Gilbert’s syndrome (GS) belongs to a group of mild, functional hyperbilirubinemias. General practitioners, pediatricians and gastroenterologists frequently encounter patients with GS in their daily practice. It occurs in 5–10% of population, more often in men than in women (4:1). Clinical symptoms are observed in the about 50% persons with GS and usually appear for the first time in puberty. Lack of abnormalities in the physical examination and normal liver`s function is helpful in the differentiation and diagnosing of GS. However, in every case of hyperbilirubinemia, the differential diagnosis must be performed. It is recommended that the diagnosis of Gilbert’s syndrome be confirmed by genetic examination, as molecular tests are widely available and are relatively not expensive. In this paper we present diagnostic and therapeutic standards of practice in children with suspiction of Gilbert’s syndrome. 

Nutrition during infancy and early childhood is crucial for the future health and proper development of children. During the last decades the milk fat globule membrane (MFGM) fraction of milk has gained interest for its potential positive effects on neurodevelopment and immunology. The article summarizes the study by Timby et al., which was performed to compare the incidence of infections among infants receiving standard formula and among infants receiving a new formula supplemented with MFGM. 

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National Immunization Program was changed in the face of threats of infectious diseases. Vaccination program for 2019 allows for BCG vaccination of a neonate at any time before discharge from the hospital. All premature infants, born before pregnancy week 37 return into the same high risk group of Invasive Pneumococcal Disease (IPD) followed by mandatory immunization program in 2019. Measles cases hit record high in Europe, also in Poland. From the beginning of 2019, the second dose of MMR vaccine is scheduled for 6 years of age children. The Paediatric Group of Experts on the Immunization Vaccination Programme formed by the Minister for Health recommends mandatory vaccinations with PCV13 vaccine in immunocompromised children at risk of PID 6 to 19 years of age and against influenza in all children at risk up to 5 years of age. The hesitancy towards vaccines among parents is known to be caused by social media and anti-vaccination movement activists. Selected strategies to control, combat, and potentially attenuate vaccine hesitancy are presented in this article. 

Influenza is an acute infectious disease known for centuries. The rapid spread of this infectious disease is caused on one hand by the possibility of fast movement of people, a very significant increase in international travel, especially between continental flights, where the flu virus circulates at other times than in Europe, and on the other hand by the existence of animal reservoirs. The characteristics of influenza are: high antigenic variability which occurs in the form of seasonal epidemics of a less frequent pandemic, high infectivity, the possibility of infection and death regardless of age or latitude, permanent mutation, multiorgan complications often leading to permanent disability, measurable, countable economic consequences, and the absolute necessity of preventive and curative activities. According to WHO data, around 5-10% of adults suffer from influenza in the world every year, and 20-30% of children register between 3-5 million acute cases and about 250,000-635,000 die. Especially small children who the immune system is not developed yet, require special care and protection against infection with the influenza virus, i.e. preventive measures using seasonal influenza vaccination. 

Transposition of the great arteries (TGA) is a cyanotic congenital heart defect characterised by ventriculoarterial discordance: the aorta arises from the right ventricle and the pulmonary trunk from the left ventricle. As a result deoxygenated blood from the right ventricle is again pumped through the aorta into the systemic circulation, whereas oxygenated blood from the left ventricle is pumped continuously back into the lungs through the pulmonary artery. Therefore, in TGA the two circulations (systemic and pulmonary) are completely separate from each other. Prenatally, TGA does not significantly affect hemodynamics of the circulatory system and newborns are born in good general condition. After birth the leading symptom is increasing central cyanosis and the survival of a newborn is only possible in the presence of a persistent ductus arteriosus or patent foramen ovale. It is therefore necessary to commence treatment immediately. First, intravenous infusion of prostaglandin E1, followed by the Rashkind procedure and then surgical treatment, which should be conducted in the first two to three weeks of life. Presently, the procedure of choice is the arterial switch operation (anatomical repair). Due to the great success of this operation, currently, patients with TGA have a chance of a long healthy life without any physical activity limitations. In this work we describe the most common symptoms of TGA, methods of diagnosis and treatment, as well as additional problems and issues of long-term care of patient after TGA correction. 

Non-alcoholic fatty pancreas disease (NAFPD) is a term used to refer to pancreatic lipid accumulation in obese people. Similarly to the non-alcoholic fatty liver disease (NAFLD), NAFPD can progress to nonalcoholic fatty steatopancreatitis (NASP) and increased adipose tissue mass is suspected to initiate carcinogenesis. Epidemiology, pathogenesis together with the relation of the disease to metabolic syndrome are not fully established yet. Moreover, the consensus about the management of NAFPD has not been reached so far. 

