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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">lvrach</journal-id><journal-title-group><journal-title xml:lang="ru">Лечащий Врач</journal-title><trans-title-group xml:lang="en"><trans-title>Lechaschi Vrach</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">1560-5175</issn><issn pub-type="epub">2687-1181</issn><publisher><publisher-name>ООО «Издательство "Открытые системы"»</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.51793/OS.2022.25.6.008</article-id><article-id custom-type="elpub" pub-id-type="custom">lvrach-925</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ПЕДИАТРИЯ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>PEDIATRICS</subject></subj-group></article-categories><title-group><article-title>Альтернативное введение молочных смесей на основе козьего молока: открытия и перспективы</article-title><trans-title-group xml:lang="en"><trans-title>Alternative introduction of milk formulas based on goat milk: discoveries and prospects</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-0547-3686</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Геппе</surname><given-names>Н. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Geppe</surname><given-names>N. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Геппе Наталья Анатольевна, д.м.н., профессор, заведующая кафедрой детских болезней</p><p>119435, Москва, ул. Большая Пироговская, 19, стр. 1</p></bio><bio xml:lang="en"><p>Nataliya A. Geppe, Dr. of Sci. (Med.), Professor, Head of the Department of Children's Diseases</p><p>19, b. 1 Bolshaya Pirogovskaya str., Moscow, 119435</p></bio><email xlink:type="simple">geppe@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-6592-0121</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Великорецкая</surname><given-names>М. Д.</given-names></name><name name-style="western" xml:lang="en"><surname>Velikoretskaya</surname><given-names>M. D.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Великорецкая Марина Дмитриевна, к.м.н., доцент кафедры детских болезней</p><p>119435, Москва, ул. Большая Пироговская, 19, стр. 1</p></bio><bio xml:lang="en"><p>Marina D. Velikoretskaya, MD, Associate Professor of the Department of Children's Diseases</p><p>19, b. 1 Bolshaya Pirogovskaya str., Moscow, 119435</p></bio><email xlink:type="simple">marvek57@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-2085-0021</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Шаталина</surname><given-names>С. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Shatalina</surname><given-names>S. I.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Шаталина Светлана Игоревна, к.м.н., ассистент кафедры детских болезней</p><p>19435, Москва, ул. Большая Пироговская, 19, стр. 1</p></bio><bio xml:lang="en"><p>Svetlana I. Shatalina, MD, assistant of the Department of Children's Diseases</p><p>19, b. 1 Bolshaya Pirogovskaya str., Moscow, 119435</p></bio><email xlink:type="simple">svetlanashatalina@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-4802-6544</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Аксенова</surname><given-names>М. Б.</given-names></name><name name-style="western" xml:lang="en"><surname>Aksenova</surname><given-names>M. B.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Аксенова Марианна Борисовна, к.м.н., доцент кафедры госпитальной терапии № 1</p><p>119021, Россия, Москва, ул. Россолимо, 11, стр. 2</p></bio><bio xml:lang="en"><p>Marianna B. Aksenova, MD, Associate Professor of the Department of Hospital Therapy No. 1</p><p>11, b. 2 Rossolimo str., Moscow, 119021</p></bio><email xlink:type="simple">axenovamarianna@mail.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-8960-5772</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Венерин</surname><given-names>А. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Venerin</surname><given-names>A. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Венерин Андрей Андреевич, студент 5-го курса</p><p>19021, Москва, ул. Россолимо, 11, стр. 2</p></bio><bio xml:lang="en"><p>Andrey A. Venerin, 5th year student</p><p>11, b. 2 Rossolimo str., Moscow, 119021</p></bio><email xlink:type="simple">venerin.andrey@gmail.com</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-4125-0335</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Полянская</surname><given-names>А. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Polyanskaya</surname><given-names>A. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Полянская Ангелина Валерьевна, к.м.н., доцент кафедры детских болезней</p><p>119435, Москва, ул. Большая Пироговская, 19, стр. 1</p></bio><bio xml:lang="en"><p>Angelina V. Polyanskaya, MD, Associate Professor</p><p>19, b. 1 Bolshaya Pirogovskaya str., Moscow, 119435</p></bio><email xlink:type="simple">meleshkina.angel@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-5669-4214</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Чебышева</surname><given-names>С. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Chebysheva</surname><given-names>S. N.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Чебышева Светлана Николаевна, к.м.н., доцент кафедры детских болезней</p><p>119435, Москва, ул. Большая Пироговская, 19, стр. 1</p></bio><bio xml:lang="en"><p>Svetlana N. Chebysheva, MD, Associate Professor</p><p>9, b. 1 Bolshaya Pirogovskaya str., Moscow, 119435</p></bio><email xlink:type="simple">svetamma@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Клинический институт детского здоровья имени Н. Ф. Филатова Федерального государственного автономного образовательного учреждения высшего образования Первый Московский государственный медицинский университет имени И. М. Сеченова Министерства здравоохранения Российской Федерации</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Clinical Institute of Children's Health named after N. F. Filatov of the Federal State Autonomous Educational Institution of Higher Education I. M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>Институт клинической медицины имени Н. В. Склифосовского Федерального государственного автономного образовательного учреждения высшего образования Первый Московский государственный медицинский университет имени И. М. Сеченова Министерства здравоохранения Российской Федерации</institution><country>Россия</country></aff><aff xml:lang="en"><institution>N. V. Sklifosovsky Institute of Clinical Medicine of the Federal State Autonomous Educational Institution of Higher Education I. M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2022</year></pub-date><pub-date pub-type="epub"><day>17</day><month>07</month><year>2022</year></pub-date><volume>0</volume><issue>5-6</issue><fpage>46</fpage><lpage>53</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Геппе Н.