) suffer from dry mouth, while (80%) do not suffer from dry mouth, The results also show (10%) suffer from syncope, (90%) do not suffer from syncope. Objectives: Evaluation of complications related to fluid disturbances with electricity in the child. Knowing the demographic characteristics of young children who suffer from fluids in disorders such as age, number of children in the family, and number of children in the family. Methodology: A descriptive study used to assess complications related to a fluid electrolyte disorder for a young child. This study was conducted at Baby and Mother Hospital of Babel during the period (5/2 / 2019_3 / 6/2019). A purposeful sample of (50) children, and the study was proven by a committee in the College of Nursing. Statistical SPSS was used to analyze the results of this study Results: According to the interpretation and discussion of the study results, (72%) of the children had diarrhea (48%) of the children had vomiting. (62%) are dependent on artificial feeding, (34%) of children have experienced accidents or fall from a height.

Diseases of the respiratory system are important causes of children’s morbidity. That is why we suggest that the spreading of the clinical experience is helpful for the pediatric community to improve the practical skills and theoretical knowledge of the physicians. The article describes clinical and anamnestic peculiarities of run of period of the breast-feeding age and pre-preschool age at a preterm newborn with a small body weight at birth with a period of gestation of 32–36 weeks and infants of 38–40 weeks of gestation. Taking into account the anatomical and functional features of premature infants, they need of a multidisciplinary approach in order to care and treat them. The important anamnestic determinants that can point possible the later complication are the interrupted pregnancy and incompetent pregnancy, harmful habits (the active and pasive smoking) of gravids and their infectious diseases (kidney disorders) and no-infectious diseases like diabetes mellitus and arterial hypertension. Actually, a physician has to know many various combinations of symptoms and syndromes, which are characteristic for the preterm infants. The article includes clinical and anamnestic patterns of motion of pneumonia in infants with a period of gestation of 32–36 weeks in the breast-feeding and the pre-preschool period of the life. The important clinical determinants that can be used for diagnostic search of family doctor have been determined. The changes in organs and systems associating with development of pneumonias in the preterm infants have been displayed. The most important the clinical determinants of development of pneumonia are the artificial feeding, the violation of feeding and composition of food, disturbance of respiration, the smoking, hyperplasia of the thymus. The main idea of our article is that the most cases of morbidity premature infants depends on immature of internal organs, immune system and development of the infection complication. The main “take-away lessons” are that premature infants should be observed a long time after disease. Conclusions: premature infants need a multidisciplinary approach in order to care and treat them.

Background: Breastfeeding is associated with lower risk of infectious diseases, leading to fewer hospital admissions and pediatrician consultations. It is cost saving for the health care system, however, it is not usually estimated from actual cohorts but via simulation studies. Methods: A cohort of 970 children was followed-up for twelve months. Data on mother characteristics, pregnancy, delivery and neonate characteristics were obtained from medical records. The type of neonate feeding at discharge, 2, 4, 6, 9 and 12 months of life was reported by the mothers. Infectious diseases diagnosed in the first year of life, hospital admissions, primary care and emergency room consultations and drug treatments were obtained from neonate medical records. Health care costs were attributed using public prices and All Patients Refined&ndash, Diagnosis Related Groups (APR&ndash, DRG) classification. Results: Health care costs in the first year of life were higher in children artificially fed than in those breastfed (1339.5&euro, 95% confidence interval (CI): 903.0&ndash, 1775.0 for artificially fed vs. 443.5&euro, 95% CI: 193.7&ndash, 694.0 for breastfed). The breakdown of costs also shows differences in primary care consultations (295.7&euro, for formula fed children vs. 197.9&euro, for breastfed children), emergency room consultations (260.1&euro, for artificially fed children vs. 196.2&euro, for breastfed children) and hospital admissions (791.6&euro, for artificially fed children vs. 86.9&euro, for breastfed children). Conclusions: Children artificially fed brought about more health care costs related to infectious diseases than those exclusively breastfed or mixed breastfed. Excess costs were caused in hospital admissions, primary care consultations, emergency room consultations and drug consumption.

