When an infant reaches 6 months of age, this milestone represents not merely a routine progression in chronological age, but a critical period marking the transition to family-led complementary feeding across all domains of infant development. To scientifically determine whether an infant′s developmental status can support a smooth initiation of complementary feeding at home, and to ensure the safety of complementary feeding while safeguarding subsequent healthy development in infants and toddlers, this consensus addresses assessment across several dimensions: feeding status, maturation of the digestive enzyme system and gastrointestinal tract, motor skill development, psychological and emotional readiness of both the infant and mother for complementary feeding, and prevention of food allergy. It further incorporates anticipatory guidance and proactive planning, proposing stratified, front-loaded, and full-cycle nutritional management strategies for special populations including preterm infants, low birth weight infants, and those with growth faltering, wasting, or overweight/obesity. Through maternal and child health institutions, this consensus aims to guide clinical child health practitioners, pediatricians, and family caregivers in identifying the appropriate timing for introducing complementary foods, progressively enhancing infants′ and toddlers′ perception and acceptance of new foods, fostering healthy dietary habits, and laying a foundation for long-term health.

This paper focuses on complementary feeding and physical activity in infants and toddlers aged 6 – 23 months, elaborating on their synergistic importance for healthy development.Children′s healthy development should follow the concept of giving equal importance to nutrition and physical activity.Nutrition provides the material basis for growth and development, whereas physical activity provides the signaling stimuli required for various aspects of development.Through shared biological mechanisms, they act synergistically to promote high-quality and comprehensive development in children′s physical growth, physiological function, cognition, behavior, and brain development.This paper highlights the concept and significance of the eat-move strategy, reviews core knowledge on complementary feeding, and outlines specific requirements and practices for physical activity at different age stages.The strategies and methods of integrating nutrition and physical activity may also provide important technical support for the Five Health Promotion Initiative.

The high-frequency loose stools commonly observed in breastfed infants are not a pathological condition, but rather a specific defecation pattern resulting from the metabolic utilization of human milk oligosaccharides (HMO).As a natural prebiotic, HMO selectively promotes the proliferation of Bifidobacterium, particularly the B.longum subsp.infantis.These bacteria metabolize HMO to produce organic acids such as lactic acid and acetic acid, lowering the intestinal lumen pH and regulating water and electrolyte balance, which may be one of the reasons for the soft consistency and frequent defecation.Secondly, if HMOs are not completely metabolized, they can increase the osmotic load in the intestinal lumen, drawing in water that is then excreted as loose stools.Clinically, assessment should not rely on stool frequency alone.Instead, a stratified evaluation integrating the infant′s general condition, growth trajectory, and stool characteristics is recommended.The diagnosis of physiological diarrhea should be used cautiously to reduce overdiagnosis and unnecessary interventions and to support the continuation and implementation of breastfeeding.

Objective To analyze the associations of serum vitamin A (VA) and vitamin D (VD) levels with blood pressure in children and adolescents, and to explore the nonlinear threshold effects based on body mass index (BMI) stratification. Methods A cross-sectional study was conducted among 447 students aged 6 -17 years in Guangdong Province from May 2019 to November 2021.Height, weight, blood pressure (mean of three measurements), and body composition (bioelectrical impedance analysis) were measured.Fasting serum VA and VD levels were determined.Optimal thresholds were identified using smoothing curves and the Akaike Information Criterion (AIC).BMI-stratified piecewise regression models were constructed to analyze the associations with adjustment for age, sex, and percent body fat (PBF). Results Overall multiple linear regression showed that the linear associations of VA and VD with systolic blood pressure (SBP) and diastolic blood pressure (DBP) were not significant after adjustment for BMI and PBF(P>0.05).In the normal-BMI group, VD exhibited a J-shaped association with SBP with an inflection point at 27.60 ng/mL; VD was positively associated with SBP above this threshold (β=2.07, P=0.003).VA was positively associated with SBP when VA>0.30 mg/L (β=0.21, P=0.006) and positively associated with DBP when VA<0.29 mg/L (β=1.34, P=0.012),exhibiting a dual pattern.In the underweight group, when VA exceeds 0.28 mg/L, it showed a significant positive correlation with DBP (β=0.45, P<0.001).No significant association was observed in the overweight/obesity group. Conclusion The associations of serum VA and VD with blood pressure in children and adolescents exhibit complex nonlinear threshold characteristics, and these effects may be dependent on individual BMI status.

