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Children with spastic cerebral palsy (CP) are at risk of undernutrition, which increases with the severity of movement disorders. Objective of the study: to assess and compare anthropometric indicators and body composition in children with cerebral palsy, depending on the level of impairment of gross motor function classification system (GMFCS). Materials and methods of research: 102 children were included in a prospective open-label comparative single-center non-randomized study: 58 (56.8%) boys and 44 (43.1%) girls with cerebral palsy aged 2 years to 16 years and 9 months who were undergoing rehabilitation in the National Medical Research Center of Children's Health in the period from 2019 to 2021. Anthropometric measurements (body weight, length, knee height, triceps and subscapular skinfold thicknesses) were performed on admission. Body fat percentage (%FM) was calculated by CP-modified (Gurka) equations and compared with results obtained using bioelectrical impedance analysis. A survey on the EDACS scale was performed to determine the ability to eat and drink. Results: patients were divided into 2 groups: the main group – 53 children (52%) with GMFCS levels IV–V and a comparison group – 49 children (48%) with GMFCS levels I–III. The groups did not differ statistically significantly in terms of gender (p=0.956) and age (p=0.207). The median age in the main group was 7.1 years, in the comparison group – 5.3 years. Children of the main group had statistically significantly lower growth indicators (HAZ1 –1.5 [–2.6; –0.74] and HAZ2 –0.58 [–1.59; 0.44], p=0.003), BMI (BAZ1 –2.43 [–3.67; –0.93]; BAZ2 –0.91 [–1.942; 0.28], p

Background. Celiac disease (gluten enteropathy) is relatively rare disease. However, such patients have higher risk of skin pathology than general the population, and their therapy efficacy is limited by the use of gluten-free diet. Therefore, screening of dermatologic patients on celiac disease may be relevant. Objective. Our aim was to study the prevalence of celiac disease among children with skin pathology. Methods. The study included children hospitalized in dermatology department. Screening for celiac disease included detection in blood serum of antibodies (IgA, IgG, IgM) to tissue transglutaminase via rapid tests. In case of positive result of rapid test, we have repeated the estimation of antibodies (IgA, IgG) to tissue transglutaminase via immunochemiluminescent method with ImmunoCAP technology or via enzyme immunoassay. In case of positive serological test, we have performed HLA typing to determine haplotypes of DQ2 and DQ8, as well as esophagogastroduodenojejunoscopy (EGDJS) with biopsy of the duodenal and jejunal mucosa for further histological verification of the diagnosis. Results. We examined 1,000 children with various dermatologic pathologies. Rapid tests showed positive result in 21 patients (2.1%; 95% C11.3-3.2%). The presence of antibodies to tissue transglutaminase was confirmed via additional serological examination in all cases. HLA-haplotypes DQ2/8 were revealed in all patients with positive rapid test results. Typical form of gluten enteropathy was confirmed in 18/21 patients (86%) according to a histological study, thus, estimated prevalence of celiac disease is 1.8% (95% C11.1-2.8%). Conclusion. The prevalence of celiac disease remains underestimated among children with skin diseases. More studies are needed on the diagnostic features of rapid tests on tissue transglutaminase, as well as the benefits of screening for celiac disease to achieve patient-relevant clinical outcomes of skin pathology with wider gluten-free diet.

Objective of the study: assessment of the nutritional status of infants with bronchopulmonary dysplasia. Materials and methods of research: a retrospective uncontrolled non-randomized cross-sectional comparative study was carried out. It involved 40 premature babies (boys – 19, girls – 21) at the corrected age of 3,3 [2,3–4,0] months and 16 age matched full-term babies (comparison group). Children born prematurely were divided into 2 groups depending on their body mass (BM) at birth: 1st – 25 children with BM less than 1500 g, 2nd – 15 children with BM from 1500 to 2500 g. The first group included subgroups 1A and 1B, depending on the presence or absence of bronchopulmonary dysplasia in children. Physical development was assessed using INTERGROWTH-21st and WHO Anthro, 2009 anthropometric calculators, body composition was determined by air plethysmography using a PEA POD apparatus. Results: the assessment of anthropometric indices (WAZ and HAZ) calculated for postnatal and corrected age revealed the most severe manifestations of nutritional deficiency in children with very low BM at birth who developed bronchopulmonary dysplasia. The percentage of fatty BM was statistically significantly lower in children of subgroups 1A and 1B compared to full-term infants (p

