Mastitis is one of the most common pyoinflammatory processes that occur in the postpartum. The mastitis incidence varies from 0.5% to 33%. Due to lack of standard algorithms, approaches to diagnosis and treatment of lactational mastitis vary between pediatricians and obstetrician-gynecologists. Plugged ducts is the basic factor that predisposes a woman to plugged milk ducts, which can lead to mastitis. Unfortunately, frequently prescribed antibacterial treatment has an adverse effect on human milk microbiota and creates subtherapeutic drug concentration in milk, which leads to antibiotic resistance in infants. Effective expression of breast milk is a key method to prevent and fight mastitis and plugged ducts. Recommendations for preferred method of breast milk expression require a personalized approach, the first of which depends on the assessment of breast nipples condition. According to some reports, 80–90% of breast-feeding women develop soreness and cracked nipples, which cause delayed or missed breastfeeding. Teaching correct breast-feeding techniques can prevent the chain of these adverse events: cracked nipples – plugged duct – lactation mastitis. Ideally, a healthy mature infant with active sucking reflex, who is breastfed effectively with a good technique, may perfectly ensure a problem-free lactation period.

In the article, the authors cite modern data on the frequency of Caesarean section in obstetric practice, report the peculiarities of adaptation of children born by Caesarean section surgery, which is characterized by a high frequency of borderline conditions, pathological loss of body weight, functional disorders of the gastrointestinal tract, higher morbidity in the subsequent period. In addition, the authors note that mothers of these children are more likely to have hypogalactia, which is largely responsible for impaired adaptation in infants and their transfer to artificial feeding. Referring to the published works, the authors offer various options to improve the process of adaptation in this contingent of children.

Infant colic is a common cause of parental anxiety and, as a result, help-seeking behaviour. However, the relationship between breastfeeding and colic is currently not fully understood. The article presents data from various studies of the relationship between breastfeeding and colic. On the one hand, the severity of infant colic may lead to the early cessation of exclusive breastfeeding due to the mother’s fear that the baby’s crying is the result of the ineffectiveness of breastfeeding and the unreasonable transition to supplemental feeding. On the other hand, many authors have identified the protective effect of breastfeeding in relation to infant colic a less pronounced degree of infant colic is reported in the group of children, who are breastfed as compared to the children, who are formula-fed. Therefore, the task of the paediatrician is to provide competent counselling for the anxious parents of an infant with colic using evidence-based medicine (EBM) databases, which will help preserve the mother’s breastfeeding. In most cases, due to competent counselling of the parents, the severity of infant colic may be reduced by improving the quality of breastfeeding (ensuring proper breast grabbing to reduce aerophagy, increasing the proportion of consumption of the so-called «back» milk), reducing anxiety of the parents and increasing the perception of breastfeeding self-efficacy levels by mothers. This may increase the duration of breastfeeding of the infants with infant colic.

Purpose of the study was to establish clinical and radiological features of bronchopulmonary dysplasia (BPD) outcomes in children. Materials and methods. A prospective follow-up study of 132 premature infants with infant respiratory distress syndrome (IRDS) was analyzed. BPD was developed in 66 cases. At a late childhood, clinical and radiological outcomes of the transferred conditions were diagnosed on the basis of anamnesis, clinical examination, and results of chest computed tomography (CT). Results. Clinical recovery was observed significantly more frequently in the outcome of IRDS without BPD development (69.6% versus 31.8% in the case of BPD development). In patients with BPD in the anamnesis, the odds ratio of asthma developed in the late childhood was 5.304 times higher than in children who had IRDS. The majority (62 cases, 93.9%) of children who had IRDS did not have structural changes in lung tissue according to CT (p = 0.000), 21 (31.8%) children with BPD had abnormal CT. In BPD, typical radiological findings were hypoattenuated lung areas (p = 0.020) and areas of pulmonary fibrosis (p = 0.016). Conclusion. Chest CT could be assigned to the patients with BPD in the anamnesis to assess lung tissue structural changes and diagnose outcomes of the disease.