Objective To investigate the ameliorative effects and potential mechanisms of breast milk-derived Lactiplantibacillus plantarum FN029 on β-lactoglobulin (β-LG)-induced food allergy in mice, in order to provide reference for the prevention and treatment of food allergy. Methods BALB/c mice were randomly divided into a control group, a food allergy group (induced by β-LG), and an FN029 intervention group.FN029 was administered by oral gavage for intervention.Allergic symptom scores were evaluated.Histopathological staining was performed to assess lung and jejunal injury as well as mast cell infiltration.Serum immunoglobulin and cytokine levels were measured.In addition, mRNA expression of Th1/Th2 cytokines in the jejunum, expression of tight junction proteins, and protein levels of the AKT/mTOR and NF-κB signaling pathways were analyzed. Results Compared with the control group, mice in the food allergy group exhibited pronounced allergic symptoms, weight loss, and increased spleen index.Lung and jejunal tissues were damaged, with increased mast cell infiltration.Serum levels of total IgE, β-LG-specific IgE, IgG1, histamine, and IL-4 were significantly elevated, accompanied by upregulated jejunal Th2 cytokine IL-4 and Th1 cytokine IFN-γ levels.Furthermore, expression of intestinal tight junction proteins (ZO-1, Occludin, Claudin-1) was decreased, and phosphorylation levels of key proteins in the AKT/mTOR and NF-κB signaling pathways were abnormally increased (P<0.05).FN029 intervention significantly ameliorated allergic symptoms and signs, alleviated tissue damage and mast cell aggregation, downregulated serum IgE, histamine, and jejunal IL-4 levels, and upregulated IFN-γ, effectively correcting the Th1/Th2 imbalance.In addition, FN029 promoted the restoration of intestinal tight junction proteins and significantly inhibited phosphorylation activation of AKT and NF-κB (P<0.05). Conclusions Lactiplantibacillus plantarum FN029 effectively alleviates food allergy symptoms in mice, and its underlying mechanisms may be related to inhibition of allergen-induced activation of the AKT/mTOR and NF-κB inflammatory signaling pathways, restoration of the intestinal physical barrier, and modulation of Th1/Th2 immune balance.

Objective To describe the prevalence and temporal trends of overweight/obesity and cardiometabolic risk indicators (blood pressure, lipids, and glucose, etc) among primary school students in Pudong New Area, Shanghai from 2020 to 2024, and to examine longitudinal associations of overweight/obesity and body mass index (BMI) with cardiometabolic risk, so as to provide evidence for early prevention of cardiovascular diseases in children and adolescents. Methods A prospective cohort was established in 2020 using stratified cluster random sampling from 13 primary schools in Pudong New Area.Children aged 6 - 7 years were assessed at baseline (2020) and followed up in 2022 (aged 8 - 9 years) and 2024 (aged 10 - 11 years).A total of 1 483 children completed all three assessments.Height and weight were measured to calculate BMI.Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured.Serum total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) were assessed at each visit.Fasting plasma glucose (FPG) was measured in 2022 and 2024 but not at baseline.Repeated-measures analysis of variance was used to compare continuous outcomes across visits.Generalized estimating equations were used to assess temporal trends in abnormal detection rate of cardiometabolic indicators.Linear mixed-effects models were used to evaluate longitudinal associations between continuous BMI and cardiometabolic measures. Results The prevalence of overweight was 18.41%, 16.93%, and 16.79% in 2020, 2022, and 2024, respectively, whereas obesity prevalence was 18.95%, 22.25%, and 21.44%.The detection rate of elevated SBP increased from 11.94% to 19.96%, while elevated DBP decreased from 18.75% to 6.07%.Hypercholesterolemia increased from 6.61% to 17.73%.Hypertriglyceridemia decreased from 9.78% to 1.69% and then rebounded to 5.73%.Elevated LDL-C was 4.25%, 11.46%, and 7.35% in 2020, 2022, and 2024, respectively, and low HDL-C was 3.57%, 1.82%, and 4.18%, respectively.The detection rate of abnormal fasting plasma glucose was 0.47% in 2022 and increased to 10.18% in 2024.Compared with normal-weight peers, overweight/obese children had higher risk of elevated systolic blood pressure at all three visits (OR=1.621, 2.564, 2.693), as well as hypertriglyceridemia (OR=1.609, 8.151, 2.814) and low HDL-C (OR=3.001, 8.927, 3.154) (P<0.05).Differences in hypercholesterolemia, elevated LDL-C, and abnormal fasting plasma glucose were not statistically significant (P>0.05).In linear mixed-effects models, each 1 kg/m² increment in BMI was associated with higher SBP (β=1.518 mmHg) and DBP (β=0.451 mmHg), higher TG (β=0.032 mmol/L), higher LDL-C (β=0.021 mmol/L), lower HDL-C (β=-0.035 mmol/L), and higher fasting plasma glucose (β=0.015 mmol/L) (P<0.001), while the association with total cholesterol was not significant (P=0.833). Conclusions Overweight and obesity are important risk factors for cardiovascular metabolic abnormalities in children, particularly associated with elevated blood pressure, increased TG, and decreased HDL-C.Continuous monitoring of BMI changes may be more sensitive than simple overweight/obesity categorization in detecting early signs of cardiometabolic risk.

