Relevance of the research. Timing, order and sequence of complementary feeding remain the subject of discussion until now. The aim of the study. Estimate influence of different outlines of introduction of complementary foods on nutritional status and food behavior in children of first year of life. Materials and methods. Examined 96 children in age of 4-6 months during introduction of complementary foods. Main group – 50 children (27 breast-feed (BF) children and 23 on milk formulas (MF)), in whose diet were introduced only complementary foods, which were made in special factories. Comparison group – 46 children (33 – BF and 13 – MF) received complementary foods made at home and in special factories. Duration of follow-up was 3 months. Physical examination, mother’s diary analysis, evaluation of tolerance of complementary foods, bacteriological examination of feces. Results. On the background of introduction of complementary foods in the main group, increased the number of children with normal fatness (BF from 66.8% to 74.2%, MF from 82.7 to 88.4%), in comparison group, their number decreased (BF from 84.8% to 78.8%, MF from 69.3 to 62.3%). In the main group when a child refuses a product, mother continues offer it insistently. 61.5% of children began to eat unloved product at the end of first year of life. In comparison group, where mother changed unloved product at once, only 25% of children began to relate to it positively. In the main group dyspeptic disorders were mild in 4% of children. In in comparison group prevailed diarrheal syndrome, related to contamination with pathogenic strains of E. coli in 13% of children. Conclusions. Using of industrial made complimentary foods according to the optimal order, with determined mothers perseverance provides equalization of fatness, allows to form a correct food behavior and decreases risk of intestinal colonization by pathogenic microorganisms.

Relevance of the study. Eating disorders in children in early childhood are among the leading causes of obesity and the metabolic syndrome. The aim of the study. For the prevention of noncommunicable diseases (obesity, metabolic syndrome) in the future, to carry out the analysis of actual nutrition of children of early age and to identify unfavorable factors influencing the formation of eating behavior. Materials and methods. A survey of 297 parents with children aged 1 to 3 years. The survey is based on the Google Form on-line platform. The platform for the survey was the social network VKontakte, in particular, thematic groups for mothers with children from 1 to 3 years old. The questions were developed taking into account the recommendations set out in the modern normative documents on children’s nutrition. Results. According to the data, only 28% of children had 5 organized meals per day, 51% had 4 feedings per day, 21% had 3 feedings. More than half of the children (52%) had 2 snacks per day. The most common snacks were flour products (30%), as well as vegetables and fruits (27%). Most parents (78%) did not pay attention to the design of dishes, 16% did not provide adequate replacement of dishes that the child refused. It should be noted that 12% of children do not like vegetables. A joint meal was not organized in 7% of families. During the meal, 40% of parents and 23% of children used a TV/tablet/smartphone. There are a large number of families (37%) who visit fast food restaurants (fast food) with young children, while 26% of them offered menu items to children. Conclusion. Identified adverse factors in the formation of eating behavior require changes in the approaches to monitoring a young child on nutritional issues both by a pediatrician and by the implementation of a number of recommendations by parents.

Санкт-Петербургский государственный педиатрический медицинский университет, Российская Федерация Цель исследования: изучить дефекты питания детей раннего и дошкольного возраста, патогенные последствия которых усугубляются неблагоприятным природно-экологическим состоянием Санкт-Петербургского региона. Пациенты и методы: проанализированы рационы питания 119 детей, посещавших детские дошкольные учреждения Санкт-Петербурга с двенадцатичасовым пребыванием (с учетом всего дополнительного питания вне учреждения), из них 53 ребенка-в возрасте 2-3, 66 детей-4-6 лет. Анализ рациона складывался из оценок фактического питания и обеспеченности пищевыми веществами. Результаты: установлено, что фактическое питание детей раннего и дошкольного возраста значительно отклоняется от рекомендуемых норм и приводит к устойчивому дисбалансу поступления важнейших пищевых веществ. Многие дефекты питания поддерживаются специфическими негативными факторами среды обитания. Совокупное влияние этих воздействий приводит к нарушению развития и росту частоты экозависимых заболеваний детей. Выводы: при организации питания детей, живущих в сложных природно-экологических условиях, должны быть учтены не только возрастные нормы потребления пищевых веществ и энергии, но и погодные характеристики, особенности природных биологических ритмов, специфические геологические показатели.

Background. The continuing increase of the prevalence of asthma in the world, the lack of the expected therapeutic effect of current programs, make this phenomenon to be studied. One of the main causes of asthma exacerbation and worsening of the prognosis in the children’s population are infectious diseases that occur in connection with steroid therapy used in the asthma treatment. Aim: to study the relationship of steroid therapy in asthmatic children with the occurrence of community-acquired pneumonia, that changes asthma symptoms in them. Materials and methods. 39 children aged 3-18 years old with atopic asthma who received corticosteroid therapy, were examined. All patients were divided into 4 groups: Group 1 – patients received inhaled corticosteroids for 2 years; Group 2 – for 3-5 years; Group 3 – for more than 5 years; Group 4 – patients with newly diagnosed asthma and a short course of corticosteroid therapy in the remission. Results. The frequency of community-acquired pneumonia was analyzed in all groups. Strong positive correlation between the duration of use of moderate and moderate/high dose inhaled corticosteroid therapy in asthmatic children for more than 2 years and the occurrence of community-acquired pneumonia with development of complications (pulmonary hypertension, pulmonary fibrosis, pulmonary bullae, bronchiectasis) in 48.7% them was revealed. Conclusions. Strong positive correlation between the duration of moderate and moderate/high dose inhaled corticosteroid therapy in asthmatic children for more than 2 years and the occurrence of community-acquired pneumonia in them was revealed, that necessitates the antibiotics to be included in the medication therapy of asthma.

Asthma remains one of the most important medical and social problems of current medicine. Despite significant approaches the increase in its incidence continues. 334 million people worldwide are affected by this chronic disease and more than 250 thousand die every year. Current asthma treatment methods arent useful to achieve asthma control in half of patients that associates with high risk of exacerbation of the disease. Modern asthma management requires a deep analysis of the factors responsible for the asthma progression and the development of exacerbations. The European Academy of Allergology and Clinical Immunology was held May 26-30, 2018 in Munich. The present publication sums up speeches of leading experts in the field of allergology and clinical immunology. Well-known experts in the field of diagnostics, treatment, prevention of bronchial asthma, modern views on the problem, a common pathology, which, despite considerable efforts, continues to grow, especially in the childrens population. The use of recent advances in molecular allergology, clinical immunology makes it possible to convincingly prove the heterogeneity of bronchial asthma, the need to use new diagnostic and therapeutic methods: biomarkers to detect pheno-endotypic diseases with the appointment of strictly targeted individualized treatment of patients with the results of new biologics. All attention was paid to the study of emerging and clinical trends of uncontrolled bronchial asthma, proposals for the use of new classification structures with indication of biological markers of each pheno-endotype of uncontrolled bronchial asthma were considered. A revised version of the GINA with the revision of therapeutic tactics, including in children, is presented. The latest EAACI Congress made a significant contribution to improving the diagnosis and effective treatment of bronchial asthma, which will allow treating patients with different clinical manifestations of this disease.