International Journal of Child Health and Nutrition

Risks of Endurance Training in Minors - A Narrative Review

Jan T. Tomasik — 2026-06-15

Background: Participation in endurance sports among children and adolescents is increasing. Pediatric athletes differ physiologically from adults due to ongoing somatic growth, biological maturation, and endocrine development, which modify both adaptive responses and injury susceptibility.

Aim: This review synthesizes current evidence on physiological adaptations to endurance training in youth and examines the major musculoskeletal, cardiovascular, metabolic, endocrine, and psychosocial risks associated with high training loads.

Materials and Methods: A narrative review of literature published between January 1990 and January 2026 was conducted using PubMed and MEDLINE, supplemented by consensus statements from major sports medicine organizations.

Results: Endurance performance improvements in youth are influenced more by neuromuscular maturation than by large central cardiovascular adaptations, with modest training-induced changes in VO₂ max before puberty. The developing musculoskeletal system demonstrates high adaptive plasticity but increased vulnerability to overuse injuries, including physeal stress injuries and bone stress injuries. Inadequate energy availability may disrupt endocrine function and impair growth and bone development.

Conclusions: While endurance training promotes beneficial physiological adaptations, the developing athlete remains vulnerable to overuse injuries, low energy availability, psychosocial stressors, and long-term health risks. Recognition of these mechanisms is essential for accurate risk interpretation and safe training practices.

Coastal Lives, Nutritional Struggles: Anemia and Poor Diet Quality among Adolescent Girls in Indonesia

Dian Resky Ekawati — 2026-06-15

Objectives: Adolescent girls living in coastal areas are nutritionally vulnerable due to limited access to diverse and nutrient-rich foods. This study aimed to provide an overview of the nutritional profile and potential vulnerability to anemia among adolescent girls in this area.

Methods: A descriptive cross-sectional study was conducted in January 2025 among 159 adolescent girls aged 11-18 years in the coastal area of Galesong Selatan, Takalar Regency, Indonesia. Data on hemoglobin levels and dietary intake were collected using Hemocue 301 and two non-consecutive 24-hour recalls. Diet quality was assessed using the Diet Quality Index for Adolescents (DQI-A) adapted to Indonesian guidelines, and all data were analyzed descriptively.

Results: The prevalence of anemia among adolescent girls was 42.8%, with 23.9% classified as mild and 18.9% as moderate anemia. The median DQI-A score was 40.33, with subcomponent scores of DQ: 5.95, DD: 71.43, and DE: 40.14, indicating overall poor diet quality. Most participants had moderate dietary diversity (60.4%) and low dietary equilibrium, with 73.0% consuming less than half of the recommended daily nutrient intake (<50% RDA). The average intake of energy, protein, iron, folate, and vitamin C was markedly below the RDA, showing substantial nutrient inadequacy. Although weekend intake was slightly higher, nutrient levels remained insufficient to meet daily requirements.

Conclusions: Improving adolescent diet quality through balanced, micronutrient-rich food intake and adherence to iron-folic acid supplementation is essential not only to prevent anemia but also to strengthen vascular health and reduce future risks of congenital vascular anomalies. The findings can inform school-based nutrition education, local food optimization, and policy planning to support adolescent health in coastal communities.

Effect of Chlorhexidine 2% versus Alcohol 70% on Catheter -Related Bloodstream Infections in Neonates: Randomized Control Trial

Rania A. El-Farrash — 2026-06-15

Background: Central venous catheters (CVCs) are essential for neonatal intensive care but are strongly associated with catheter-related bloodstream infections (CRBSI), which significantly increase morbidity, mortality, and hospital stay. The optimal antiseptic for neonatal skin disinfection remains debated, with chlorhexidine-alcohol solutions increasingly recommended but still under investigation for safety and efficacy.

Objective: To compare the effectiveness of 2% chlorhexidine in 70% isopropyl alcohol versus 70% alcohol alone in reducing catheter-related bloodstream infections among neonates requiring CVCs.

Methods: A prospective randomized controlled trial was conducted on 100 neonates admitted to the NICU at Ain Shams University Hospital. Participants were randomly assigned to two groups: Group A (alcohol-only antisepsis) and Group B (chlorhexidine-alcohol antisepsis). Data collected included patient demographics, catheter type and duration, infection rates, blood culture results, inflammatory markers, and clinical outcomes.

