medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2019-2-209-215medsovet-2878Research ArticleШкола педиатраSchool for pediatricianПравильный уход за ребенком раннего возраста – залог его здоровьяTaking good care of a young child is a guarantee of his healthСаверскаяЕ. Н.SaverskayaE. N.

Саверская Елена Николаевна – доктор медицинских наук, профессор кафедры фармации 

125080, г. Москва, ул. Врубеля, д. 12

Elena Saverskaya – Dr. of Sci. (Med), Professor of the Department of Pharmacy

125080, Moscow, Vrubela St., 

Медицинский институт непрерывного образования Федерального государственного бюджетного образовательного учреждения высшего образования «Московский государственный университет пищевых производств»РоссияMedical Institute of Continuing Education of the Federal State Budgetary Educational Institution of Higher Education «Moscow State University of Food Production»Russian Federation20191502201902209215Copyright © Саверская Е.Н., 20192019Саверская Е.Н.Saverskaya E.N.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/2878

В обзорной статье рассматриваются основные проблемы здоровья детей раннего возраста – дефицит витаминов и минералов при грудном вскармливании, сложности ухода за кожей, проявления аллергии, острые респираторные вирусные инфекции. Уделено внимание гиповитаминозам и трещинам сосков у мам в период лактации, а также необходимости дотации витаминноминеральными комплексами и уходу за кожей молочных желез в этот период. Правильный уход за ребенком раннего возраста – залог его здоровья и гармоничного развития. Педиатры должны способствовать повышению грамотности матерей в области современных методов ухода за детьми, профилактики и лечения заболеваний.

In the review article the basic problems of children’s health of young age are considered deficiency of vitamins and minerals at breastfeeding, complexity of skin care, allergies, acute respiratory viral infections. Attention is paid to hypovitaminosis and nipple cracks in mothers during lactation, as well as to the necessity of vitamin-mineral complexes subsidizing and mammary gland skin care during this period. Proper care for a child of early age is a guarantee of his health and harmonious development. Paediatricians should promote maternal literacy in modern methods of child care, disease prevention and treatment.

гармоничное развитиегрудное вскармливаниевитаминно-минеральные комплексыкрапивницаатопический дерматитпеленочный дерматиттрещины сосковдекспантенолметилпреднизолона ацепонатдезлоратадинострая респираторная вирусная инфекциясимптоматическая терапияharmonious developmentbreastfeedingvitamin-mineral complexesurticariaatopic dermatitisdiaper dermatitisnipple cracksdecspanthenolmethylprednisolone aceponatedeslorotadineacute respiratory viral infectionsymptomatic therapyReferencesWhy Early Childhood Development? Unicef for every child. Last approval 26 July 2013. URL: https://www.unicef.org/earlychildhood/index_40748.html (дата обращения 10.12.2018).Why Early Childhood Development? Unicef for every child. Last approval 26 July 2013. URL: https://www.unicef.org/earlychildhood/index_40748.html (дата обращения 10.12.2018).Early child development – Child health and developmen URL:https://www.who.int/topics/early-child-development/child-health-development/en/ (дата обращения 10.10.2018).Early child development – Child health and developmen URL:https://www.who.int/topics/early-child-development/child-health-development/en/ (дата обращения 10.10.2018).Marangoni F., Cetin I., Verduci E., Canzone G., Giovannini M., Scollo P., Corsello G., Poli A. Maternal Diet and Nutrient Requirements in Pregnancy and Breastfeeding. An Italian Consensus Document. Nutrients. 