vspВопросы современной педиатрииCurrent Pediatrics1682-55271682-5535Издательство «ПедиатрЪ»10.15690/vsp.v13i1.920vsp-235Research ArticleОБМЕН ОПЫТОМEXCHANGE OF EXPERIENCEЗАПОРЫ У ДЕТЕЙ РАННЕГО ВОЗРАСТА: ПРИЧИНЫ И ОСОБЕННОСТИ ДИЕТОЛОГИЧЕСКОЙ КОРРЕКЦИИCONSTIPATIONS IN INFANTS: CAUSES AND MECHANISMS OF DIETARY CORRECTIONКомароваО. Н.KomarovaO. N.komarovadoc@yandex.ruХавкинА. И.KhavkinA. I.komarovadoc@yandex.ruРоссийский национальный исследовательский медицинский университет им. Н.И. Пирогова, МоскваРоссияN.I. Pirogov Russian National Research Medical University, MoscowRussian Federation201411012014131Вопросы современной педиатрии114118Copyright © Комарова О.Н., Хавкин А.И., 20142014Комарова О.Н., Хавкин А.И.Komarova O.N., Khavkin A.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://vsp.spr-journal.ru/jour/article/view/235

Запоры у детей первых месяцев жизни являются актуальной проблемой в связи с их широкой распространенностью. При этом в 90–95% случаев органическая причина запора у ребенка отсутствует, а наиболее распространены запоры, носящие функциональный характер. Поскольку целью лечения запоров у детей является восстановление консистенции кишечного содержимого и его пассажа по толстой кишке, для коррекции запоров должен использоваться комплексный подход с проведением диетотерапии, при необходимости — лекарственной терапии и механического опорожнения кишечника. Одним из основных способов коррекции запоров в раннем детском возрасте является диетотерапия, которая имеет свои особенности в зависимости от вида вскармливания и далее, при введении прикорма. У детей на грудном вскармливании оптимизируют пищевой рацион матери, дополняя его растительными маслами и пищевыми волокнами. Ребенку, находящемуся на искусственном вскармливании, осуществляют индивидуальный подбор смеси, в зависимости от клинической ситуации и сопутствующей симптоматики ― наличия срыгиваний, колик, непереносимости белка коровьего молока. Пациентам с функциональными запорами показаны лечебные смеси и продукты прикорма, содержащие пребиотики (пищевые волокна, лактулозу, инулин). Клиническая эффективность продуктов детского питания, обогащенных пребиотиками, при запорах подтверждена в исследованиях.

 

Constipations in infants of the first months of life are an important problem due to their high prevalence. There is no organic cause of constipation in 90–95% of all cases, so the most common are functional constipations. As the main target in treatment of constipations in infants is normalization of the intestinal contents consistency and its movement through the large intestine, in order to correct this condition a complex approach should be provided with dietary treatment and as required — medicinal treatment and mechanical evacuation of the intestine contents. One of the main methods of constipations correction in infancy is dietary treatment, which has its own special characteristic according to the type of feeding and further when additional food is introduced. If infants are on breast feeding their mothers are recommended to add vegetable oils and dietary fibers into their diet. Children on artificial feeding are switched to milk formulas according individual clinical situation and associated manifestations — such as regurgitation, colic and cow milk protein intolerance. Patients with functional constipations are indicated medicinal mixtures and additional food with prebiotics (dietary fibers, lactulose, inulin). Clinical efficacy of children food enriched with prebiotics in treatment of constipations is confirmed in various studies.

