Introduction: The impact of breastfeeding is undoubtedly exceptional for the nutrition of children today. Several factors influence the establishment of breastfeeding, including parental participation in the programme ‘Preparation for childbirth and parenthood’. The purpose of this research was to determine which factors influence the establishment of breastfeeding in the maternity hospital. Method: The research was based on a quantitative descriptive research method using a survey technique. A sample of 90 breastfeeding mothers in 3 maternity hospitals in Slovenia was determined. 82% questionnaires were filled in correctly. Results: Just over half of the mothers (56 %) decided to breastfeed on their own and 91 % of the mothers decided to breastfeed due to the benefits for both the mother and the child. 68% of the mothers successfully breastfed their newborns within 30 minutes of giving birth. Interestingly, 87 % of these mothers received help from a nurse. Factors that affect the establishment of breastfeeding are: first skin contact and first breastfeeding, roomingin, the decision of mothers to breastfeed before childbirth, the method of delivery, familiarizing mothers with the benefits of breastfeeding, and others. Discussion and conclusion: The study has shown that mothers are aware of the advantages of breastfeeding for themselves and for their newborns. According to the results, it can be concluded that the mothers trust the nurses. They believe the nurses are able to provide adequate consult if problems with breastfeeding arise.
Dedna bulozna epidermoliza je genetsko povzročena bole-zen krhkosti kože. Doslej so bile identificirane mutacije, ki vključujejo vsaj 20 različnih genov s posledično konformacijsko spremenjenostjo ali odsotnostjo beljakovin citoskeleta, celičnega matriksa ali beljakovin medcelične adhezije v koži. Na osnovi genetsko povzročenih molekularnih nepravilnosti in zato nastalih razslojevanj kožnega tkiva razlikujemo 4 osnovne tipe bolezni: simpleks, junkcijsko in distrofično dedno bulozno epidermolizo ter Kindlerjev sindrom; v sklopu osnovnih tipov poznamo vsaj 30 klinično različnih podtipov bolezni. Pri težjih oblikah dednih buloznih epidermoliz se lahko pojavljajo zapleti na koži, sluznicah ali kožnih adneksih, pridruži pa se lahko tudi sistemska prizadetost. Med drugim se na mestih kroničnih ran ali brazgotin že v zgodnji odrasli dobi lahko razvijejo karcinomi kože s pogosto agresivnim potekom. Sodobna zdravila in individualno prilagojena klinična interdisciplinarna obravnava teh bolnikov kljub izredno težki bolezni prispevajo k boljši kakovosti življenja.
Družinska hipomagnezemija s hiperkalciurijo in nefrokalcinozo (angl. familial hypomagnesemia with hypercalciuria and nephrocalcinosis, FHHNC) je redka avtosomno recesivna presnovna bolezen s prizadetostjo ledvičnih tubulov. Zanjo je značilna izgubljanje magnezija in kalcija preko ledvic s pridruženo nefrokalcinozo in/ali ledvičnimi kamni že v zgodnjem otroštvu, zaradi česar gre tudi za napredujočo ledvično okvaro, ki se klinično izrazi v drugem ali tretjem desetletju življenja. FHHNC uvrščamo med redke presnovne vzroke za nastanek ledvičnih kamnov, nefrokalcinoze in kronične ledvične bolezni pri otrocih. Zaradi neizogibne napredujoče in nepovratne okvare ledvic pa moramo pri vseh otrocih, pri katerih odkrijemo ledvične kamne ali nefrokalcinozo, pomisliti tudi na redke presnovne razloge za njihov nastanek, saj lahko samo z doslednimi simptomatskimi ukrepi podaljšamo čas do nastanka kronične ledvične okvare in s tem pomembno izboljšamo kakovost življenja.
Background: Cleft palate, with or without lip and/or alveolar ridge cleft, is a congenital craniofacial anomaly that affects feeding from birth due to the open communication between the oral and nasal cavities. This study aims to examine the feeding difficulties experienced by children with cleft palate (CP) and cleft lip and palate (CLP), the extent to which these difficulties persist into toddlerhood, potential differences in the prevalence of feeding disorders between children with CP and CLP, and the characteristics of children who required alternative feeding methods. Methods: Data on feeding was collected through a questionnaire completed by parents of children born within the five years preceding the study. With written parental consent, the questionnaire data was supplemented with information from medical records. Results: The study included 98 children (41% of those invited), comprising 56 children with CP and 42 with CLP. The findings indicate that in approximately 10% of children with CP and CLP, feeding difficulties persisted beyond the age of two and, in some cases, even after the completion of surgical treatment in the third year of life. These children exhibited significantly greater challenges. Fourteen children required a nasogastric feeding tube for several months during their first year of life, while one child required a gastrostomy. The most significant factors associated with the need for alternative feeding methods were the presence of syndrome and CP. Overall, no significant differences in feeding difficulties were observed between children with CP and those with CLP. Conclusions: Identifying risk factors for the persistence of feeding difficulties into toddlerhood is essential for timely intervention. Adequate nutrition is fundamental for normal child development and has a direct impact on the overall quality of life.