This overview presents frenotomy indications and techniques in breastfeeding infants according to the current medical knowledge. The procedure is performed in shortening of tongue frenulum causing breastfeeding difficulties when other causes of those difficulties are excluded. Frenotomy indications can be evaluated with a couple of assessment tools for lingual frenulum appearance and function. The procedure can improve the quality and effectiveness of sucking the breast. Researchers and clinicians usually agree on benefits of frenotomy in cases of a severe degree of ankyloglossia. However, there are not enough of evidence explicitly confirming procedure effectiveness due to lack of standardized qualification tools and lack of reliable scientific research methods. The subject is disputable and there are no answers to many questions about frenotomy indications in posterior ankyloglossia cases, the optimal time of procedure performance, use of topical anaesthesia or wound management. Then there are no identified potential risks for an infant, except rare cases of contraindications. The procedure can be helpful to achieve successful breastfeeding. 

The aim of this article is to present how the representatives of the anti-vaccination movement communicate in the social media and to what extent this communication influences patient–doctor relationship which occurs during the consultations. This article also briefly presents the history of the anti-vaccination movement and arguments used by the activists. The research material consists of statements of the opponents of vaccinations from social media (Facebook and Twitter), a total of 800 statements from 30 days (July and August 2018), marked as “negative” in media monitoring. As a result of the analysis, it was established that the arguments of the opponents of vaccination seem to remain unchanged and concentrate on problems of the freedom of choice (mandatory vaccinations) and concerns about the biochemical structure of vaccines. In the social media, opponents of vaccination should be classified as “the activists”, since they differ significantly in the intentions and purpose of their communication from “haters”, "trolls" and people using the hate speech. The conclusions are limited to the preliminary findings as to the potential impact of the information found in the social media on patient relationship with the doctor in the context of the vaccines.

One of the basic skills of a pediatrician is to assess the child’s somatic development that allows to determine: a health and nutrition status, a level of health care and education of the patient. The most important parameters in daily practice are: height (length – up to 18 months of the life), weight, head circumference and chest circumference. In clinical practice, it is useful to assess the indicators of underweight/overweight/obesity such as: BMI (Quetelet II index) and I (Cole’s index). Simple tools such as weight scale, measuring tape, Epstein’s bench, square set, anthropometer, and liberometer are used to make measurements. Interpretation of the measurement results should be based on current growth charts and take into account the phenomenon of acceleration. Currently available and recommended growth charts for children 0-5 years are WHO Child Growth Standards, for children aged 3-18 years OLAF growth charts, and for premature babies Fenton’s Preterm Growth Charts and new INTERGROWTH21 Standards, available online. 

The terms atypical pneumonia or walking pneumonia are usually reserved for infections with bacteria without cell wall Mycoplasma pneumoniae or Chlamydia spp. The course of the disease is usually benign, self-limiting with moderate fever, dry cough and good general condition. Clinical symptoms are nonspecific and does not allow to confirm the diagnosis. There are no rapid tests available and the treatment is generally started empirically. The results of laboratory tests are more valuable for the epidemiologic purposes than for the specific patient. First line treatment is macrolides. 

The article is a summary of the current state of knowledge on plant drinks and discusses in detail the quantitative and qualitative composition of products available on the market. 

The dairy-free, elimination diet is the only effective method of treatment in allergy to cow’s milk proteins in children. Milk substitutes, including amino acid-based formulas, allow to replace the eliminated food, by ingredients with equivalent nutritional values. The time of their application should be optimal i.e. result in the remission or reduction of clinical symptoms and ensure proper growth of the sick child. This article discusses the factors determining the time of use of amino acid-based formulas with particular emphasis on the age of the child and the clinical form of allergy to cow’s milk proteins. 

Objective: The aim of the study was the analysis of the reasons for the resignation of parents from their child vaccination, and sources of information of parents about immunizations.

Material and methods: The study involved healthy, parents of full-term newborns born in the Department of Neonatology in Wroclaw from January 2011 to December 2014. After the medical examination qualifying for the vaccination, the questionnaire regarding mandatory and recommended vaccination was carried out among parents. Inclusion criteria was met by 428 patients during hospitalization after birth, and finally, after 12 months 176 patients were included . The control group (n = 133) consisted of patients vaccinated in the hospital with refundable preparations. The study group (n = 43) consisted of patients vaccinated with preparations which were non-refundable or patients vaccinated outside the department. ANOVA method was used in order to verify the equality of mean parameters in the groups. The groups with heterogeneous variances were subjected to non-parametric test of Kruskal-Wallis.

Results: Parents waive the vaccination of their child after the birth most commonly (38%) as a result of concerns about the development and side effects to the immune system of the newborn. Medical personnel remains the main source of information on vaccination, both at birth and at one year of age in both groups (p = 0.0182).

Conclusions: 1. Unfounded concerns of parents about vaccination indicate the need for education of medical personnel and the public, especially future parents, in the field of immunization. 2. Information on vaccination is acquired by parents mostly from doctors, so in order to properly implement vaccination schedule continuous education on communication between doctors and parents is necessary. 

Patients with insufficient supply of nutrients by gastrointestinal tract require total parenteral nutrition (TPN). Sepsis is one of more serious and common complications that can occur during TPN, while septic arthritis was diagnosed in our unit in three patients. We present children with TPN who during sepsis had joint infection. In all our cases orthopedic intervention was needed, in two cases it was necessary to remove permanent central catheter. Antibiotic treatment was used for 4 to 6 weeks.