This article describes briefly the history of creation of disposable diapers, the structure of modern diapers, and skincare during use of disposable diapers, first aid methods, if a baby develops diaper dermatitis, and answers to the main questions asked by parents about possible risks for babies’ health during constant use of disposable diapers. The article underlines the nurses’ role in advising parents on the newborn care.

The aim of this paper was to assess vitamin D status in infants and young children in Moscow. 211 children aged 0 to 3 years were examined, of which 103 (48.8%) were under the age of 12 months, 64 (30.3%) children were 2 years old, 44 (20.9%) were 3 years old. The number of boys and girls was almost equal (52.6 and 47.4%). In the examined group of children, only 38.4% had the serum calcidiol level within the normal range (> 30 ng/ml). In other cases (61.6%), the children were diagnosed with one or another degree of vitamin D deficiency: severe deficiency in 2.4%; deficiency in 27.5%; insufficiency in 31.8% of patients. The frequency of registration of vitamin D insufficiency or deficiency increases significantly with the increase of years (R = -0.22, p = 0.0018). When comparing the obtained data with the results of study RODNICHOK, it was found that the vitamin D deficiency value in Moscow children was significantly lower than that in the regions located to the south (Kazan 65.0%; p <0.01; Stavropol 45 , 8%; p <0.05), and the Far East (Blagoveshchensk 42.6%; p <0.05; Khabarovsk 42.9%; p <0.05; Vladivostok 72.7%; p < 0.01). The absolute majority of the examined children (84.8%) received a prophylactic dose of vitamin D of 500 to 1500 IU/day. The 500 IU/day dose is insufficient, because 71.2% of patients in this subgroup had a low vitamin D status. A similar effect was obtained in patients taking vitamin D at a dose of 1000 and 1500 IU/day: the absolute values of cholecalciferol reliably increased by 1.8 and 1.9 times, the number of patients with normal vitamin values increased by 2.7 and 2.2 times as compared with intake of vitamin D at a dose of 500 IU; the deficiency level reduced by more than 8 times as compared to the control group and more than 2 times as compared to the patients receiving 500 IU. The seasonal factor does not have a significant effect on the serum calcidiol level (r = 0.06 at p = 0.3), which may be due to the peculiarities of the specific prevention of hypovitaminosis: a bit more than a third of children take vitamin D in summer (39.2%), whereas absolute majority (83.3%) take it in winter.

Temporal eruption for children is a natural and physiological process. However, in some cases, it may be accompanied by numerous unpleasant symptoms, such as fever, decreased appetite, anxiety, sleep disorders and indigestion. These symptoms nonspecific and may occur in other somatic diseases. The Violation of stages, timing of eruption may be indicated a variety of somatic diseases and the development of further pathology of the dental-jaw system, as well as depends of the child`s constitutional characteristics. In this article we are presents an analysis, which dedicated problems of infant`s tooth eruption. Special attention is paid to the available means for the normalization of pathological symptoms, which accompanied the process of teething. Sometimes, parents try to alleviate the child`s condition and use different means independently, but uncontrolled and prolonged use of NSAIDs and local anesthetics can leads to allergic or toxic effects. Currently, with the help of research, it has been established that the use of herbal preparations is better, they are safer.

The use of combined medicines simultaneously influencing various pathogenetic mechanisms of inflammation and coughing becomes an essential direction of mucoactive therapy in childhood. One of these is thiamphenicol glycinate acetylcysteinate, which has both mucolytic and antibacterial effects, which significantly expands the possibilities of therapy in bacterial etiology of acute and exacerbation of chronic respiratory diseases, increases the effectiveness of therapeutic measures, improves compliance.

Acute respiratory infections – the most common diseases in childhood, accompanied by cough. Treatment of cough is determined by the disease, the nature of sputum, the the general condition of the patient. The choice can be considered justified, depending on these conditions, herbal preparations or preparations of allo-medicine, their combination. In respiratory infections of the upper respiratory tract, it is possible to use eucaball, the active components of which are thyme and plantain. For infections of the lower respiratory tract with a viscous difficult-to-expelled sputum, Espa-nac (acetylcysteine) is indicated.