 

запорыранний возрастлактулозалечебные смесиconstipationsinfancylactulosemedicinal milk formulasReferencesKhavkin A.I. Correction of functional constipation in children. Ross. vestn. perinatol. i pediatrii = Russian bulletin of perinatology and pediatrics. 2012; 4 (1): 127–130.Khavkin A.I. Correction of functional constipation in children. Ross. vestn. perinatol. i pediatrii = Russian bulletin of perinatology and pediatrics. 2012; 4 (1): 127–130.North American Society for Pediatric Gastroenterology, Hepatology and Nutrition. Evaluation and treatment of constipation in children: summary of updated recommendations of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition. J. Pediatr. Gastroenterol. Nutr. 2006; 43 (3): 405–407.North American Society for Pediatric Gastroenterology, Hepatology and Nutrition. Evaluation and treatment of constipation in children: summary of updated recommendations of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition. J. Pediatr. Gastroenterol. Nutr. 2006; 43 (3): 405–407.Talley N. Definition, epidemiology and impact of chronic constipation. Rev. Gastroenterol. Disord. 2004; 4(2): 1–4.Talley N. Definition, epidemiology and impact of chronic constipation. Rev. Gastroenterol. Disord. 2004; 4(2): 1–4.Tunc V.T., Camurdan A.D., Ilhan M.N., Sahin F., Beyazova U. Factors associated with defecation patterns in 0–24-month-old children. Eur. J. Pediatr. 2008; 167: 1357–1362.Tunc V.T., Camurdan A.D., Ilhan M.N., Sahin F., Beyazova U. Factors associated with defecation patterns in 0–24-month-old children. Eur. J. Pediatr. 2008; 167: 1357–1362.Hyman P.E., Milla P.J., Benninga M.A., Davidson G.P., Fleisher D.F., Taminiau J. Childhood functional gastrointestinal disorders: neonate / toddler. Gastroenterology. 2006; 130 (5): 1519–1526.Hyman P.E., Milla P.J., Benninga M.A., Davidson G.P., Fleisher D.F., Taminiau J. Childhood functional gastrointestinal disorders: neonate / toddler. Gastroenterology. 2006; 130 (5): 1519–1526.Weaver L.T., Steiner H. The bowel habit of young children. Arch. Dis. Child. 1984; 59: 649–652.Weaver L.T., Steiner H. The bowel habit of young children. Arch. Dis. Child. 1984; 59: 649–652.Iacono G., Cavataio F., Montalto G., Florena A., Tumminello M., Soresi M. Intolerance of cow's milk and chronic constipation in children. N. Engl. J. Med. 1998; 339 (16): 1100–1104.Iacono G., Cavataio F., Montalto G., Florena A., Tumminello M., Soresi M. Intolerance of cow's milk and chronic constipation in children. N. Engl. J. Med. 1998; 339 (16): 1100–1104.El-Hodhod M.A., Younis N.T., Zaitoun Y.A., Daoud S.D. Cow's milk allergy related pediatric constipation: appropriate time of milk tolerance. Pediatr. Allergy Immunol. 2010; 21 (2, Pt. 2): 407–412.El-Hodhod M.A., Younis N.T., Zaitoun Y.A., Daoud S.D. Cow's milk allergy related pediatric constipation: appropriate time of milk tolerance. Pediatr. Allergy Immunol. 2010; 21 (2, Pt. 2): 407–412.Lenyushkin A.I., Komissarov I.A. Pediatricheskaya koloproktologiya. Ruk-vo dlya vrachei [Pediatric Proctology. Guideline for physicians]. St. Petersburg, SPbGPMA, 2008. pp. 279–313.Lenyushkin A.I., Komissarov I.A. Pediatricheskaya koloproktologiya. Ruk-vo dlya vrachei [Pediatric Proctology. Guideline for physicians]. St. Petersburg, SPbGPMA, 2008. pp. 279–313.Kon' I.Ya., Abramova T.V., Georgieva O.V., Kurkova V.I., Konovalova L.S., Pustograev N.N., Safronova A.I. Diet therapy of constipation in infants. Lechashchii vrach = The attending physician. 