NEW GENERATION ADAPTED MILK FORMULAS PRODUCED BY UKRAINIAN MANUFACTURERS FOR FEEDING INFANTS UNDER ONE YEAR

Breastfeeding is known as the only one form of human feeding that formed during the biological evolution. However, when breastfeeding is impossible, the only solution is to use modern adapted milk formulas to nourish infants. One of the most challenging issues is the adaptation of the formula protein quantity and quality to those in breast milk. Reducing the protein content in the adapted formula "Malutka Premium" prevents protein overload of the immature metabolic system of the child. Fats also play an important role in the nutrition of children as they perform two main functions in the body: they serve as structural components of biological cell membranes and energy material. The fatty component of "Malutka Premium" adapted formula is represented by 50% vegetable oils, which provides the required level of polyunsaturated fatty acids. The carbohydrate component of the adapted formula "Malutka Premium1" is represented by lactose; the adapted formula "Malutka Premium 2" also contains dextrinmaltose (30%). Prebiotics oligosaccharides and five most important nucleotides are added to the composition of "Malutka Premium" that enables to normalize the composition of the intestinal microflora and to intensify the digestive processes. Clinical observations of children receiving formulas with oligosaccharides and nucleotides have shown their high efficacy. Children gained weight better and were found as less likely to have functional digestive disorders. Introducing "Malutka premium with the addition of cereals" formulas to the child's diet enables to choose the most appropriate formula taking into account the peculiarities of the child's digestion. Feeding infants with domestic milk formula ensures the balanced intake of all necessary substances required in accordance with the age and allows to parents and paediatricians solve many problems in the nutrition of both healthy children and children with special nutritional needs.

NUTRITIONAL PROBLEMS AND FACTORS FORMING HEALTH STATUS OF CHILDREN OVER THEIR FIRST YEAR

Purpose: to investigate the impact of the type of feeding on the incidence and physical development of infants. Material and methods. During a year, 250 children of the first year of life under control received different types of feeding (breast milk and milk formulas, differing in composition). Physical development was assessed according to the generally accepted measurement technique in terms of absolute values, monthly increases in anthropometric indicators and mass-growth indices. Outpatient records of children, protocols of examination of a 1-year-old child were studied. The inclusion criteria for the main group of infants were: breastfeeding for at least 9 months; the age of children up to 1 year. The second comparison group included children who received mixed feeding, which includes probiotics. Results. In the girls of the second group, who received mixed feeding with probiotics (7100.0±95.9 g), the weight gain in the first year was significantly higher than the weight gain in the girls who received breast milk and standard formula - 6671 , 0±72.6 g. and 6733.3±91.8 g, respectively. Despite the fact that there were no significant differences in the medians of body weight and height in children of the main group and the comparison groups, it was found that children in the main group were overweight / obese at the age of 2 months had twice as less indicators than children who received mixed feeding. Breastfed children began to sit without support much earlier, on average at 7.6±0.05 months after birth, and children of the other two groups who are bottle-fed, on average, at 8.0±0.13 and 8,1±0.12 months, respectively (p <0.05). When studying the most common diseases of children over their first year of life, depending on the type of feeding, the following results were found out: acute intestinal infections made up the largest share in both groups, 7.7±2.34% of children in the I group, and 11.7±2.93% of children in the II group (p = 0.3905). Conclusion. The study has demonstrated that breastfeeding in the first year of life reduces the risk of overweight and ensures harmonious physical development, neuropsychic development, cuts down the frequency of infectious diseases, alimentary disorders, functional digestive disorders, and contributes to the normalization of intestinal microflora. It is also important to introduce optimal combinations of feeding methods for young children and adding probiotics.

A modern view of medical accompaniment of the colic in neonate (literature review)

Many infants who represent one of the nosological units that refined functional digestive disorders remain an urgent problem of high frequency of parents' referrals to neonatologists, pediatricians, and general practice — family doctors. Existing studies of a number of hypotheses regarding the etiology, mechanisms of origin, and different approaches to the treatment of colic in infants indicate the relevance of this problem. The article presents current literature data, highlighting the main complaints of parents with suspected colic in a child, presents an analysis of the main causes of this functional bowel disorder, some knowledge about the etiopathogenetic mechanisms of colic, modern components of medical care in infants. Emphasis is placed on the existing ambiguous hypotheses that explain the pathogenetic processes in the body of infants with colic. The focus is on the fact that colic remains a diagnosis of exclusion from other functional bowel diseases. It is noted that the basis of medical support of colic are personalized measures aimed at reducing the severity of pain and choosing the optimal tactics for managing the baby in the period between attacks (background correction), taking into account the existing causes and mechanisms of colic. No conflict of interest was declared by the authors. Key words: functional disorders of digestion refinement, infants, colic in neonate, diagnosis, management.

