The authors present current data on the etiology, pathogenesis, clinical manifestations of celiac disease in children of different ages, associated diseases, laboratory and instrumental diagnostics, diet therapy, additional treatment methods, vaccination, and follow-up of children with celiac disease based on the developed clinical guidelines “Celiac Disease. Children”.

Introduction. There were conducted numerous studies to assess the management of nutrition in young children living in the Russian Federation. However, this problem remains poorly studied in the regions of the North Caucasus Federal District and requires further development. Aim. To determine the features of nutrition management and the frequency of alimentary-dependent conditions in young children living in the regions of the North Caucasus Federal District (using the cities of Stavropol, Nalchik, and Cherkessk as examples).Materials and methods. A multicenter non-randomized cross-sectional study was conducted: a survey of pediatricians and parents on the management of rational nutrition in, children from 1 year to 3 years of age from health groups I and II based on questionnaires developed by the researchers.Results. The data of the study demonstrated significant differences in the opinions of pediatricians and parents on the adequacy of nutrition in young children (p < 0.001). A significantly high frequency of overweight/obesity was revealed in Stavropol (39%) compared to Cherkessk (22%), iron deficiency conditions, including anemia: 30%, 52%, 21%, respectively, while in Stavropol it was more common compared to Nalchik and Cherkessk (p < 0.001), as well as rickets: Stavropol — 39% versus Nalchik — 37% and Cherkessk — 20% (p = 0.029). A significant increase in the consumption of “unhealthy” food products by children over the third year of life in Cherkessk (p = 0.015) and Stavropol (p < 0.001) was revealed, as well as a direct effect of the level of mothers’ education on the consumption of such “harmful” products for children as carbonated sweet drinks (p < 0.001) and sausages (p = 0.013).Conclusion. The identified violations in the nutrition of young children living in the North Caucasus region can be the cause of a high frequency of alimentary-dependent conditions, which requires increased attention to educational work in primary outpatient care using popular information materials available to the population to introduce the principles of healthy nutrition for children into practice and form correct eating behavior in them.Contribution: Bushueva T.V., Borovik T.E., Skvortsova V.A. — concept and design of the study; Khubieva M.U., Lukoyanova O.L., Guseva I.M., Chernikov V.V., Komarova O.V. — collection and processing of the material; Bushueva T.V., Khubieva M.U., Chernikov V.V. — statistical processing of the material; Bushueva T.V., Borovik T.E., Khubieva M.U. — writing the text; Fisenko A.P. — editing the text.All co-authors — approval of the final version of the article, responsibility for the integrity of all parts of the article.Acknowledgment. The study had no sponsorship.Conflict of interest. The authors declare no conflict of interest.Received: August 11, 2025Accepted: October 02, 2025Published: October 30, 2025

Background. Crohn’s disease in children is often accompanied by impaired nutritional status, including severe malnutrition. Elimination diets are often unjustified and lead to deterioration of the patient’s condition. The aim of the study: to determine the trend in the nutritional status against the background of optimizing the diet in children with Crohn’s disease (CD). Materials and methods. A comprehensive study of nutritional status was carried out including parameters of bone mineral density in 191 children 7–17 years-old with a confirmed diagnosis of CD. 54 patients were examined dynamically before and after the prescribing of a balanced sparing diet developed by us with or without the addition of specialized products for enteral nutrition (groups 1 and 2, respectively). Results. More than half (52,9%) of the children had malnutrition, with 49 (25,7%) patients having moderate to severe malnutrition, accompanied by loss of lean mass, skeletal muscle mass, and bone mineral density. The widespread use of unbalanced diets with insufficient caloric content, low levels of protein, calcium- and iron-containing foods, and dietary fiber was revealed. Against the background of a comprehensive approach with the inclusion of dietary support developed by us, significant positive trends were noted (p < 0,001) as BMI increasing against the background of an increase in lean and skeletal muscle mass of the body without an increase in the content of adipose tissue (p > 0,05). A significant decrease in the disease activity indices — PCDAI and SES-CD was noted. Conclusion. Prescribing unbalanced restrictive diets is unsafe. A comprehensive approach to correcting the nutritional status in patients with a sparing balanced diet against the background of immunosuppressive therapy has proven its effectiveness not only in gaining weight, but also in improving the component composition of the body, but also in monitoring disease activity.