The characteristics of the diet traditionally recommended for Crohn’s disease often reduce patients’ consumption of essential nutrients. Therefore, an important role belongs to nutritional support with specialized formulas, the effectiveness of which has been proven both for inducing remission and optimizing the parameters of physical development and puberty, bone mineralization. Nutritional support should be provided for patients with newly diagnosed Crohn’s disease in the form of full enteral nutrition, and subsequently in remission, exacerbation, in the pre- and postoperative periods as an addition to the standard diet. Of particular interest is the CDED ModuLife program, which is based on a combination of enteral nutrition with specially selected foods aimed at reducing the activity of intestinal inflammation in Crohn’s disease. Key words: inflammatory bowel disease, Crohn’s disease, full enteral nutrition, partial enteral nutrition, enteral nutrition formulas

The incidence of functional gastrointestinal disorders (FGIDs) in infants is very high. They are not only a medical challenge, but also a social problem. The causes of FGIDs are still being discussed by researchers. Particular attention is paid to impairments in functioning of the brain-intestine axis, formation of the intestinal microbiota, as well as psychological factors. FGID is a diagnosis of exclusion; however, no clear criteria for this diagnosis have been developed so far. If a baby has regurgitation, colic and/or constipation, an active search and differential diagnosis with various diseases manifesting themselves with such symptoms are necessary. Nutrition diagnosis is an important step in the diagnosis of FGIDs, which allows timely identification or exclusion of this pathology. In this study, we have demonstrated high efficacy of Comfort baby formulas, adapted fermented milk formulas, and antireflux formulas in artificial feeding of infants with FGIDs. Key words: functional gastrointestinal disorders, regurgitation, colic, constipation, infants, diet therapy, Comfort formulas, functional components

There is no universal diagnostic and treatment strategy of subclinical hypothyroidism (SHT) in pregnant women and those who are planning pregnancy due to differences in population-specific and trimester-specific thyroid-stimulating hormone (TSH) reference values, influence of thyroid autoimmunity markers on pregnancy outcomes, adherence to fixed universal cutoff concentrations TSH in Russia and multidisciplinary team care with different treatment opinions involving. An absence of universal approach to SHT leads to excess treatment, financial and psychological burden on pregnant women.Up to American Thyroid Association (ATA) Guidelines 2017 and project of Clinical Guidelines of Russian Association of Endocrinologists 2019 a treatment strategy of SHT should be left up to the endocrinologist to choose. In our paper we systematize global scientific and clinical experience of planning and management pregnancies with SHT to help physicians to choose treatment option based on principals of evidence-based medicine.

Diabetic nephropathy (DN) is specific kidney damage in patients with diabetes mellitus. DN develops relatively often in pregestational diabetes patients (5,9-26%) and stills one of the main limitations for successful pregnancy in this patients’ group. Advanced DN increases risks of poor pregnancy outcomes for women and fetuses including chronic kidney disease (CKD) progression, high rate of preeclampsia, preterm deliveries, Cesarean sections, perinatal mortality and neonatal morbidity. At the same time there are more and more successful pregnancies with advanced DN in the wold.In our paper we systematize global experience of planning and management pregnancies with type 1 diabetes and DN in different stages of renal impairment. We discuss role of nephroprotective therapy in preconception care, achievement and maintaining blood pressure goals, multidisciplinary team care for improvement pregnancy outcomes in type 1 diabetic women with DN.

Objective: The aim of this study was to compare mothers' attitudes toward infant feeding and infant eating behavior in different countries, and their associations with infant feeding at 3 and 6 mon...

The article presents the results of clinical observation of cystic fibrosis (CF) patients received the enteral nutrition product Nutrient Standard (Russia) as nutritional support. The high efficiency of this product has been shown for the correction of malnutrition in СF children.

In a review there are presented current data both on the formation of Hirschsprung disease (HD) in children and complications of its surgical treatment. The importance of interrelations of intestinal microbiota, agangliosis of the large intestine and the mechanisms of formation of HD-associated enterocolitis as a leading complication in the postoperative period are described. The value of the intestinal microbiota in its interaction with the immune system as a factor of pathogenesis and prevention of postoperative complications in HD patients is determined. Changes in the intestinal microbiota were shown to play a significant pathogenetic role in the appearance and progression of HD-associated enterocolitis in children. It is indicated that early manipulations with microbial intestinal communities through the use of probiotics can become the basis of a new strategy for the prevention of postoperative complications in HD. Modulation of the intestinal microbiota with antibiotics and probiotics can be a promising method of the management and prevention of complications of surgical treatment of HD in children.

