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Gluten ingestion can cause a series of distinct clinical disorders with overlapping symptoms. These disorders are celiac disease, wheat allergy, and non-celiac gluten sensitivity (NCGS). Celiac disease and wheat allergy are widely recognized among pediatricians. In contrast, NCGS is not as well known. NCGS is a syndrome of intestinal and extra intestinal manifestations that occur in response to the ingestion of gluten.

Human milk oligosaccharides (HMO) have no nutritive value, yet mothers spend significant energy for their synthesis. So what do they do? Clinical observational studies together with basic research position HMO as multifunctional innate breastmilk component. They shape the establishing gut microbiota and supposedly help the development of appropriate immune competence.

During pregnancy and infancy, the human brain is growing extremely fast; the brain volume increases significantly, reaching 83% of the volume of adults 2 years of age which is essential to establish the neuronal networks and capacity for the development of cognitive, motor, social, and emotional skills.

Non-celiac gluten sensitivity (NCGS) is a syndrome characterized by intestinal and extra intestinal symptoms related to the ingestion of gluten-containing food in subjects who are not affected by either celiac disease (CD) or wheat allergy (WA). The prevalence of NCGS is not clearly defined yet. Indirect evidence suggests that NCGS is slightly more common than CD, the latter affecting around 1% of the general population.NCGS has been mostly described in adults, particularly females in the age group of 30–50 years; however, pediatric case series have also been reported.

A different and probably pseudo-allergic, but inflammatory, GI disorder also caused by cow’s milk is in the form of an eosinophilic GI disorder (EGID). EGID can occur in patients with well-known allergy as well as in patients without any notion of atopy or allergy. The present review of Doctor Koutry and Professor Papadopoulou highlights that the clinical presentation depends on the involved GI sites as well as on the extent and the depth of eosinophilic inflammation of the intestinal mucosa, sub-mucosa, or muscularis.

Oral immunotherapy (OIT) is a novel strategy for the treatment of food allergies. Clinical trials have shown that OIT can be effective at desensitizing subjects to a particular food allergen, such as peanut, milk, egg or wheat. The first clinical trial of peanut OIT indicated that OIT could be successfully used to induce desensitization in subjects with peanut allergy, with a favorable tolerability profile and low rates of anaphylaxis. The widespread use of OIT is currently limited by its safety and tolerability.

FGIDs are very frequent. Indeed, for many of us, it’s one of the most common diagnoses of the patients that we see is that they suffer from FGIDs. I will focus on regurgitation, infant colic and constipation because they are definitely the most frequent. 

Within the past 20 years, major advances in molecular biology methods have demonstrated in detail how iron is absorbed, transported and utilized in the human body.  Of particular importance has been the discovery of the liver-derived hormone hepcidin, which is now known to be the master regulator of iron, including switching down iron absorption to protect the body against infection.  These new insights suggest that interventions to reduce infection and inflammation will be at least as effective as dietary interventions and that the two approaches are interdependent.