medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2022-16-1-18-26medsovet-6679Research ArticleНЕОНАТОЛОГИЯNEONATOLOGYСложности грудного вскармливания при затрудненном носовом дыхании у ребенка: альтернативные методы докормаBreastfeeding challenges in infants with nasal breathing difficulties: alternative supplemental feeding methodshttps://orcid.org/0000-0003-0353-6372ЖдановаС. И.ZhdanovaS. I.

 к.м.н., ассистент кафедры госпитальной педиатрии; врач-неонатолог отделения новорожденных детей; специалист по грудному вскармливанию отдела поддержки грудного вскармливания 

420012, Россия, Казань, ул. Бутлерова, д. 49

420064, Россия, Казань, ул. Оренбургский тракт, д. 138

117997, Россия, Москва, ул. Академика Опарина, д. 4 

 Cand. Sci. (Med.), Teaching Assistant of Department of Hospital Pediatrics; Neonatologist, Department of Newborn Infants; Lactation Specialist, Lactation Support Department, Institute of Neonathology and Pediatrics

49, Butlerov St., Kazan, 420012, Russia

138, Orenburg Tract St., Kazan, 420064, Russia

4, Academician Oparin St., Moscow, 117997, Russia 

votinia@mail.ruhttps://orcid.org/0000-0002-3749-9664КостычеваА. А.KostychevaA. A.

специалист по грудному вскармливанию отдела поддержки грудного вскармливания, Институт неонатологиии педиатрии

117997, Россия, Москва, ул. Академика Опарина, д. 4 

 Lactation Specialist, Lactation Support Department, Institute of Neonathology and Pediatrics 

4, Academician Oparin St., Moscow, 117997, Russia 

anna-ak@inbox.ruhttps://orcid.org/0000-0001-5443-3192ЛеваднаяА. В.LevadnayaA. V.

 к.м.н., заведующая отделом нутритивных технологий, Институт неонатологии и педиатрии 

117997, Россия, Москва, ул. Академика Опарина, д. 4 

 Cand. Sci. (Med.), Head of Nutritional Technologies Department, Institute of Neonathology and Pediatrics 

4, Academician Oparin St., Moscow, 117997, Russia 

evadnaya.av@gmail.comhttps://orcid.org/0000-0003-0494-6402ГутороваТ. В.GutorovaT. V.

 специалист по грудному вскармливанию отдела поддержки грудного вскармливания, Институт неонатологии и педиатрии 

117997, Россия, Москва, ул. Академика Опарина, д. 4 

 Lactation Specialist, Lactation Support Department, Institute of Neonathology and Pediatrics 

4, Academician Oparin St., Moscow, 117997, Russia 

t_gutorova@oparina4.ruhttps://orcid.org/0000-0001-9815-5841АлексеенкоГ. А.AlekseenkoG. A.

специалист по грудному вскармливанию отдела поддержки грудного вскармливания, Институт неонатологии и педиатрии  

117997, Россия, Москва, ул. Академика Опарина, д. 4 

 Lactation Specialist, Lactation Support Department, Institute of Neonathology and Pediatrics 

4, Academician Oparin St., Moscow, 117997, Russia 

noelle-87@mail.ruhttps://orcid.org/0000-0003-1265-803XСивохинаА. А.SivokhinaA. A.

 специалист по грудному вскармливанию отдела поддержки грудного вскармливания, Институт неонатологии и педиатрии

117997, Россия, Москва, ул. Академика Опарина, д. 4 

 Lactation Specialist, Lactation Support Department, Institute of Neonathology and Pediatrics 

4, Academician Oparin St., Moscow, 117997, Russia 

asivokhina@mail.ruКазанский государственный медицинский университет; Республиканская клиническая больница; Национальный медицинский исследовательский центр акушерства, гинекологии и перинатологии имени академика В.И. КулаковаРоссияKazan State Medical University; Republican Clinical Hospital; Kulakov National Medical Research Center of Obstetrics, Gynecology and PerinatologyRussian FederationНациональный медицинский исследовательский центр акушерства, гинекологии и перинатологии имени академика В.И. КулаковаРоссияKulakov National Medical Research Center of Obstetrics, Gynecology and PerinatologyRussian Federation202225022022011826Copyright © Жданова С.И., Костычева А.А., Левадная А.В., Гуторова Т.В., Алексеенко Г.А., Сивохина А.А., 20222022Жданова С.И., Костычева А.А., Левадная А.В., Гуторова Т.В., Алексеенко Г.А., Сивохина А.А.Zhdanova S.I., Kostycheva A.A., Levadnaya A.V., Gutorova T.V., Alekseenko G.A., Sivokhina A.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/6679