Introduction The childhood obesity epidemic has caused the global prevalence of hypertension (HTN) in children to increase from 2% to 4%. However, there is limited data regarding this issue in Pakistan. Hence this cross-sectional study aims to document the prevalence of HTN and its risk factors among children visiting the out patient department (OPD) of a government hospital in Karachi, which is one of the largest cities in Pakistan. Methods One thousand children aged between 4 and 12 years who visited the OPD in October 2019 were included. Blood pressures (BPs) for each child were measured manually and recorded. Their guardians were then interviewed to assess the risk factors present in each child. Data collected were analyzed using SPSS (Statistical Package for the Social Sciences). Results Among all the children, those between 4 and 7 years of age had a higher prevalence of HTN (19.2%; 9.2% stage 1 and 10.0% stage 2) than children aged between 8 and 12 years (14.5%; 8.0% stage 1 and 6.5% stage 2). Obese children between the age of 4 and 7 years (OR = 3.11) were more likely to develop HTN. Moreover, children with a positive family history of HTN were 1.43 times more likely to have HTN and 1.32 times more likely to have pre-HTN. There was no significant association of gender, artificial feeding, low birth weight, and maternal smoking with HTN. Conclusion The prevalence is particularly higher in children aged between 4 and 7 years (19.2%) and there is a strong association between high BMI (body mass index), family history of HTN, and high-fat diet intake with HTN in children. There was no significant variation of prevalence between both genders.

Background: Infant formula is considered an effective alternative to breast milk. Safe preparation of infant formula is a crucial goal by the World Health Organization for infants receiving some or all of their feeding using infant formula. Objectives: The objective is to find out the errors in the method of bottle-feeding which leads to feeding problems in infants in Al-Hilla city. Methods: This cross-sectional study was conducted on a convenient sample of 384 infants (who attended the general wards in Babylon Maternity and Pediatric Hospital, AL-Noor Hospital and some primary health-care centers). Results: The percentage of mothers who had followed all the recommended steps for feeding and sterilization of infant bottle was (16.90%). Conclusions: Very low percentage of mothers were found to follow all the proper steps of bottle-feeding.

Premature infants are vulnerable in the course of feeding practices, with lower rates of breastfeeding and inadequate feeding. To analyze breastfeeding rates, use of cow's milk and dietary inadequacies of premature infants in the second semester of Corrected Gestational Age (CGA), comparing them in two moments. This is a non-concurrent cohort with documentary analysis of medical records of 118 premature infants monitored at a secondary referral health service. Sociodemographic and perinatal data were analyzed in relation to the type of breastfeeding, feeding error and use of cow's milk in two moments: 6 months and 12 months of CGA. A reduction in breastfeeding rates was observed by the second semester of CGA (48.3% vs. 36.4%). The prevalence of dietary inadequacies was significant and showed no differences between the two periods (26.3 vs. 27.1%), but the rates of use of cow's milk increased in the second moment (11% vs. 26.3%). Birth weight less than 2000g was associated with a 4.2 times greater chance of artificial feeding in the first year of CGA. Low rates of breastfeeding, use of cow's milk and inadequate complementary feeding are expressive in premature infants whose families have low education and low income.

Mosquito and tick feeding activity represent a key threat for humans, livestock, pets and wildlife worldwide. Rearing these vectors in laboratory conditions is extremely important to investigate basic facets of their biology, vector competence, new control strategies, as well as mechanisms of pesticide resistance. However, the use of animals or humans to provide blood for hematophagous arthropod feeding poses a strict limit to these researches, due to the accidental transmission of diseases, ethical problems concerning animal welfare, as well as expensive and time-consuming animal rearing procedures. The use of devices to artificially feed arthropod vectors can importantly leverage progresses in parasitology and entomology. The aim of this review is to summarize current knowledge about artificial feeding of mosquitoes and ticks, focusing on key concepts and case studies about the design and fabrication of blood feeding devices. From a technical standpoint, the literature analyzed here showed little standardization of materials used for fabricating membrane interfaces, as well as in the strategy used to heat the "biomimetic host". In addition, a lack of uniform methods to design an architecture merging complex and realistic cues with an easy-to-assemble approach have been found. Some commercial products are available, but they are quite expensive, thus hard to reach for many laboratories, especially in developing countries. An important challenge for future research is represented by the introduction of automation and bioinspired engineered solutions in these devices, improving the effectiveness of blood-feeding systems by increasing their host-mimicking features. Automation can reduce labor costs and provide interesting solutions - in line with the 3R principle "reduce, replace and refine" - aimed to minimize the employ of experimental animals in research.