Results: Group B (chlorhexidine-alcohol) demonstrated significantly lower rates of positive blood cultures (notably Klebsiella and E. coli) compared to Group A. The incidence of infection was highest in neonates with percutaneous central venous catheters (PCVCs) and umbilical venous catheters (UVCs), while peripherally inserted central catheters (PICCs) showed the lowest infection burden. Mean catheter duration was 9-11 days, with most infections occurring beyond the seventh day. Hemoglobin and hematocrit levels declined significantly over time in infected cases. Group B also required fewer escalations to second-line antibiotics.

Conclusions: Using 2% chlorhexidine in 70% isopropyl alcohol significantly reduced catheter-related bloodstream infections (CRBSIs) in neonates, compared to 70% alcohol alone. Peripherally inserted central catheters (PICCs) exhibited the lowest infection rates, highlighting the importance of both antiseptic selection and catheter type in neonatal infection prevention protocols.

Survival Analysis of Newborns with Low Birth Weight (Very and Extremely Low) in Kyrgyzstan

Ainura Tabyshova — 2026-06-15

Purpose: The increase in the number of premature births in the Kyrgyz Republic was accompanied by the growth of the proportion of newborns with very low (VLBW) and extremely low birth weight (ELBW), which required a systematic analysis of the survival. The study aimed to determine the dynamics of survival among newborns in these groups for 2019-2024, accounting for regional differences.

Material and Methods: Kaplan-Meier curves and the log-rank test were used to assess statistical significance. Data, including medical records, reports from perinatal centres, and official statistics from the National Statistical Committee of the Kyrgyz Republic, were collected from all regions of the country, with an emphasis on regional differences in neonatal care infrastructure.

Results: The survival of newborns weighing 1,000 to 1,499 grams increased from 23.4% to 51.8%, accompanied by a reduction in early neonatal mortality from 48% to 26%. Among children weighing less than 1,000 grams, survival increased from 2.2% to 8.6%, at remained low. It was established that the most pronounced improvement was observed in the southern regions of the country, whereas in the northern and mountainous areas, the lag remained. The main factors driving positive dynamics were the expansion of antenatal care, the equipping of hospitals with intensive care equipment, and improvements in staff qualifications.

Conclusion: The practical significance of the study lies in the justification for further development of neonatal care infrastructure to reduce infant mortality and balance regional differences in Kyrgyzstan.

Biopsychosocial Rehabilitation of Children with Type 1 Diabetes Mellitus

Vitalina Ojovan — 2026-06-15

Background: The relevance of this study is determined by the need to develop an effective model of rehabilitation for children with type 1 diabetes mellitus (T1DM), considering medical, psychological, and social factors in the context of increasing chronic morbidity among the paediatric population. The purpose of the study is to substantiate the applicability of the biopsychosocial approach within the rehabilitation system for children with T1DM.

Methods: Within a multidimensional review of the literature, approaches to the comprehensive evaluation of the functional state of children with T1DM are synthesised, encompassing clinical and laboratory indicators, psychological and emotional aspects of adaptation, and social determinants.

Findings: It is established that the effectiveness of biological rehabilitation depends on the combination of individualised insulin therapy, nutritional regimen modification, physical activity, and the correction of oxidative stress. The psychological and emotional component includes identifying emotional difficulties, particularly during adolescence, and implementing psychoeducational and psychotherapeutic interventions to facilitate the stabilisation of behavioural responses. Institutional support and interdisciplinary cooperation ensure the application of an individualised approach in clinical practice.

Conclusion: The implementation of the biopsychosocial approach enables comprehensive attention to the needs of children with T1DM, adapts rehabilitation pathways to the social environment, and improves the quality of care during long-term follow-up. The practical value of the study lies in developing a foundation for enhancing multidisciplinary paediatric endocrinology programmes that can be adapted within healthcare systems.

Profile of Early Childhood Education Services and Students' Nutritional Status: Designing an Integrated Stunting Intervention Model

Amirul Mukminin — 2026-06-15

Background: Stunting management in Semarang City remains sectoral and has yet to involve early childhood education centres. This study investigates early childhood education services, nutritional status, and the impact of services on stunting prevalence and designs a stunting intervention model.

Methods: A cross-sectional survey was conducted to collect data from 314 integrated early childhood education centres in Semarang City, with 20 selected for anthropometric data collection. Nutritional status was classified as wasting, stunting, and underweight. Dummy variable regression analysis was used to determine the impact of services on stunting prevalence.