В статье освещаются особенности грудного вскармливания (ГВ) при затрудненном носовом дыхании у младенцев. Особенное внимание уделено несосательному (альтернативному) бутылочному методу докорма сцеженным грудным молоком, который является актуальным на тот период, когда невозможно ГВ или необходим докорм смесью как дополнение к нему.Дыхание через рот считается патологической адаптацией вследствие затруднения носового дыхания и связано с развитием многих патологических состояний. Доказано, что длительное ГВ связано с устоявшимся носовым дыханием в более старшем возрасте, а также с правильным формированием прикуса. Анатомо-физиологические особенности строения верхних дыхательных путей у младенцев обуславливают более частое появление затрудненного носового дыхания по сравнению со взрослыми, что вызывает сложности при ГВ вплоть до отказа ребенка от груди. В связи с этим знание современных методов докорма сцеженным грудным молоком наряду с осведомленностью в области эффективной и безопасной терапии заложенности носа у младенцев поможет врачам и родителям преодолеть трудный период заболевания и сохранить ГВ как можно дольше, что особенно важно в свете современных представлений о влиянии этого метода кормления на последующую жизнь матери и ребенка.Основным методом лечения заложенности носа различной этиологии является ирригационно-элиминационная терапия. Согласно научным данным, назальный аспиратор обладает хорошей переносимостью и не имеет побочных эффектов, применение лекарственного средства особенно эффективно совместно с изотоническим солевым раствором.

This review article highlights the features of breastfeeding in case of obstructed nasal breathing in infants, special attention is paid to non-sucking or alternative methods of bottle feeding with expressed breast milk for the period when breastfeeding is not possible or formula supplementation is necessary as an addition to breastfeeding.Breathing through the mouth is considered a pathological adaptation due to difficulty in nasal breathing and is associated with the development of many pathological conditions. There is an evidence base that prolonged breastfeeding is associated with nasal breathing at an older age, as well as the correct formation of the bite. The anatomical and physiological features of the structure of the upper respiratory tract in infants predispose to a more frequent occurrence of difficult nasal breathing compared to adults, which causes difficulties in breastfeeding, up to the refusal of the child’s breast. Therefore, knowledge of modern methods of supplementary feeding with expressed breast milk for this period, as well as ways to effectively and safely deal with nasal congestion in infants, will help doctors and parents to overcome the difficult period of the disease, accompanied by nasal congestion without loss and maintain breastfeeding for as long as possible, in the light of modern data on influence of breast milk on the subsequent life of mother and child.The main method of treatment for nasal congestion of various etiologies is irrigation-elimination therapy. According to the literature, good tolerability and no side effects were found when using a nasal aspirator used in conjunction with isotonic saline.

грудное вскармливаниеметоды докорманосовое дыханиевозрастные особенностиострые ринитыирригационно-элиминационная терапияbreastfeedingsupplementary feeding methodsnasal breathingage-related featuresacute rhinitisirrigationelimination therapyReferencesBasheer B., Hegde K.S., Bhat S.S., Umar D., Baroudi K. Influence of mouth breathing on the dentofacial growth of children: a cephalometric study. J Int Oral Health. 2014;6(6):50–55. Available at: https://pubmed.ncbi.nlm.nih.gov/25628484/.Basheer B., Hegde K.S., Bhat S.S., Umar D., Baroudi K. Influence of mouth breathing on the dentofacial growth of children: a cephalometric study. J Int Oral Health. 2014;6(6):50–55. Available at: https://pubmed.ncbi.nlm.nih.gov/25628484/.Garde J.B., Suryavanshi R.K., Jawale B.A., Deshmukh V., Dadhe D.P., Suryavanshi M.K. An epidemiological study to know the prevalence of deleterious oral habits among 6 to 12 years old children. J Int Oral Health. 2014;6(1):39–43. 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The authors declare that there are no conflicts of interest present.