К вопросу о роли возможного синдрома мальабсорбции жиров при грудном вскармливании в развитии поздней геморрагической болезни новорожденного

Abstract

The causes of late hemorrhagic disease of the newborn (HDN) are parenteral nutrition, severe diseases (e.g., biliary atresia, congenital or inherited diseases associated with cholestasis, short bowel syndrome), exclusive breastfeeding, and digestive disorders with malabsorption. Meanwhile, vitamin K deficiency develops in severe malabsorption and digestive disorders resulting from an irrational diet of a nursing mother or viral infections with the intestinal syndrome. Lipidogram of feces was evaluated by thin-layer chromatography in 15 children with late HDN. Lipidogram demonstrated high lipid content (on average, 77.47 μg/g). Moreover, the maximum levels of higher fatty acids, cholesterol, and phospholipids were detected in children with the most severe clinical presentations of bleeding. Clinical manifestations of hemorrhagic syndrome included umbilical cord bleeding (66.7%), gastrointestinal bleeding (28.5%), and intracranial hemorrhage (6.7%). In addition, all children have one or more clinical symptoms of digestive disorders (i.e., frequent bowel movements, excessive pooping, watery diarrhea). Occasionally, bloody streaks were reported. Education of nursing mothers to plan their diet and follow a balanced diet demonstrates that strict adherence to these recommendations significantly reduces the risks of vitamin K deficiency in newborns and late HDN. KEYWORDS: vitamin K, vitamin K deficiency bleeding, breastfeeding, children, lipidogram of feces, late hemorrhagic disease of the newborn, malabsorption. FOR CITATION: Mozzhukhina L.I., Kalgina S.E., Stroeva L.E., Teyf V.A. Role of fat malabsorption during breastfeeding in late hemorrhagic disease of the newborn. Russian Journal of Woman and Child Health. 2022;5(1):85–89 (in Russ.). DOI: 10.32364/2618- 8430-2022-5-1-85-89