Children with Crohn's disease (CD) are at high risk for developing nutritional deficiencies. According to studies in adult patients with CD, loss of lean and skeletal muscle mass and decreased bone mineral density (BMD) are unfavorable prognostic factors for the course of the disease; among children, the prevalence of these changes has not been sufficiently studied as yet. The purpose of this research was to study the frequency and correlation between disorders of body composition and decreased bone mineral density in children with CD. Materials and methods used: medical records of 163 aged 5 to 17 y/o with a confirmed CD diagnosis were assessed for the risk of nutritional deficiency using STRONGkids screening tool, anthropometric parameters, body composition with bioimpedance measurements as well as the disease activity index with PCDAI and endoscopic activity with SES-CD. BMD was assessed in 145 using densitometry. Results: depending on the degree of risk of malnutrition, children were divided into 2 groups as follows: G1 with high and G2 with moderate risks for malnutrition. G1 patients had significantly lower values of both anthropometric indices (Z-scores BMI/age, mid-upper arm circumference/age) and lean and skeletal muscle mass (p<0.001) along with more severe course of CD according to PCDAI (p<0.001). According to bioimpedansometry data, a significant increase in catabolic processes was found in G1 children as a decrease in Z-scores for both the phase angle (p<0.001) and the active cell mass (p<0.001). A decrease in BMD was detected in 9 (37%) of G1 and 26 (21.4%) of G2. A correlation was found between Z-scores lean body mass/age and BMD/age (p<0.001, Rs=0.612). Among children with reduced BMD values, the indicators for BMI, lean, skeletal muscle and active cell mass according to bioimpedance measurements were significantly lower (p<0.001). Conclusion: the data obtained during the study proposes high incidence of decreased bone mineral density along with pathological changes in body composition in children with CD. The use of STRONGkids tool to identify children at high risk of developing malnutrition, especially in the absence of the technical ability to conduct a detailed assessment of nutritional status with determination of body composition and BMD indicators, makes it possible to timely identify patients requiring individual nutritional support aiming to optimizing diets and, if necessary, prescribing addition of specialized food supplements.

