Navigating Digestive Disorders in Young Children: DGBIs from Infancy to Toddlerhood

Navigating Digestive Disorders in Young Children: Disorders of Gut-Brain Interaction from Infancy to Toddlerhood 

Yvan Vandenplas, Elisabeth DeGreef  

KidZ Health Castle, UZ Brussel, Vrije Universiteit Brussel, Brussels? Belgium.  

Functional gastrointestinal disorders (FGIDs) in infants and toddlers are common worldwide and cover a variety of disorders associated with chronic, recurrent symptoms attributable to the gastrointestinal tract, but not explained by structural or biochemical abnormalities. Although these disorders have historically been described as “functional”, they are now considered as “disorders of gut–brain interaction” (DGBI) emphasizing that the term “functional” should not be misconstrued to imply a non-organic condition. 

DGBIs during toddlerhood (1-3 years) are limited to cyclic vomiting syndrome, functional diarrhoea and constipation. Prevalence data are limited, although it is known that functional constipation is frequent in this age group (prevalence ranging from 10 to 30%). Functional diarrhoea, previously called toddler's diarrhoea, and cyclic vomiting syndrome are seldom  

Late onset congenital lactose intolerance may already occur in 3 year old toddlers, and deserves consideration during "late toddlerhood" in the presence of important gassiness.  

At all ages, there is a close interaction between DGBI and the gastrointestinal microbiome, although the evidence specifically in toddlers is limited. Administration of biotics to infant formula decreases stool consistency. Some specific probiotic strains have bene shown to be effective in the management of infant colic, especially in breastfed infants. Data show also efficacy for probiotic administration in older children with functional abdominal pain, not otherwise specified.  

DGBI have been poorly studied during toddlerhood. Besides a high prevalence of constipation, it is not clear if DGBI are infrequent in this age group or poorly recognised. The available evidence suggests that administration of biotics may also be helpful in this age group.  

References 

Velasco-Benítez CA, et al. Disorders of gut-brain interaction are common diagnoses among infants and toddlers in gastroenterology practices in Latin America. J Pediatr Gastroenterol Nutr. 2024 Nov;79(5):969-975 

Benninga MA, et al. Childhood Functional Gastrointestinal Disorders: Neonate/Toddler. Gastroenterology. 2016:S0016-5085(16)00182-7 

Heine RG, et al. Lactose intolerance and gastrointestinal cow's milk allergy in infants and children - common misconceptions revisited. World Allergy Organ J. 2017 Dec 12;10(1):41. 

Vandenplas Y, et al. Understanding functional abdominal pain disorders among children:  
a multidisciplinary expert consensus statement. Front Pediatr. 2025:13:1576698.  

Happy Tummy Consortium, et al. Limosilactobacillus reuteri DSM 17938-Containing Infant Formulas and the Associations with Gastrointestinal Tolerance: A Cross-Sectional Observational Study. Nutrients. 2023 Jan 19;15(3):530