LASPGHAN 2023 An overview
By Dr. Lygia de Souza Lima Lauand
Departamento de pediatria, São Paulo, SP, Brasil
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About this article
Created
31 January 2024
Updated
23 July 2024
The 24th Latin American Congress and 15th Ibero-American Congress on Pediatric Gastroenterology, Hepatology, and Nutrition, organized by LASPGHAN, took place in October in Rio de Janeiro, Brazil. Additionally, on October 24, the PROBIOTICS, PREBIOTICS, POSTBIOTICS IN PEDIATRICS (PPPP) meeting was held featuring a workshop on clinical applications.
Functional gastrointestinal disorders and the microbiota
The intestinal microbiota has a bidirectional relationship with motility, visceral sensitivity, GI secretory function, permeability, and the immune system. Probiotics show promise in managing functional disorders. For infantile colic, ESPGHAN recommends some strains of Lactobacillus and Bifidobacterium in exclusively breastfed infants. HCPs may suggest different strains of Lactobacillus for functional abdominal pain, or to reduce symptoms in IBS [1].
Modulating microbiota to impact infant’s life
Factors such as delivery mode, breastfeeding [2], environment and no antibiotic use positively impact neonatal colonization, fostering a healthy intestinal environment, metabolic balance, homeostasis, and immune tolerance. Conversely, preterm birth, C-section, lack of breastfeeding, NICU admission, and antibiotic use may lead to dysbiosis, contributing to immune-related diseases. Strategies for modulation and prevention of dysbiosis involve a balanced diet and the use of probiotics, prebiotics, synbiotics, and postbiotics.
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Human milk microbiota
Human milk encompasses probiotics, prebiotics, synbiotics, and postbiotics, collectively contributing to the microbiota balance in breastfed children. Maternal skin and the infant’s oral cavity are identified as the primary contributors to the milk microbiota. Factors that modulate the human milk microbiota include gestational age, infant gender, mode of delivery, lactation stage, feeding mode, geographic location, social network density, maternal health status, and maternal diet [3].
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Upper respiratory tract infection (URTI) and microbiota
URTIs leads to indiscriminate antibiotic prescription worldwide, and the WHO estimates that antibiotic resistance-related deaths could reach 10 million by 2050. A systematic review showed an overall 35% reduction in the number of URTIs when probiotics were used, 2-day decrease in
the severity of symptoms, and 45% reduction in antibiotic use. Certain probiotic strains appear promising in reducing the incidence of viral URTIs, severity of infections, and antibiotic use [4].
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Sources
1. Szajewska H, Berni Canani R, Domellöf M, et al; ESPGHAN Special Interest Group on Gut Microbiota and Modifications. Probiotics for the Management of Pediatric Gastrointestinal Disorders: Position Paper of the ESPGHAN Special Interest Group on Gut Microbiota and Modifications. J Pediatr Gastroenterol Nutr 2023; 76: 232-47.
2. Levy M, Kolodziejczyk AA, Thaiss CA, et al. Dysbiosis and the immune system. Nat Rev Immunol 2017; 17: 219-32.
3. Boix-Amorós A, Collado MC, Van’t Land B, et al. Reviewing the evidence on breast milk composition and immunological outcomes. Nutr Rev 2019: nuz019.
4. Ozen M, Kocabas Sandal G, Dinleyici EC. Probiotics for the prevention of pediatric upper respiratory tract infections: a systematic review. Expert Opin Biol Ther 2015; 15: 9-20.