Children's Digestive Health

Children's Digestive Health: A Nutrition and Natural-Health Reference

1. Definition and Scope

There is arguably no group of conditions more common and expansive in children than gastrointestinal disorders. The term "children's digestive health" encompasses the full range of structural, functional, infectious, inflammatory, and microbiome-related conditions that affect the gastrointestinal (GI) tract from infancy through adolescence. Nutrition and intestinal function are strictly interrelated: the main role of the gut is to digest and absorb nutrients in order to maintain life and well-being. From a nutritional and natural-health perspective, the subject spans not only acute disorders but also chronic functional complaints, the developing gut microbiome, and the dietary factors that shape both.

Pediatric gastrointestinal conditions can be classified into three broad categories: infectious, inflammatory, and immunologic pathology; motility disorders; and functional gastrointestinal disorders. Chronic conditions affecting the GI tract commonly impact nutrition adversely, and this is especially relevant in children and adolescents with chronic GI conditions, where growth and development are key outcomes.

2. How It Presents: Common Conditions and Symptoms

2.1 Functional Gastrointestinal Disorders (FGIDs)

Functional gastrointestinal disorders (FGIDs) are conditions that include a combination of symptoms that are chronic or recurrent and are not explained entirely with current structural or biochemical investigations. The term "functional" emphasizes that many of the symptoms may accompany normal development (e.g., infant regurgitation) or may be a response to otherwise normal internal or external cues (e.g., constipation following painful stooling).

The most common pediatric functional GI condition is functional abdominal pain. Children with this disorder usually experience recurrent pain in the middle of the abdomen. The pain may be severe and commonly results in the child missing school and other activities. Abdominal-pain-related functional gastrointestinal disorders (AP-FGIDs) are diagnosed in children with chronic and recurrent abdominal pain meeting clinical criteria set forth in the Rome IV criteria. AP-FGIDs affect approximately 20% of children worldwide and include functional dyspepsia (FD), irritable bowel syndrome (IBS), functional abdominal pain (FAP), and abdominal migraine. IBS accounts for 45% of pediatric AP-FGIDs.

The brain and the GI tract are closely connected. Functional GI conditions are due to a combination of extra sensitivity of the GI tract, with changes in the motility or movement of the digestive system.

2.2 Infectious Gastroenteritis

Every year, about 3 to 5 billion children develop infectious gastroenteritis, the most common pediatric gastrointestinal disorder and second cause of death worldwide. This condition presents primarily as acute diarrhea, vomiting, and abdominal cramping, and is frequently caused by rotavirus, norovirus, and enteric bacterial pathogens.

2.3 Constipation

Due to the high prevalence and morbidity of these conditions in children, it is essential to understand the effectiveness of available treatments for the three common pediatric gastrointestinal conditions: diarrhea, constipation, and irritable bowel syndrome (IBS). Functional constipation in children is defined by the Rome IV criteria and is characterized by infrequent defecation, hard stools, painful defecation, and, in some cases, fecal incontinence.

2.4 Chronic Conditions Affecting Nutritional Status

Chronic gastrointestinal disease commonly results in malnutrition and increased morbidity and mortality. Furthermore, chronic malnutrition impairs digestive and absorptive function because food and nutrients are not only the major trophic factors in the gut but also contribute to the structure and functioning of digestive enzymes and absorptive cells. The nutritional impacts of chronic GI conditions in childhood include weight loss, or reduced weight gain, impaired linear growth, and delayed pubertal development.

3. Body Systems Involved

Children's digestive health involves multiple interacting biological systems:

• The gastrointestinal tract itself — from the esophagus through the colon — as the site of digestion, absorption, and motility.
• The gut microbiome: The gut microbiota is a complex and dynamic environment containing 10–100 trillion microorganisms represented by 1,000 species, involved in numerous biological processes. They assist in the breakdown of foods into metabolically and functionally important metabolites, such as short-chain fatty acids (SCFAs) and vitamin K. They also play a role in immune development and several other areas crucial for future health.
• The gut-brain axis: IBS is a disorder of gut-brain interaction (DGBI), whose exact etiology remains unclear. The "brain–gut-microbiota axis" has proved to be a key target in IBS management.
• The immune system: Microbial colonization of the GI tract is fundamentally linked to metabolic programming, immunologic maturation, and proper gastrointestinal development. Perturbations in colonization in infancy have been associated with an increased risk for multiple conditions, including asthma, atopic dermatitis, food allergy, diabetes, inflammatory bowel disease, and obesity.

