The aim of the study: to assess supplementary feeding in breastfed neonate, evaluate infant and maternal indications for supplementation in healthy infants. Methods. An anonymous voluntary survey about supplementary feeding of 50 women who has breastfed children and visited the hospital for various reasons, not related to breastfeeding. According to the results of survey, the main reason for starting supplementary feeding was the insufficient amount of breast milk in the mother (63,20%). Other reasons included: low body weight of the child, illness of the mother, difficulties in applying to the breast, restlessness of the child. After the introduction of supplementary food, only 3,80% of children were returned to exclusively breastfeeding, 22,20% - remained on mixed feeding until the introduction of complementary food, and 29,60% had artificial feeding. The majority of women (74,10%) did not use any methods to improve lactation. Half of the surveyed mothers (56,00%) who introduced supplementary feeding gave milk formula to feed their child and used bottle feeding (32,60%) and spoon feeding (21,30%). Conclusions: the majority of interviewed women had a shortage of breast milk, which was the main reason for the introduction of supplementary food; the best supplementary food product is mother's or donor's milk; a third part of the surveyed women used bottle feeding; the decision to introduce supplementary food should be made by the doctor individually to every child.

Advantages and disadvantages of distance learning at the Department of Propaedeutic Pediatrics of M. Pyrohov Vinnytsia National Medical University were assessed. Students′ attitudes to distance learning was analyzed. Most of foreign students were satisfied with the educational process at the Department of Propaedeutic Pediatrics. On the one hand, they have enumerated lots of advantages, the most important of them are staying safe and interruption of infections spreading, comfortable and convenient learning, saving a lot of time, reduction stress and tiredness. On the other hand, distance learning has disadvantages. Distance learning at medical universities are having theoretically classes mainly without practical and communicative skills at the patient’s bedside. The main barrier of remote learning is the quality of internet connection. Active communication, interaction, getting feedback, understanding the needs and feelings of students are significant during remote studying.

Annotation. Timely detection of influenza cases and modern opportunities for prevention of the disease are becoming important in the season of increasing the incidence of respiratory diseases in a pandemic COVID-19.The aim was to study the clinical and laboratory features of influenza in children in the season 2021/2022, who were hospitalized in the departments of Vinnytsia City Hospital “Mother and Child Center” since December 2021 till February 2022, as well as to analyze the current possibilities of specific prevention of the disease. 30 children were examined to clarify the clinical course of influenza. To diagnose influenza A and B, children underwent a smear of the nasal mucosa. Immunochromatographic method was used, namely cito-test of LLC "Pharmaco - Ukraine". To rule out coronavirus infection, a rapid antigen test for the coronavirus "SARS-CoV-2 Rapid Antigen Test" was performed. An analysis of prophylactic vaccination cards №063/o was performed to study the coverage of influenza vaccination. It was found that preschool children predominated (17 people – 56.7%), while school-age children accounted for 43.3%. A quarter of children (26.6%) sought medical help on the first day of illness, half (56.6%) - on the second day and the rest (16.6%) – on the third day. The children with flu mostly complained of chills, headache, loss of appetite, aches in the joints and muscles, most children suffered from high body temperature, which lasted up to 3±0.8 days. The average temperature figures were 39.52±0.58ºC. Catarrhal phenomena were present in the biggest part of children (86.7%). It was revealed a clear lung sound and vesicular breath sound in a physical examination. There were no significant changes in the blood count in 70% of children. Children were prescribed special and symptomatic therapy. No one of the hospitalized children received specific influenza prophylaxis according to the prophylactic vaccination cards №063/o, although vaccination remains the best way to protect against influenza and is of great importance, especially in a pandemic COVID-19. Inactivated tetravalent vaccines present in Ukraine provide reliable protection against influenza and are completely safe.

Purpose - to improve diagnostics and making multisystem inflammatory syndrome diagnosis in children based on the study of the clinical course and determination of laboratory and instrumental features. Materials and methods. 15 cases of multisystem inflammatory syndrome in children who were hospitalized in the Infectious Diseases Boxed Department No.1 of the Vinnytsya Regional Children’s Clinical Hospital in 2021 were analyzed. Results. The most common symptom was fever. Gastrointestinal disorders (53.33%), neurocognitive and vegetative symptoms (86.67%) were also found in children. Arthralgias, myalgias and pains in the lower extremities were in 33.33% of children, respiratory symptoms - in 20.00% of ones. Almost half of the children had skin rashes at physical examination. Scleritis and conjunctivitis was also noted in the quarter children. Leukocytosis was detected in 8 children (53.33%) in the results of blood count. Majority of children had elevated erythrocyte sedimentation rate, C-reactive protein and fibrinogen. D-dimer was increased in all children. 46.67% of children, according to chest ultrasound had fluid in the pleural cavity up to 7-10 mm, signs of interstitial pulmonary edema, increased echo-signals along the axillary line and the consolidation zone in the middle right lung from 3 mm to 6 mm. 60.0% of children had enlarged liver, spleen, fluid in the abdomen and enlarged multiple mesenteric lymph nodes according abdominal ultrasound. Conclusions. The diagnosis of multisystem inflammatory syndrome should be made according to the main criteria. It requires differential diagnosis with a number of infectious and systemic diseases. Prolonged fever and neurocognitive symptoms were the most common symptoms in hospitalized patients. Gastrointestinal and cardiovascular disorders, skin rashes prevailed. Typical laboratory changes were elevated markers of inflammation, evidence of coagulopathy and markers of previous coronavirus infection. Significant features among echosonographic changes were enlargement of parenchymal organs and signs of effusion in the cavities. Child protection from the impact of coronavirus infection should be improved. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors. Keywords: multisystem inflammatory syndrome, MIS-C, SARS-CoV-2, children.

The main principles of specific immunoprophylaxis of COVID-19 in children and adolescents were determined based on the accumulated scientific data. It was established that only two vaccines, Pfizer-BioNTech (BNT162b2) «Comirnaty» and Moderna mRNA-1273 «Spikevax» were approved by the WHO for emergency use in children and only the first of them was approved for use in Ukraine. Both vaccines have a proven safety and efficacy profile according to the results of clinical trials. The current analysis of side effects associated with Pfizer-BioNTech (BNT162b2) "Comirnaty" and Moderna mRNA-1273 "Spikevax" vaccination indicates a favorable clinical course of local, systemic reactions and myocarditis following a vaccination with regression of symptoms in all patients. The risk of the multisystem inflammatory syndrome in children following acute infection, the potential for other sequelae of SARS-CoV-2 infection, the risk of severe disease in children with underlying medical conditions, remain compelling reasons for vaccination of children and outweigh possible risks of side effects associated with vaccination. In the context of the global shortage of vaccines in the world, immunization programs should focus on groups of highest risk of hospitalizations and deaths, according to the Prioritization Roadmap. Children vaccination against COVID-19 with risk factors, comorbidities, immunodeficiency is a priority. Before vaccinating children and adolescents at low risk of serious disease, children from high-risk groups should be actively identified and vaccinated, justifying the importance of their vaccination. Despite the widespread introduction of vaccination, appropriate preventive measures for fighting COVID-19 should be taken, including physical distancing, frequent handwashing, wearing masks. It is extremely important to maintain a high level of vaccination coverage against other infectious diseases and not to delay the planned vaccination of children. No conflict of interests was declared by the authors. Key words: vaccination, COVID-19, children.