Aim. Study of the state of intestinal microflora in young children seen in an outpatient setting with acute enteric infections. Methods. The state of microflora of 156 children was examined. All children underwent bacteriological study. Children were divided into following groups by age: 0-6 months - 59 (37.8%) patients; 6-12 months - 32 (20.5%) and 1-3 years - 65 (41.7%) subjects. Among them, 33 (21.1%) received breast milk, 46 (29.5%) received artificial feeding and 77 (49.4%) - mixed feeding. Results. Conditionally pathogenic bacteria were revealed in 114 (73.08%) patients, mainly (92.98% of cases) Candida alone or in combination with other conditionally pathogenic microorganisms were detected in 57 (50.0%) children: Candida + St. aureus - in 32 (28.1%) patients, Candida + P. vulgaris - in 9 (7.9%), Candida + P. vulgaris + St. aureus - in 12 (10.5%), Candida + St. aureus + Ps. aeroginosa - in 4 (3.5%) subjects. In 42 (26.92%) children conditionally pathogenic flora was not detected. As a result of the study of intestinal microflora structure of outpatients, decreased number of E. coli and B. bifidum by 67.3 and 36.5%, respectively, was revealed. The leading place was taken by Candida albicans identified in more than 50% of outpatients. Conclusion. Young children with acute enteric infections had mainly conditionally pathogenic and pathogenic microorganisms isolated in different associations.

Weight is an important predetermining factor for surgical reconstruction of clefts in infants. These clefts causes’ difficulties in swallowing of milk leading to inadequate nutrition resulting in gradual loss of weight gain making surgical corrections difficult. Fabrication of artificial feeding plate prosthesis is the best alternative suggested treatment of choice in such situations. This prosthesis helps in proper devouring of the milk there by regaining required weight for surgical management of clefts. This article describes the simplified prosthetic approach in constructing a properly functioning feeding prosthesis and to reduce the parents’ anxiety originating from multiple dental visits. Keywords: Feeding plate, Obturator, Cleft lip, Cleft palate.

The aim of the research is to study the peculiarities of brain electrical activity in infants who suffered from stress due to military conflict and who were on different types of feeding. An electroencephalographic study was conducted in 68 infants who were in the military conflict zone and formed the main group. These infants were divided into 2 subgroups. Subgroup Ia included 36 infants who were breastfeeding. Subgroup Ib included 32 infants who were on artificial feeding. EEG was also made to 88 children who made up a control group and were outside the zone of military conflict. Of these, 47 children were breastfed, who entered the subgroup IIa and 41 children were on artificial feeding, included in subgroup IIb. The study was carried out with the help of a hardware-software complex for recording and processing electroencephalograms and evoked potentials DX-NT 32. The most pronounced physiological changes in brain bioelectrical activity were detected in the group of children undergoing stress of war and being on artificial feeding, which were manifested by lower parameters of the amplitude, frequency and time index of alpha and beta rhythms, increased amplitude, frequency and time index of delta and theta rhythms.

As a result of a literature-based expert process, this review provides an overview about the principles of palliative care for people with advanced dementia that are relevant for clinical practice. In particular, the indications, impact and aims of palliative care for advanced dementia are described. Life-prolonging measures and management of symptoms at the end of life are discussed. Furthermore, the overview focuses on the legal basis of decision making.