4. The Developing Pediatric Gut Microbiome

The preadolescent gut microbiome is dominated at the phylum level by Firmicutes (weighted overall average relative abundance = 51.1%) and Bacteroidetes (36.0%); at the genus level by Bacteroides (16.0%), Prevotella (8.69%), Faecalibacterium (7.51%), and Bifidobacterium (5.47%).

After birth, when principal colonization occurs, the microbial diversity increases and converges toward a stable adult-like microbiota by the end of the first 3–5 years of life. A lack of Bifidobacteria during infancy may result in the proliferation of pathogenic bacteria or a decrease in the nutritional status of the infant. Later in life, these microorganisms may play a role in the development or mediation of several acute and chronic illnesses.

Discoveries of key microbiome features of carbohydrate and amino acid metabolism are lending new insights into possible therapies or preventative strategies for inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS). Dysbiosis has been explored in the context of pediatric allergy and asthma, recurrent C. difficile infection, IBD, IBS, and metabolic disorders. The central premise is that the human intestinal microbiome plays a vital role in health and disease, beginning in the prenatal period and extending throughout childhood.

5. Contributing and Associated Factors

5.1 Mode of Delivery

Delivery mode itself is a larger determinant for infant gut microbiome composition than exposure to maternal peripartum antibiotics. However, both delivery mode and antibiotic use may influence maternal gut microbiota composition. Cesarean section delivery appears to decrease the diversity of gut microbiota in neonates, leading to dysbiosis.

5.2 Breastfeeding

Breastfeeding is recognized as one of the most influential drivers of gut microbiome composition during infancy, with potential implications for function. Differences in gut microbial communities between breastfed and formula-fed infants have been consistently observed and are hypothesized to partially mediate the relationships between breastfeeding and decreased risk for numerous communicable and non-communicable diseases in early life. Human milk has evolved to support Bifidobacterium, which often represents 50–70% of the infant gut microbiome early in life through human milk oligosaccharides (HMOs).

5.3 Antibiotic Exposure

Delivery mode, breastfeeding, and intrapartum and early-life antibiotic treatment have the largest effects on microbial composition in early life. Disruption in the gut microbiota (i.e., gut dysbiosis) has been linked to necrotizing enterocolitis in infancy, as well as some chronic diseases in later life, including obesity, diabetes, inflammatory bowel disease, cancer, allergies, and asthma.

5.4 Dietary Pattern and Geographic Factors

Participants from non-Western locations, who were less likely to follow a Westernized dietary pattern, had higher α-diversity and SCFA concentrations in the pediatric gut microbiome. Factors including diet and environment are significant modulators of the gut.

The vast majority of toddlers and preschoolers do not consume enough fiber. There was a considerable intersection of individual values in fiber intake of the constipation and control groups, suggesting that low fiber intake acts in association with other factors on the genesis of constipation in children.

5.5 Psychosocial and Stress Factors

Functional gastrointestinal disorders continue to be a prevalent set of conditions faced by the healthcare team and have a significant emotional and economic impact. The gut-brain axis means that psychological stress, anxiety, and adverse life events in children are well-recognized associated factors in functional GI disorders such as IBS and functional abdominal pain, as discussed extensively in the Rome IV framework.

5.6 Obesity and Metabolic Dysbiosis

Pediatric obesity represents a multifactorial condition in which gut microbiota dysbiosis, low-grade systemic inflammation, and metabolic dysfunction are intricately connected. Obesity, inflammatory bowel disease, and other metabolic illnesses may result from an imbalance in the composition of the gut microbiome.

6. Nutrients Studied in Relation to Children's Digestive Health

6.1 Zinc

Scientific Evidence:

Zinc supplementation during acute diarrhea is currently recommended by the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF). In response to mounting evidence supporting the efficacy and effectiveness of therapeutic zinc supplementation for diarrhea among children under five years of age, WHO and UNICEF issued a global recommendation in 2004, which advised zinc supplementation in addition to oral rehydration solution (ORS) for the treatment of all diarrhea episodes among children under 5 years of age.