Введение. В комплексном лечении недоношенных детей важная роль принадлежит питанию, от адекватности которого в значительной степени зависят их рост и развитие. Цель работы. Оценка антропометрических показателей и состава тела детей с очень низкой и экстремально низкой массой тела при рождении и в 38-40 недель постконцептуального возраста. Материалы и методы. Нами проведено когортное амбиспективное рандомизированное исследование. В него включены 70 недоношенных детей (28 девочек и 42 мальчика), рожденных с массой тела менее 1000 г (1-я группа, n = 40) и от 1000 до 1500 г (2-я группа, n = 30). Антропометрические данные при рождении и на момент исследования оценивались с помощью международных стандартов роста INTERGROWTH-21st. Количество и соотношение жировой и безжировой массы тела определялись с помощью воздушной плетизмографии. Результаты. При оценке нутритивного статуса недоношенных детей обеих групп на сроке доношенности (38-40 недель постконцептуального возраста) установлено значимое снижение показателей стандартизированной оценки z-scores – массы, длины тела и окружности головы к возрасту в 1-й группе, а также массы и окружности головы к возрасту во 2-й группе, более выраженное в 1-й группе. Недостаточность питания (z-score массы тела к возрасту менее 1 SD) выявлена у 77,5% детей 1-й группы и 23,3% – 2-й группы. Анализ показателей состава тела не выявил значимых различий в процентном содержании жировой и безжировой массы тела детей 1-й и 2-й групп, но безжировой массы тела было на 440 г меньше у детей с экстремально низкой массой тела при рождении. В 1-й группе установлены статистически значимые прямые корреляционные связи между z-score массы тела и безжировой массы тела, выраженной как в процентном отношении, так и в кг, а также значимая обратная корреляционная связь с жировой массой тела в процентах. Заключение. Формирование постнатальной задержки роста у значительной части детей, родившихся с массой тела менее 1500 г, диктует необходимость тщательного динамического контроля их нутритивного статуса для проведения своевременной коррекции. Background. In the complex treatment of premature infants, nutrition plays an important role, the adequacy of which largely determines their growth and development. Objective. Assessment of anthropometric parameters and body composition of children with very low and extremely low body weight at birth and at 38-40 weeks of postconceptional age. Materials and methods. We conducted a cohort ambispective randomized study. It included 70 premature babies (28 girls and 42 boys), born with a body weight of less than 1000 g (group 1, n = 40) and from 1000 to 1500 g (group 2, n = 30). Anthropometric data at birth and at the time of the study were assessed using international growth standards INTERGROWTH–21st. The amount and ratio of fat and lean body mass were determined using air plethysmography. Results. When assessing the nutritional status of premature infants of both groups at term (38-40 weeks of postconceptual age), a significant decrease in standardized z-scores was found – weight, body length and head circumference for age in group 1, as well as weight and head circumference by age in the 2nd group, more pronounced in the 1st group. Malnutrition (z-score of body weight for age less than 1 SD) was detected in 77.5% of children in group 1 and 23.3% in group 2. Analysis of body composition indicators did not reveal significant differences in the percentage of fat and lean body mass in children of groups 1 and 2, but lean body mass was 440 g less in children with extremely low birth weight. In group 1, statistically significant direct correlations were established between the z-score of body weight and lean body mass, expressed both as a percentage and in kg, as well as a significant inverse correlation with body fat mass as a percentage. Conclusion. The formation of postnatal growth retardation in a significant proportion of children born weighing less than 1500 g dictates the need for careful dynamic monitoring of their nutritional status for timely correction.

Introduction. Postnatal growth retardation in premature infants with very low birth weight (VLBW) remains an unresolved problem. There are different approaches regarding the duration of use of breast milk fortifiers during breastfeeding and specialized formulas during formula feeding, as well as the timing of the appointment of complementary feeding. Objective: to evaluate the physical development and component body composition in VLBW infants, depending on nutritional support over the first year of life. Materials and methods. The study included ninety three VLBW premature infants of 2 to 11 months postnatal age (PNA). The main (1st) group included infants (n = 74) who received dietary correction depending on the nutritional status, while no such intervention was performed in the (2nd) comparison group (n = 19). Up to 64 weeks of postconceptional age (PCA), weight, body length, and head circumference were assessed using INTERGROWTH-21st international growth standards, then in the software “WHO Anthro (2009)”. Fat and fat-free (lean) mass were determined using the air plethysmography method (PEA POD, LMi, USA). Results. The analysis of the nutritional status revealed a moderate deviation, not exceeding 1 sigma, decrease in indices (Z-scores) of anthropometric indices in infants of the 1st and 2nd groups by PNA of 2–3 months. Further in infants of the 1st group on the background of prolonged use of fortified nutrition (breast milk fortifier or specialized formulas for preterm infants) and timely introduction of complementary foods, nutritional deficiencies throughout the first year of life in general were not revealed. In the 2nd group of infants without additional correction of nutrition by 4–5 months of age, the development of mild nutritional deficiency was noted by 6–7 months of age. By 6–7 months of age, it turned into moderate nutritional deficiency, which persisted until 8–9 months of age and then turned into mild nutritional deficiency. Analysis of the component body composition showed that during the observation period, the fat-free body mass (FFM) gain in infants in the 1st group was 3.40 kg, in Group 2 infants — 2.2 kg. At the same time, % body fat mass (FM) in infants in groups 1 and 2 had no significant differences (%FM 1 = 19.3 [15.3–22.5], %FM 2 = 19.9 [16.7–24.6], p = 0.769) and did not exceed the values characteristic of preterm infants. Conclusion. A comprehensive assessment of the nutritional status of VLBW infants during the first year of life allowed us to eva­luate the positive impact of long-term use of fortified diets and timely introduction of certain complementary foods. Optimization of nutrition made it possible to prevent the development of nutritional deficiency, which can have a significant positive impact on their further growth, development, and health status.