The analysis of the prevalence, clinical manifestations, diagnosis, and treatment of functional gastrointestinal disorders (FGID) in infants was carried out. According to the analysis results the development of FGID in infancy is caused by disorders of motor function and somatic sensitivity of the digestive organs, changes in the secretory and suction functions of this system, largely due to anatomophysiological features of an early age. The peculiarities of posseting, colic, and constipation are considered as the most frequent FGID manifestations in infants. The current approaches to the treatment of the specified manifestations are analyzed, including a number of activities, in particular, psychological preparation of parents, support of breastfeeding, rational nutrition of the mother during breastfeeding, if necessary, the selection of formulas for mixed or artificial feeding, the use of medicines and probiotics. We noted that the high incidence and adverse effects of FGID in children determine the urgency to research on the mechanisms of their development in order to improve preventive and curative interventions.

Background: Human milk meets all the nutritional requirements of infants for the first 6 months of life, and it is associated with a lower incidence of diarrhea than partial or artificial feeding. The infant should be exclusively breastfed for at least 4 months of life and if possible for 6 months, as recommended by WHO and UNICEF. Aim of the Study: was to assess the breastfeeding practice for children under 24 months in Arar city, as well as its relation to some sociodemographic and nutrition related variables. Participants and methods: A cross-sectional study was carried out in Arar city, mothers were selected from the attendees of 6 randomly selected primary health care centers in the city. They were interviewed and filled in a questionnaire that included the key questions. Results: 11.8% of infants received exclusive breastfeeding, 39.7% received a mix of both breast and artificial feeding while 48.5% depended only on artificial feeding. More than 50% of the studied infants were males, 70% of the mothers weren't working. No significant relationship between type of child feeding and child age, sex, mother education, mother's working status, father's work or mother age group (P >0.05). About 2 thirds of children who had mixed feeding suffered from repeated gastroenteritis, delayed teething, standing and walking. Conclusion: In accordance with the obvious deficiency of exclusive breastfeeding in Arar city which is located in Northern Saudi Arabia, we highly recommend that programs promoting exclusive breastfeeding in the first 6 months of age must be conducted to increase mothers’ awareness of the exclusive breastfeeding duration is recommended.

Oral nutritional supplements (ONS) are substances taken by mouth as an addition to the child's usual diet. They can benefit a child who does not manage to ingest and absorb sufficient nutrients to grow and develop in the usual way. ONS can be used in the management of a wide range of medical conditions such as neurodevelopmental disorders with associated dysphagia, intestinal inflammatory disorders e.g. Crohn's disease and non-IgE slow onset food allergies (when a protein hydrolysate or amino-acid based ONS is usually needed) major organ failure or in areas of food insecurity to avoid starvation. Appropriate use at the earliest opportunity may preclude or postpone the need to insert an artificial feeding device. Once on treatment children need to be reviewed at least 6-monthly by a dietitian as well as a paediatrician.

Proper child positioning and attachment initiates the production of optimal amounts of breast milk and contribute to the comfort of a child during suckling. Poor breastfeeding practices like early cessation and poor breastfeeding skills, introduction of unclean artificial feeding have been widely documented in the world. This cross-sectional community based study was carried out between October 7 and 25, 2013 in Arba Minch Zuria. Structured questionnaires and observational-checklist were used to collect data. The missing values and outliers, data, were checked and entered in double. Multivariable logistic regression was done to identify the predictors of poor and good positioning and attachment to breast. More than one-fifth of 384 (20.1%) infants was poorly positioned and attached to breast. Poor attachment of children to the breast were negatively associated with infant’s age below 6 (AOR=0.03 (0.01, 0.11)), attending breast feeding education (AOR=0.42(0.19, 0.93)) and positively associated with having an uneducated husband (AOR=0.07(0.01, 0.51)). Poor child positioning were also negatively associated with infant’s age below 6 (AOR=0.03(0.01, 0.10)), lack of information on breastfeeding (AOR=0.42(0.19, 0.94)), and early introduction of additional food (AOR=0.44(0.20, 0.97). Overall, in more than one-fifth of mothers (20.1%), the breastfeeding attachment and positioning were found to be lower than the national and global recommendations. It is highly related to infant’s age, paternal educational and an exposure to breastfeeding education. Thus, continuous community based nutritional health education were needed to promote optimal breastfeeding skills using health workers, religious leader and local community resource people as key actors. Key words: Positioning, attachment, breastfeeding, Arba Minch.