In children with persistent diarrhea, zinc supplementation led to a greater proportion of children who recovered from diarrhea (RR = 1.75; 95% CI = 1.34, 2.30; low certainty of evidence). The low certainty-of-evidence ratings were mostly due to high heterogeneity among the studies. Zinc should continue to be recommended in children under the age of 10 years with acute or persistent diarrhea, but moderate certainty of evidence concludes that the dose of zinc should be reduced. This is a well-supported, policy-level recommendation; however, it applies most clearly to low- and middle-income country contexts where zinc deficiency is prevalent.

6.2 Dietary Fiber and Prebiotics

Scientific Evidence:

The North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) and the European Society of Pediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) guidelines state that the evidence does not support the use of fiber supplements in the treatment of functional constipation (FC) in children, and the Rome IV criteria do not recommend an increase in fiber consumption in children with IBS. Despite this, in general practice, it is commonly recommended that children who experience constipation and IBS increase their fiber intake.

Thirteen full-text articles with a total of 723 pediatric participants were included in a systematic review. Three clinical trials found positive effects of dietary fiber for the management of IBS. By contrast, a separate systematic review and meta-analysis found that no statistical significance was observed for bowel movement frequency, stool consistency, therapeutic success, fecal incontinence, and abdominal pain with fiber intake in patients with childhood constipation. The evidence base for fiber in pediatric functional constipation is therefore mixed and largely weak.

Another functional aspect of the intestinal microbiome is the ability to manage small fermentable sugars known as FODMAPs (fermentable oligosaccharides, di- and mono-saccharides, and polyols), which are inadequately digested in the small bowel. Authors of a recent review emphasized the low number of studies assessing a low-FODMAP dietary change in children, the importance of a skilled dietitian to safely guide the use of the diet, and the potential role of a FODMAP-gentle diet as a less restrictive intervention.

6.3 Vitamin D

Scientific Evidence:

Early childhood is a critical stage for the foundation and development of the gut microbiome, and large amounts of essential nutrients are required, such as vitamin D. Race, mode of delivery, breastfeeding, and cord blood vitamin D levels are associated with infant gut microbiome composition, with possible long-term implications for immune system modulation and asthma/allergic disease incidence.

The gut microbiota of infants who were exclusively breastfed displayed significantly lower Shannon diversity and different gut microbiota composition compared to infants who were not breastfed. Among exclusively breastfed infants, recipients of vitamin D supplements displayed significantly lower Shannon diversity and different gut microbiota composition structure than non-supplemented, breastfed infants. These findings are preliminary and require larger confirmatory trials; the mechanisms remain under investigation.

7. Herbs and Natural Ingredients: Traditional Use and Scientific Evidence

7.1 Peppermint (Mentha × piperita)

Traditional Use:

Peppermint has a centuries-long history of use in European herbal medicine for digestive complaints including nausea, flatulence, colic, and abdominal cramping. It has been employed as teas and infusions in traditional practice across European and Asian folk medicine systems to relieve intestinal spasm and bloating.

Scientific Evidence:

Peppermint oil (PMO) is extracted from fresh peppermint leaves by steam distillation and contains menthol as the primary ingredient. PMO has a therapeutic effect in patients with functional gastrointestinal disorders due to its actions at various levels of the microbiome–gut–brain axis. It exerts a spasmolytic effect on smooth muscle cells by decreasing calcium influx via inhibition of L-type Ca²⁺ channels and reduction of acetylcholine release from enteric nerves via its action on nicotinic receptors in the GI tract.

In a landmark pediatric clinical trial: In a randomized, double-blind controlled trial, 42 children with irritable bowel syndrome (IBS) were given pH-dependent, enteric-coated peppermint oil capsules or placebo. After 2 weeks, 75% of those receiving peppermint oil had reduced severity of pain associated with IBS. Peppermint oil may be used as a therapeutic agent during the symptomatic phase of IBS.