Adequate nutritional status in a patient with cystic fibrosis (CF) positively correlates with the normal function of the bronchopulmonary system. Many domestic and foreign studies have been conducted so far to assess the nutritional status of children and adults with CF. However, there is no data as yet on the phenotypic characteristics of children from different ethnic groups of the North Caucasus depending on their genotype. The purpose of this research was to study the peculiarities of nutritional status in children with CF of the following Russia’s North Caucasus ethnic groups: Chechen, Karachay-Circassian, Dagestani, Ingush and Ossetian-Alanian. Materials and methods used: a single-center open prospective study of 117 children with CF aged 2 months to 17 years old (Me 6 y/o) of various North Caucasus ethnic groups was conducted. All patients have undergone molecular diagnosis and assessment of both nutritional status and exocrine pancreatic function. Results: 50.4% of pediatric patients with CF in the Russia’s North Caucasus have had pathological mutations in c.1545_1546delTA, p.(Tyr515*) and c.3846G>A, p.(Trp1282*) in homozygous state. These mutations were most often found in the Ingush (100%) and Chechen (82%) ethnic groups and somewhat less frequently in the Dagestani (57.1%) and Karachay-Circassian (54%) ethnic groups. In the Chechen and Ossetian-Alanian ethnic groups, when these mutations were detected, severe pancreatic insufficiency was established in 40.5% and 100% of cases, respectively. Pseudo-Bartter syndrome was diagnosed in 60% of cases with this genetic variant in a homozygous or compound heterozygous states during the patients’ first years of life. Indicators for the nutritional status of children with CF from different ethnic groups were significantly lower compared to those recorded officially in the 2021 Russian National Register of Patients with CF. Conclusion: it is necessary to study the course of CF and the state of nutritional status separately in each population and its connection with the identified genetic characteristics of the Russia’s North Caucasus ethnic groups. The genotype and phenotype patterns for these patients were the reason for the development of disorders of the exocrine function of the pancreas and pseudo-Bartter syndrome at an early age, which in its turn could lead to further development of nutritional deficiency.

Introduction. The review is devoted to the importance of lipids in the nutrition of premature infants with bronchopulmonary dysplasia (BPD). In recent years, the proportion of children born prematurely especially babies with very low and extremely low body weight, has been increasing due to the introduction of reproductive technologies that allow women with various pathologies and health abnormalities having children, as well as the use of modern neonatal intensive care and intensive care facilities. One of the most common diseases in such patients is BPD. An important component of the system of caring for prematurely born infants is adequate nutrition, which plays an important role in the development and maturation of all organs and systems, including lung tissue, changing its morphology. It is important to note that in severe BPD, there is a direct relationship between nutritional status, normal lung function, and psychomotor development of the infant. Therefore, the nutritional needs of premature BPD infants are increased and this imposes special requirements on their admission and individual dietary correction, taking into account all the features of the child’s development and the presence of concomitant pathology. The optimal nutrition for a premature baby is recognized as mother’s milk, which is enriched with breast milk. However, the fat component (the main energy substrate) is either absent in the fortifier, or lipids amounts in to fail to be sufficient. The use of specialized mixtures also does not overlap the caloric content of the diet to provide the growth rate of BPD infant against the background of increased energy needs by 15–25% when compared with patients without BPD) and the necessary restriction of the volume of injected fluid due to the high risk of hypervolemia of the small circulatory circle. Conclusion. Thus, an additional supply of medium-chain triglycerides seems to be a promising direction that increases the fat component of the diet and, as a result, its energy value in conditions of limiting fluid intake in premature BPD infants.