2016;8:629.Marangoni F., Cetin I., Verduci E., Canzone G., Giovannini M., Scollo P., Corsello G., Poli A. Maternal Diet and Nutrient Requirements in Pregnancy and Breastfeeding. An Italian Consensus Document. Nutrients. 2016;8:629.Picciano M.F. Pregnancy and lactation: physiological adjustments, nutritional requirements and the role of dietary supplements. Journal of Nutrition. 2003;133(6):1997S‐2002S.Picciano M.F. Pregnancy and lactation: physiological adjustments, nutritional requirements and the role of dietary supplements. Journal of Nutrition. 2003;133(6):1997S‐2002S.Hermoso M., Vollhardt C., Bergmann K., Koletzko B. Critical micronutrients in pregnancy, lactation, and infancy: considerations on vitamin D, folic acid, and iron, and priorities for future research. Annals of Nutrition and Metabolism. 2011;59(1):5‐9.Hermoso M., Vollhardt C., Bergmann K., Koletzko B. Critical micronutrients in pregnancy, lactation, and infancy: considerations on vitamin D, folic acid, and iron, and priorities for future research. Annals of Nutrition and Metabolism. 2011;59(1):5‐9.Kramer M.S., Kakuma R. The optimal duration of exclusive breastfeeding: a systematic review. Advances in Experimental Medicine and Biology. 2004;554:63‐77.Kramer M.S., Kakuma R. The optimal duration of exclusive breastfeeding: a systematic review. Advances in Experimental Medicine and Biology. 2004;554:63‐77.Коденцова В.М., Вржесинская О.А. Витамины в питании беременных. Гинекология. 2002;4(1):7–12.Kodentsova V.M., Vrzhesinskaya O.A. Vitamins in the diet of pregnant women. Gynecology. 2002;4(1):7–12. (In Russ).Gellert S., Ströhle A., Hahn A. Breastfeeding woman are at higher risk of vitamin D deficiency than non-breastfeeding women-insights from the German VitaMinFemin study. International breastfeeding journal. 2016;12(1):19.Gellert S., Ströhle A., Hahn A. Breastfeeding woman are at higher risk of vitamin D deficiency than non-breastfeeding women-insights from the German VitaMinFemin study. International breastfeeding journal. 2016;12(1):19.Pathak P., Kapil U., Kapoor S.K., Saxena R. et al. Prevalence of multiple micronutrient deficiencies amongst pregnant women in a rural area of Haryana. Indian. J. Pediatr. 2004;71(11):1007– 1014.Pathak P., Kapil U., Kapoor S.K., Saxena R. et al. Prevalence of multiple micronutrient deficiencies amongst pregnant women in a rural area of Haryana. Indian. J. Pediatr. 2004;71(11):1007– 1014.Ren A., Zhang L., Li Z., Hao L. et al. Awareness and use of folic acid, and blood folate concentrations among pregnant women in northern China – an area with a high prevalence of neural tube defects. Reprod. Toxicol. 2006;22(3):431–436.Ren A., Zhang L., Li Z., Hao L. et al. Awareness and use of folic acid, and blood folate concentrations among pregnant women in northern China – an area with a high prevalence of neural tube defects. Reprod. Toxicol. 2006;22(3):431–436.Коденцова В.М., Гмошинская М.В., Вржесинская О.А. Витаминно-минеральные комплексы для беременных и кормящих женщин: обоснование состава и доз. Репродуктивное здоровье детей и подростков. 2015;3:73-96.Kodentsova V.M., Gmoshinskaya M.V., Vrzhesinskaya O.A. Vitaminmineral complexes for pregnant and lactating women: substantiation of composition and doses. Reproductive health of children and teenagers [Reproduktivnoe zdorovje detej i podrostkov]. 2015;3:73-96. (In Russ).Коденцова В., Гмошинская М. Обеспеченность грудного молока витаминами и ее оптимизация. Врач. 2015;1:68-73.Kodentsova V., Gmoshinskaya M. Vitamin supply of breast milk and its optimization . Doctor [Vrach]. 