Objective To explore the potential associations among maternal pre-pregnancy overweight/obesity, the miRNA expression profile of human milk exosomes, and gut microbiota characteristics in 3-month-old infants, so as to provide clues for mechanistic hypotheses. Methods Mother-infant dyads were recruited from healthy check-ups at the Department of Child Health Care, the Second Affiliated Hospital of Nanjing Medical University, between August 2021 and June 2023. Infant fecal samples and human milk samples were collected. Dyads were classified by maternal pre-pregnancy body mass index (BMI) into an overweight/obesity group (BMI ≥24.0 kg/m²; 5 pairs) and a normal-weight group (18.5 kg/m² ≤BMI<24.0 kg/m², 9 pairs). High-throughput sequencing of exosomal miRNAs in human milk was performed, followed by differential expression analysis and KEGG pathway enrichment. Infant fecal samples underwent 16S rRNA gene sequencing; α- and β-diversity were compared and differential taxa were identified. Correlations between differentially expressed exosomal miRNAs and gut microbiota were examined based on whether the features of differential taxa were consistent with the predicted functions of differential miRNAs. Results Compared with the normal-weight group, 73 exosomal miRNAs were differentially expressed in the overweight/obesity group, including 16 known miRNAs (5 upregulated and 11 downregulated; |log2FC|>1, P<0.05). KEGG analysis showed that target genes of the differential miRNAs were significantly enriched in lysosome, glycerophospholipid metabolism, and the intestinal immune network for IgA production pathways (P<0.02). No statistically significant differences were observed in α- or β-diversity of infant gut microbiota between groups (P>0.05). The linear discriminant analysis effect size (LEfSe) analysis indicated higher relative abundances of Citrobacter, Prevotella, and Campylobacter in infants of the overweight/obesity group (LDA>2.0, P<0.05). Conclusion Maternal pre-pregnancy overweight/obesity may be associated with altered exosomal miRNA profiles in human milk and differences in the abundance of specific infant gut genera, which still needs to be verified in larger sample sizes and longitudinal studies.

Objective To investigate the physical growth and neuropsychological behavioral development of preschool children conceived through assisted reproductive technology (ART), so as to provide scientific evidence for their health management. Methods A total of 65 ART-conceived children aged 3 to 6 years were recruited from Dalian Women and Children′s Medical Group between January 2023 and December 2024.A control group of 65 naturally conceived (NC) children, matched 1:1 for age, was selected.Physical development indicators were assessed, including height, weight, body mass index (BMI), blood pressure, etc., and the Children Neuropsychological and Behavioral Scale (2016 Edition) was used to evaluate developmental status. Results The parental age in the ART group was significantly higher than that in the NC group (t=7.184, 8.337, P<0.05).Although maternal weight gain during pregnancy (t＝3.237), as well as the rates of multiple pregnancy, preterm birth (χ²=9.531), pregnancy complications (χ²=10.586), cesarean section (χ²=12.671), and neonatal hospitalization rate(χ²=13.510) were higher in the ART group (P<0.05), no statistically significant differences were found in these perinatal outcomes after adjusting for multiple pregnancies (P>0.05).Regarding physical development, there were no significant differences in height, weight, or blood pressure between the two groups; however, the BMI, waist circumference, and prevalence of overweight/obesity were significantly higher in the ART group compared to the NC group (t=2.067,3.781,Z=-2.194,P<0.05).In terms of neuropsychological development, no significant differences were observed in gross motor, fine motor, adaptive ability, warning behavior, or total developmental quotient (P>0.05).However, the ART group scored significantly higher in language ability and social behavior than the NC group (t=3.764,2.210,P<0.05).Subgroup analysis by gender revealed that boys in the ART group had significantly better language scores than boys in the NC group (t=3.565, P=0.001), while no significant differences were found between girls in the two groups across all developmental domains. Conclusions After adjusting for multiple pregnancies, the risk of adverse perinatal outcomes in ART children does not increase significantly.In the preschool period, ART children demonstrate generally good physical and neuropsychological development, with better performance in language and social behavior compared to NC children, particularly in language skills among boys.However, ART children are at a higher risk of overweight and obesity, suggesting a need for regular monitoring and intervention regarding their nutritional status and BMI.