Functional nausea and vomiting in children

The diagnoses «functional nausea» and «functional vomiting» were for the first time described in the structure of paediatric functional digestive disorders in the 2016 Rome IV criteria. The prevalence of functional nausea approximates 0.1–0.5%, functional vomiting – 0.6–1.4%. Functional nausea and vomiting arise from complex interactions between the gastrointestinal tract, the central and autonomic nervous systems. Furthermore, functional nausea is considered in the continuum of gastroparesis and is also associated with an increased mast cell density in the duodenal mucosa. Functional nausea and vomiting are clinical diagnoses that do not require additional testing. Sometimes, recommendations are to examine the nausea profile and the Baxter retching faces scale. No evidence of the efficacy of specific pharmacological and nonpharmacological methods of treating functional nausea and vomiting have been received by now. The use of antidepressants, metoclopramide, ondansetron and other drugs is considered. It is necessary to develop clinical guidelines on diagnosis and treatment of functional nausea and functional vomiting. Key words: functional nausea, functional vomiting, children, Rome IV criteria

Giardia intestinalis and Fructose Malabsorption: A Frequent Association

Nowadays, scientific studies are emerging on the possible etiological role of intestinal parasites in functional digestive disorders. Our study was carried out with healthy individuals (control group; n = 82) and symptomatic patients with lactose or fructose malabsorption, including positive (malabsorbers; n = 213) and negative (absorbers; n = 56) breath test, being analyzed for the presence of intestinal parasites. A high parasitic prevalence was observed in malabsorbers (41.8%), exclusively due to single-cell eukaryotes but not helminths. Giardia intestinalis was the predominant parasite in cases of abnormal absorption (26.5%), significantly associated with fructose malabsorption and doubling the probability of developing this pathology. Within controls, Blastocystis sp. (13.4%) was almost the only parasite, being the second among patients (12.6%), and Cryptosporidium parvum, the last species of clinical relevance, was detected exclusively in two malabsorbers (0.9%). The consumption of ecological food and professions with direct contact with humans arose as risk factors of parasitism. A diagnosis of carbohydrate malabsorption in adulthood is the starting point, making the search for the primary cause necessary. Accurate parasitological diagnosis should be considered another tool in the clinical routine for patients with recurrent symptoms, since their condition may be reversible with adequate therapeutic intervention.

The role of dietary fiber in the correction of digestion and constipation of various etiologies

Psyllium is a predominantly soluble fiber among other natural plant-based dietary fiber used in food and pharmaceuticals and is sold as a laxative fiber. Isphagula (lat. ispaghula)– international nonproprietary name of a medicine of «psyllium». Accordingly to ATX belongs to the group of «Laxatives», subgroup «A06AC «Laxatives increasing volume of intestinal contents» (Bulking laxatives) and has the following code and name: «A06AC01 «Ispaghula» (plantain oval seeds)». Isphagula is a medical dietary fiber; in the context of gastrointestinal problems in terms of «ispaghula» and «psyllium» are synonymous. Psyllium flour has virtually no digestible carbohydrates. This fact is a significant advantage of psyllium over oat bran, in which such carbohydrates are more than 60%. A distinctive feature of psyllium is that it is almost completely (80–85%) consists of fiber (about 70% of which is soluble), which in contact with water turns into a soft gel. Only 1 gram of fiber ground fiber flour is able to absorb up to 45 ml of water. In the colon, psyllium is resistant to fermentation, remains intact in the feces and significantly increases the water content in the feces, providing a laxative effect. Psyllium softens hard stools in constipation, normalizes loose stools in diarrhea, and normalizes stool shape in patients with IBS, relieving gastrointestinal symptoms. Dietary supplement «Fitomucil® Norm» contains 4.5 g of psyllium (Plantago psyllium), and dry pulp of prunes (Prunus domestica) – 0.5 g. This combination of psyllium and prunes can be widely used in patients with constipation and other functional digestive disorders in different age groups, including pregnant and lactating women, as a first-line remedy.

An Osteopathic Approach to Functional Digestive Disorders

Alternative treatments for gastrointestinal (GI) diseases, of which irritable bowel syndrome (IBS) ranks as one of the most common functional GI disorders, are needed because the current medical treatments have deleterious side effects and do not significantly improve quality of life (QOL). Furthermore, symptoms relapse and disease incidence have risen, underscoring its complex nature and substantial burden on the economy, hospitals, patients, and families. This chapter will discuss how an osteopathic approach embraces the concept of the biopsychosocial model, which allows a multipronged strategy for treating chronic pain conditions, using IBS as a model of chronic pain, poor QOL, and disability, and how the understanding of pain neurophysiology can further aid this approach as a viable treatment option for long-term patient satisfaction and improvement in QOL.