Introduction. Despite the use of modern approaches to feeding preterm infants with extremely low birth weight (ELBW) with the prescription of breast milk fortifiers during breastfeeding and specialized products for preterm infants during formula feeding, postnatal delay in their physical development remains an unsolved problem. There is no consensus on the timing of complementary feeding for such infants.
Objective: to determine the peculiarities of nutritional status of ELBW infants depending on the specifics of nutrition over the first year of life.
Materials and methods. One hundred fourteen ELBW infants aged from birth to 11 months postnatal age (PNA) were examined. Patients were categorized into 2 groups: group 1 (main group) consisted of infants (n = 59) whose diets were adjusted by us depending on the degree of nutritional deficiency. The group 2 (control) consisted of infants (n = 55) who did not receive our recommendations or did not follow them. Anthropometric parameters were assessed using the INTERGROWTH-21st international growth standards until the babies reached 64 weeks of postconceptional age (PCA), and then using the WHO Anthro (2009) software. Body composition (fat and fat-free mass) was determined by air plethysmography (PEA POD, LMi, USA).
Results. Analysis of the nutritional status in ELBW infants revealed decrease in anthropometric indices by the time of discharge from the hospital; both groups had nutritional deficiencies of varying severity: the medians of body weight (BW) to PCA were –1.92 [–2.72– –1.18] and –2.18 [–3.57– –1.37]). Nutritional correction: the use of breast milk fortifiers, high-protein, high-calorie mixtures for prematurity and inclusion of certain complementary foods starting from 4 months of age allowed to significantly increasing the nutritional value of the diets of babies from the group 1 and improve their nutritional status, having corrected nutritional deficiencies by 6 months of age. The fat-free body weight (g) content increased significantly, while the amount of body fat (%) did not exceed the values characteristic of preterm infants. In the 2nd gr. by 6 months, malnutrition persisted: BW to PCA was –2.06 [–2.52– –1.66], which persisted until the end of the study (11 months).
Conclusion. Dynamic assessment of the nutritional status in ELBW infants and timely optimization of nutrition allowed correcting nutritional deficiency during a relatively short time, which can have a significant positive impact on their further growth, development, and health status.

Introduction. Infants born between the ages of 34 0/7 and 36 6/7 weeks of pregnancy (so-called late premature babies) pose a particular problem for doctors and public health systems. The frequency of births in late premature babies in recent years has not shown a significant downward trend. In this regard, the work aimed at identifying and analyzing risk factors and finding methods for preventing the birth in late premature babies is relevant.
Objective was to determine the main risk factors for the birth in late premature babies
Materials and methods. Data analysis of one hundred fifty six developmental histories of newborns (form No. 097/y) born alive from 34 0/7 to 36 6/7 weeks of gestation, as well as birth histories (form No. 096/y) was carried out. A simultaneous analysis of the data on the social, somatic, obstetric, and gynecological anamnesis of women was performed, and the significance of various forms of obstetric and gynecological pathology that complicated the course of a real pregnancy was determined. Factors such as various forms of obstetric and gynecological pathology in women, the threat of termination of pregnancy, fetal umbilical cord entanglement, maternal body mass index, residence in the city and region were found to have a significant impact on the birth of an infant at 34–36 weeks. Late premature babies were also revealed to be born mainly from the first pregnancy of the first delivery.
Conclusion. The patterns of changes in the significance of the factors of late premature birth that we have established are necessary to determine the volume of specialized medical care for late premature infants in the conditions of intensive care units and neonatal care and nursing in the conditions of pathology departments of newborns and premature infants.

Introduction. Angiogenesis of pulmonary vessels is an integral part of the development of lung tissue capable of effective gas exchange. Exposure to high concentrations of oxygen, to which premature infants are exposed, disrupts the physiological process of alveolar development and suppresses angiogenesis, leading to abnormal vascular growth and the development of interstitial fibrosis, underlying bronchopulmonary dysplasia. To prevent the development of this disabling pathology, prevention should be started at the earliest possible time. To achieve this aim, it is necessary to identify new available predictors of the development of bronchopulmonary dysplasia during the neonatal period.
Objective. To search for new biomarkers as predictors of the formation of bronchopulmonary dysplasia in premature newborns in the structure of creating a prognostic model.
Materials and methods. Two hundred four premature infants were included in the study. All premature infants were analyzed for clinical, anamnestic parameters, and duration of various respiratory therapy methods. Serum concentrations of 13 biomarkers of angiogenesis were identified by enzyme immunoassay in all patients.
Results. The significant role of anamnestic risk factors for the formation of bronchopulmonary dysplasia in premature infants and the duration of respiratory therapy has been confirmed. There have been identified 6 prognostically significant biomarkers of angiogenesis (angiopoietin-1, angiopoietin-2, platelet growth factor BB, platelet/endothelial cell adhesion molecule 1 (PECAM-1), vascular endothelial growth factors A and D), changes in the concentration of which can also be considered as predictors of the development of bronchopulmonary dysplasia in premature infants.

Introduction. A feature of the rational feeding of children with bronchopulmonary dysplasia is the subsidy of an additional amount of nutrients and calories (up to 150–160 kcal/kg/day) necessary to compensate for metabolic costs. If the issue of protein subsidies (using breast milk fortifiers, high-protein high-calorie mixtures) has already been resolved, then the possibility of additional introduction of a fat component into nutrition requires further study. We investigated the effectiveness of adding 100% medium-chain triglycerides (MCT) (Kanso oil) to the diet, which is allowed to be used in infants from birth.
Aim: To study the effect of the inclusion of MCT in the nutrition of premature BPD infants on their nutritional and anthropometric status.
Materials and methods. There were examined 75 BPD premature infants, divided in 2 groups: main (n = 49) — infants receiving a fat module with nutrition, represented by 100% medium-chain triglycerides (SCT); control (n = 26) — infants received no SCT. Before the start, 1 month and 4 months after the beginning of the study, the quantitative content of biochemical indices characterizing protein and fat metabolism was determined. 1 month and 4 months after the beginning of the study, the examination of body composition (indices of fat and fat-free mass), as well as residual lung capacity, was carried out on a PeaPod analyzer, LMi, USA.
Results. An increase in fat content in diets and their caloric content, even against the background of dietary restrictions in BPD infants, provided positive trend in anthropometric indices, a gain in the amount of lean mass without excessive accumulation of body fat and an increase in lung volume.

Introduction. Children with Crohn’s disease (CD) are at high risk of developing nutritional deficiencies. Assessment of anthropometric parameters alone does not give us enough information to judge about changes in body composition, while the attention to the problem of deficiency of fat-free and skeletal-muscular body mass in chronic pathology, which may serve as risk factors for a more severe course of the disease, is increasing.
Materials and methods. The study included 121 child diagnosed with CD. All children underwent anthropometric measurements, assessment of body composition by bioelectrical impedance analysis and disease activity index according to the PCDAI scale.
Results. Nutritional deficiency was detected in 55% of the examined children. When assessing body composition, a deficiency of the fat-free mass was detected in 46% of the examined children, 39.7% had a deficiency of skeletal muscle mass, while Z-score of fat mass was reduced in only 6.6% of patients. Thus, a relative increase in the fat component of body composition was detected in the examined patients. A statistically significant inverse correlation of the PCDAI disease activity index was observed with fat-free (p < 0.001; rxy = –0.331), skeletal muscle mass (p < 0.001; rxy = –0.359) and phase angle (p < 0.001; rxy = –0.356). No correlation was obtained with fat mass content. The closest correlation with BMI (p < 0.001; rxy = 0.856) and fat-free mass (p < 0.001;
rxy = 0.764) Z-scores was found for the mid-upper arm circumference. In active CD patients fat-free mass, skeletal-muscular mass, active cellular mass, and phase angle were significantly lower than in those in remission.
Conclusion. Assessment of anthropometric indices, in addition to determining height, body weight, and their indices, should necessarily include measurement of the mid-upper arm circumference and skinfold according to the Z-score for age, the study of body composition parameters in children using bioelectrical impedance analysis, which is an easy to perform, non-invasive and reliable method.

Introduction. Pneumococcal infection is one of the main causes of morbidity and mortality in children. Asymptomatic nasopharyngeal carriage of Streptococcus pneumoniae plays an important role in the development of the disease and for the spread of resistant strains.
Objective: To investigate serotypes and sensitivity to antibiotics of nasopharyngeal strains of S. pneumoniae in children under 6 years.
Materials and methods. A retrospective cohort study of patients under 6 years with nasopharyngeal pneumococcal carriage was conducted. Children were examined at the National Medical Research Center for Children’s Health during 2017–2022. Serotyping was performed using specific pneumococcal antisera and/or molecular typing by PCR. Antimicrobial resistance was determined using the microdilution method.
Results. The study included three hundred eighty nasopharyngeal pneumococcal isolates: 316 (83%) from healthy children (without acute infection or exacerbation of chronic diseases) and 64 (17%) from children with acute bacterial infections (pneumonia, otitis, sinusitis). In total, 32 different serotypes were identified. In the general group of children, the proportion of vaccine strain isolates was 41%, while in the group of children with acute diseases it was 58%. Vaccination coverage was low: 28% of children were completely vaccinated, 10% were partially vaccinated. The highest level of resistance of pneumococcal strains was detected to erythromycin (33%), tetracycline (26%), trimethoprim/sulfamethoxazole (25%) and clindamycin (19%). 24% of isolates were multidrug resistant, the majority of which were serotype 19F.
Conclusion. Studying the current spectrum of pneumococcal serotypes and sensitivity to antibiotics is the most important task for optimizing therapy and preventing infection.

Background. Hepatitis B virus infection is among the top ten causes of death worldwide. Vaccination is the most effective way to prevent this infection. According to international recommendations disrupted vaccination schedule against hepatitis B virus infection does not require a «restart» of the course of immunization, and an increase in the interval between doses of the vaccine does not affect or even increases the final titer of protective antibodies. At the same time, the frequent untimely vaccination of children, which significantly increases the risk of hepatitis B virus infection is an urgent problem for our country.
The aim of the study was to assess the coverage of vaccination against hepatitis B virus infection in children by the example of the experience of the department of vaccination of children with health disorders and family vaccination.
Materials and methods. The analysis of the department’s statistics included data from the outpatient medical records of nine hundred ninety eight children aged of from 1 month to 17 years 11 months: 769 children — in 2020, 229 children — in 2021.
Results. There were no statistically significant differences in terms of complete timely vaccination against hepatitis B virus infection between the two analyzed years: 48.9% of children were vaccinated in 2020 according to the National schedule, 49.2% of children were vaccinated in 2021 (p = 0.94). In general, children with chronic diseases were vaccinated significantly earlier than healthy children at the time of the second (p = 0.014) and third (p = 0.008) administration of the vaccine. Children with chronic diseases in 2021 were significantly more likely to comply with the hepatitis B vaccination scheme than healthy (p = 0.0041).
Conclusion. Reducing the coverage of timely vaccination in children increases the risk of outbreaks of vaccine-controlled infections and is an urgent problem for our country. In this regard, it is necessary to intensify the monitoring of immunization of both healthy children and patients with chronic diseases.

Introduction. As a result of the fighting in Donbas, the number of children left without parental care has increased significantly. At the same time, one of the key links influencing the formation of a child’s body is proved to be is parent-child interaction, which determines both the physical and neuropsychic development of a child. Objective was: to determine the features of the quality of life of primary school-age children living in different social conditions against the background of parental deprivation and prolonged military operations in Lugansk under the influence of the integrated multidisciplinary program “Health for children!”.
Materials and methods. Two hundred twenty two children aged of 7–10 years were examined. Depending on the living conditions, there were identified 3 groups of the children: Group I — 74 children (36 boys and 38 girls) living in disadvantaged families. The criteria of disadvantage were a combination of the following aspects: incomplete family, unfavourable living conditions, antisocial behaviour of parents. Group II included 62 children (32 boys and 30 girls) raised in orphanage in Lugansk and group III consisted of 86 children (40 boys and 46 girls) from well-off families. All children had their quality of life assessed using the Pediatric Quality of Life — Peds QLTM4.0 questionnaire before and after the implementation of the health-saving program “Health for children!”.
Results. During the implementation of the program “Health for children!” throughout the year, optimization of indicators of social and school functioning in institutionalized children was established, which exceeded the values of children from disadvantaged families by 10,04 points and 5,42 points, respectively. Despite the complex of health-saving measures carried out, children from destructive families maintained low indicators of emotional and physical functioning. The highest results of psychosocial health were observed in children from well-off families, which exceeded the indicators of children from disadvantaged families by 18,15%, and children from an orphanage by 11,2%.
Conclusion. The consequences of the stress of parental deprivation against the background of the military operations suffered leave a deep imprint on all components of children’s health. An extremely important area for optimizing health and quality of life indicators is the introduction of integrated multidisciplinary comprehensive rehabilitation and wellness programs.

Introduction. The maternal experience of a sense of the child illness is an integral part of the whole situation of illness and it develops in the context of interaction with a doctor and a medical institution. This experience must be taken into account when building an individualized strategy for medical and socio-psychological assistance to such families.
Goal is to identify the specifics of the mother’s experiences in the situation of a child’s long-term illness and determine the ways for constructing the psychologically optimal interaction in the “doctor–parent” dyad.
Materials and methods. Twelfe mothers in difficult life situations (mothers to a child with a severe disease) were interviewed; they were divided into two subgroups depending on the presence/absence of detailed medical knowledge about the disease and its prognosis. The method of the original clinical-psychological interview was used. Data were analyzed using qualitative methods.
Results. The mother’s experience of a sense of the child’s illness consists of medical and psychological components. The psychological component is formed among others through the doctor’s explanations. In the mother’s inner world, it is closely connected with the perception of the disease and the treatment. The results obtained indicate the need to improve communication between mothers and medical personnel, taking into account objective differences in the course of the disease and in how mothers work through it. The results also demonstrate the importance of psychological support, which would facilitate meaning-making processes about the disease among mothers during their children’s hospitalizations.
Conclusion. When speaking to mothers of sick children and clarifying the origin of the disease, its course, and prognosis, doctors need to take into account the psychological meaning of these explanations by using their psychotechnical function to support mothers and ensure active cooperation with medical personnel.

Aim of the work. To determine the current state of the problem of abandonment of newborn infants in Russia and justify the need for further development of services for the prevention of early abandonment of children on the basis of healthcare institutions.
Materials and methods. There was carried out h analysis of data obtained in a number of interdisciplinary scientific studies, as well as in the course of social projects implemented in practice to prevent the abandonment of newborn infants.
Results. The data from Russian sociological, psychological, and psychopathological studies of the problem of abandonment of newborn infants was compared. It is shown that when providing assistance to a family that abandons a child, specialists act in the interests of children and protect their right to grow up in a family. The results of the activities of interdisciplinary teams of specialists within the framework of social projects to prevent early child abandonment, carried out in a number of Russian regions, are considered. Their practical developments, conclusions, and problems posed during the work are covered. The possibility of using the “Case Work” technology in managing medical, psychological, and social assistance to families in the situation of abandonment of a newborn is shown.
Conclusion. As a result of the work of Russian services for the prevention of early child abandonment, from 30 to 50 percent of women who announced the abandonment of a born child changed their decision and were able to adapt to life with their children. Based on the results of implemented social projects, recommendations of the Ministry of Health of the Russian Federation “Prevention of abandonment of newborns in maternity hospitals (for public authorities of the constituent entities of the Russian Federation)”, as well as a number of methodological materials, were developed. These materials can be of great help to existing and newly created services for the prevention of early child abandonment.

Introduction. Adolescence is characterized by high specificity and importance of ongoing psychological processes and personal constructs formed against its background. This period of individual development is often described by authors as an intermediate age between childhood and adulthood. Chronic somatic illness at this age increases the risk of pathologizing the course of natural psychological processes. The processes of psychological adaptation and self-regulation of adolescents are of particular importance in conditions of illness.
Purpose is theoretical analysis of the problem of psychological self-regulation of adolescents in conditions of chronic somatic illness.
Results. The normative phenomena occurring in adolescence, as well as the negative effects of the traumatic effects of chronic somatic disease, have been described. There is proposed the model that reflects the connection between stress factors of illness and psychological self-regulation of adolescents. The results of previous empirical studies of the authors are also described, their generalization and a new conceptualization of data within the framework of this problem are proposed.
Conclusion. The main parameters of successful self-regulation of adolescents in conditions of illness are identified as a holistic and coordinated illness and treatment perception, a formed internal picture of the illness, as well as a wide repertoire of coping strategies.

Introduction. The article briefly presents the history of clinical psychology as an educational specialty, various versions and sy­nonyms of the concept of “clinical psychology” at different time stages for the time being.
The goal is to highlight and discuss modern issues in the training of medical psychologists. Main content. The practical and scientific-practical areas and tasks of the activities of clinical psychologists and the subtleties of their training at the present time are outlined. The training of clinical psychologists at Moscow State University of Psychology and Education in the specialization “Clinical and psychological assistance to children and families” is presented in detail.
Conclusion. The problems of practical training of specialists, performing final qualification works, and the importance of diagnostic tools are discussed. New ideas for development of training and education for clinical psychologists are suggested.