Objective To characterize dietary patterns and nutrient intakes among children with wasting, in order to provide evidence for targeted nutritional interventions. Methods This retrospective study included 195 children with wasting who attended the nutrition clinic of the Children′s Hospital affiliated with Nanjing Medical University from June 2021 to June 2025.Dietary intake was assessed using a 24-hour dietary recall supplemented by a food frequency questionnaire.Food and nutrient intakes were calculated using nutrition management software and compared with recommended reference values. Results The proportions of children with intakes below the lower recommended limits were high for vegetables (91.8%), dairy (74.9%), and soybeans (91.8%).Compared with preschool children, school-age children had significantly higher prevalence of inadequate intake of grains, vegetables, and meat (P<0.05).Girls showed significantly higher prevalence of inadequate intake of grains, meat, and eggs than boys (P<0.05).Intakes of energy, calcium, iron, vitamin B1, and vitamin B2 were insufficient.Girls had lower protein-to-recommended nutrient intake ratios (t=2.913) and iron-to-recommended nutrient intake ratios (Z=2.018) than boys, and the differences were significant (P<0.05).Significant differences across age groups were observed for the ratio of energy intake to estimated energy requirement (F=2.691) and the ratio of protein intake to recommended nutrient intake (F=5.403) (P＜0.05). Conclusions Children with wasting exhibit an imbalanced dietary structure and multiple nutrient inadequacies, with variations by age group and sex.Stratified dietary counseling and targeted nutritional interventions are warranted to improve energy and key nutrient intakes, so as to support normal growth and development.

Objective To characterize nutritional status of children with Williams syndrome (WS), so as to provide clinical evidence for standardized nutritional management. Methods A cross-sectional survey was conducted in children with genetically confirmed WS who attended the Children′s Hospital, Zhejiang University School of Medicine, from March to September 2023.Forty-two children were enrolled; 4 did not complete the dietary survey and 6 were excluded due to incomplete dietary records, leaving 32 children for the anthropometric and dietary analysis.Nutritional risk was assessed using STRONGkids.Height and weight were measured, and Z-scores were calculated based on the WHO 2006 growth standards using WHO Anthro/AnthroPlus, including height-for-age Z score (HAZ), weight-for-height Z score (WHZ,<5 years old), and BMI-for-age Z score (BAZ, ≥5 years old).Wasting was defined as WHZ/BAZ<-2 and stunting as HAZ<-2; either criterion indicated malnutrition.Dietary intake was assessed using 3-day food records.Daily mean energy and macronutrient intakes were calculated with nutrition software, and adequacy was expressed as intake/age- and sex-specific DRIs ×100%;<80% was considered inadequate. Results Among the 32 children, 24 (75.0%) were male and 8 (25.0%) were female, with a mean age of 3.88 years old.STRONGkids indicated moderate risk in 13 (40.6%) children and high risk in 19 (59.4%) children.Malnutrition was identified in 12 (37.5%) children.Inadequate intake was observed for energy in 27 (84.4%) children, carbohydrate in 29 (90.6%) children, fat in 23 (71.9%) children, and protein in 4 (12.5%) children. Conclusions Children with WS have a high nutritional risk and a considerable prevalence of malnutrition, along with widespread inadequacy of energy and macronutrient intake.Long-term nutritional assessment and individualized interventions are warranted to improve the nutritional outcome.