А., Великорецкая М.Д., Шаталина С.И., Аксенова М.Б., Венерин А.А., Полянская А.В., Чебышева С.Н., 2022</copyright-statement><copyright-year>2022</copyright-year><copyright-holder xml:lang="ru">Геппе Н.А., Великорецкая М.Д., Шаталина С.И., Аксенова М.Б., Венерин А.А., Полянская А.В., Чебышева С.Н.</copyright-holder><copyright-holder xml:lang="en">Geppe N.A., Velikoretskaya M.D., Shatalina S.I., Aksenova M.B., Venerin A.A., Polyanskaya A.V., Chebysheva S.N.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://journal.lvrach.ru/jour/article/view/925">https://journal.lvrach.ru/jour/article/view/925</self-uri><abstract><p>Оптимальным источником питания для ребенка первого года жизни является материнское грудное молоко, обеспечивающее ему полноценное физическое и нервно-психическое развитие. Известно, что грудное молоко содержит высокие концентрации (5-20 г/л в зрелом молоке) и большое разнообразие олигосахаридов. Ряд исследований показали, что олигосахариды грудного молока эффективно стимулируют рост бифидобактерий и формируют состав кишечной микробиоты, снижая риск инфекций, а также модулируя функцию иммунных клеток и обеспечивая питательные вещества для развития ребенка. Однако существует ряд причин перевода малыша на смешанное или искусственное вскармливание. В случае недостаточного количества молока или полного его отсутствия у матери, а также при абсолютных противопоказаниях к грудному вскармливанию эффективной альтернативой будет введение детской молочной смеси. В этой связи необходимо правильно выбрать молочную смесь, чтобы не допустить или скорректировать возникшие ранее функциональные нарушения желудочно-кишечного тракта, которые можно охарактеризовать как нарушения сложной двухсторонней связи между центральной и энтеральной нервной системой. Множество исследований показали, что козье молоко по составу больше похоже на женское, чем коровье молоко. Козье молоко содержит высокие уровни олигосахаридов по сравнению с молоком других млекопитающих и более низкие уровни казеина αs1. Сообщается также, что козье молоко имеет значительную гомологию N-гликанов лактоферрина с материнским молоком. С 1906 г. козье молоко признано лучшим естественным заменителем женского молока и источником протеинов для различных молочных смесей, а с 2013 г. внесено в Директиву Европейской Комиссии. В результате в козьем молоке выявлено большое количество разнообразных олигосахаридов, многие из которых по структуре схожи с олигосахаридами грудного молока. Современные смеси на основе козьего молока выпускаются с обновленной формулой. Изменения коснулись белкового и жирового компонентов смеси. Во всех продуктах – с учетом возраста малыша – снижено содержание общего количества белка и увеличена доля сывороточной фракции белка.</p></abstract><trans-abstract xml:lang="en"><p>The optimal source of nutrition for a child of 1 year old is breast milk, which provides him physical and neuropsychic development. Human milk is known to contain high concentrations (5-20 g/l in mature milk) and a wide variety of oligosaccharides. A number of studies have shown that human milk oligosaccharides effectively stimulate the growth of bifidobacteria and shape the composition of the intestinal microbiota, reducing the risk of infections, as well as modulating immune cell function and providing nutrients for the development of the child. However, there are a number of reasons for transferring a baby to mixed or artificial feeding. In case of insufficient amount of milk or its complete absence from the mother, as well as with absolute contraindications to breastfeeding, the introduction of infant formula will be an effective alternative. It is necessary to make the right choice of the milk formula in order to prevent or correct the functional disorders of the gastrointestinal tract that have arisen earlier, which can be characterized as violations of the complex twoway connection between the central and enteral nervous system. Many studies have shown that goat's milk is more similar in composition to women's milk than cow's milk. Goat milk contains high levels of oligosaccharides compared to milk from other mammals and lower levels of αs1 casein. Goat milk is also reported to have significant lactoferrin N-glycan homology with human milk. Since 1906, goat's milk has been recognized as the best natural substitute for human milk and a source of proteins for various milk formulas, and since 2013 it has been included in the Directive of the European Commission. As a result of studies during 150 years, a large number of various oligosaccharides have been identified in goat milk, many of which are similar to breast milk oligosaccharides. Modern mixtures based on goat milk has a new formula now. The changes affected the protein and fat components of the formula. In all products the total amount of protein is reduced and the proportion of the serum fraction of protein is increased.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>дети первого года жизни</kwd><kwd>вскармливание</kwd><kwd>молочная смесь</kwd><kwd>козье молоко</kwd><kwd>олигосахариды</kwd></kwd-group><kwd-group xml:lang="en"><kwd>children of the 1st year of life</kwd><kwd>feeding</kwd><kwd>milk formula</kwd><kwd>goat's milk</kwd><kwd>oligosaccharides</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">WHO (World Health Organisation). Report of the Expert Consultation on the Optimal Duration of Exclusive Breastfeeding; WHO: Geneva, Switzerland, 2001.</mixed-citation><mixed-citation xml:lang="en">WHO (World Health Organisation). 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