The indoor factory aquaculture is almost all artificial feeding. The feeding amount and feeding time are basically determined by the individual experience of the farmers. There are some problems, such as the timing of feeding, the low precision of the ration, the labor intensity, the time consuming, the power consumption, and the poor effect. The design uses the computer vision with high positioning accuracy and no dependence on the external environment. The COMS camera is carried on the carrier equipment in the pond, and the image information of the target location is collected. By fuzzy processing of the acquired image information, the target location is recognized to plan the route for the ship-borne equipment, and then feed operation of aquatic products is implemented. In this design, the relationship between the moment and position information of the target image is analyzed in detail, and the accuracy of the location of the ship-borne equipment to the target location and the location of the actual location and the robustness of the system are analyzed experimentally, which is of great application value for the precise feeding of aquatic products.

Innovation of semi-intensive milkfish cultivation and modular methods in the farming unit of the Indonesian Muslim University, Parreang Hamlet, Bontosunggu Village (Kalibone), Minasatene District, Pangkep Regency. The problem of demand for milkfish is the size of a lot of consumption, low production yields, traditional cultivation technology used, facilities and infrastructure are irrelevant, production management does not use good farming methods. The purpose of this activity is (1). applying the semi-intensive milkfish cultivation system technology innovation with a modular method, (2). Developing an economic culture, (3) creating new entrepreneurs of milkfish cultivation in ponds, (4) increasing milkfish production (4) stimulating the community to develop semi-intensive milkfish cultivation with a modular method, (5) stimulating students to innovate and develop milkfish farming. The implementation method is a demonstration of milkfish farming in ponds ranging from pond preparation, natural food growth, seed stocking, artificial feeding and probiotics, handling water quality, pests, and diseases, and harvesting. The density of seeds stocked with a semi-intensive system was 10,000 heads / ha. Map the ponds used for shifting maintenance (modular method) of 3 ponds for 5 months. The results achieved are the production of milkfish with size of 5 milkfish / kg or ± 250 g as much as 423 kg with a net income of Rp.4,390,000. The maintenance cycle is carried out one cycle because of the dry season constraints from the planned 3 maintenance cycles.

Background Australia experiences a high incidence of natural emergencies and Australian governments have committed significant investment into emergency preparedness and response. Amongst the population groups most vulnerable to emergencies are infants and young children with their vulnerability centering around their specific food and fluid needs. For this reason, the World Health Assembly has urged all member states to develop and implement infant and young child feeding in emergency (IYCF-E) plans in line with international guidance. This study aimed to determine the degree to which Australia has complied with this direction by conducting an audit of Australian emergency plans and guidance. Methods Australian Federal, State/Territory and a sample of Local government emergency plans and guidance were located via web searches. Documents were searched for key words to identify content dealing with the needs of infants and young children. Plans and guidance were also searched for content dealing with the needs of animals as a comparison. Results While plans and guidance contained numerous pointers to the desirability of having plans that address IYCF-E, there was a dearth of planning at all levels of government for the needs of infants and young children. Guidance related to heat waves contained information that could prove dangerous to infants. No agency at Federal or State/Territory had designated responsibility for IYCF-E or children in general. This was in stark contrast to the situation of animals for which there was widespread and comprehensive planning at all levels of government with clear designation of organisational responsibility. Conclusions Lack of planning for IYCF-E in Australia places infants and young children at serious risk of adverse health consequences in emergencies. Australian Federal, State/Territory and Local governments need to take action to ensure that IYCF-E plans and guidance are developed and deployed in line with international standards. The pathway to successful integration of animal welfare plans provides a method for a similar integration of IYCF-E plans. Government health authorities are best placed to lead and be responsible for IYCF-E in Australia. National governments internationally should similarly take action to ensure that their youngest, most vulnerable citizens are protected in emergencies.