Objective To systematically evaluate the effects of donor human milk (DHM) versus formula feeding on complications, growth, and length of hospital stay in preterm infants, so as to provide reference for prioritizing nutritional support strategies for preterm infants. Methods Randomized controlled trials (RCT) comparing DHM feeding with formula feeding were searched from database inception to May 1st, 2025.Data were extracted and pooled using RevMan 5.4. Results A total of 18 articles were included.Meta-analysis results showed that compared with formula feeding, DHM feeding significantly reduced the incidence of necrotizing enterocolitis (NEC)(RR=0.65, 95%CI: 0.51 - 0.84), feeding intolerance (RR=0.63, 95%CI: 0.42 - 0.94), and infection (RR=0.84, 95%CI: 0.72 - 0.98), and shortened the time to full enteral nutrition (MD=-7.44, 95%CI: -8.48 to -6.39) and length of hospital stay (MD=-3.97, 95%CI: -5.10 to -2.85) (P＜0.05).However, growth rates were significantly lower in the DHM group(P＜0.05), including head circumference (MD=-0.06, 95%CI: -0.08 to -0.03), length (MD=-0.07, 95%CI: -0.10 to -0.05), and weight gain (MD=-0.61, 95%CI: -0.73 to -0.49).No significant differences were found in the prevalence rates ofbronchopulmonary dysplasia or retinopathy of prematurity (P＞0.05). Conclusions DHM feeding is associated with lower risks of NEC, feeding intolerance, and infection, and shorter time to full enteral nutrition and hospital stay compared with formula feeding.However, growth outcomes are less favorable, suggesting that appropriate fortification may be required to support growth in preterm infants, and further high-quality RCT are warranted to confirm these findings.

Objective To investigate the epidemiological characteristics of myopia among primary and secondary school students in Midong District, Urumqi, and to identify the associated factors, so as to provide a basis for formulating corresponding strategies. Methods In November 2024, a stratified cluster sampling design was used to recruit 13 548 students aged 6 - 18 years from 11 primary and secondary schools.Visual acuity and non-cycloplegic refraction were assessed, and spherical equivalent (SE) was calculated.Myopia was defined as unaided visual acuity<5.0 and SE>-0.50 D, and high myopia as SE>-6.00 D (classified as positive if either eye met the criterion).Group differences were compared using the chi-square test.Multivariate logistic regression models were used to examine factors associated with myopia and high myopia. Results A total of 7 249 students were identified with myopia (53.51%), including 180 with high myopia (1.33%).Myopia prevalence was higher in girls than in boys (54.78% vs. 52.33%), was highest in senior high school students (90.39%), and was higher in township schools than in urban schools (57.42% vs. 50.64%), the differences were significant (P<0.05).In multivariate analysis, compared with primary school students, the risk of myopia were significantly higher among junior high school students (OR=1.610) and senior high school students (OR=15.950), and higher among township students (OR=1.999). Compared with Han students, Uygur and Hui students had a higher risk of myopia (OR=1.329,1.151), whereas Kazakh students had a lower risk of mlyopia (OR=0.723)(P<0.001).The risk of high myopia increased with grade level (junior high school: OR=6.343; senior high school: OR=24.407, P<0.001). Conclusions The prevalence of myopia among primary and secondary school students in Midong District is high.Although high myopia is relatively uncommon, its risk rose sharply with grade level.Targeted, tiered prevention and control strategies are warranted, especially for junior/senior high school students and those in township areas.

Objective To investigate plantar pressure distribution patterns in preschool children attending childcare institutions in Tongzhou District, Beijing, and to estimate the detection rates of flatfoot and high-arched foot, so as to provide clinical evidence for flatfoot prevention. Methods In 2024, a plantar pressure screening was conducted among 1 935 preschool children aged 4 - 6 years from eight childcare institutions in Tongzhou District, Beijing.Differences in sex, family history, age, region, body mass index (BMI), and daily extracurricular physical activity duration were compared across foot types.Multivariate logistic regression was used to identify factors associated with foot type. Results The detection rates of flatfoot and high-arched foot were 19.8% and 3.9%, respectively.Higher BMI (OR=1.113, 95%CI: 1.057 - 1.172), younger age (reference: 6 years old; 4 years old: OR=2.223, 95%CI: 1.599 - 3.091; 5 years old: OR=1.377, 95%CI: 1.027 - 1.847),<2 h/d of extracurricular physical activity (OR=3.271, 95%CI: 2.501 - 4.280), and family history (OR=1.494, 95%CI: 1.108 - 2.016) were risk factors for flatfoot.For high-arched foot, lower BMI (OR=0.701, 95%CI: 0.606 - 0.810), <2 h/d of extracurricular physical activity (OR=5.532, 95%CI: 3.272 - 9.352), and family history (OR=9.118, 95%CI: 4.852 - 17.135) were risk factors, whereas rural residence was a protective factor (OR=0.373, 95%CI: 0.215 - 0.646). Conclusions Preschool children with higher BMI and shorter extracurricular physical activity time are more likely to have flatfoot, and insufficient extracurricular physical activity is also associated with a higher likelihood of high-arched foot. Strengthening plantar muscle function and maintaining an appropriate body weight may help reduce the risk of flatfoot and high-arched foot in preschool children.