2015;1:6873. (In Russ).Dijkhuizen M.A., Wieringa F.T., West C.E. Concurrent micronutrient deficiencies in lactating mothers and their infants in Indonesia. The American journal of clinical nutrition. 2001;73(4):786-791.Dijkhuizen M.A., Wieringa F.T., West C.E. Concurrent micronutrient deficiencies in lactating mothers and their infants in Indonesia. The American journal of clinical nutrition. 2001;73(4):786-791.Adalat S., Wall D., Goodyear H. Diaper dermatitis-frequency and con-tributory factors in hospital attending children. Pediatr Dermatol. 2007;24:483-488.Adalat S., Wall D., Goodyear H. Diaper dermatitis-frequency and con-tributory factors in hospital attending children. Pediatr Dermatol. 2007;24:483-488.Visscher M.O., Chatterjee R., Munson K.A. et al. Changes in diapered and nondiapered infant skin over the first month of life. Pediatr Dermatol. 2000;17:45–51.Visscher M.O., Chatterjee R., Munson K.A. et al. Changes in diapered and nondiapered infant skin over the first month of life. Pediatr Dermatol. 2000;17:45–51.Atherton D.J. The aetiology and management of irritant diaper dermatitis. J Eur Acad Dermatol Venereol. 2001;15(Suppl 1):1–4.Atherton D.J. The aetiology and management of irritant diaper dermatitis. J Eur Acad Dermatol Venereol. 2001;15(Suppl 1):1–4.Чебуркин А.В., Заплатников А.Л. Пеленочный дерматит: профилактика и лечение. РМЖ. 2009;17(15):970-973.Cheburkin A.V., Zaplatnikov A.L. Diaper dermatitis: prevention and treatment. RMJ. 2009;17(15):970-973. (In Russ).Василевский И.В. Оптимизация ухода за кожей у новорожденных и детей грудного возраста. Международные обзоры: клиническая практика и здоровье. 2015;1:5-18.Vasilevsky I.V. Optimization of skin care in newborns and infants. International reviews: clinical practice and health [Mezhdunarodnye obzory: klinicheskaya praktika i zdorovje]. 2015;1:5-18. (In Russ).Gao X., Simpson E.L. Market trends in baby skin care products and implications for clinical practice. Pediatric dermatology. 2014;31(6):734738.Gao X., Simpson E.L. Market trends in baby skin care products and implications for clinical practice. Pediatric dermatology. 2014;31(6):734738.Дерматовенерология. Национальное руководство. Краткое издание. Под ред. Ю.С. Бутова, Ю.К. Скрипкина, О.Л. Иванова. М.: ГЭОТАРМедиа, 2013. 896 с.Dermatovenerology. National guidelines. Brief edition. Edited by Yu. S. Butova, Yu. K. Skripkin, O.L. Ivanova. M.: GEOTAR-Media, 2013. 896 p. (In Russ).Ebner F., Heller A., Rippke F., Tausch I. Topical use of dexpanthenol in skin disorders. Am J Clin Dermatol. 2002;3(6):427-33.Ebner F., Heller A., Rippke F., Tausch I. Topical use of dexpanthenol in skin disorders. Am J Clin Dermatol. 2002;3(6):427-33.Василевский И.В. Оптимизация ухода за кожей у новорожденных и детей грудного возраста. Медицинские новости. 2014;9:13– 18.Vasilevsky I.V. Optimization of skin care in newborns and infants. Medical news [Medicinskie novosti]. 2014;9:13–18. (In Russ).Тютюнник В.Л. Трещины сосков у кормящих ам, методы их лечения и профилактики. РМЖ. 2004;5:1-3.Tyutyunnik V.L. Nipple cracks in breastfeeding mothers, methods of their treatment and prevention. RMJ. 2004;5:1-3. (In Russ).Kent J.C. et al. Nipple pain in breastfeeding mothers: incidence, causes and treatments. International journal of environmental research and public health. 2015;12(10):12247-63.Kent J.C. et al. Nipple pain in breastfeeding mothers: incidence, causes and treatments. International journal of environmental research and public health. 