Background: According to the Baby Friendly Hospital Initiative, when supplementary feeding occurs, mothers should be counseled on the use and risks of feeding bottles and teats. To help support this initiative it is important to understand the supplementation practices of Internationally Board Certified Lactation Consultants (IBCLC)®. Research aims: To determine (1) if the location of an IBCLC’s practice has any impact on supplemental feeding methods; (2) the preferred methods of and the main reasons for supplementation; (3) the level of an IBCLC’s confidence with supplemental feeding methods; (4) who is making supplemental feeding decisions; and (5) if there are geographical differences among supplementation choices and reasons for supplementation. Methods: An exploratory, descriptive, cross sectional survey of IBCLCs was conducted to generate data about their use of supplemental feeding methods. The survey was sent via email invitation through the International Board of Lactation Consultant’s Board of Examiners, with a response rate of 11.5% ( N = 2,308). Results: There was no standard method of supplementation among participants. Participants indicated that they were confident advising mothers on alternative feeding methods. Only 17.6% ( n = 406) of participants reported that the IBCLC was the caregiver who recommended the method of supplementation used. The majority of participants believed the Supplemental Feeding Tube Device SFTD) best preserves the breastfeeding relationship, and this was their preferred method of supplementation. However, the bottle was ranked as the number one method used in the United States, Australia, and Canada. The use of alternative feeding methods may be overwhelming to the mother. Conclusion: Supplementation by alternative feeding methods might help preserve the breastfeeding relationship and help reach the World Health Organization’s goal of increasing exclusive breastfeeding rates.

Background Acute otitis media (AOM) is the most common bacterial infection in children. Some children with AOM tend to be otitis-prone, such as to have frequent recurrence of AOM (RAOM). The possible RAOM risk factors are widely debated. Objective The aim was to identify predictive factors, including clinical data and endoscopic findings, for RAOM in children. Methods The current study was performed in a real-life setting, such as an otorhinolaryngologic (ORL) clinic. In this study, 1,002 children (550 males, 452 females; mean age, 5.77 ± 1.84 years), complaining upper airway symptoms, were consecutively visited. Detailed clinical history and nasal endoscopy were performed. Results Throughout the ORL visit, it was possible to define some factors involved in the recurrence of AOM, including female sex, artificial feeding, tonsillar and adenoid hypertrophy, whereas male sex and recurrent respiratory infections could protect from RAOM. Conclusion Allergy was not associated with RAOM. In addition, this real-life study identified some predictive factors of RAOM, thus also in a primary care setting it is possible to achieve important information that is relevant in clinical practice.

This article analyzes the data of the literature about the effect of nutritional support in the prenatal period and infancy on the development of obesity in children. We know that almost 60% of adults who are obese, have overweight problems that began in childhood and adolescence. Obesity and its complications (diabetes type 2, hypertension, coronary heart disease, atherosclerosis, cancer) are associated with numerous genetic markers, but some hormonal, syndromic or molecular genetic disorders can explain less than 5% of all cases of obesity. We have shown the role of low and high protein content in the diet of fetus and child in the first year of life in the development of obesity in children. It was analyzed the concept and predictable mechanisms of food (nutritional) software for obesity. Breastfeeding reduces the risk of excessive weight gain in adulthood, while the artificial feeding promotes obesity. Attention is focused on maintaining breastfeeding until 6 months of age to ensure optimal growth and development. Key words: obesity in children antenatal period, nutritional status, nutritional programming.

