Videos

With the major advancements in enteral nutrition, such as in feeding approaches and products, more patients with pediatric chronic conditions have improved prognosis and life expectancy where nutritional support became a cornerstone in supportive care. Improving nutritional status has not only allowed for survival, but has also enhanced the patient’s health and quality of life. This symposia featuring Prof. Frederic Gottrand, Prof. Valerie Marchand, and Dr. Graeme O’Connor, discusses the specifics of weaning patients from enteral nutrition, new evidence on whether real food-based nutrition may improve tolerance to enteral nutrition in children, and new trends in using real-food based formula in different conditions as seen in practical clinical cases in the UK.

Exciting discussion unravelling the emerging evidence that supports HMOs role in modulating the immune system in infants with CMPA, defining the important clinical implications in this patient population. The key presentations address how the infants microbiome composition and the resulting metabolic functions are critical for early life immune development and how HMO potentially influence this important phase, including recent data from the CORAL study. Further evidence is presented from the CINNAMON study, whereby 2’-FL and LNnT, two major HMOs accounting for almost 30% of the total amount of HMOs in mother’s milk, have a clinical impact when added to hypoallergenic speciality formulas for CMPA, including reduction in frequency of URTI. Finally the emerging evidence is presented detailing the impact of early supplementation of HMO in infants with CMPA, specifically on the infant type bifidobacteria and the associated metabolic products that create a healthy age appropriate gut microbiome.

The establishment of the gut microbiome and its development in early life, especially given the changes in diversity and composition during this time, may influence the training and development of the host immune system, in turn it may also affect the current and future health of a child. In this NNI Symposium at ESPGHAN 2023, moderated by Prof. Raanan Shamir, and lectured by Dr. Martin Frederick Laursen and Dr. Mario Noti, aspects related to the gut microbiome’s requirements for optimal growth, how food can shape this and the need for age and diet adapted synbiotic concepts to correct the disrupted gut microbiome associated with modern lifestyle pressures were discussed.

Moderator Eline van der Beek, along with speakers Maria Makrides, and Keith Godfrey entertain further queries in the Q&A section of the NNI Symposia at DIP 2023. Questions revolved around the studies presented: Influence of a preconception and pregnancy myo-inositol, probiotics, and micronutrient intervention on pregnancy outcomes (NiPPeR Trial), and Women most likely to benefit from personalization of Omega-3s in pregnancy to reduce the risk of early preterm birth.

Omega-3 supplementation has been well reviewed over the years with regards to its effects on preventing preterm births. With this, duration of gestation being longer, there has been an increase in mean birthweight and a decrease in risk for low birthweight. Women with low omega-3 status are at higher risk of early birth compared to women with sufficient status. Correcting low omega-3 status can reduce the risk of early birth.

A good baseline metabolic and nutritional status pre-pregnancy may promote better pregnancy outcomes. To further this hypothesis, the Nutritional Intervention Preconception and During Pregnancny to Maintain Healthy Glucose Metabolism and Offspring Health (NiPPeR) study investigates the supplementation of myo-inositol, probiotics, and micronutrients in preconception and followed through pregnancy. The main findings were that this particular blend of nutrients was associated with reduced incidence of preterm birth, particularly with preterm pre-labour rupture of membranes, and shortens the second stage of labour, leading to reduced operative delivery for delayed second stage, and decreased postpartum blood loss.

Nutrition in pregnancy is at the base of good pregnancy outcomes and sets the stage for the health of the fetus later in life. With the majority of women not starting pregnancy with non-ideal nutritional status—both overnutrition and undernutrition, and only less than 10% being able to meet the main food group intake recommendations, studies on supplementation and personalized nutritional interventions may become necessary for the best outcomes. Eline van der Beek sets up the discussion in the NNI symposium at DIP with her session, “Innovative approach to personalized nutrition management of pregnancy complication”.

The gut microbiota impacts several functions mediated by the gut-brain axis. Research has shown that probiotics (e.g., L. reuteri) may have a role in improving FGID symptoms associated with dysbiosis.