Objective To analyze the characteristics of bone age (BA) distribution and its key influencing factors—specifically gender, age, and nutritional status—among children and adolescents in the Changchun region, in order to provide data support for growth assessment and intervention strategies for related disorders. Methods A cross-sectional study was conducted involving children and adolescents aged 2 - 18 years who visited the Department of Child Health Care at the Children′s Medical Center, Affiliated Hospital of Changchun University of Chinese Medicine, between January 2021 and June 2024. Physical examination and BA data were collected. BA was assessed using the China 05 method, and the bone age difference (BAD) was calculated as BA minus chronological age (CA). Multivariate logistic regression analysis was employed to identify influencing factors. Results A total of 6 231 participants were enrolled. The prevalence of significant BA deviation (|BAD|≥1 year), indicating either advanced or delayed development) was 37.63% (2 345/6 231).The overall mean BAD was (0.17±1.12) year. Significant gender differences in skeletal development were observed, with females exhibiting higher BAD values than males (t=8.501, P<0.05). Nutritional status emerged as a core influencing factor; compared to the normal-weight group, the obesity group showed a significantly increased risk of advanced bone age (OR=4.109, P<0.001), with mean BAD values reaching (1.04±1.12)years for males and (1.20±1.01) years for females. Age stratification analysis indicated that after age 7, BA generally exceeded chronological age (P<0.001). Conclusions Skeletal development among children and adolescents in Changchun region is significantly influenced by gender, age, and nutritional status. Generally, skeletal maturation in females precedes that in males. Overweight and obesity are identified as the primary risk factors for advanced bone age, suggesting that weight management should be prioritized as a critical component of pediatric growth and development healthcare.

Objective To characterize current intervention patterns for functional constipation (FC) in children in Xi′an, and to compare the effectiveness of different intervention strategies, so as to identify their strengths and limitations to inform clinical management. Methods From November 2022 to February 2023, a Rome Ⅳ-based questionnaire was administered via an online platform to primary caregivers of children aged 1 - 14 years with FC in Xi′an.Participants were stratified into <4 years and ≥4 years subgroups.The chi-square test or Fisher′s exact test was used to compare effectiveness across interventions and related factors. Results A total of 1 988 questionnaires were collected, of which 1 911(96.1%) were valid.Of these, 728 children (38.10%) received no intervention, whereas 1 183 (61.90%) received one or more interventions, including hospital-based treatment, pharmacotherapy, dietary adjustment, and physical therapy.Within each age subgroup, sex, residence, and only-child status were not associated with intervention effectiveness (P>0.05).Dietary adjustment was the most frequently adopted strategy and had the highest effectiveness in both subgroups; children with effective outcomeshad shorter initialintervention durationthan those with ineffective outcomes (both P<0.05).Hospital-based treatment effectiveness was associated with family cooperation (P<0.05).In the ≥4-year subgroup, lactulose, probiotics, enema/suppository, and traditional Chinese medicine/Chinese patent medicine were associated with higher effectiveness (P<0.001).Increasing vegetable and fruit intake was the most common dietary approach (92.97% vs.91.13% in the <4-year and ≥4-year subgroups, respectively). Conclusions Intervention strategies for pediatric FC vary substantially in Xi′an, and overall effectiveness remains suboptimal.Early identification and guideline-concordant, individualized multimodal interventions, together with caregiver education, may improve outcomes.