На формирование зубочелюстной системы наряду с генетическими и другими факторами большое влияние оказывают механические воздействия. Акт сосания является необходимым этапом развития и формирования зубочелюстной системы человека как многоблочной специализированной биомеханической системы. При искусственном вскармливании во многих случаях изменяется механическая нагрузка на блоки жевательного аппарата, что приводит к отклонению в развитии челюстно-лицевой области ребенка и отрицательно влияет на формирование височно-нижнечелюстных суставов. Дисфункция суставов может приводить к сдавливанию и нарушению прямолинейности внутренней сонной артерии. При этом нарушается питание головного мозга, что может вызвать одонтогенный инсульт, приводящий, по статистическим данным, к смерти в 57 % случаев. Неправильное искусственное вскармливание является первичным звеном в цепи функциональных нарушений, являющихся наиболее частыми этиологическими факторами проявления зубочелюстных аномалий. В данной работе на основе биомеханического моделирования разработаны режимы искусственного вскармливания (размеры отверстия в соске, форма соски и т.д.), позволяющие приблизить энергосиловые характеристики к величинам, наблюдаемым при естественном вскармливании, что приведет к снижению частоты появления зубочелюстных аномалий. Поэтому построенные модели естественного и искусственного вскармливания позволяют проводить исследования зубочелюстной системы с позиций биомеханики и открывают для педиатров и стоматологов новые возможности влияния на ее формирование во все периоды жизни ребенка. Благодаря этому можно добиться улучшения диагностики аномалий развития и приобретенных заболеваний с учетом отдаленных последствий врачебного вмешательства.Mechanical action has a great influence upon the formation of the maxillodental system along with genetical and other factors. The suction act is a necessary stage of the human maxillodental system development and formation as the multiunit specialised biomechanical system. At artificial feeding, the mechanical loading on the units of the masticatory apparatus in many cases is varied that leads to a diversion in development of the maxillofacial region of the infant and has negative impact on the temporomandibular joint formation. Dysfunction of joints can result to squeezing and disturbance of straightness of the interior carotid artery. The disturbance of the brain trophism can invoke the odontogenous stroke leading under the statistical data to death in 57 % cases. Incorrect artificial feeding is a primary part in a chain of the functional disturbances, which are the most frequent etiological factors of dentoalveolar anomalies. On the basis of biomechanical modelling, the conditions of artificial feeding were developed in the given work (the dimensions of a hole in a nipple, the nipple shape, etc.), that allowing to approach energy-power characteristics to the quantities observed at the breast feeding that will lead to reduction of frequency of dentoalveolar anomalies. Therefore, the constructed models of breast and artificial feeding allow conducting examinations of the dentoalveolar system from the viewpoint of biomechanics and unclose for pediatricians and dentists the new possibilities to influence on its formation in all periods of the child life. It allows us to achieve enriching of diagnostics of anomalies of development and acquired diseases taking into account the remote consequences of a medical intervention.

As communities worldwide shift from consuming traditional diets to more processed snacks and sugar-sweetened beverages (SSBs), increases in child obesity and tooth decay and persistence of undernutrition are particularly apparent in Latin American countries. Further evidence of shared risk factors between child undernutrition and poor oral health outcomes is needed to structure more effective health interventions for children&rsquo, s nutrition. This study aims to identify dietary, oral health, and sociodemographic risk factors for child undernutrition and severe early childhood caries (sECC) among a convenience sample of 797 caregiver&ndash, child pairs from rural Salvadoran communities. Caregiver interviews on child dietary and oral health practices were conducted, and their children&rsquo, s height, weight, and dental exam data were collected. Multivariable regression analyses were performed using RStudio (version 1.0.143). Caregiver use of SSBs in the baby bottle was identified as a common significant risk factor for child undernutrition (p = 0.011) and sECC (p = 0.047). Early childhood caries (p = 0.023) was also a risk factor for developing undernutrition. Future maternal&ndash, child health and nutrition programs should coordinate with oral health interventions to discourage feeding children SSBs in the baby bottle and to advocate for policies limiting SSB marketing to young children and their families.

Background: Breastfeeding is the best way of providing nutrition for the healthy growth and development of infants. It is an essential part of the reproductive process with important inferences for the health of mothers. Exclusive breastfeeding for 6 months is the recommended way for infants nourishing. Complementary foods should be introduced after the age of 6 months, and breastfeeding should continue until the age of 2 years. This study was conducted to measure the prevalence of exclusive breastfeeding and to identify the most common obstacles confronting the practice between mothers attending El-Darrassa PHC centre. Methods: A descriptive cross-sectional study included all mothers attending the PHC centre. The data was collected by a questionnaire. The descriptive method and inferential statistics were used for data analysis. Results: The prevalence of breastfeeding was 97%, while the prevalence of exclusive breast-feeding was 51%. The obstacles facing breastfeeding were: 38% decreasing amount of mother’s milk, 16.8% the ease of artificial feeding and 16% the mothers’ working status. Nearly half knew the breastfeeding benefits for mother and child. There were no significant relations between exclusive breastfeeding and demographic characteristics, while there were significant relationships, between breastfeeding and medications contraindicated with lactation, easiness of artificial feeding, and decreased amounts of milk. Conclusions: The study revealed that the key factors for improving exclusive breastfeeding are raising the mothers’ awareness, enhancing health facilities policies to support mothers’ initiation of breastfeeding immediately after birth, promoting effective breastfeeding and enforcing laws protecting working mothers and facilitating their breastfeeding practice during work.

