Probiotics as prevention for gastro-intestinal disorders in pediatrics

This is a narrative review of largely randomized trials on the impacts of probiotics. It concludes that evidence for beneficial effects of selected probiotics in the prevention of gastrointestinal disorders is limited mainly to acute gastroenteritis, antibiotic-associated diarrhea, infantile colic and necrotizing enterocolitis.  However, there is no broad consensus to recommend the use of probiotics in the prevention of these conditions, mainly because of the different designs used in different studies, resulting in limited evidence for specific strains, dosages and indications. More well-designed studies utilizing standardized methodologies are needed before recommendations can be proposed. At this stage, there is insufficient evidence to recommend the routine use of probiotics in infants and children for the prevention of gastro-intestinal disorder

Benefit and Challenge of Soy Plant-based Formula in Infant and Children

The first report of soy being administered to an infant is over 100 years old (1).  Since the 1960s the composition of soy formula has been better adapted to the nutritional needs of infants and since 2000 infant formula based on soy fulfills European Directives and legislation for infant feeding.Soy infant formula contains a soy protein isolate (95% protein), and methionine, carnitine, taurine, iron, calcium phosphor and zinc are added. Heating destroys the anti-protease activity of soy for over 90 %. In 2016, soy infant formula was still 12% of the USA market and 25 % of infants were fed soy infant formula during their first years of life (2)

Probiotic interventions to optimize the infant and child microbiota

The optimal healthy microbiota during early life still needs further evaluation. Pre- and probiotics are commonly used as supplementation in infant formula. Prebiotic oligosaccharides stimulate the growth of bifidobacteria aiming to mimic the gastrointestinal microbiota of breastfed infants. In general, results with prebiotics in therapeutic indications are disappointing. Studies suggest that probiotic supplementation may be beneficial in prevention and management of disease such as e.g., reducing the risk of necrotizing enterocolitis in preterm infants, prevention and treatment of acute gastroenteritis in infants, etc. Although many studies show promising beneficial effects, the long-term health benefits and eventual  risks of probiotic supplementation during early life are not clear. It is likely that ongoing research will result in the use of specific probiotic organisms and/or prebiotic oligosaccharides during the first 1,000 days of life, with the goal to develop a healthy microbiota from conception over birth into the first two years of life with a lowered risk of infections and inflammatory events

Probiotics and Prebiotics in Pediatrics

The goal of this Special Issue, “Probiotics and Prebiotics in Pediatrics”, is to focus on the importance of pediatric nutrition with probiotics and prebiotics to improve gastrointestinal health in newborn, infants, and children.Specifically, the aim is to clarify if probiotics and prebiotics can influence gut microbiota composition and host-interaction favoring human health and preventing diseases.This new information will provide health care professionals with a widespread, clear and update evidence on probiotics and prebiotics and intestinal gut microbiota in pediatric care

Soy-based infant nutrition: a review

Dietary consumption of soy varies worldwide. In Asia, people traditionally consume large quantities of soy, while in Europe, soy is not part of the traditional or daily eating habits. The USA is a major soy producer. The mean intake of isoflavones by an adult is 8 - 50 mg/day in Asia but only 0.5 - 3.5 mg/day in the Western world.1 The soy intake of a vegetarian is 3 - 12 mg/day and a vegan achieves an intake of 15-60 mg/day.2 In the early 1900s, soy-protein preparations were the only option for the treatment of cow's milk protein allergy (CMPA) . The first report of the use of a soybean -based formula for infants dates from 1909.3 Most soy drinks are not enriched with zinc, iron, calcium, phosphorous, methionine, or carnitine. Soy drinks also do not contain soy isolate. Soy products that do not fulfill the criteria to be an infant formula are not adapted for infant feeding

Breastfeeding for Gut Infant Health

Infants react sensible to dietary changes because the gut physiology and functionality is not fully mature. The first few months of life is the \u27window of opportunity\u27 for optimal physical growth and development, cognitive development, and emotional and social development. Exclusive breastfeeding is recommended for the first 6 months of life. Breast milk is important for the maturation of the infant\u27s digestive system. Potentially protective factors are present in higher amounts in feces from breast-fed infant than from formula-fed infants. The amount of intestinal bifidobacteria in breastfed infants is higher than in formula-fed babies. Mother\u27s milk protects against infection because it contains different factors with immologic properties. The differences in protein fractions between human and cow milk are impressive. The human milk oligosaccharides are the third most important nutritional component are fermented in the colon, making the environment in the colon suitable for the growth of bifidobacteria and lactobacillus

Antibiotic treatment in infants: effect on the gastro-intestinal microbiome and long term consequences

The gastrointestinal microbiome is crucial for the development of a balanced immune system. Antibiotics are frequently administered to infants and cause intestinal dysbiosis. This narrative review highlights the long term health consequences of antibiotic administration to infants and young children. The necessity of administration of antibiotics should be well considered, since an association with short term consequences such as antibiotic associated diarrhoea and long term adverse effects such as overweight, inflammatory bowel syndrome, allergic disease  have been reported.  Conclusion:  The pros and cons of antibiotic administration to infants and young children should be considered

Influence of xanthines on gastroesophageal reflux in infants at risk for sudden infant death syndrome

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Esophagus and Its Function Related to Gastro-esophageal Reflux

The main function of the esophagus is to transport food from the mouth into stomach. Anatomical structures, innervations and blood supplies are needed in order to transport the food into stomach. Mastication stimulates the parasympathetic nerves that regulate salivary, gastric and pancreatic secretion. Saliva secretion stimulates swallowing and increases primary esophageal peristalsis, helps in clearing the esophagus from refluxed material. Swallowing induces peristaltic of esophagus that propulses a solid bolus down the esophagus into the stomach. Innervations are important for esophagus to do its function. One of the most important is coordination between the various reflexes. Delayed clearance of acid from the esophageal and decreased pressure of the lower sphincter esophagus (LES) are the major mechanisms involved in the development of esophagitis. The resistance of the mucosa to the noxious effect of the refluxed material (acid, pepsin, chymotrypsin and trypsin, bile, etc.) is different from person to person. The LES pressure is a defense mechanisms to prevent gastro-esophageal reflux disease (GERD). The LES pressure decreases postprandially. The frequency of postprandinal GER is related to the meal size. Gastric bolus feeding is related to greater intragastric pressure causes more of transient LES relaxations. Osmolality and volume of the feeding slow gastric emptying and incrase postprandial GER. The occurrence of GERD is associated with whether or not the preventive factors are functioning. Other preventive factors for GERD are esophageal peristalsis, secretion and mucosal resistance, gravity and position, the LES tone and angle of his. Patient with GERD should be searched for any disturbances on those factors