Short-chain fatty acids (SCFAs), mainly including acetate, propionate and butyrate, are key metabolites produced by gut microbiota through the fermentation of dietary fiber.They play a crucial role in maintaining intestinal mucosal barrier integrity and immune homeostasis.Recent studies suggest that SCFAs may partucipate in the development, progression, and prognosis of allergic diseases in children, such as allergic rhinitis, atopic dermatitis, asthma, and food allergies, through various pathways.These pathways include modulating the gut-lung axis, activating G protein-coupled receptors, inhibiting histone deacetylases, and activating peroxisome proliferator-activated receptor γ.Current clinical and animal studies generally indicate that children with allergic diseases often exhibit decreased levels of SCFAs and related acid-producing bacteria in their gut.External supplementation of SCFAs or promotion of acid-producing bacterial proliferation may alleviate allergy-related symptoms and enhance barrier function.However, existing evidence is still predominantly based on animal experiments, in vitro mechanistic studies, and observational research, with a lack of high-quality randomized controlled trials.Key factors such as the optimal intervention timing, effective and safe dosages, and treatment durations remain to be clarified.Future research should focus on conducting multicenter, large-scale, long-term follow-up intervention studies to systematically evaluate efficacy and safety of SCFA-based approaches.Additionally, developing risk prediction models related to SCFAs could facilitate their translational application in the prevention and treatment of allergic diseases in children.

The health benefits of breastfeeding extend far beyond basic nutrition, and its potential role in reducing the risk of autoimmune diseases in children has attracted increasing attention.Breast milk contains a wide range of immunomodulatory components, including antibodies, lactoferrin, cytokines, and shapes the neonatal microbiome, collectively promoting immune maturation and the development of balanced immune tolerance.This review examines the protective mechanisms of breastfeeding against autoimmune diseases and outlines future research directions.A deeper understanding of the immune-protective role of breastfeeding will not only provide new insights into the etiology of autoimmune diseases, but also lay an important theoretical foundation for developing effective primary prevention and public health strategies.This review summarizes the protective effects of breastfeeding against autoimmune conditions such as rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE), and discusses the underlying mechanisms.

Children with cerebral palsy (CP) are prone to nutritional problems due to their common oropharyngeal dysfunction and feeding difficulties, as well as too much consumption caused by motor dysfunction.These nutritional issues not only affect disease prognosis but also indirectly impact their quality of life.Solving the nutrition problem of children with CP depends on timely, accurate and comprehensive evaluation on their nutritional status.The process of nutritional status evaluation includes nutritional screening and nutritional assessment, which aim at rapid and sensitive early-time screening of malnutrition, or comprehensive and accurate assessment of nutritional status respectively.Nutritional screening and assessment are closely linked but still differs obviously.The clinical variability of CP and the specificity of the growth and development of CP children make it difficult to standardize their nutritional status evaluation, and this field has become a research hotspot in recent years.This review summarizes current methods and research advances in nutritional screening and evaluation for children with CP, analyzes the strengths, limitations, and interrelationships of different approaches, so as to provide valuable insights for healthcare professionals dedicated to improving the nutritional management of children with CP.

Sleep health profoundly affects overall well-being.This review summarizes the Peds B-SATED model proposed by Meltzer et al., which conceptualizes pediatric sleep health across six dimensions: satisfaction, alertness, timing, efficiency, duration, and sleep-related behaviors, and analyzes multi-level environmental influences based on socio-ecological systems theory.Existing assessment models are largely western-oriented and poorly capture Chinese children′s unique sleep patterns and cultural contexts.Future work should prioritize cross-cultural validation, develop culturally adapted measures, integrate multidimensional subjective-objective data, and leverage artificial intelligence for real-time monitoring and personalized interventions to facilitate translation into clinical and public health practice.

Post-traumatic bone loss is an under-recognized complication following fractures in children and adolescents, which may compromise peak bone mass and increase the long-term risk of refracture.As a key regulator of bone-muscle health, vitamin D may contribute to post-traumatic bone loss through multiple pathways, including modulation of calcium-phosphate metabolism, immune and inflammatory responses, and musculoskeletal mechanical loading.Available clinical evidence suggests that vitamin D deficiency/insufficiency is prevalent among pediatric fracture patients and is associated with reduced bone mineral density, increased refracture risk, and delayed fracture healing.Focusing on mechanisms such as inflammation, reduced disuse-related mechanical stimulation, and parathyroid hormone dysregulation, this review systematically summarizes the association between vitamin D and post-traumatic bone loss in children and adolescents and its potential interventional value, and discusses practical considerations for vitamin D supplementation in clinical practice.Further multicenter prospective studies and randomized controlled trials are warranted to determine the optimal timing, dosage, and monitoring strategy for post-injury vitamin D supplementation.