Type 1 diabetes mellitus is a condition associated with an increased risk of adverse perinatal outcomes such as spontaneous abortions, preterm birth, placental insufficiency, congenital malformations, and perinatal mortality. Diabetes mellitus combined with cardiovascular diseases in women during pregnancy often leads to hypertensive disorders and pre-eclampsia. The severity of the microvascular diabetic complications and frequency of hypoglycemic episodes, particularly in early pregnancy, are related to the risk of pre-eclampsia. We report the case of pregnancy and delivery of a live newborn in a 42-year-old woman with type 1 diabetes mellitus, pre-existing hypertension, heritable thrombophilia, and antiphospholipid syndrome. She had a 40-year history of type 1 diabetes mellitus with well-controlled diabetic nephropathy and retinopathy. The woman had been receiving continuous subcutaneous insulin therapy for the last five years, which allowed maintaining an appropriate glycemic control during pregnancy. Multidisciplinary supervision of course of pregnancy was carried out from the pre-gravidity stage until delivery and postpartum. In spite of the severe pre-eclampsia and preterm delivery by cesarean section at 36 weeks, she and newborn could avoid the intensive unit care and discharge from perinatal center without any complications.

Goat’s milk-based formulas are becoming more and more widespread in Europe and Russia. The article discusses the latest data on the composition and properties of goat’s milk. The article presents data on the content of functional components in goat’s milk, including lactoferrin and other bioactive peptides, oligosaccharides, nucleotides, polyamines and taurine. The authors assess adapted goat’s milk-based formulas and compare with cow’s milk-based formulas. The research described in the article demonstrates the positive effect of goat’s milk-based formulas on the physical development of young children. The article presents the study demonstrating the effectiveness of Kabrita® Gold formula in young children with functional gastrointestinal disorders. Conflict of interest: The authors of this article confirmed the absence of any other possible conflict of interest, which should be reported. The article is sponsored by the company Kabrita.

Homocystinuria is a genetically heterogeneous hereditary disease from the group of aminoacidopathies caused by a metabolic disorder of sulphur-containing amino acids, primarily methionine. The article presents the etiopathogenetic, diagnostic and therapeutic aspects of this disease and covers modern opportunities of biochemical and molecular diagnostics. The approach to dietary and pharmacological correction of metabolic disorders in homocystinuria and the general strategy of patients’ management are described in detail. Important information is given for physicians of various disciplines and parents of patients.

Methylmalonic acidemia (aciduria) is an inherited metabolic disturbance from the group of organic acidemias (acidurias). The article presents etiopathogenetic, epidemiological, diagnostic, and therapeutic aspects of the problem. The possibilities of laboratory and instrumental diagnostic methods the tactics of dietary correction of metabolic disorders in acute and interstitial periods of the disease are described in details; features of drug treatment are outlined. The necessary information for clinical practice and patients’ everyday life is given in the article.

Background. There is no doubt that it is necessary to study the efficiency of milk formulas that are introduced into the Russian market of baby food. This applies to both new products and known brands of formulas whose composition is subject to change. Objective. Our aim was to assess the clinical efficacy of the adapted goat's milk formula in the diet of young infants. Methods. We conducted a prospective comparative study with healthy full-term children aged 0–5 months being on a formula (main group) or breast feeding (comparison group). The tolerability of the adapted goat's milk formula, the dynamics of anthropometric indicators, changes in body composition as well as microscopic characteristics of stool and general clinical and biochemical parameters of peripheral blood were assessed after 1 month. Results. Good tolerability of the goat's milk formula was noted in 184 (96.8%) of 190 children in the main group. In the course of taking the product, the proportion of children with functional disorders of the gastrointestinal tract decreased significantly from 57 (30%) to 27 (14%) (p < 0.001). Physical development, complete blood count results, the levels of ferritin, prealbumin and 25(OH)D in children of the main group and the comparison group (n = 71) were comparable and were within the mean age parameters. Qualitative analysis of the level of specific IgE to goat's milk proteins did not reveal any sensibilization in any of the children receiving the milk formula, either at the beginning of the study or after 1 month of taking the product. Conclusion. The studied adapted goat's milk formula can be used in nutrition of young infants in cases of lack or absence of mother's milk.