2015;12(10):12247-63.Аверина В.И. Профилактика и лечение трещин сосков у женщин в период лактации. Медицинский совет. 2014;9:132-136.Averina V.I. Prevention and treatment of nipple cracks in women during lactation. Medical advice [Medicinskij sovet]. 2014;9:132-136. (In Russ).Котлуков В.К., Кузьменко Л.Г., Антипова Н. В. Наружные дерматологические средства серии «Бепантен» в практике педиатра. Медицинский совет. 2012;5:81-85.Kotlukov V.K., Kuzmenko L.G., Antipova N.V. External dermatological means of «Bepanten» series in pediatrician practice. Medical advice [Medicinskij sovet]. 2012;5:81-85. (In Russ).Atherton D. et al. Irritant diaper dermatitis: best practice management. SelfCare. 2015;6(S1):1-11.Atherton D. et al. Irritant diaper dermatitis: best practice management. SelfCare. 2015;6(S1):1-11.Намазова-Баранова Л.С., Сновская М. А., Митюшин И. Л., Кожевникова О. В, Батырова А. С. Особенности диагностики аллергии у детей. Вестник РАМН. 2017;72(1):33-41.NamazovaBaranova L.S., Snovskaya M. A., Mityushin I. L., Kozhevnikova O. V, Batyrova A.S. Features of diagnosis of allergies in children. Vestnik RAMS [Vestnik RAMN]. 2017;72(1):33-41. (In Russ).Wollenberg A., Sharma S., von Bubnoff D., Geiger E., Haberstok J., Bieber T. Topical tacrolimus (FK506) leads to profound phenotypic and functional alterations of epidermal antigen– presenting dendritic cells in atopic dermatitis. J Allergy Clin Immunol. 2001;107:519–525.Wollenberg A., Sharma S., von Bubnoff D., Geiger E., Haberstok J., Bieber T. Topical tacrolimus (FK506) leads to profound phenotypic and functional alterations of epidermal antigen– presenting dendritic cells in atopic dermatitis. J Allergy Clin Immunol. 2001;107:519–525.Hoare C., Li Wan Po A, Williams H. Systematic review of treatments for atopic eczema. Health Technol Assess. 2000;4:1–191.Hoare C., Li Wan Po A, Williams H. Systematic review of treatments for atopic eczema. Health Technol Assess. 2000;4:1–191.Ревякина В.А. Крапивница в практике педиатра. Лечащий врач. 2007;4:17-22.V.A. Revyakina Urticaria in pediatrician practice. Attending physician [Lechashchij vrach]. 2007;4:17-22. (In Russ).Simons F.E.R. Prevention of acute urticaria in young children with atopic dermatitis. J. Allergy Clin. Immunol. 2001;107:703–706.Simons F.E.R. Prevention of acute urticaria in young children with atopic dermatitis. J. Allergy Clin. Immunol. 2001;107:703–706.Venter C., Pereira B., Grundy J., et al. Incidence of parentally reported and clincally diagnosed food hypersensitivity in the first year of life. J Allergy Immunol. 2006;117(5):1118–1124.Venter C., Pereira B., Grundy J., et al. Incidence of parentally reported and clincally diagnosed food hypersensitivity in the first year of life. J Allergy Immunol. 2006;117(5):1118–1124.Echeverría-Zudaire L.A., Ortigosa-del Castillo L., Alonso-Lebrero E., Álvarez-García F.J., CortésÁlvarez N., García-Sánchez N., MartorellAragonés A. Consensus document on the approach to children with allergic reactions after vaccination or allergy to vaccine components. Allergol Immunopathol (Madr). 2015 MayJun;43(3):304-25. doi: 10.1016/j.aller.2015.01.004. Epub 2015 Apr 16.Echeverría-Zudaire L.A., Ortigosa-del Castillo L., Alonso-Lebrero E., Álvarez-García F.J., CortésÁlvarez N., García-Sánchez N., MartorellAragonés A. Consensus document on the approach to children with allergic reactions after vaccination or allergy to vaccine components. Allergol Immunopathol (Madr). 2015 MayJun;43(3):304-25. doi: 10.1016/j.aller.2015.01.004. Epub 2015 Apr 16.Tan E.K.H., Grattan C.E.H. Drug-induced urticarial. Expert opinion on drug safety. 