The article presents the results obtained from the use of aeration with large forms of bactericidal spray (cedar) in preschool and school institutions in Krasnoyarsk in conjunction with individual aeration of small forms of bactericidal spray (cedar) at home in the season of rising incidence of influenza and ARVI. Due to a decrease in the total microbial contamination of the air environment and surface when using the harmless bactericidal spray (cedar), there is a decrease in the incidence of ARVI among children who regularly receive aeration for 4 weeks, and there is a lighter course of ARVI and the absence of complicated forms in 2 times in the observed children in comparison with the group where aeration was not applied. The positive results obtained during the 4-week observation, and the absence of any side effects from the spraying of bactericidal spray (cedar) allows us to recommend it for the prevention of influenza and ARVI during the period of epidemic or seasonal increase in morbidity in organized groups of preschool and school institutions. Considering that since the beginning of the heating season, dry air is installed in the premises, the use of aeration of bactericidal spray reduces the impact of harmful environmental factors on the child’s body, which is facilitated by the ionization and moistening of the air with phytoncide spray components.

This article deals with difficulties in differential diagnosis of lingering dry cough in children. The focus of the article is on the rare reason for lingering cough: hypersensitive pneumonitis. A brief review of the literature on this rare form of pathology is presented. The authors described two own clinical observations that demonstrate the difficulties in diagnosis, features of the course and management of patients with acute / subacute form of hypersensitive pneumonitis in prolonged observation.

The article deals with topical issues of secretolytic therapy for coughing in adults and children. Special attention is paid to modern herbal expectorants produced at high-tech pharmaceutical production, which has a certificate of GMP (Good Manufacturing Practice). Today these are well studied products containing extracts of thyme, primrose and ivy, the mechanisms of action of which are well studied in vivo and in vitro studies. Among these herbal medicines, one of the well studied is Bronchipret®. Its high clinical efficacy and good tolerability of treatment for adults and children is shown in large multicenter studies, including those performed according to the «gold standard» of evidence-based medicine, randomized, double-blind, placebo-controlled.

The high incidence of respiratory infections at an early age requires constant attention of doctors of various specialties. It should be born in mind that the development of the respiratory tract in young children has unique features, and that different drugs can have different effects on the mucous membrane and ciliated epithelium. Also take into account the possibility of using different ways drugs can be administered to prevent and treat respiratory infections with due account for the age of the child, the effectiveness of action and adverse events risk reduction.

A clinical and epidemiological study was performed including 295 Caucasian children (137 boys, 158 girls) of school age (coverage 93.7%) and 571 adults (208 male, 363 female) from their parents (coverage 82.4 %) in the settlement of Atamanovo, Sukhobuzimsky district of Krasnoyarsk Territory. The study showed that there was an association of the prevalence of dyspepsia, erosion and ulcers of the gastroduodenal zone in children who had parents with dyspepsia. Helicobacter pylori infection was more common in children with dyspepsia than in healthy individuals.

The immune system of the body’s mucous membranes plays a huge role in the development, maintenance and regulation of immune homeostasis, being an important component of the multi-component immune system. The structural basis of local immunity is the lymphatic tissue associated with the mucous membranes (MALT). There is now scientific evidence that the mucous membrane sections of different body systems interact closely with each other, subject to the same regulatory influences. This relationship is particularly close between the digestive and respiratory tract, and studies have shown that vaccination of the mucosa of one part increases the protective function of the mucosa of another part, and that virus infection leads to virus-specific concentrations of immunoglobulins in the secretion of the mucosa of another part. The impact on the intestinal microbiota can be a convenient tool to prevent not only gastrointestinal, but also respiratory diseases. In a number of works the clinical effects confirming expediency of probiotics application both at healthy, and at sick children are confirmed. An extremely important component of the local immune system is the antimicrobial peptides, which play a key role in the formation of the first line of defense against infections. AMP have a number of proven biological effects: antibacterial, antiviral and antifungal effects, and some have antitumor properties. Thus, the prospects for prevention and treatment of many infectious diseases lie in the new possibilities for influencing mucosal immunity.