Detection of a large number of oligosaccharides in breast milk predetermined their use in the composition of infant formula. The most studied prebiotic simulating the unique properties of breast milk oligosaccharides is the scGOS/lcFOS mixture. Its efficacy is confirmed in clinical studies. In 2017, the experts of the International Scientific Association of Probiotics and Prebiotics (ISAPP) adopted a new definition for «prebiotics», which greatly expanded the concept of their application. The World Allergy Organization (WAO) recommends the use of prebiotics in allergy- prone children. The guidelines are based on the results of studies of the influence of prebiotics on the intestinal microbi, a violation of the composition and functions of which predisposes to the development of allergy. Currently, the search for more promising technologies for the production of prebiotics continues.

Background:Misbalance between energy intake and consumption is considered the main reason of obesity. However, over the recent years there has been a lot of emerging data concerning early origins of obesity that forms during intrauterine development and/or early age periods.Objective:Our aim was to study how physically developed are the children of early school ages.Methods:The study included children aged 7 to 10 years. Their physical development was assessed with the WHO AnthroPlus (2009) software.Results:652 children were examined. Of them, balanced development was found in: according to the WAZ index (body mass/age) — 466/530 (87,9%) schoolchildren; HAZ index (height/age) — 620/652 (95,1%); BAZ (body mass index/age) — only 438/652 (67,2%) children. Excessive body weight was found in 61 (18,8%) of the 324 girls and 65 (19,8%) of the 328 boys (р = 0,891), obesity — in 24 (7,4%) and 52 (15,9%) children correspondingly (р = 0,038).Conclusion:Having evaluated the physical development of early aged schoolchildren between the ages of 7 and 10 years, it is possible to state that there is evidence in favour of higher readings of mass-weight indexes as compared to the standard WHO population. Every third early age schoolchild can have physical development deviations, at the same time boys are obese twice as often as girls.

Background: The article discusses a controversial issue of time for the introduction of complementary feeding for exclusively breastfed infants. Objective: Our aim was to determine the best time to begin complementary feeding of exclusively breastfed infants. Methods: Cohort observational study. We assessed actual nutrition and chemical composition of diets of infants, nalyzed anthropometric indicators, as well as clinical and biochemical parameters of blood. Results: The study included 203 infants. 112 of these infants were breastfed up to six months of age (exclusive breastfeeding or mixed feeding with the amount of breast milk of not less than 150–200 ml) and 91 infants were bottle-fed with adapted milk formulas. More than half of breastfed infants with complementary feeding introduction time of 4 and 5 months of age — 55 (57%) and only 4 (10%) exclusively breastfed infants received all necessary complementary foods by the age of 9 months. By the age of 9 months, diets of exclusively breastfed infants were 30–35% deficient in proteins, carbohydrates and energy, and 45% deficient in fat. Introduction of complementary feeding from the 4th month, rather than from the 5th or 6th month, reduces incidence of breast feeding in children aged 9 months up to 44% (p = 0.003). In the group of infants exclusively breastfed up to 6 months of age, the lowest concentration of ferritin in serum [median 28.0 (16.4; 45.0) ng/ml] was observed in this age. In this group, infants with unbalanced diets at the age of 9 months had the ferritin concentration of 11.7 (8.4; 22.6) ng/ml. Conclusion: The best time to begin complementary feeding of exclusively breastfed infants can be considered the age of 5 years.

The article presents data on the peculiarities of the prescription of cereal complementary feeding for young children. It is emphasized the importance of manufactured cereals in young child feeding. The article analyzes data on the nutritional value and chemical composition of the most popular buckwheat and oatmeal porridge in the Russian Federation, as well as the benefits of cereal as the first complementary feeding for an infant. The characteristics of the different manufactured cereals for infant feeding prescribed to healthy children are given: dry instant, ready-to-use liquid, and fruit and grain cereals. The article also presents the rationale for the prescription of cereals at certain pathological conditions — food allergy, cow's milk protein intolerance, celiac disease, digestive problems, as well as information about the nutritional value of milk and dairy-free cereals.

The article provides information on disorders of nutritional status (malnutrition) in children with chronic heart failure (congenital heart diseases, cardiomyopathy), discusses the causes of growth retardation and failure to thrive. The factors of the risk of nutritional deficiency development and the possibility of its correction with the use of nutritional products with a specially given composition. It is presented the clinical observation of an infant with congenital heart disease, aortic coarctation and patent ductus arteriosus, chronic heart failure 2B-A st. and severe malnutrition. The correction of nutritional status using a specialized formula for enteral nutrition in the course of adequate medical therapy allowed to improve the general condition of a patient and positive dynamics of body weight.