The article provides an update on infant supplementation with vitamin D3, vitamin K1, and DHA. Breastfeeding is generally the most effective way to support infant growth, development, and overall ...health. In cases where breastfeeding is not possible, infant formula is the only appropriate alternative that provides adequate energy and nutrients to facilitate infant growth, development, and long-term health. It has long been known that mother's milk is insufficient in vitamin D and vitamin K, which is why supplementation from the first days of life is recommended. Infant intake of polyunsaturated long-chain fatty acids, specifically docosahexaenoic acid (DHA) and eicosapentaenoic acid, largely depends on the mother's dietary intake. Global dietary patterns have changed significantly over the past 30 years or more, especially in developed countries. In conclusion, there are studies showing that maternal supplementation does not have a significant impact on concentrations of docosahexaenoic acid in infant erythrocytes, especially in preterm infants. Moreover, direct supplementation of both preterm and term infants showed significantly better outcomes in terms of mental and psychomotor development, as well as eyesight. Currently, aside from the recommendation for infant formula supplementation with DHA, formal international recommendations are not available.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Functional abdominal pain is a very frequent functional gastrointestinal disorder but still without adequate treatment options. Therefore, the main aim of this systematic review and meta-analysis was ...to evaluate strain-specific probiotic effects on functional abdominal pain in children. This was a systematic review and meta-analysis of randomized controlled trials published in a period up to 1st of April 2020 that analyzed probiotic interventions for pediatric functional abdominal pain. We included 9 randomized controlled trials (a total of 702 children, 506 with functional abdominal pain; 4 to 18 years); 8 studies were available for meta-analysis (a total of 641 children).
Lactobacillus rhamnosus
GG and
Lactobacillus reuteri
DSM 17938 were the only two probiotic strains investigated. Significant reduction in pain intensity (6 trials,
n
= 380, mean difference − 1.24, 95% CI − 2.35 to − 0.13) and increase in number of days without pain (2 trials,
n
= 101, mean difference 26.42, 95% CI 22.67 to 30.17) were found in children taking
L. reuteri
DSM 17938. For all other outcomes, there were no significant differences between probiotic and placebo.
Conclusion:
Based on the available evidence, no firm conclusions can be given; however,
L. reuteri
was proven to decrease the pain intensity in children with functional abdominal pain. Further trials regarding long-term outcomes, possibly involving longer interventions, are needed.
What is Known:
•
Previously published systematic reviews have suggested that probiotics may have an effect on the pain in children with functional gastrointestinal disorders, but limited data exist on strain-specific effects.
What is New:
•
This systematic review provides evidence on the probiotic use on the strain-specific level.
•
This systematic review showed that the use of Lactobacillus reuteri DSM 17938 modestly reduces the pain intensity in children with functional abdominal pain.
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DOBA, EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, IZUM, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, SIK, UILJ, UKNU, UL, UM, UPUK, VKSCE, VSZLJ, ZAGLJ
Although parenteral nutrition (PN) significantly improves mortality rates in pediatric short bowel syndrome (SBS), long-term PN has many possible complications and impacts quality of life. Bowel ...lengthening procedures (BLPs) increase the contact surface of food and the intestinal mucosa and enable the better absorption of nutrients and liquids, possibly leading to a PN decrease.
We retrospectively reviewed the data of patients with short bowel syndrome who underwent BLPs in the period from January 2016 to January 2022. Overall, eight patients, four male, five born prematurely, underwent BLPs.
There was a significant decrease in the percentage of total caloric intake provided via PN and PN volume after the BLPs. The more evident results were seen 6 months after the procedure and at the last follow-up, which was, on average, 31 months after the procedure. Two patients were weaned off PN after their BLPs. Patients remained well nourished during the follow-up.
The BLP led to a significant decrease in PN needs and an increase in the food intake; however, significant changes happened more than 6 months after the procedure.
Food frequency questionnaire (FFQ) is an important method for the estimation of dietary intake in epidemiologic studies. The aim of the study is to develop a FFQ and evaluate its relative validity ...for adolescents 12 to 18 years old.