Pediatricians face a problem of functional constipation in children and adolescents in one-third of cases of observation. Functional disorders of the gastrointestinal tract are based on disregulatory processes of the cortical-vegetative-endocrine complex. Magnesium deficiency is one of the factors influencing the formation of functional constipation in children, and an important link in the pathogenesis of the disease. Correction of magnesium level by means of magnesium-containing mineral water is one of the safe, effective and complex factors influencing a number of pathogenetic mechanisms of formation of functional constipation in children and teenagers.

Clinical urine test with the correct interpretation can help the clinician in the diagnosis of the urinary system diseases, as well as other organs and systems. Most laboratories in medical institutions are currently switching to an automated urinary sediment test, but microscopy appears relevant. Unfortunately, clinicians often interpret only three or four (most often proteinuria, leukocyturia and erythrocyturia) of all the numerous indicators of urine test, unfairly ignoring the others. The urinary cylinders are one of these important elements of the urinary sediment. The article presents the characteristics of the main types of urinary cylinders, their origin, composition, morphology and clinical significance.

The review provides current data on terminology, prevalence, etiopathogenesis, clinic and differential diagnosis of diaper dermatitis (DD). Particular attention is paid to approaches to the prevention and treatment of DD. Modern emollients and moisturisers, production technologies and possibilities of superabsorbing diapers have made it possible to significantly facilitate skin care for newborns and infants, and reduce the frequency and severity of the clinical manifestations of this disease. The key to successful prevention of DD is raising parents’ awareness and teaching them how to care for their baby’s skin.

Allergic rhinitis is a common problem in childhood, and symptoms are increasingly common in children from the early years of life. The article presents the features of prevalence, factors contributing to the formation, clinical manifestations and principles of allergic rhinitis therapy in young children.

Babies born through in vitro fertilization (IVF) treatment are most often born preterm [1]. Most authors state that these children are more likely to have congenital malformations, bronchopulmonary dysplasia (BPD), hypoxic central nervous system damage, hyperbilirubinemia. It is known that these children are 6 times more likely to have an extremely low birth weight and intrauterine growth retardation [2]. More than 35 years have passed since the birth of the first child through the IVF treatment. During this time, the assisted reproductive technologies have improved and therewith the number of children conceived in vitro has also increased. In this regard, the issues relating to the study of the health of children conceived through IVF treatment are growing more urgent. In the Russian Federation, the share of premature babies averages 6–8% among all newborns. Children born prematurely should always be in the center of attention of pediatricians, since it is among them that the highest percentage of perinatal pathology is observed and deviations in subsequent development are detected much more often [3].

Objective of the study: to study the state of health of a premature baby in the first year of life born through IVF. Material and methods: the researchers performed a continuous, documentary, retrospective analysis of the medical history of a child treated in the Special Care Nursery of the City Children’s Clinical Hospital in Ufa, and afterwards monitored the child in the Catamnesis Unit. The child underwent clinical examination, assessment of physical development using the centile method, laboratory tests, analysis of primary medical documentation (hospital neonatal record f. 097/u, outpatient medical record f. 112/u). The premature baby was examined taking into account the adjusted age (from the calendar age to 40 weeks of gestation).

Results: the health and age of the mother are crucial in forming the health of the child. The mother had a combined pathology. The 3rd pregnancy (the 1st pregnancy ended in childbirth at 35 weeks, the child grows in a family, the 2nd pregnancy ended in spontaneous abortion) through IVF treatment developed against the threat of interruption starting from 8 weeks, combined gestosis, grade 1B placental violation, low placentation, isthmic-cervical insufficiency (ICI), antiphospholipid syndrome, which resulted in early, premature birth at 29 weeks’ gestational age. The child was born prematurely with perinatal nervous system damage, the development of acute pneumonia, respiratory distress syndrome of the newborn.

Findings: A clinical case determines the need for targeted observation of a premature child from a risk group, timely advanced training of a pediatrician regarding the features of management of premature babies born through the IVF treatment, taking into account the adjusted age.

Previous pharmacogenetic studies demonstrate significant genes’ polymorphisms effect on the efficacy and safety of pharmacotherapy, including in bronchial asthma (BA). According to the literature, there are data on the effect of polymorphisms CYP3A4*22 and CYP3A5*3 on the efficacy of inhaled corticosteroids in children with BA. Further research on the effect of pharmacogenetic features on the efficacy and safety of drugs is one of the way to optimize asthma therapy in children.