Background Early reports of COVID‐19 in pregnancy described management by caesarean, strict isolation of the neonate and formula feeding, is this practise justified? Objective To estimate the risk of the neonate becoming infected with SARS‐COV‐2 by mode of delivery, type of infant feeding and mother‐infant interaction Search Strategy Two biomedical databases were searched between September 2019 ‐ June 2020. Selection Criteria Case reports or case series of pregnant women with confirmed COVID‐19, where neonatal outcomes were reported. Data Collection and Analysis Data was extracted on mode of delivery, infant infection status, infant feeding and mother‐infant interaction. For reported infant infection a critical analysis was performed to evaluate the likelihood of vertical transmission. Main Results We included 49 studies which included 666 neonates and 655 women where information was provided on the mode of delivery and the infant’s infection status. 28/666 (4%) neonates had confirmed COVID‐19 infection postnatally. Of the 291 women who delivered vaginally, 8/292 (2.7%) neonates were positive. Of the 364 women who had a Caesarean birth, 20/374 (5.3%) neonates were positive. Of the 28 neonates with confirmed COVID‐19 infection, 7 were breast fed, 3 formula fed, 1 was given expressed breast milk and in 17 neonates the method of infant feeding was not reported. Conclusions Neonatal COVID‐19 infection is uncommon, uncommonly symptomatic, and the rate of infection is no greater when the baby is born vaginally, breastfed or allowed contact with the mother.

Introduction and objective : Reducing the neonatal mortality rate in half is an objective proposed by WHO for the year 2025 through coverage strategies from the prenatal stage, delivery, birth, and hospitalization, one of these low-cost strategies is exclusive breastfeeding (EBF) in preterm infants, that contributes to the prevention of neonatal mortality, a population that contributes in the first place to neonatal mortality. The objective of this study was to identify the frequency and survival of exclusive breastfeeding and related factors in premature infants of two referral hospitals, one of them certified as Baby-Friendly Hospital Initiative (BFHI). Methods : Follow-up study of 111 premature infants after hospital discharge with equivalent corrected age among hospitals: BFHI 36.1 ± 1.6; non-BFHI (nBFHI) 36.4 ± 1.8 weeks ( p ≥ .05). Data collection carried out from February 2016 to March 2017, through records in clinical files and surveys of mothers upon hospital discharge and by telephone during follow-up after 15 days post-discharge, 3, and 6 months of extrauterine life. Kaplan-Meier analysis to determine breastfeeding survival over time, and with Pearson’s r with significance p ≤ .05, the relation was established between EBF with sociodemographic, perinatal, and clinical status factors of the child. Results : Urban maternal origin (68.1%), maternal age (25.7 ± 7.9 years), schooling < 12 years (56.6%). EBF upon discharge on 45/111 dyads (40.5%), 15 days post-discharge 35/73 (47.9%), third month 23/61 (37.7%) and sixth month 7/44 (15.9%). EBF survival was 15 days post-discharge, at this cut-off point, among the correlated factors are: “having received guidance to use Exclusive Breastfeeding until the sixth month of extrauterine life of the premature child” positively correlated with EBF ( r = 0.294, p ≤ .05), “the maternal perception that her milk dried” correlated negatively with EBF ( r = -0.313, p ≤ .01), if “breastfeeding caused anxiety to the mother” it positively correlated with artificial feeding (AF) ( r = 0.237, p ≤ .05). Conclusions : Exclusive breastfeeding in premature infants is below WHO standard, it is favorably related to maternal orientation, and barriers are maternal perceptions of non-milk supply and anxiety. It could be encouraged through actions carried out in hospitals certified with the Baby-Friendly Hospital Initiative and follow up with post-discharge breastfeeding at least to the sixth month of life of premature infants. Similar studies should establish better monitoring mechanisms to avoid losses during the follow-up.