Epidermolysis bullosa is a genetically inherited disorder characterized by extreme skin fragility. Mutations in at least 20 different genes have been identified, leading to structural or functional abnormalities or the absence of proteins involved in the cytoskeleton, extracellular matrix, or intercellular adhesion within the skin. These molecular defects result in separation at various levels in the skin, forming the basis for the classification of epidermolysis bullosa into four major types: simplex, junctional, dystrophic epidermolysis bullosa, and Kindler syndrome. More than 30 clinically distinct subtypes are recognized within these main categories. Patients may develop various complications, including aggressive forms of skin cancer, especially in areas with long-term wounds. Even though epidermolysis bullosa is a very serious condition, modern treatments and a carefully tailored, team-based approach to patient care can help improve the comfort, health, and overall quality of life for those living with the disease.
Familial hypomagnesemia with hypercalciuria and nephrocalcinosis (FHHNC) is a rare autosomal recessive disorder. It is characterized by renal wasting of magnesium and calcium, associated with the development of nephrocalcnosis and renal stones in early childhood. FHHNC is a rare cause of nephrocalcinosis and/or kidney stones and should be considered when encountered in small child since it progressively and irreversibly leads to chronic kidney disease and end stage kidney failure no later then in the second or third decade of life. With agressive therapy which is exclusively symptomatic and includes fluid, dietary restrictions, potassium citrate and magnesium supplemention, progression to an end stage kindney disease could be postoponed.
Uvod: Pomen dojenja je v sodobni prehrani otrok nedvom-no izjemen. Na vzpostavitev dojenja vpliva več dejavnikov, vključno z udeležbo staršev na pripravah z naslovom Priprava na porod in starševstvo. Namen raziskave je bil ugotoviti, kateri dejavniki vplivajo na vzpostavitev dojenja v porodnišnici. Metoda: Raziskava je temeljila na kvantitativni metodi raziskovanja, metodi deskripcije. Uporabili smo tehniko anketiranja. Uporabili smo vzorec 90 doječih mater v 3 slovenskih porodnišnicah. Pravilno je bilo izpolnjenih 82 anketnih vprašalnikov. Rezultati: Največ mater (56 %) se je samih odločilo za dojenje, 91 % se jih je za dojenje odločilo iz razloga, ker je dojenje najbolj koristno za mater in otroka. 68 % mater je uspelo podojiti svojega novorojenca v prvih 30 minutah po porodu. 87 % mater je pri tem prejelo pomoč medicinske sestre. Dejavniki, ki vplivajo na vzpostavitev dojenja v porodnišnici so: prvi kožni stik in prvi podoj, sobivanje matere z novorojencem, odločitev mater za dojenje še pred porodom, način poroda, seznanitev mater s prednostmi dojenja in drugi. Razpravljanje in sklep: Ugotovili smo, da se matere zavedajo vseh prednosti, ki jih ima dojenje zanje in za njihove novorojence. Matere zaupajo medicinskim sestram, saj jim znajo uspešno svetovati, ko se pojavijo zapleti pri dojenju in pristavljanju.
Breastfeeding is the cornerstone of a children’s survival, nutrition and development, as well as the foundation for mothers’ health. Children have the right to living, survival, optimal development and the highest attainable standard of health, which must include breastfeeding and safe and nutritious food. Women have the right to accurate, unbiased information necessary to make an informed choise about breastfeeding. They also have the right to quality health services. Also, they have the right to adequate maternity protection at the workplace and to a friendly environment and adequate breastfeeding conditions in public environments. Facilities providing maternity and newborn services must be aware of the infant feeding policy, their health workers should have the knowledge of infant feeding. Implementation of the Ten Steps to Successful Breastfeeding, incorporated in the Baby Friendly Hospitals Initiative (BFHI) has a positive impact on breastfeeding outcomes. The National Breastfeeding Promotion Committee at UNICEF Slovenia implemented several initiatives based on the ten steps of the WHO: BFHI, Breastfeeding Friendly Health Facility, Neo-BFHI and Breastfeeding Friendly Cities. The article presents the substantive highlights of the afore mentioned initiatives, as well as opens up the space for new initiatives that would also enable a wider supportive environment for mothers during breastfeeding, which contribute to reducing risk of inequalities between mothers.