Purpose. Identification of possible ways to optimize asthma therapy by the analysis of CYP3A5 (A6986G) gene polymorphism effect on the asthma therapy efficacy.

Materials and methods. The study was conducted on the basis of three children’s polyclinics of Moscow. 100 children aged 6–17 years with an established diagnosis of BA were included. Dynamic assessment of asthma control and the amount of therapy needed was carried out. All patients underwent genotyping for the A6986G polymorphism of CYP3A5 gene by real-time PCR. Statistical data analysis was carried out using a programming language for statistical data processing R.3.4.0.

Results. It was found that 8% of children with asthma were heterozygous for the A6986G polymorphism of the CYP3A5 gene, 92% of respondents were homozygous with the GG genotype. In 6 out of 8 heterozygotes, the amount of control therapy corresponded the third and fourth therapy stages according to GINA criteria. In the group of moderate and severe BA, the number of heterozygotes for the A6986G polymorphic marker of the CYP3A5 gene was statistically higher compared to the group of children with mild BA (p = 0,048).

Conclusion. Thus, we identified a statistically significant difference in the occurrence of heterozygotes for the A6986G polymorphism of the CYP3A5 gene between groups of children with mild asthma and patients with moderate and severe asthma. The AG genotype and the presence of the A allele (CYP3A5 gene (A6986G)) are associated with more severe BA and the need for more anti-inflammatory therapy.

In the article, the authors raise the issue of protection of the reproductive health of adolescent girls. 50 adolescent girls, who studied in the technical and humanitarian classes of the secondary general school in Vladimir, were enrolled in the study. They had participated in the anonymous questionnaire survey for 3 years. It was found that the majority of adolescent girls had a low level of knowledge on reproductive health, as well as altered sexual behaviour (attitude toward the family, motherhood, childbirth, abortion, marriage), moreover the indicators on these issues deteriorated with the passage of time. The religious schoolgirls from families with two or more children showed the «highest» reproductive attitudes; they were negative about abortion.

The results of treatment of eleven children aged six to eleven years with fecal incontinence were traced. It was found that nine of them did not have an organic cause of the disease. Regular irrigation of the rectum in this group of patients contributed to the elimination of the encopresis.

The search for factors affecting the efficacy of bronchial asthma (BA) therapy in children is an actual problem. subject of many modern scientific studies. Authors note that adherence to therapy in patients with asthma ranges from 30 to 70%. Often this index does not exceed 50%. Analysis of adherence to medical recommendations in children with asthma and the search for compliance reduction factors is one of the ways for optimizing therapy and improving the quality of life for children with asthma.

Purpose. In order to optimize bronchial asthma therapy in pediatric practice, we analysed adherence to medical recommendations and its effect on the controllability of the disease in children with asthma.

Materials and methods. The study included 94 children aged 6 to 17 years with an established diagnosis of bronchial asthma. All patients had previously been recommended basic therapy in the form of inhaled glucocorticosteroids (ICS) or their fixed combinations with long-acting beta2-adrenomimetikami (LABA). An assessment of BA control symptoms was carried out, and factors affecting adherence to medical recommendations were analyzed. The effect of decreased patient compliance on the control of asthma symptoms was evaluated.

Results. 61.7% of children with asthma have insufficient disease control. In 42.55% of patients, a survey revealed insufficient adherence to medical recommendations. 88.3% of children and their parents reported the presence of factors capable of influencing the decrease in compliance. The most frequently occurring factor in reducing adherence to therapy turned out to be insufficient patient awareness of the disease itself, the mechanisms of therapy action, and the prospect of treatment. Statistical data processing showed a statistically significant decrease in adherence to medical recommendations in the group of patients with insufficient asthma symptom control (p = 0.038).

Conclusion. Only 38.3% of children had complete asthma symptom control. The statistically significant reduction in adherence to medical recommendations in the group of children with insufficient symptom control suggests the need for educational activities for children with BA and their parents in order to increase adherence to medical recommendations, optimize the effectiveness of therapy and improve the quality of patients’ life.