Evidence was found for peppermint oil in decreasing duration, frequency, and severity of pain in children suffering from undifferentiated functional abdominal pain. Across adult IBS trials: eight out of 12 placebo-controlled studies show statistically significant effects in favor of peppermint oil. Average response rates in terms of "overall success" are 58% (range 39–79%) for peppermint oil and 29% (range 10–52%) for placebo.

The evidence base for peppermint oil in children with IBS and functional abdominal pain is among the stronger in the pediatric herbal GI literature, though it rests primarily on a small number of trials. Enteric coating appears important to deliver the oil to the lower GI tract without relaxing the lower esophageal sphincter.

7.2 Fennel (Foeniculum vulgare)

Traditional Use:

Fennel seed and its volatile oil have been used for centuries across Mediterranean, Middle Eastern, and Asian traditional medicine systems as a carminative for infants with colic and adults with bloating and flatulence. Fennel teas and seed infusions were (and remain) a common first-line folk remedy for infant colic in many cultures.

Scientific Evidence:

Evidence for effectiveness was found for different fennel preparations (e.g., oil, tea, herbal compound) in treating children with infantile colic. A fennel oil emulsion helped 65% of infants in a randomized controlled trial of infantile colic. In terms of experimental models, fennel oil can be used as a safe and efficient treatment for infantile colic, according to a study by Alexandrovich et al. (2003). The total evidence base, while promising, remains limited in trial number and methodological quality.

7.3 Chamomile (Matricaria chamomilla)

Traditional Use:

Chamomile has a long history of use for various gastrointestinal issues, including colic, diarrhea, stomachache, nausea, indigestion, ulcers, and irritable bowel syndrome. It is known for its ability to alleviate gas, soothe upset stomachs, and relax intestinal muscles. It has been used in European folk medicine for centuries, brewed as tea and administered to infants and children for digestive upset.

Scientific Evidence:

Promising evidence for effectiveness was found for an herbal compound preparation including Matricaria chamomilla in treating diarrhea in children. In a 2005 study involving 93 infants with colic, an extract of fennel, chamomile, and lemon balm was tested against a placebo, with positive results reported. Herbal tea containing chamomile, vervain, licorice, fennel, and balm mint was effective in one randomized controlled trial for infantile colic. The evidence for chamomile alone — as opposed to in combination products — remains limited in scope and quality in the pediatric population.

7.4 Multi-Herb Combination: STW 5 (Iberogast®)

Traditional Use and Background:

STW-5 is a liquid preparation made from extracts of nine well-known herbs, obtained using alcohol and combined at a fixed ratio. It has been used clinically in German-speaking countries for over several decades and is sold in Europe as an over-the-counter medication. STW5 or Iberogast® is a combination of multiple herbs including an extract from bitter candytuft (Iberis amara), angelica root (Angelica radix), milk thistle (Silybi mariani fructus), celandine herb (Chelidonium majus), caraway fruit (Carvi fructus), licorice root (Liquiritiae radix), peppermint (Menthae piperitae folium), lemon balm leaves (Melissa folium), and chamomile flower (Matricariae flos).

Scientific Evidence in Children:

Bitter candytuft (I. amara) selectively inhibits binding to muscarinic M3 receptors, while extracts of celandine and chamomile inhibit binding to 5-HT4 receptors and licorice root to 5-HT3 receptors. To date, there are no prospective, randomized placebo-controlled clinical trials evaluating the use of STW 5 in children with functional abdominal pain disorders that meet standard inclusion criteria. Given the scarcity of data, researchers have drawn on two published works that include a total of 2,022 children and demonstrate treatment efficacy. The available pediatric evidence is therefore largely retrospective or observational; the evidence strength for STW 5 in children specifically should be considered preliminary.

7.5 Ginger (Zingiber officinale)

Traditional Use:

Ginger root has been used for millennia in Ayurvedic, Traditional Chinese, and many other traditional medicine systems as a digestive tonic, carminative, and anti-nausea remedy. Ginger tea and preparations are widely used in folk traditions across Asia, the Middle East, and the Americas for nausea, vomiting, and intestinal discomfort in both children and adults.

