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IntroductionIn the first year of life it is crucial to maintain a well-balanced diet. It ensures optimal growth and development of the child. Feeding difficulties experienced by a child might lead to impairment of the nutritional status. Despite the importance of the subject, we did not find much recent published information. The aim of the study was to assess the etiology and growth parameters in children with feeding difficulties.Material and methodsChildren with feeding difficulties admitted to the Department of Pediatrics (September 2013 – April 2019) were recruited. Feeding difficulties were diagnosed by a minimum of two specialists. Based on medical records and clinical evaluation they were categorized as: organic, nonorganic or mixed (both medical and behavioral). To assess nutritional status weight, length/height, and body mass index (BMI) were obtained and compared with WHO reference standards.ResultsFour hundred twenty-two children with mean age of 35 months (range: 3 to 156 months) were recruited. Fifty-three percent of feeding difficulties were nonorganic (behavioral), whereas the remaining 47% were caused by mixed factors. Organic factors were mostly related to gastroenterological disorders, food allergy or coexistence of more than one medical problem. Underweight (weight < –2 z-score) was observed in 18% of patients, stunted growth (length/height < –2 z-score) in 11%, wasting (BMI < –2 z-score) in 15%, and overweight (BMI > + 2 z-score) in 1%.ConclusionsOur study showed that organic feeding difficulties coexisted with a behavioral component. The observed nutritional impairments in children with feeding difficulties indicate that there is a need for quick detection of these difficulties in order to provide appropriate support and help as soon as possible.

Background The goal of treatment of functional constipation (FC) is to restore a regular defecation pattern and to prevent relapses. Aim To assess long-term outcomes in children with FC. Methods This was a follow-up study of children previously enrolled in 2 independent randomized controlled trials. In the first trial, children randomly received glucomannan (GNN) or placebo for 4 weeks. In the second study, children received a fermented dairy product with Bifidobacterium lactis I-2494 (B. lactis) or placebo for 3 weeks. Follow-up data were collected using a standardized questionnaire. The primary outcome measure was treatment success (≥3 spontaneous bowel movements with no episodes of soiling during the last week, abdominal pain, or need for laxatives). The secondary outcomes were FC according to the Rome III criteria and the need for laxative therapy. Results In the GNN study, follow-up data at 24 months were obtained from 63 of 72 (87.5%) of children. Treatment success was reported in 36/63 (57%), FC in 17/63 (27%), and the need for laxatives in 13/63 (21%). There were no differences in outcomes between groups. In the B. lactis study, follow-up data at 36 months were obtained from 57 of 82 (70%) of children. Treatment success was reported in 26/57 (46%), FC in 21/57 (37%), and the need for laxatives in 15/57 (26%). There were no differences in outcomes between groups. Conclusion A substantial portion of children remained symptomatic after 2–3 years of follow-up indicating a need for regular evaluation of children with FC.

Recent updates of the European, American and Polish nutritional recommendations require updates of the nutritional norm for children. We present the Polish Expert Group statement (2012) on the intake of selected nutrients (proteins, lipids, carbohydrates, vitamin D and E) essential for nutrition in children aged 1–3 years. For this purpose the Expert Group reviewed available scientific data consisting of the recent guidelines, nutritional norms and recommendations, systematic reviews and expert opinions as well as original publications, in relation to the specific requirements for the Polish population.

Recent updates of the European, American and Polish nutritional recommendations require updates of the nutritional norm for children. We present the Polish Expert Group statement (2012) on the intake of selected nutrients (proteins, lipids, carbohydrates, vitamin D and E) essential for nutrition in children aged 1–3 years. For this purpose the Expert Group reviewed available scientific data consisting of the recent guidelines, nutritional norms and recommendations, systematic reviews and expert opinions as well as original publications, in relation to the specific requirements for the Polish population.

Streszczenie Wprowadzenie Wedlug aktualnych wytycznych Komitetu Żywienia Europejskiego Towarzystwa Gastroenterologii, Hepatologii i Żywienia Dzieci, zaleca sie wylączne karmienie piersią do 6. m. z. Pokarmy uzupelniające nalezy zacząc wprowadzac do diety niemowląt nie wcześniej niz przed ukonczeniem 17. tyg. z. i nie poźniej niz przed ukonczeniem 26. tyg. z. Nie znajduje uzasadnienia zbyt wczesne ( Cel Celem pracy bylo zbadanie praktyk karmienia dzieci przez matki z Warszawy i okolic. Metodyka Przeprowadzono ankiete wśrod matek dzieci w wieku 5–22 m. z. hospitalizowanych lub leczonych ambulatoryjnie w ośrodkach Warszawy i okolic. Na podstawie ankiety oceniono okres wylącznego karmienia piersią, wprowadzania pokarmow uzupelniających ze szczegolnym uwzglednieniem glutenu, jak rowniez pochodzenie pokarmow (przeznaczone dla niemowląt czy przygotowywane samodzielnie) oraz źrodla informacji na temat zywienia niemowląt. Wyniki Przeanalizowano 105 ankiet. Średni wiek dzieci wynosil 11,3 miesiąca. Jedynie 29,5% poddanych badaniu matek kontynuowalo wylączne karmienie piersią, wedlug obowiązujących wytycznych. Pokarmy uzupelniające zostaly wprowadzone do diety w zalecanym okresie w przypadku 62,4% dzieci. W analizowanej grupie niemowląt niemal 37% matek przygotowywalo posilki samodzielnie. Ekspozycja na gluten przebiegala zgodnie z zaleceniami wylącznie u 20% dzieci. Najczestszym źrodlem w procesie informowania o zaleceniach dotyczących zywienia niemowląt dla polskich matek okazali sie lekarze (68%), Internet (56%) oraz magazyny branzowe (48%). Wnioski Wiekszośc matek nie stosuje aktualnych zasad zywienia niemowląt i malych dzieci, co sugeruje potrzebe szerszego informowania na temat najnowszych rekomendacji w tym zakresie.