Bullous skin involvement with necrosis in IgA vasculitis in children is rare. In most cases, systemic treatment is not required for isolated skin involvement, except in severe clinical presentations. This article presents a 4-year-old child with a severe necrotic bullous form of IgA vasculitis. The patient was treated with intravenous immunoglobulins and methylprednisolone. The disease outcome was excellent, with no long-term consequences of skin necrosis.
Bulozna prizadetost kože z nekrozo v sklopu IgA vaskulitisa pri otrocih je redka. Po večini za izključno kožno prizadetost sistemsko zdravljenje ni potrebno, razen pri težjih kliničnih slikah. V prispevku predstavljamo 4-letnega otroka s težko klinično sliko nekrotične bulozne oblike vaskulitisa IgA. Deklica je bila zdravljena z intravenskimi imunoglobulini in metilprednizolonom. Izid bolezni je bil odličen in brez dolgoročnih posledic nekroze kože.
Dojenje je temelj otrokovega preživetja, prehrane in razvoja ter temelj za zdravje žensk. Tako za otroka kot za mater je dojenje področje človekovih pravic. Otroci imajo pravico do življenja, optimalnega razvoja in do najvišjega dosegljivega standarda zdravja, katerega sestavni del naj bo dojenje ter varna in ustrezna hrana. Ženske imajo pravico do zanesljivih in nepristranskih informacij, ki so potrebne za ozaveščeno odločitev o dojenju. Prav tako imajo pravico do kakovostnih zdravstvenih storitev. Pravico imajo do ustreznega varstva materinstva na delovnem mestu ter do prijaznega okolja in ustreznih razmer v javnih prostorih za dojenje. Ustanove, ki nudijo storitve za matere in dojenčke, morajo biti seznanjene s politiko hranjenja dojenčkov. Izvajanje Desetih korakov do uspešnega dojenja, vključenih v pobudo Novorojenčku prijazne porodnišnice (NPP), pozitivno vpliva na rezultate dojenja. Nacionalni odbor za spodbujanje dojenja pri UNICEF Slovenija je uvedel več pobud, ki temeljijo na desetih korakih SZO: NPP, Dojenju prijazna zdravstvena ustanova, Neo-BFHI in Dojenju prijazna mesta. Članek prikaže vsebinske poudarke teh pobud, odpira pa tudi prostor novim pobudam, ki bi omogočale širše podporno okolje materam pri dojenju in prispevajo k enakosti obravnav mater.
Izhodišča: Pri razcepu neba, z razcepom ustnice ali brez njega, in oz. ali pri razcepu čeljustnega grebena gre za prirojeno obrazno nepravilnost, ki zaradi odprte povezave med ustno in nosno votlino od rojstva dalje vpliva tudi na hranjenje. V raziskavi smo proučevali, kakšne težave imajo otroci z razcepom neba (angl. cleft palate, CP) in z razcepom ustnice in neba (angl. cleft lip and palate, CLP) pri hranjenju, ali težave pri hranjenju vztrajajo tudi še v obdobju malčka, ali se otroci s CP in CLP razlikujejo glede pogostnosti motenj hranjenja in kaj so značilnosti otrok, ki so potrebovali alternativne načine hranjenja. Metode: Podatke o hranjenju smo pridobili s pomočjo anketnega vprašalnika, ki so ga izpolnili starši otrok, rojenih v zadnjih petih letih pred začetkom raziskave. S pisnim dovoljenjem staršev smo podatke vprašalnika dopolnili s podatki iz otrokove zdravstvene dokumentacije. Rezultati: V raziskavo je bilo vključenih 98 otrok (41 % povabljenih), od tega 56 otrok s CP in 42 otrok s CLP. Ugotovili smo, da pri približno desetini otrok s CP in CLP težave s hranjenjem vztrajajo tudi po drugem letu starosti oz. celo po končanem kirurškem zdravljenju v tretjem letu starosti. Ti otroci imajo statistično zna-čilno več težav. 14 otrok je v prvem letu življenja več mesecev potrebovalo nazogastrično sondo za hranjenje, 1 otrok pa celo gastrostomo. Najpomembnejša dejavnika, povezana z uporabo teh alternativnih metod hranjenja, sta bila prisotnost sindroma pri otroku in CP. Skupini otrok s CP in CLP se glede težav s hranjenjem večinoma nista statistično značilno razlikovali. Zaključki: Poznavanje dejavnikov tveganja za vztrajanje težav s hranjenjem v obdobju malčka je ključnega pomena, saj omogoča strokovnjakom pravočasno ukrepanje. Le otrok, ki je primerno prehranjen, se lahko normalno razvija, kar pozitivno vpliva na kakovost življenja otroka in njegove družine.