Scientific Evidence:

Placebo-controlled trials show that specific herbal preparations, including peppermint oil, ginger, and commercial formulations like STW-5, significantly improve gastrointestinal symptoms. However, the majority of ginger trials for digestive complaints have been conducted in adults. Specific high-quality randomized controlled trials in children for ginger's GI effects are lacking, and the evidence in the pediatric population should be considered indirect or extrapolated from adult data.

8. Probiotics in Children's Digestive Health

Probiotics represent the most extensively studied natural intervention in pediatric GI health, with a body of evidence spanning multiple conditions.

8.1 Acute Diarrhea

Probiotics have not been established as a recommended management option for diarrhoeal illness by the World Health Organization (WHO). Meta-analyses of RCTs have examined their utility. The systematic review evidence base is substantial in volume but heterogeneous in quality, with outcomes varying considerably by probiotic strain, dose, and study population.

8.2 Antibiotic-Associated Diarrhea

There is a more consistent evidence base for probiotics in the prevention of antibiotic-associated diarrhea in children. Multiple systematic reviews have found that co-administration of certain probiotic strains (particularly Lactobacillus rhamnosus GG and Saccharomyces boulardii) with antibiotics reduces the incidence of antibiotic-associated diarrhea, though evidence quality remains variable across trials.

8.3 Functional Constipation

Seventeen RCTs with 1,504 patients were included in one systematic review and meta-analysis. Compared to placebo, probiotics significantly improved defecation frequency (SMD 0.40, 95% CI 0.10 to 0.70, I²=0%) and fecal incontinence (OR 0.53, 95% CI 0.29 to 0.96, I²=0%). However, they did not significantly improve treatment success, painful defecation, and abdominal pain.

The majority of the evidence had an unsatisfactory level of certainty, according to GRADE. These findings are consistent with concerns that low-quality data often suggest that findings of systematic reviews may not match actual results. Low-quality original RCTs were the common direct cause of low evidence. There is still much room for improvement in published RCTs of probiotics for the treatment of functional constipation in children in terms of randomization, allocation concealment, or blinding bias.

8.4 Irritable Bowel Syndrome (IBS) in Children

A systematic review and meta-analysis of RCTs evaluated the effects of probiotic supplementation in pediatric patients diagnosed with IBS according to Rome III or IV criteria. Scopus, PubMed, and Cochrane Library were searched up to February 2025. Six RCTs with 604 participants were included. Three RCTs provided data from which the meta-analysis demonstrated that probiotic supplementation has a significant effect on reducing abdominal pain in patients with IBS (SMD −0.95, 95% CI −1.63 to −0.27). While this is a promising finding, the small number of qualifying trials and methodological limitations mean the evidence is best characterized as moderate.

9. Dietary and Lifestyle Factors

9.1 Breastfeeding Duration and Introduction of Solids

Breastfeeding and infant vitamin D supplement intake play an important role in shaping infant gut microbiota. A healthy non-obese mother, vaginal delivery, and strict breastfeeding contribute to microbiome health in a newborn and young infant. The timing and composition of the introduction of solid foods are also recognized as key modulators of the trajectory of gut microbial diversity in early life.

9.2 Dietary Diversity and the Western Diet

Participants from non-Western locations, who were less likely to follow a Westernized dietary pattern, had higher α-diversity and SCFA concentrations in their gut microbiome. Diets rich in plant-based foods, whole grains, legumes, and fermented foods supply the fermentable substrates that support microbial diversity. Gut microbiota dysbiosis, low-grade systemic inflammation, and metabolic dysfunction are intricately connected in the context of pediatric obesity associated with nutrient-poor, energy-dense dietary patterns.

9.3 Fiber Intake in Practice

Approximately half of the children from families who were health conscious enough to request dietary evaluation still fell below the age + 5 guidelines for grams of dietary fiber intake per day. Those constipated patients were consuming less than one-fourth of the recommended fiber intake. This survey underscored the difficulties in beginning and in maintaining high-fiber diets in children. When families receive advice to administer a high-fiber diet, they are unable to accomplish this unless they receive intensive and ongoing dietary counseling.

