Early-Life Events and the Prevalence of Gut–Brain Interaction Disorders in Children

TL;DR

Early-life factors like breastfeeding and antibiotic use affect gut-brain interaction disorders in young children.

Contribution

Identifies breastfeeding and antibiotic exposure as key factors in DGBI development in children under 3 years.

Findings

24.5% of 3-year-olds showed symptoms of gut-brain interaction disorders.

Breastfeeding for ≥3 months significantly reduces DGBI risk.

Antibiotic/antiviral exposure in the first year increases DGBI risk.

Abstract

What are the main findings?
•Environmental factors in the first 3 years of life could influence postnatal development and lifelong health and well-being.•Breastfeeding, particularly for ≥3 months, is the most important protective factor against DGBI, whereas antibiotic/antiviral exposure, particularly in the first year of life, may increase the risk of DGBI development.

Environmental factors in the first 3 years of life could influence postnatal development and lifelong health and well-being.

Breastfeeding, particularly for ≥3 months, is the most important protective factor against DGBI, whereas antibiotic/antiviral exposure, particularly in the first year of life, may increase the risk of DGBI development.

What is the implication of the main finding?
•Exclusive breastfeeding should be continuously promoted to prevent the occurrence of DGBI.•The rational use of antibiotics/antivirals should be advocated to decrease the risk of developing DGBI.

Exclusive breastfeeding should be continuously promoted to prevent the occurrence of DGBI.

The rational use of antibiotics/antivirals should be advocated to decrease the risk of developing DGBI.

Background/Objectives: Disorders of gut–brain interaction (DGBI) include a spectrum of disorders with chronic/recurrent gastrointestinal symptoms, caused by dysregulation of microbiota–gut–brain interaction. Early-life events have been suggested as the main factors influencing the microbiota–gut–brain axis. We aimed to evaluate the prevalence of DGBI in 3-year-old children and its relationship with early-life events. Methods: The parents of children aged 3 years, who had been followed up in a well-baby clinic since they were 2 months old, were asked about any GI symptoms their child had experienced during the check-up visits between September 2023 and June 2024. The final diagnosis of DGBI was based on ROME IV criteria. Demographic data, including early-life factors, were collected. Results: Overall, 568 children (48.6% boys) were included, of whom 139 (24.5%) had symptoms consistent with at least one DGBI diagnosis. The most prevalent DGBI was functional constipation (20.4%), followed by colic (4.6%), infant regurgitation (2.8%), and dyschezia (1.6%). Approximately 48% of the children were breastfed for ≥6 months, and 21% were exposed to ≥1 antibiotic/antiviral drugs in the first year of life. DGBI prevalence was significantly higher in girls than in boys (28.1% vs. 20.7%; p = 0.041). Exclusive breastfeeding was the most significant protective factor against DGBI, particularly if performed for ≥3 months. Conclusions: Sex was the most significant factor affecting DGBI prevalence in children aged ≤3 years; breastfeeding offers the most effective protection against DGBI development.

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