Results: The integrated early childhood education (IECE) was considered good in 55.97% of cases, while 44.03% were rated as less satisfactory. The prevalence of stunted students (29%) was the highest, followed by underweight and wasting. The prevalence of stunting was higher among male students than female students, and the rate of stunting in boys increased with age. Although the influence of early childhood education services on stunting reduction was found to be very weak, it remains a positive factor in lowering stunting prevalence. Enhancing the quality of IECE through an integrated intervention model, especially targeting nutrition and health among young children, represents a significant opportunity to implement effective non-medical interventions to reduce stunting, as evidenced by service-delivery rates.

Conclusion: IECE service was found to be effective in reducing the prevalence of student stunting. These findings imply an urgent need for coordinated, targeted actions that leverage existing policy frameworks to improve service quality and focus interventions on the most vulnerable groups.

Aetiological Risk Factors for Congenital Haemangiomas in Children

Saltanat Toktosunova — 2026-06-15

Background: Congenital haemangiomas are rare vascular tumours in children, and their complex aetiology involving genetic, hormonal, and environmental factors remains insufficiently understood.

Purpose: This study aims to systematise and analyse data on the aetiological risk factors for congenital haemangiomas in children. The main objective was to identify key trends and patterns related to the aetiology of the disease.

Methods: A structured review of 46 published sources (2013-2025) was conducted, including peer-reviewed articles, clinical case reports, and molecular studies. 91% of the included sources were published within the last 5-6 years. Materials were examined using thematic analysis, comparative methods, and systematic organisation, integrating both quantitative and qualitative approaches to assess genetic, hormonal, environmental, and perinatal risk determinants.

Findings: Genetic mutations, such as missense mosaic mutations in GNAQ and GNA11, as well as the pathogenic somatic variant PIK3CA (p.His1047Gln) with an allele frequency of 8.3%, play a key role in the pathogenesis of congenital haemangiomas. Mutations in the VEGF-A and TIE2 genes also contribute to their development. Newborns with large placental chorioangiomas are more likely to develop haemangiomas. Oestrogens stimulate the proliferation of vascular cells; approximately 60% of children with periorbital haemangiomas are girls, which indicates the role of female sex hormones in the pathogenesis of haemangiomas, and hypoxia affects the expression of angiogenic inducer 61. Klippel-Trénaunay syndrome can cause haemangiomas, especially when internal organs are affected. Data showed that infantile haemangiomas occur in 75% of children with a gestational age of less than 33 weeks and in 57% of children with a gestational age of 33 to 37 weeks. Hyperemesis gravidarum can cause deficiencies of essential micronutrients in the mother, increasing the risk of congenital haemangioma by 1.75 times. The use of medications during pregnancy also increases the risk of developing a congenital hemangioma by 1.8 times

Conclusion: The results of the study can be used to develop new approaches to the diagnosis and treatment of congenital hemangiomas in children, as well as to create more accurate and personalised treatment methods that account for genetic and environmental risk factors.

Dental Treatment Data in Children Living in Areas with Elevated Fluoride Content in Water

Akmaanai Kamchybekova — 2026-06-15

Objectives: This study aimed to comprehensively assess the dental status of children aged 5-11 years residing in areas with naturally fluoridated water. The study included 486 children, selected by age and permanent residence using randomisation in Kyzyl-Suu and a continuous survey in Orgochor. Dental status was assessed according to World Health Organization recommendations using the KPUp+kpp and KPUz+kpz indices, while oral hygiene was evaluated using the Fedorov-Volodkina index.

Methods: The concentration of fluorides in drinking water was determined by the potentiometric method, with multiple samples collected at different times of day. Statistical processing of the data involved the use of the standard error of the mean (m), Student's t-test, and quantile-quantile plots to assess distribution normality. The results showed that the prevalence of caries among children aged 5-11 years ranged from 93.1% to 100%, depending on age group and place of residence: in Kyzyl-Suu it reached 100% in all groups except 10-11 years (96.0%), while in Orgochor it varied from 93.1% (7 years) to 98.5% (10-11 years), with a clear age-related trend towards a decline in the incidence of deciduous teeth caries and a simultaneous increase in the intensity of damage to permanent teeth.

Findings: In Orgochor, where the fluoride concentration was 1.44 mg/l, a moderate decrease in caries activity was observed; however, the incidence of fluorosis reached 27.3%. More than 60% of children had unsatisfactory or poor oral hygiene, which further aggravated the risk of dental diseases. The relationships identified between fluoride levels, hygiene conditions, and the prevalence of pathology indicate a complex interdependence of risk factors in the study population.

Conclusions: The findings underscore the need for comprehensive sanitary control, educational programmes, and regular monitoring of drinking water quality to prevent dental diseases in paediatric populations.