Pain in a joint can be a symptom of many illnesses. The most common infectious diseases are osteoarticular infections, typically affecting the lower extremities. The infectious cause of bone and joint involvement is obvious with fever as an accompanying symptom. Still, with certain pathogens (Kingella kingae, B. burgdorferi), the systemic response may be less pronounced, and they may present without fever. Transient synovitis is one of the most common causes of hip pain in children. Transient synovitis occurs less frequently in children under three years of age, where the frequency of osteoarticular infections caused by Kingella kingae, which can also present without fever, is highest. Timely recognition of a joint infection is crucial for successful treatment and prevention of long-term consequences. In addition to septic arthritis, the article also presents characteristics of Kingella kingae infections, including transient hip synovitis and Lyme arthritis. Furthermore, it discusses reactive arthritis, which typically occurs a few weeks after infection, most often in the gastrointestinal or urinary tract.
Bolečine v mišičnoskeletnem sistemu so v otroškem obdobju sorazmerno pogoste. Delimo jih na akutne in kronične, slednje trajajo več kot 3 mesece. Diferencialna diagnoza tako akutnih kot kroničnih bolečin v sklepih pri otrocih je široka. Slikovne preiskave so poleg anamneze, klinične slike in laboratorijskih izvidov pomembne v diagnostičnem postopku iskanja vzrokov bolečine. Katero slikovno metodo uporabimo najprej, je odvisno od mesta bolečine in od prizadetosti tkiva. Pri mehkotkivnih spremembah in oteklinah sklepov je prva diagnostična metoda ultrazvočna preiskava, pri sumu na prizadetost kosti pa rentgensko slikanje. Če je potrebno, sledi magnetnoresonančno slikanje ali računalniška tomografija. V prispevku bomo opisali anatomske in morfološke značilnosti otroškega skeleta, ki lahko dajejo videz patoloških sprememb ter slikovne diagnostične postopke pri akutnih in kroničnih bolečinah v sklepih.
Musculoskeletal pain is relatively common in childhood. It is divided into acute and chronic pain, with the latter lasting more than three months. The differential diagnosis of both acute and chronic joint pain in children is broad. In addition to medical history, clinical presentation and laboratory findings, imaging is important in the diagnostic process of identifying the causes of pain. Which imaging method is used first depends on the location of the pain and the extent of tissue damage: for soft tissue changes and joint swelling, the first diagnostic method is ultrasound, while for suspected bone damage, x-rays are used. If necessary, magnetic resonance imaging or computed tomography may follow. In this article, we will discuss the anatomical and morphological characteristics of the paediatric skeleton that can mimic pathological changes, as well as imaging diagnostic procedures for acute and chronic joint pain.
Joint pain is a common clinical symptom in children with a broad and diverse etiology – ranging from benign, self-limiting conditions to serious and potentially life-threatening diseases. The differential diagnosis is extensive and includes both musculoskeletal and non-musculoskeletal causes from various organ systems. A thorough medical history and clinical examination form the foundation of the diagnostic process, supported by targeted laboratory and imaging investigations. A particular diagnostic challenge is the involvement of a single joint. It is essential to first rule out other potential causes, including infections, trauma, orthopedic conditions, and malignancies, before considering rheumatologic origin. Early recognition of serious conditions significantly influences disease outcomes, enabling timely treatment and prevention of complications. For this reason, a broad understanding of possible etiologies across different medical specialties is crucial when evaluating joint pain in children. In this article, we present four clinical cases that illustrate the variety of underlying causes and highlight some of the diagnostic and therapeutic challenges encountered in the assessment of joint pain in the pediatric population.