Introduction. The results of treatment of children who are preparing or have already undergone major surgery depend on many factors, including the nutritional status — the presence/absence of malnutrition. Aim: to assess the nutritional risk and nutritional status in children with surgical diseases during pre- and postoperative periods. Materials and methods. A prospective, single-center, non-comparative study included 60 children aged from 1 month to 17.5 years with diseases of the esophagus, intestines, urogenital system, admitted for surgical treatment. In all patients, the anamnestic data of life and disease were analyzed, screening of nutritional risk was assessed according to the validated Russian version of the STRONG-kids screening tool, nutritional status was evaluated using the WHO AnthroPlus program (2009) and the anthropometric indices (Z-scores: weight/age, height/age, BMI/age), the biochemical parameters (concentrations of C-reactive protein, total protein, albumin, prealbumin, transferrin) were estimated. Results. A high nutritional risk at admission was established in more than half (57%) of patients, moderate — in 36% of patients, low — only in 7% of cases. Malnutrition (Z-score BMI/age from –1 to –3) was diagnosed in 24 (40%) patients, 58% of them suffered from diseases of the esophagus, 37% had pathology of the intestine and 36% — the genitourinary system. Conclusion. Nutritional risk screening and nutrition status assessment are necessary in all patients admitted to pediatric surgical hospitals for the timely appointment of adequate nutritional support, which will reduce the incidence of postoperative complications and decreasing the length of hospital stay.

Introduction. To improve the quality of surgical treatment and prevent postoperative complications, there is needed an integrated multidisciplinary professional approach including a combination of nutritional support with therapeutic methods and psychological assistance that reduces stress throughout the perioperative period. Clinical guidelines and standards to manage the patients on this issue in pediatric surgical hospitals have not been developed. Objectives: to assess the nutritional risk of malnutrition and nutritional status in children with surgical diseases, to elaborate algorithms for nutritional support over the pre- and postoperative periods. Materials and methods. The single center non-comparative study included sixty children aged from 1 month to 17 years 5 months, with diseases of the esophagus, intestine, and genitourinary system, were admitted for surgical treatment at the Research Institute of Pediatric Surgery of the Federal State Autonomous Institution «National Medical Research Center for Children’s Health» of the Ministry of Health of Russia. All patients underwent a nutritional risk screening according to a validated Russian version of the STRONGkids. Clinical and anamnestic data were analyzed. Anthropometric indices (Z-scores: weight/age, height/age, BMI/age) using the WHO AnthroPlus program (2009), and biochemical parameters (concentrations of C-reactive protein, total protein, albumin, prealbumin, transferrin) were evaluated. Results. A high nutritional risk at admission was established in more than half (57%) of patients, moderate — in 36% of patients, low — only in 7% of cases. Malnutrition (Z-score BMI/age from –1 to –3) was diagnosed in 26 (43%) patients, 58% of them suffered from diseases of the esophagus, 37% — the intestine pathology, and 36% of the genitourinary disorders. Conclusion. Nutritional risk screening and nutrition status assessment are necessary in all patients admitted to pediatric surgical hospitals for the timely appointment of adequate nutritional support, which will reduce the incidence of postoperative complications, and allow diminishing the length of the hospital stay.