FFQ was developed from a previously validated youth/adolescent diet questionnaire (YAQ) by modifying it in order to include Croatian national foods. The final version of the FFQ (FFQ-m) comprised 87 food items. The reference method was a set of two 3-day food records (3DFR) administered twice during the 3 non-consecutive days, one month apart. The FFQ-m was administered approximately on the last day of the second applied dietary food record. Adolescents were recruited from randomly selected elementary and high schools in urban and rural areas of Croatia. FFQ-m was validated on a sample of 84 adolescents (70.2% female). Nutritional intake from FFQ-m and 3DFR were analysed for each participant. Spearman correlation coefficients (r) and Bland-Altman method were used to assess the validity of the FFQ-m compared to 3DFR. Anthropometric parameters were assessed in 78 adolescents.
The mean nutrient intake estimated by the FFQ-m was higher than that of the 3DFR. The average correlation coefficient for energy and nutrients in our validation study was 0.40. On average, 76.5% of adolescents were classified in the same or adjacent quartile of the nutrient intake. Bland-Altman analysis showed good agreement with all macronutrients and some micronutrients (sodium, phosphorus, potassium, calcium, magnesium and iron). A simple self-administered questionnaire completed by adolescents is a valid tool for measuring energy and nutrient intake among adolescent population.
This is the first FFQ developed and validated for population of adolescents in Croatia. It will contribute to further research of nutritional intake in the population of adolescents, especially those from the region.
A positive correlation between malnutrition and length of hospital stay has been shown previously. However, the impact of malnutrition on an incidence of nosocomial infections and their effect on the ...duration of hospitalization has not been established among paediatric patients in developed countries. We investigated the correlation between malnutrition, nosocomial infections and LOS in hospitalized children in our University Children's Hospital.
We conducted prospective longitudinal cohort study during the period of 1 year. Nutritional status (body weight and length/height, body mass index) was measured on hospital admission and the existence and type of nosocomial infections were monitored and evaluated during hospital stay of all recruited children.
367 paediatric patients were included into the study (girls 184, 50.1%; mean age 7.3 years (IQR: 1 month - 18 years). On hospital admission overall 47 patients (12.8%) were malnourished; moderate malnutrition (BMI −2 to −3 SDS) was present in 8.7% patients, severe malnutrition (BMI <−3 SDS) in 4.1%, and 29 (7.9%) patients were stunted ((body length) BL/(body height) BH < −2 SDS). Altogether 21 children (5.7%) experienced nosocomial infection. Malnourished patients acquired nosocomial infections significantly more often in comparison to well-nourished patients (11/47 (23.4%) vs. 11/318 (3.5%), respectively; p < 0.001). The LOS was significantly longer in children who were malnourished (12.3 vs. 7.3 days, respectively; p = 0.004), and by an identical number of days, the hospitalization was prolonged also in children who developed nosocomial infection (12.3 vs. 7.3 days, respectively; p = 0.004). Binary logistic regression showed that odds of acquiring nosocomial infections were 5 times higher (RR 5.1 (95% CI 2.276–11.485)) in children who were malnourished, and the risk increased with prolonged hospital stay.
Malnutrition is an important risk factor for developing nosocomial infection, and they both independently increase LOS. However, what is the cause and what is the consequence in the vicious circle of malnutrition, nosocomial infection and LOS remains questionable. Nevertheless, the timely addressed malnutrition could prevent longer hospital stay and higher incidence of nosocomial infection.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
A dairy meal is defined as a specific food serving composed from milk and dairy products. Because of its nutritional value and complex chemical composition, milk and dairy products play an important ...role in the diet of children and represent a rich source of calcium, phosphorus, as well as valuable proteins, B vitamins and minerals. Healthy children should consume at least three servings of dairy products daily, which contributes to the total energy and nutrients that children need. The needs of an unhealthy child are often higher than those who are healthy and depend on the state of the body. The aim of this study was to determine the incidence of consumption of dairy meals in hospitalized children and to find out if their energy needs, as well as their need for calcium and phosphorus through the consumption of the same were met. Significant differences were found between recommended energy intake from dairy products and actual energy intake from consumed milk and dairy products in three Croatian regions (P=0.021) tested. The highest values were recorded in central Croatia (253 Kcal or 34.4 %) and the lowest in the northern Croatian coastal region (17.05 Kcal or 20.1 %), which indicates a greater representation of milk and dairy meals in children’s daily menu. Furthermore, hospitalized children meet almost half of their recommended daily intake of calcium and phosphorus from dairy meals for all three regions. The highest rate was found in central Croatia, 48.7 % or 400 mg of calcium, respectively 42.9 % or 322.69 mg phosphorus, while the remaining portion of calcium and phosphorus originates from different rich non-dairy food sources. In all regions the most common forms of dairy foods consumed were milk and dairy desserts.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK