Prenatal iron status and iron deficiency may influence neurobehavioral development in infancy. Early detection, prophylaxis and treatment of iron deficiency
to prevent anemia and developmental deficits is of public health significance. In this paper authors show the most common risk factors of iron deficiency
and strategies in screening and treatment.

The article presents the new recommendations of the Polish Society of Pediatric Endocrinology and Diabetes and the Expert Panel concerning vitamin D
supplementation and treatment of vitamin D deficiency.

Changes in the Polish Immunization Programme for 2018 are small – broader intervals for mandatory vaccinations in the 2nd year of life were brought back,
there is a new recommendation concerning the time of the 3rd dose of anti-pneumococcal vaccination application and new rules for so-called compensatory
vaccinations were introduced.

The correct application of parenteral nutrition in newborn babies with very low and extremely low body weight is one of important means of treating them.
To realize this procedure in the right way is absolutely essential to insert venous central catheter into peripherally vein. The aim of this study is to present:
indications and contraindications for using PICC, choosing the proper type of central catheter, insertion methods and also complications of this procedure
with special attention given to central line-associated bloodstream infection (CLABSI), prevention and catheter maintenance carried out in neonatal intensive
care unit (NICU).

Human milk oligosaccharides (HMOs) are the third largest component of human milk. Many benefits of breastfeeding, particularly protection against child
infections, may be, at least partially, related to the presence of HMOs. Approximately 150 HMOs have been described. Among others, the postulated effects
of HMOs include prebiotic and antiadhesive/antimicrobial effects, modulation of intestinal epithelial cells, and immune modulation. Progress in biotechnology
nowadays allows the production of at least some HMOs. Two HMOs, 2-fucosylactose and lacto-N-neotetraose, which are also the most common in
human breast milk, have recently been added to infant formula, either alone or in combination. This paper outlines the basic facts about HMOs (the composition,
structure, metabolism, functions). It also discusses evidence on infant formulas supplemented with currently available HMOs.

Food intolerances are a significant problem in clinical practice, are common in industrialized countries and the morbidity is constantly increasing. Symptoms
of food intolerance are non-specific, most often accompanied by chronic stomach pain, abdominal discomfort, diarrhea. It is stated that abdominal pain
with unexplained causes among the youngest is one of the most frequent reasons of visits to doctors. A lot of them have a functional basis. Potential causes
include the brain-intestinal axis disorders, gastrointestinal motility disorders, genetic and personality tendencies, and food intolerances. Ailments associated
with the diseases significantly reduce the quality of life of children. Patients are treated symptomatically pharmacologically and/or through dietary
modifications. Food intolerance results from the change in societies eating habits, which has been observed over the years. The main change is the higher
intake of ready-made, chemically processed food.

Menstrual cycle in a woman is the expression of achieving sexual maturity and one of the most important characteristics determining the possession of
offspring. Physiological, hormonal and environmental changes influence the maturation process. It is estimated that disturbances of the normal menstrual
cycle may affect up to 75% of women. The disturbances of the regularity of the menstrual cycle include primary and secondary amenorrhea. The primary
amenorrhea is defined as the absence of menarche and secondary sexual maturation in patients up to 14 years of age or the absence of menarche with
normal secondary sex characteristics up to the age of 16. In turn, the secondary amenorrhea is the absence of menstrual bleeding for 3-6 months in a woman
after menarche. One of the consequences of irregular and anovulatory menstrual cycles are juvenile bleeding, which affects about 12-37% of girls during
adolescence. Dysmenorrhea is diagnosed in 30-70% of teenagers and young women.

Atherosclerosis is one of the main risk factors of cardiovascular diseases. The causes of atherosclerosis in children include, as in adults, an abnormal diet
with overweight or obesity, low physical activity or tobacco smoke exposure. The risk of premature cardiovascular events due to atherosclerosis is greatest
in children and adolescents, with additional risk factors, such as familial hypercholesterolemia, diabetes mellitus, chronic kidney disease, Kawasaki disease
or chronic inflammatory diseases. The basic prevention methods of atherosclerosis and its complications include proper nutrition and dietary treatment in
the case of abnormal eating habits or excessive body weight. According to current recommendations, the lipid profile screening should be performed in
children between 9 and 11 years of age and in the case of familial occurrence of dyslipidemia as early as 2 years of age. Prevention of cardiovascular diseases
due to atherosclerosis include regular, moderate physical activity and avoidance of tobacco smoke exposure.

The manuscript discusses the definition of polyuria and polydipsia. The conditions for proper urine density, the role of the antidiuretic hormone and its type 2 receptor, aquaporin channels and the role of renal interstitium in this process are presented. It has been indicated that it may be difficult to diagnose and establish the etiology of polyuria. Clinical symptoms and diagnostic algorithms for polyuria including water deprivation test and deamino-D-arginine vasopressin test were discussed. It has been indicated that the diagnosis of polyuria type is crucial for the prescription of therapeutic management. The most common types of diabetes insipidus (DI) are presented. Because of possible inherited pattern, genetic analysis is indicated in patients with idiopathic central DI or nephrogenic DI, or with suspected tubulopathy irrespective of age or family history. The principles of pharmacological treatment of diabetes insipidus are outlined. It has been emphasized that in treatment the main objective is to reduce urine volume, while ensuring proper growth and development of the child and the minimal occurrence of side effects.

Proper nutrition during fetal and infant life leads special role in good development and is an important prevention of many civilization diseases at this time.
Despite the detailed guidelines set by the scientific societies, there are still many irregularities with the expansion of the infant diet. Nutrition in the first 6
months of life is an exclusive breastfeeding. Breast milk provides all the essential nutrients. It is recommended that complementary foods be introduced
to cover the increased nutrient requirements. Nowadays alternative methods of introducing foods are commonly used. They are called: Baby-Led Weaning
(BLW) or Baby-Led Introduction SolidS (BLISS). The use of new techniques is to give the child control over the introduction of solid foods into its diet. So, it
will be able to efficiently read the signals of hunger and satiety.

Clinical picture of borreliosis varies and makes precise diagnosis difficult. EM is the only one clinical presentation without the need of laboratory confirmation.
In case of other disease’s manifestations the diagnosis requires not only clinical but also laboratory confirmation. Currently lots of diagnostic tests are
available, but their accuracy should be critically assessed before usage and interpretation. Additionally, the timing of taking samples and performing laboratory
tests makes an impact on precise diagnosis. Currently available diagnostic tools and protocols for LD are described in this publication.

Intermittent hypoxia episodes (IH) were desribed in preterm and low birth weight neonates during the standard pulsoximetry monitoring. IH defined as
brief with repetitive cycles of disturbed in hemoglobin oxygen saturation with spontaneous return to normoxia after while. IH induced care providers anxiety
during hospitalization in neonatal intensive care units. Usually hypoxic episodes were not clinically apparent. However, the etiology of IH remains
unclear.
Data suggest the adverse effects of intermittent hypoxia, such as retinopathy of prematurity, bronchoplumonary dysplasia, periventricular leukomalacia
and intraventricular hemorrhage. Additionally, IH may have an adverse effect on cardiovascular regulation.

Small intestinal bacterial overgrowth (SIBO) is a heterogeneous syndrome characterized by an increased number and presence of atypical types of bacteria
from large intestine in the small bowel, exceeding > 103 CFU per mL of proximal jejunal aspiration. SIBO etiology is usually complex, associated with the
disruption of mechanisms protecting against bacterial colonization of the small intestine.
The clinical picture of bacterial overgrowth in children is variable and depends on the intensity of bacterial metabolism and damage to the mucous membrane
of the small intestine. Clinical symptoms occur with varying severity and frequency, the clinical course may also be asymptomatic. SIBO diagnosis
is indicated in all cases of complex, non-specific dyspeptic disorders (diarrhea, abdominal pain, bloating) and motor disorders, anatomical abnormalities
of the gastrointestinal tract, malabsorption syndromes, as well as diseases in which there is a high risk of SIBO. Treatment of small intestinal bacterial overgrowth should be comprehensive and include the treatment of the underlying disease, nutritional deficiencies, selective antibiotic therapy, in specific cases,
nutritional treatment.

The microbial theory of allergy development assumes that the increase in the occurrence of allergies in highly developed countries observed for decades
is associated with disorders in the composition of intestinal microbiota. The formation of intestinal microbiota depends on many factors and lasts about
1000 first days of life, including the prenatal period. During this time, microbiota programs the functioning of the immature immune system of the child
towards immune tolerance. The development of tolerance is also dependent on the early exposure to potential food allergens, which is called nutritional
programming. The article describes the concept of microbial and nutritional programming and their importance in the prevention of primary allergy.

The article constitutes an up-to-day overview on liver involvement in celiac disease. In the first part, authors present the review of relevant studies concerning
the spectrum of liver abnormalities in untreated celiac patients.

The article constitutes an up-to-day overview on liver involvement in celiac disease. In the second part, authors present the review of relevant studies concerning
the prevalence of celiac disease in selected liver diseases.

Background: Hereditary Tyrosinemia type 1 is caused by a genetically determined defect of tyrosine metabolism. Untreated leads to the development of
hepatic and renal failure and is associated with an increased risk of hepatocellular carcinoma (HCC).
Methods: The aim of the study was to perform a retrospective analysis of the clinical picture and treatment effects of patients with tyrosinemia type 1.
Results: There were 9 patients with a median age of 9.7 years. The diagnosis was based on an extended selective screening (detection of succinylacetone in
the profile of organic acids in the urine by GC/MS). Five patients underwent neonatal screening tests (determination of tyrosine concentration in a dry drop of
blood by tandem mass spectrometry), which were false negative. At the time of diagnosis, the predominant symptom was acute hepatic failure, hepatomegaly,
and abnormal structure of the liver parenchyma in imaging studies. Over half of the patients also had tubulopathy and calcium and phosphate disturbances.
In all patients, the alpha-fetoprotein (AFP) and aminotransferases (AST, ALT) were significantly elevated and 88.9% patients had disturbances in the coagulation system. From the time of diagnosis, patients are treated with nitisinone (NTBC) and remain on a low-protein and low-phenylalanine diet − the median duration of therapy was 8.4 years (a total of 957 months). We observed normalization of liver and kidney function, significant reduction of AFP (except for one patient who was diagnosed with HCC during treatment. All patients have changes in imaging results in the liver. One patient, treated for almost 2 years from 24 months of age, he required liver transplantation due to the development of HCC. The cognitive development of all patients remained within normal limits.
Conclusion: The determination of tyrosine concentration is an insufficient HT-1 screening method − the determination of succinyl acetone (qualitative
analysis by GC/MS in the urine and/or quantitative in a dry drop of blood on the paper) is required. Treatment with NTBC and a proper diet significantly reduce
the risk of HCC development and allow the maintenance of normal liver and kidney function as well as intellectual performance in patients with HT-1,
provided that the drug is introduced as soon as possible.

Dental caries is widely accepted as a one of the risk factors for cardiovascular diseases. Stroke in children is rare and in each case there is a need of identification
of risk factors, including infections, vasculitis, and hypercoagulable states. Acute disseminated encephalomyelitis (ADEM) is an autoimmune demyelinating
disorder, in which infections are believed to play an important role in its complex pathogenesis.
We report two cases of children with acquired severe disorders of the central nervous system: stroke and ADEM. In both children severe caries was found
and no other risk factors for neurological conditions were identified.