Due to the new legislative sanitary and epidemiological rules and norms that came into effect in Russia in 2021 and the obvious advantages of breast milk (BM), there is an increasing trend towards its use in neonatal clinics in the form of BM banks (BMBs). The purpose of this retrospective research was to assess the impact of BMBs in a neonatal hospital on the prevalence of breastfeeding (BF) of infants at discharge. Materials and methods used: the study included 692 infants at the age of the first 28 days of life who were hospitalized in the Neonatal Pathology Department with the National Medical Research Center for Children’s Health (which is located in Moscow, Russia) prior to the opening of BMB (Group 1) and during the BMB functioning (Group 2). Results: it was found that mothers from G2 pumped BM statistically significantly more often than mothers from G1 (64% vs. 43%). The incidence of exclusive BF (EBF) at discharge statistically significantly increased compared to the same indicator at admission, in both groups: from 41% to 51% in 2013 (p<0.001) and from 48% to 65% in 2015 (p<0.001). The prevalence of EBF at discharge during the BMB functioning in 2015 (65%) was therefore statistically significantly higher compared to this indicator in 2013 (51%), p=0.009. Conclusion: the strong positive effect from BMB on the prevalence of BF at discharge from the hospital was recorded.

Background. Appropriate prescribing of complementary food allows to optimize the intake of macro- and micronutrients, provides adequate indicators of growth and development of the child, reduces the risk of non-infectious pathology. Taking into account the significance of this problem, World Health Organization (WHO) experts, together with The European Society for Paediatric Gastroenterology Hepatology and Nutrition, carried out a research where they studied issues related to the appointment of complementary food for children in the European Region and their compliance with existing recommendations. Aim. To study the features of the introduction of complementary food in the Russian Federation on the basis of an assessment of the implementation of the recommendations of the "National program for optimizing the feeding of children in the first year of life in the Russian Federation", 2009 and to conduct a comparative analysis of the results obtained and the data presented in the study carried out by WHO experts. Materials and methods. A multicenter retrospective, uncontrolled, non-randomized study was conducted in 7 cities of the Russian Federation. Results. The median age at which complementary foods were introduced was 5 [46] months; vegetables (51.0%) and cereals (31.2%) were the first complementary food products; children began to receive fruit mainly (77.3%) in the second half of life; the age of introduction of meat puree was 7 [68] months, while every 4th child by 9 months did not receive meat; juices were introduced at 7 [69] months, but in 8.8% of children juices became the first product of complementary foods; median age for yolk administration was 8 [710] months, fish 9 [810] months. Only 14.0% of mothers used products of exclusively industrial production in the nutrition of their children, 33.9% prepared it themselves. Correlation analysis did not revealed any relationship between the body weight of a child at the age of 12 months and the time of introduction of the first complementary food product, as well as with the age of introduction of each of the introduced products. A connection was established between the body weight of a child at the age of 12 months and the volume of individual products that children receive between the age of 6 and 12 months. The recommendations of the National program for optimizing the feeding of children in the first year of life in the Russian Federation were generally implemented. Our analyses revealed the most frequent violations during the introduction and use of complementary food products: late start of their introduction (after the age of 6 months) in 41.3% of children, delayed prescription of meat, frequent use of home-made cereals not enriched with micronutrients, dilution of dairy-free porridge with water, irregular inclusion in the diet of egg yolk. Conclusion. The results obtained confirm the importance of implementation of the Program for Optimizing Feeding of Children in the First Year of Life in the Russian Federation updated in 2019 and approved by the Ministry of Health of Russia and indicate the need for further work on its improvement.