Background: Chronic non-cancer pain in children and adolescents is a complex health challenge, defined as pain lasting at least three months and significantly affecting daily activities, cognition, emotions, and behavior. It is recognized as a primary pain type in ICD-11 (2019) and affects about 21% of children and adolescents worldwide, with 1.7–5% experi-encing severe forms. Materials and Methods: This review summarizes current literature on the prevalence, risk factors, diagnostic approaches, and multidisciplinary therapeutic strategies. Results: Risk factors include female sex, adolescence, elevated BMI, genetic predisposition, psychological factors, family history of chronic pain, and lower socioeconomic status. The most common pain types are headaches and musculoskeletal pain, followed by general pain and back pain. Slovenian data show correlations between anxiety/depression symptoms and pain, with additional risks linked to parental separation, family conflicts, and peer violence. Conclusions: Chronic pain in children requires a biopsychosocial approach with multidisciplinary team management. Early recognition is crucial to prevent long-term consequences, as 80% of adults with chronic pain report symptom onset in childhood. Integrated care involving physicians, psychologists, physiotherapists, and family support is essential for optimal outcomes.
Izhodišča: Kronična nerakava bolečina pri otrocih in mladostnikih je kompleksen izziv, opredeljen kot bolečina, ki traja vsaj 3 mesece in pomembno vpliva na vsakodnevne aktivnosti, mišljenje, čustvovanje in vedenje. Prepoznana je kot primarni tip v ICD-11 (2019) in prizadene okoli 21 % otrok in mladostnikov po svetu, huda oblika pa 1,7–5 %. Material in metode: Pregled povzema literaturo o pojavno-sti, dejavnikih tveganja, diagnostiki in multidisciplinarnih terapevtskih pristopih. Rezultati: Dejavniki tveganja vključujejo ženski spol, mladostniško starost, povišan ITM, genetsko predispozicijo, psihične dejavnike, družinsko anamnezo in nižji socialno-ekonomski status. Najpogostejši so glavoboli in mišično-skeletne bolečine, sledijo splošne in bolečine v hrbtu. Slovenski podatki kažejo povezave med anksioznostjo/depresijo in bolečino, tveganje pa povečajo ločitev staršev, družinski konflikti in vrstniško nasilje. Zaključki: Kronična bolečina pri otrocih zahteva bio-psihosocialni pristop z multidisciplinarnim timom. Zgodnje prepoznavanje je ključno za preprečevanje posledic, saj 80 % odraslih s kronično bolečino poroča o začetku v otroštvu. Integrirana oskrba z zdravniki, psihologi, fizioterapevti in družinsko podporo je bistvena za optimalni izid.
Pri otrocih so bolečine v sklepih pogost simptom z zelo raznoliko etiologijo – od nenevarnih, prehodnih stanj do resnih, lahko tudi nevarnih bolezni. Diferencialna diagnoza je široka in vključuje tako bolezni in poškodbe mišično-skeletnega sistema kot tudi drugih organskih sistemov. Temelj diagnostičnega procesa sta natančna anamneza in klinični pregled, v pomoč pa so ciljno usmerjene laboratorij-ske in slikovne preiskave. Poseben izziv je, ko gre za prizade-tost enega samega sklepa. Pred razmišljanjem o revmatski etiologiji je potrebno najprej izključiti ostale vzroke, kot so okužbe, poškodbe, ortopedske bolezni in malignomi. Zgodnja prepoznava resnih vzrokov pomembno vpliva na potek bolezni in omogoča pravočasno zdravljenje in preprečuje zapletov. Zato je pri obravnavi otrok z bolečinami v sklepih ključnega pomena dobro poznavanje možnih etiologij z različnih področij medicine. Prispevek prikazuje 4 klinične primere, ki ponazarjajo raznolikost vzrokov ter diagnostične in terapevtske izzive, s kate-rimi se srečujemo pri obravnavi otrok z bolečino v sklepih.
Joint pain in children is a common reason for pediatric consultation. While most cases are benign and transient, it is crucial to identify rare rheumatic diseases that may lead to lasting consequences. This article outlines the approach to a child with joint pain, including history taking, clinical examination, diagnostic procedures, and management of common pediatric rheumatic conditions such as juvenile idiopathic arthritis, rheumatic fever, post-streptococcal arthritis, chronic nonbacterial osteomyelitis, connective tissue diseases, systemic vasculitides, and Raynaud’s phenomenon. Emphasis is placed on early recognition, multidisciplinary care, and individualized treatment.