In the framework of the XXI Congress of Pediatricians of Russia with international participation «Actual problems of pediatrics», held in early 2019, an interdisciplinary symposium on modern principles of treatment of children with acute respiratory diseases took place. In their reports, foreign and Russian experts highlighted the most discussed topics of pediatrics: the choice and application of immunostimulating therapy in the management of children with recurrent infections, the tactics of cough treatment in children, the impact of antibiotic therapy on microbiome and rational approaches to antibiotic therapy in childhood. 

Due to increase in S. pneumonia resistance to penicillin, macrolides and oral cephalosporin, the treatment of community-acquired pneumonia in children has to be revised. The article presents current (Eurasian and WHO) recommendations on the choice of rational antibiotic therapy for pneumonia in the outpatient setting. The common mistakes in choosing an initial antibacterial drug, replacing an antibiotic, if it is ineffective, and prescribing inadequate dosage are shown by two clinical examples from real outpatient practice. Due to mistakes in the treatment, pneumonia may take a more protracted course and complicate the clinical situation, forcing the physicians to resort to additional tests.

The article provides information on the main groups of vitamins and their effects on the child’s body. The negative effect of the macroand micro-elements deficit on the human body, both of the adults and children, has been proved convincingly. The essential triad of vitamins (A, C, D,) is the most significant vitamins for children under one year. This combination of vitamins ensures the safety of the combination and the possibility of mutual supplement of ingredients for effective formation of infant immunity, neuropsychic development, harmonious physical development and prevention of rickets. The vast majority of children under one year have an essential vitamins A, C, D deficiency, regardless of the nature of feeding. The Russian studies showed that only 45.6% of children have an adequate vitamin D level. It is also proven that children with atopic dermatitis have low vitamins A, C, and E levels.

A survey of 182 children aged 5 to 9 years in the children’s sanatorium «Duslyk» Ufa. A survey of 182 children aged 5 to 9 years in the children’s sanatorium «Duslyk» Ufa.The main group included 101 children with relapsing respiratory pathology, the control group 81 healthy children. The article presents an analysis of the actual weekly diet of children at home, modern approaches to the study of nutritional status using clinical, biochemical, anthropometric, somatometric methods, bioimpedance measurements. The actual nutrition of children with relapsing respiratory pathology was characterized by an imbalance in the content of the main nutrients. A comprehensive assessment of nutritional status revealed malnutrition in children of the main group. The aim of the study was to assess the actual nutrition, the study of nutritional status, taking into account the clinical and laboratory parameters and the component composition of the body of children in the children’s sanatorium. The inclusion of an assessment of actual nutrition and nutritional status in the survey program will make it possible to timely identify malnutrition in children with relapsing respiratory pathology, purposefully carry out preventive measures.

Photodynamic diagnosis is a promising method in the treatment of laryngeal papillomatosis, which includes an assessment of the increased visual and spectrometric contrast of papillomatosis masses against the background of the introduction of the photosensitizer. We have developed a method of treatment of laryngeal papillomatosis in two stages: intraoperative diagnosis using the domestic preparation of 5-aminolevulinic acid hydrochloride and subsequent surgical treatment using a carbon dioxide laser. Using the new method, we treated 21 patients, of which 13 (61.9%) had the inter-recurrent period longer than 12 months.

Carrying out antitumor treatment of children with oncological diseases is often accompanied by many complications, one of the most significant eating disorders. These disorders can aggravate the existing problems, complicate the patient’s treatment and often dictate the need for special nutritional support. First of all, it is based on the limitations associated with the requirements for low microbial density of food (due to sharply reduced immunity), gastrointestinal disorders of varying severity and prevalence, peculiarities of taste and appetite of the child (which are almost always violated in the process of antitumor therapy), as well as psychological problems. In children of early age, this situation is very significant, since complications (especially gastrointestinal complications) can last for a long time, which may limit the development of the child, even if the basic treatment is successfully completed, or even prevent him or her from developing at all. Therefore, such patients need special nutritional support: enteral and often parenteral nutrition, as well as a special approach to diet, which is often based on industrial baby food products.