2004;3(5):471-484.Tan E.K.H., Grattan C.E.H. Drug-induced urticarial. Expert opinion on drug safety. 2004;3(5):471-484.Мокроносова М.А., Мац А.Н. Инфекция и аллергия: две стороны одной медали. Астма и аллергия. 2015;4:9-12.Mokronosova M.A., Mats A.N. Infection and allergies: two sides of the same coin. Asthma and allergy [Astma i allergiya]. 2015;4:9-12. (In Russ).Сизякина Л.П., Лебеденко А.А., Мальцев С.В., Посевина А.Н., Аверкина Л.А. Крапивница у детей: современный взгляд на проблему. Медицинский вестник Юга России. 2015;4:513.Sizyakina L.P., Lebedenko A.A., Maltsev S.V., Posevina A.N., Averkina L.A. Urticaria in children: a modern view of the problem. Medical Bulletin of the South of Russia [Medicinskij vestnik Yuga Rossii]. 2015;4:5-13. (In Russ).Chervinsky P. et al. Efficacy and safety of desloratadine/pseudoephedrine tablet, 2.5/120 mg two times a day, versus individual components in the treatment of patients with seasonal allergic rhinitis. Allergy and asthma proceedings. OceanSide Publications. 2005;26(5):391.Chervinsky P. et al. Efficacy and safety of desloratadine/pseudoephedrine tablet, 2.5/120 mg two times a day, versus individual components in the treatment of patients with seasonal allergic rhinitis. Allergy and asthma proceedings. OceanSide Publications. 2005;26(5):391.Prenner B. et al. Safety of desloratadine syrup in children six months to younger than 2 years of age: a randomized, double-blinded, placebocontrolled study. Pediatric Asthma, Allergy & Immunology. 2006;19(2):91-99.Prenner B. et al. Safety of desloratadine syrup in children six months to younger than 2 years of age: a randomized, double-blinded, placebocontrolled study. Pediatric Asthma, Allergy & Immunology. 2006;19(2):91-99.Niedner R., Zaumseil R.-P. Advantan milk ⁄ cream ⁄ ointment in children with atopic eczema and other dermatoses: an observational study in 558 children. Akt Dermatol. 2004;30:200–203.Niedner R., Zaumseil R.-P. Advantan milk ⁄ cream ⁄ ointment in children with atopic eczema and other dermatoses: an observational study in 558 children. Akt Dermatol. 2004;30:200–203.Ponte L.G., Ebert U. Frontiers of rapid itch relief: a review of methylprednisolone aceponate. Journal of the European Academy of Dermatology and Venereology. 2012;26:9-13.Ponte L.G., Ebert U. Frontiers of rapid itch relief: a review of methylprednisolone aceponate. Journal of the European Academy of Dermatology and Venereology. 2012;26:9-13.Niedner R.-P. Zaumseil Advantan® Milk/Cream/ Ointment in Children with Atopic Eczema and other Dermatoses – An Observational Study in 558 ChildrenR. Akt Dermatol. 2004;30(6):200203.Niedner R.-P. Zaumseil Advantan® Milk/Cream/ Ointment in Children with Atopic Eczema and other Dermatoses – An Observational Study in 558 ChildrenR. Akt Dermatol. 2004;30(6):200203.Peserico A. Reduction of relapses of atopic dermatitis with methylprednisolone aceponate cream twice weekly in addition to maintenance treatment with emollient: a multicentre, randomized, double-blind, controlled study. Br J Dermatol. 2008;158(4):801-7.Peserico A. Reduction of relapses of atopic dermatitis with methylprednisolone aceponate cream twice weekly in addition to maintenance treatment with emollient: a multicentre, randomized, double-blind, controlled study. Br J Dermatol. 2008;158(4):801-7.Luger T.A. Balancing efficacy and safety in the management of atopic dermatitis: the roleofmethylprednisolone aceponate. J Eur Acad Dermatol Venereol. 2011 Mar;25(3):251-8.Luger T.A. Balancing efficacy and safety in the management of atopic dermatitis: the roleofmethylprednisolone aceponate. J Eur Acad Dermatol Venereol. 