Editorial: Insights in Pediatric Gastroenterology 2024

Andrew S Day^*

• University of Otago, Christchurch, Christchurch, New Zealand

The aim of this Research Topic was to gather a range of publications to illustrate some of the breadth of pediatric gastroenterology research during 2024. The six reports that have been included touch on aspects of the intestinal microbiome, nutrition in early life, pancreatitis and congenital abnormalities leading to diarrhoea.A number of key factors are important in the development of the intestinal microbiome in early life [1]. These include the method of birth delivery, early infant feeding practices and antibiotic exposure. The acquisition of the Bifidobacteria group/class is one key early stage in the development of the microbiome, with relevance to early nutrition and longer-term immune responses. Xu et al {LINK TO PUBLICATION} evaluated the presence of Bifidobacterium in infants across the three predominant ethnicities in Singapore. Samples were collected from infants over their first three months of life. Real-time PCR used to ascertain the presence and pattern of the bacteria of interest. Overall, less than 5% of the infants were shown to have Bifidobacteria. Factors contributing to these patterns were immigration status, method of delivery and previous use of antibiotics.Infants born prematurely have increased risks of various adverse events, including compromised growth, gut disorders, chronic lung disease and poor neurodevelopmental outcomes. One gut disorder of note is necrotising enterocolitis (NEC), which is more commonly seen in infants born prematurely than in those born at term. O'Connell [LINK TO PUBLICATION] provided an overview of key aspects of NEC and provided a new perspective for the approach to NEC.Another aspect of the care of premature infants is the optimization of feeding to ensure appropriate growth: this may require enhancing the caloric content of milk feeds [2]. Lavassini et al {LINK TO PUBLICATION} prospectively compared the outcomes of a human milk-derived fortifier (HMDF) to those of a bovine milk-derived fortifier (BMDF) in a cohort of 139 premature infants. Specific outcomes of interest were growth and vitamin D status. Growth parameters at 4 and 8 weeks of age did not differ between the groups. However, those who received the HMDF had better vitamin D status at 4 weeks. This study was not, however, designed to elucidate the underlying mechanism behind this observation.Baran and colleagues {LINK TO PUBLICATION} provided some interesting perspectives of changes in access to specific infant formulae in the United Sates of America in 2022. The global pandemic interrupted supplies of these formula, with peak disruptions in February 2022. The research team surveyed pediatric health care providers who managed children with cow's milk protein intolerance. The respondents' answers illustrated the impact of the formula shortage at that time upon the management of children.Over recent years a number of forms of recurrent or familial pancreatitis have been described: in a number of these the underlying genetic factors have been elucidated enabling a specific diagnosis to be made [3]. In some instances, repeated episodes of acute pancreatitis can lead on to chronic pancreatitis. Destro et al {LINK TO PUBLICATION} reported the case of a young boy who was diagnosed with familial pancreatitis after his first episode of pain requiring hospitalization. This boy was also shown to have duplication of a portion of the pancreatic duct. The case report outlines his progress over time and then provides an overview and context for his issues.The final report in this RT is another case report. On this occasion, the authors {LINK TO PUBLICATION} described two infants who had presented with chronic intractable diarrhoea and hypoalbuminemia (thought to be due to an associated protein-losing enteropathy). Numerous investigations were unhelpful and various interventions did not improve the infants' situation. In the end they were found to have small bowel malrotation with chronic volvulus. Correction of this abnormality lead to complete resolution of their problems.Together these reports covered some varied and interesting aspects relevant to the field of pediatric gastroenterology. Hopefully, the publication of these articles will generate further research endeavours and also improve the outcomes for children suffering with these issues.