With the purpose of successful rehabilitation, reduction of concomitant diseases, improvement of nutritional status and the quality of life of patients with cerebral palsy (CP) it is necessary to develop therapeutic nutrition technology, which would include methods for nutritional status assessment, choosing of enteral nutrition formulas, methods of their delivery and the duration of nutritional support. The purpose of this research was to substantiate the nutritional support for patients with CP. Materials and methods used: 98 children aged 2 to 16 years and 9 months old (Me 5.7 y/o) with a spastic form of CP that had been admitted for examination, treatment and rehabilitation at the National Medical Research Center for Children’s Health (Moscow, Russia) were examined. Depending on the level of motor activity calculated with GMFCS, the participants were divided into two groups: G1 of 51 (52%) with severe motor impairment (GMFCS IV to V) and G2 of 47 (48%) with mild and moderate motor impairment (GMFCS I to III). Clinical and anamnestic data, information about the severity and the course of the disease, concomitant pathology were analyzed as well as the anthropometric data (Z-scores: weight/age, height/age, BMI/age) using the WHO AnthroPlus application (2009 revision). EDACS survey had also been carried out. Results: Patients with severe motor impairments were significantly more likely to have problems associated with food intake, such as: prolonged feeding (over 30 minutes), predominance of semi-liquid and pureed food in the diet as well as frequent choking, vomiting, wheezing and coughing during the feeding process. All patients in this group needed external assistance in feeding. 75% had respiratory and 72% had gastrointestinal complications. Severe impairments (EDACS IV to V) characterized by significant restrictions on food safety were identified in 24 (23%) children, that met statistically significantly (p<0.001) more often in patients from G1 than from G2 (41% vs. 4%, respectively). Dietary analysis children with CP had showed that the quality and quantity of food consumed were monotonous and deficient. Consumption of pasta, cereals, and baking was 1.5 times higher than recommended whilst vegetables, fruits and healthy dairy products were reduced by 3 and 1.8 times, respectively, on the contrary. The WHO recommendations for children on the mandatory daily intake of 3 to 4 servings of various vegetables and fruits were not followed: in the majority (80%) of cases they’ve only had it once per day, and they even were completely absent in some cases. Nutritional assessment revealed that patients with severe movement disorders, regardless of the gender and nutritional status, had significant deficiencies in energy and protein intake. All studied anthropometric indicators in G1 patients were significantly (p<0.005) lower compared to G2 children. Prevalence of undernutrition was 72% and 32% (p<0.001), respectively. Individual nutritional program was developed for each and every studied patient with identified malnutrition and oropharyngeal dysphagia, followed by its clinical effectiveness assessment. Conclusion: enteral nutritional support with specialized formulas based on both whole and hydrolyzed proteins using the sipping/gastrostomy method, as well as with the use of a food and liquids thickeners, proved to be highly effective in the treatment and rehabilitation of CP children. Indicators characterizing food intake (time taken for feeding, frequency of choking records during meals, episodes of vomiting and regurgitation) have improved as well as the anthropometric indicators improved accordingly.

The short bowel syndrome (SBS, or simply short gut) is the most common cause for the chronic intestinal failure (CIF). The purpose of the study was to present the results of treatment of infants at risk for the development of post-resection SBS and the formation of CIF. Research materials and methods: 22 children threatened by the formation of post-resection SBS were treated in the Surgical Department of Newborns and Infants of the National Medical Research Center for Children’s Health (Moscow, Russia) from 2017 to 2021. Results: All patients have undergone the surgical treatment. The scope of the surgical intervention included adhesiolysis with the imposition of an interintestinal anastomosis. Simultaneous imposition of multiple interintestinal anastomoses (more than 4) was performed in 7 patients (32%). As a result, the CIF formation was avoided in 8 patients (36%) by maintaining the total length of the remaining small intestine. The follow-up period ranged from 12 to 46 months. Currently, 2 patients (9%) receive partial parenteral nutrition, and in 17 patients (77%) it was possible to achieve completely autonomous enteral nutrition. A lethal outcome was stated in 3 patients (14%) due to the development of a catheter-associated infection. Conclusion: in the course of this work, the principles of surgical treatment of patients threatened by the development of post-resection SBS and the formation of CIF were developed. Adequate parenteral and enteral nutrition can optimize intestinal adaptation and improve the nutritional status of the pediatric patient.

