Early nutrition and its effect on the development of functional gastrointestinal disorders

Exclusive breastfeeding is the best way to feed all infants. According to literature, 25 up to 50% of infants develop functional gastrointestinal disorders (FGIDs), and half of them present with a combination of different FGIDs. Although considered as benign transient conditions, FGIDs in infants do have negative short- and long-term health consequences, with a major impact on quality of life of the infant and its family. GI microbiota has been shown to be involved in infantile colic (strong), constipation (moderate), and gastroesophageal reflux (weak evidence). Besides reassurance and anticipatory guidance, nutritional interventions restoring a balanced gastrointestinal microbiota appear to be an effective and safe approach to management in specific scenarios. In those infants that cannot be breastfed, the use of partially hydrolyzed whey proteins, reduced lactose, probiotics, and prebiotics, including human milk oligosaccharides, high levels of magnesium and palm-oil free formulas have been shown to be effective in varying degrees in the prevention and management of specific FGIDs. Dietary interventions can improve the quality of life in FGIDs, particularly in infants. Limited data are available in toddlers. Many toddlers have imbalances in dietary intake, and excess dietary protein may play a role. Recurrent abdominal pain or irritable bowel syndrome is frequent in this age group, with few studies suggesting that interventions with an impact on the gastrointestinal microbiota composition might be beneficial. More data are needed in this age group. © 2022 Elsevier Ltd. All rights reserved.