2009; 8: 20–24.Kon' I.Ya., Abramova T.V., Georgieva O.V., Kurkova V.I., Konovalova L.S., Pustograev N.N., Safronova A.I. Diet therapy of constipation in infants. Lechashchii vrach = The attending physician. 2009; 8: 20–24.Natsional'naya programma optimizatsii vskarmlivaniya detei pervogo goda zhizni. Utverzhdena na XVI S"ezde pediatrov Rossii [The National Program to Optimize Infants’ Feeding. Approved at the XVI Congress of Pediatricians of Russia]. Moscow, 2010. 68 p.Natsional'naya programma optimizatsii vskarmlivaniya detei pervogo goda zhizni. Utverzhdena na XVI S"ezde pediatrov Rossii [The National Program to Optimize Infants’ Feeding. Approved at the XVI Congress of Pediatricians of Russia]. Moscow, 2010. 68 p.Moro G.E., Mosca F., Miniello V., Fanaro S., Jelinek J., Stahl B. et al. Effects of a new mixture of prebiotics on faecal flora and stools in term infants. Acta Paediatr. 2003; 91 (Suppl.): 77–79.Moro G.E., Mosca F., Miniello V., Fanaro S., Jelinek J., Stahl B. et al. Effects of a new mixture of prebiotics on faecal flora and stools in term infants. Acta Paediatr. 2003; 91 (Suppl.): 77–79.Bulatova E.M., Bogdanova N.M., Pirtskhelava T.L., Shestakova M.D., Lobanova E.A. Dietary correction of constipation in infants. Vopr. det. dietol. = Problems of pediatric nutritiology. 2004; 2 (5): 51–57.Bulatova E.M., Bogdanova N.M., Pirtskhelava T.L., Shestakova M.D., Lobanova E.A. Dietary correction of constipation in infants. Vopr. det. dietol. = Problems of pediatric nutritiology. 2004; 2 (5): 51–57.Kon' I.Ya., Sorvacheva T.N., Pashkevich V.V., Efimov B.A., Konovalova L.S. The prebiotic properties adapted milk formula "Semper Bifidus": clinical evaluation in infants. Vopr. sovr. pediatrii = Current pediatrics. 2002; 1 (1): 39–43.Kon' I.Ya., Sorvacheva T.N., Pashkevich V.V., Efimov B.A., Konovalova L.S. The prebiotic properties adapted milk formula "Semper Bifidus": clinical evaluation in infants. Vopr. sovr. pediatrii = Current pediatrics. 2002; 1 (1): 39–43.Griffin I.J., Davila P.M., Abrams S.A. Non-digestible oligosaccharides and calcium absorption in girls with adequate calcium intakes. Brit. J. Nutr. 2002; 87 (2): 187–191.Griffin I.J., Davila P.M., Abrams S.A. Non-digestible oligosaccharides and calcium absorption in girls with adequate calcium intakes. Brit. J. Nutr. 2002; 87 (2): 187–191.Langlands S.J., Hopkins M.J., Coleman N., Cummings J.H. Prebiotic carbogydrates modify the mucosa associated microflora of the human large bowel. Gut. 2004; 53: 1610–1616.Langlands S.J., Hopkins M.J., Coleman N., Cummings J.H. Prebiotic carbogydrates modify the mucosa associated microflora of the human large bowel. Gut. 2004; 53: 1610–1616.Waligora-Dupriet A.J., Campeotto F., Nicolis I., Bonet A. Effect of oligofructose supplementation on gut microflora and welldeing in young children attending a day care center. Int. J. Food Microbiol. 2007; 113: 108–113.Waligora-Dupriet A.J., Campeotto F., Nicolis I., Bonet A. Effect of oligofructose supplementation on gut microflora and welldeing in young children attending a day care center. Int. J. Food Microbiol. 2007; 113: 108–113.Letexier D., Diraison F., Baylot M. Addition of inulin to moderately highcarbogydrates diet reduces hepatic lipogenesis and plasma triacylglycerol concentrations in humans. Am. J. Clin. Nutr. 2003; 77; 559–564.Letexier D., Diraison F., Baylot M. Addition of inulin to moderately highcarbogydrates diet reduces hepatic lipogenesis and plasma triacylglycerol concentrations in humans. Am. J. Clin. Nutr. 2003; 77; 559–564.

The authors declare that there are no conflicts of interest present.