2011 Mar;25(3):251-8.Почивалов А.В., Погорелова Е.И. Лечение острой респираторной вирусной инфекции у детей с атопическим дерматитом. Consilium Medicum Ukraina, 2010:30-32.Pochivalov A.V., Pogorelova E.I. Treatment of acute respiratory viral infection in children with atopic dermatitis. Consilium Medicum Ukraina, 2010:30-32. (In Russ).Таточенко В.К. Препараты для симптоматического лечения острых респираторных вирусных инфекций у детей. Вопросы современной педиатрии. 2004;3(4):112-114.Tatochenko V.K. Drugs for symptomatic treatment of acute respiratory viral infections in children. Questions of modern pediatrics [Voprosy sovremennoj pediatrii]. 2004;3(4):112-114. (In Russ).Иванова Н.А. Часто болеющие дети. РМЖ. 2008;16(4):183-185.Ivanova N.A. Often sick children. RMJ. 2008;16(4):183-185. (In Russ).Гирина А.А., Заплатников А.Л., Бурцева Е.И., Майкова И.Д., Короид Н.В., Кириллова Е.С., Феодоритова Е.Л. Лечение острых респираторных вирусных инфекций и гриппа у детей – принцип минимальной достаточности. Медицинский совет. 2016;7:44-48Girina A.A., Zaplatnikov A.L., Burtseva E.I., Maikova I.D., Koroid N.V., Kirillova E.S., Feodoritova E.L. Treatment of acute respiratory viral infections and influenza in children the principle of minimum sufficiency. Medical advice [Medicinskij sovet]. 2016;7:44-48. (In Russ).Федеральные клинические рекомендации по оказанию медицинской помощи детям с острой респираторной вирусной инфекцией (острый назофарингит), 2013. [Federal Clinical Guidelines on Medical Care for Children with Acute Respiratory Viral Infection (Acute Nasopharyngitis), 2013.] (In Russ).Federal Clinical Guidelines on Medical Care for Children with Acute Respiratory Viral Infection (Acute Nasopharyngitis), 2013. (In Russ).Крамарев С.А. Симптоматическая терапия гриппа и ОРВИ у детей. Новости медицины и фармации. 2010;16(336).Kramarev S.A. Symptomatic therapy of influenza and acute respiratory infections in children. News of medicine and pharmacy [Novosti mediciny i farmacii]. 2010;16(336). (In Russ).Заплатников А.Л. Рациональное применение жаропонижающих лекарственных средств при ОРВИ у детей. РМЖ. 2009;17(19):12231226.Zapatnikov A.L. Rational use of antipyretic medicines in ARVI in children. RMJ. 2009;17(19):1223-1226. (In Russ).Зайцева О.В. Современные возможности профилактики и лечения острых респираторных заболеваний. РМЖ. 2011;19(23):1458-1461.Zaitseva O.V. Modern possibilities of prevention and treatment of acute respiratory diseases. RMJ. 2011;19(23):1458-1461. (In Russ).Ших Е.В. Витамины с антиоксидантными свойствами в профилактике и лечении острых респираторных инфекций у детей. Вопросы современной педиатрии. 2013;12(4).Shikh E.V. Vitamins with antioxidant properties in the prevention and treatment of acute respiratory infections in children. Issues of modern pediatrics [Voprosy sovremennoj pediatrii]. 2013;12(4).(In Russ).Ляликов С.А. и др. Йод как фактор, модифицирующий иммунитет. Иммунопатология, аллергология, инфектология. 2004;2:63-67.Lyalikov S.A. et al. Iodine as a factor modifying immunity. Immunopathology, allergology, infectious diseases [Immunopatologiya, allergologiya, infektologiya.]. 2004;2:63-67. (In Russ).Студеникин В.М. Возможности применения поливитаминных комплексов в нейропедиатрии. Лечащий врач. 2013;9:60–64.Studenikin V.M. Possibilities of using multivitamin complexes in neuropediatrics. Attending physician [Lechashchij vrach]. 2013;9:60–64. (In Russ)

The authors declare that there are no conflicts of interest present.