Breastfeeding (BF) in the first 6 months of a child’s life with the addition of other foods until the age of 12–24 months is globally recognized as the “gold standard” for infant feeding. For children with cystic fibrosis (CF), it is particularly relevant that breast milk contains a wide range of protective factors against pathogenic bacteria colonization, thermolabile lipase, which facilitates fat digestion, and polysaccharides, which are essential for the trophism of colonocytes and the formation of normal gut microbiota. Objective. To study the effect of BF and its duration on the course of the disease, nutritional status of children with cystic fibrosis. Patients and methods. Questionnaire results on the duration of breastfeeding in 60 mothers of children with cystic fibrosis were analyzed, with further retrospective assessment of the severity of CF in these children. Results. The nutritional status of children who did not receive breast milk at both 1 and 3 years of age was lower than the mean age standards in contrast to patients who were breastfed; the number of bronchopulmonary exacerbations was significantly greater compared with children who received breast milk. The longer the duration of BF was, the later Pseudomonas aeruginosa was isolated from the sputum of CF patients (r = 0.68, p < 0.005). Conclusion. Maintenance of BF leads to a milder course of the disease in later years, which becomes especially important for children with CF. Key words: cystic fibrosis, children, breastfeeding

Congenital glucose-galactose malabsorption is an orphan autosomal recessive life-threatening disease resulting from a selective defect in the intestinal glucose and galactose/sodium co-transport system in the brush border membrane of the enterocyte. In glucose-galactose malabsorption, glucose, galactose, as well as di- and polysaccharides: starch, dextrins, maltose, sucrose, lactose cannot be absorbed. The disease manifests itself in the neonatal period in the form of severe watery osmotic diarrhea, leading to rapid dehydration and metabolic acidosis. The only treatment is diet therapy with the exclusion of all carbohydrates except fructose. In infants with glucose-galactose malabsorption, diet therapy using specialized formulas with fructose as a carbohydrate component is vital. Subsequently, such infants need the introduction of low-carbohydrate complementary foods with primarily fructose content. The article presents a clinical example of the disease course and its successful dietary correction in an infant using a specialized formula and a specific diet. Key words: congenital diarrheal disorders, glucose-galactose malabsorption, infants, diet therapy, specialized milk formula based on fructose

The article presents a review of modern domestic and foreign literature, which reflects the current problems associated with the diagnosis of malnutrition in children admitted to surgical hospitals. The article gives definition of the concept of «nutritive insufficiency», and its prevalence. The clinical, anthropometric, instrumental and laboratory research methods used to assess the nutritional status are characterized in detail. It has been shown that malnutrition has a negative impact on the course of surgical pathology, reduces immunological protection, increases the risk of complications, nosocomial infections, and length of hospital stay. Various methods for assessing the risks of malnutrition in surgical patients upon hospital admissions are presented.

A unique clinical case of a combination of malformations of the anterior abdominal wall (omphalocele of large size) and malformation of the lymphatic system (congenital chyloperitoneum) is presented. Each of these defects can lead to a fatal outcome, and the combination of them has greatly increased the risk of developing an unfavourable outcome. The use of immunosuppressive therapy with Sirolimus used for the first time during the newborn period made it possible to completely stop the chyloperitoneum. This clinical example shows that in the treatment of surgical patients with multiple congenital malformations, a multidisciplinary approach and observation is necessary for timely response to the patient’s condition.

The prevalence of food allergy (FA) among children with atopic dermatitis (AD) ranges from 26 to 38%. The article presents an analysis of domestic and foreign publications devoted to the peculiarities of the AD flowing from the FA in children, in which the withdrawal diet plays a leading role in elimination diet. The complete or partial exclusion of one or several foods from the diet contributes to an insufficient intake of macro- and micronutrients, which can lead to a decrease not only in body weight, but also in a delay in the growth of children, as well as in decrease in parameters of bone mineral density. According to research results, the intake of calcium and vitamin D in children with AD and FA is below the recommended levels. The serum 25(OH)D level in these patients is lower than in the general population and is inversely proportional to the SCORAD index. Vitamin D supplementation improves the effectiveness of treatment, helps to reduce the clinical manifestations of AD, as evidenced by a decrease in indicators of both the SCORAD index and the EASI index. The timely and adequate correction of the diets of children with FA who follow strict elimination diets requires an interdisciplinary approach in close cooperation between the pediatrician, allergist and nutritionist.

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