9.4 FODMAP Considerations

One functional aspect of the intestinal microbiome is the ability to manage small fermentable sugars known as FODMAPs (fermentable oligo-, di-, and mono-saccharides, and polyols), which are inadequately digested in the small bowel. The low-FODMAP diet has been studied in pediatric IBS and functional abdominal pain disorders, but authors emphasize the low number of studies assessing this dietary change in children and the importance of a skilled dietitian to safely guide the use of the diet.

9.5 Physical Activity and Bowel Habit

Physical activity is recognized in general pediatric guidelines as a contributor to regular bowel habits and reduced constipation risk. While specific high-quality RCT data in children are sparse, observational studies support a relationship between sedentary behavior and functional constipation, consistent with adult physiology.

9.6 Complementary Use of Herbal Teas and Botanical Supplements in Infants

The four most common reasons that mothers fed dietary botanical supplements and teas to their infants were to help with fussiness, digestion, colic, and relaxation. Preparations containing ginger, chamomile, and fennel are the most commonly used. The use of medicinal plants in pediatric care has gained popularity as an alternative or supplement to conventional treatment options. Herbal medicine, which includes plant herbal ingredients, preparations, and finished products, has been increasingly popular among people of all ages. Medicinal herbs have long been used in traditional medicine to treat respiratory diseases, gastrointestinal problems, skin disorders, fevers, infections, and sleep difficulties in children.

10. Summary of Evidence Quality

• Zinc supplementation for acute/persistent diarrhea in children (WHO/UNICEF recommended): Strong evidence from multiple RCTs and systematic reviews in low- and middle-income country contexts; moderate evidence in high-income settings.
• Probiotics for antibiotic-associated diarrhea: Moderate evidence; strain-specific effects; well-supported for specific strains such as LGG and S. boulardii.
• Probiotics for IBS in children (abdominal pain reduction): Preliminary to moderate evidence from meta-analysis of 6 small RCTs.
• Probiotics for functional constipation: Statistically significant improvement in defecation frequency and fecal incontinence; no significant improvement in treatment success or pain; overall GRADE evidence certainty low.
• Peppermint oil for pediatric IBS/functional abdominal pain: Moderate evidence from small RCTs; mechanistically well-characterized; enteric coating required.
• Fennel for infantile colic: Preliminary evidence from a limited number of small RCTs; mechanistically plausible.
• Chamomile for infant colic and diarrhea: Preliminary evidence, primarily from combination herbal products; limited single-herb pediatric RCT data.
• STW 5 (Iberogast®) in children: No prospective placebo-controlled pediatric RCTs meeting standard quality criteria; retrospective observational data only.
• Dietary fiber for pediatric functional constipation: Current society guidelines do not support fiber supplementation; meta-analysis found no significant benefit; evidence for IBS more mixed but slightly positive.
• Vitamin D and gut microbiome in infancy: Early/preliminary evidence from small cohort studies; mechanisms and clinical significance not yet established.

References

• Chitkara DK et al. Pediatric Functional Gastrointestinal Disorders. PMC / NIH, 2010.
• Schurman JV et al. Common Pediatric Gastrointestinal Disorders. PubMed, 2021.
• American College of Gastroenterology. Functional Gastrointestinal Disorders in Pediatric and Adolescent Patients. ACG, 2013.
• Romano C, Dipasquale V. Nutrition in Pediatric Gastroenterology. Nutrients, 2021.
• Krishnan U, Day AS. Advances in Nutrition in Pediatric Gastroenterology. Nutrients, 2023.
• Derrien MMC et al. Characterizing the Composition of the Pediatric Gut Microbiome: A Systematic Review. PMC / PubMed, 2019.
• Flannery DD et al. Development of the Pediatric Gut Microbiome: Impact on Health and Disease. PubMed, 2018.
• Current Use of Complementary and Conventional Medicine for Treatment of Pediatric Patients with Gastrointestinal Disorders. PMC, 2023.
• Efficacy of Probiotics for Treatment of Acute or Persistent Diarrhoea in Children from Birth till 10 Years: Systematic Review and Meta-Analysis. PMC, 2024.
• Efficacy and Safety of Probiotics and Synbiotics for Functional Constipation in Children: A Systematic Review and Meta-Analysis of Randomized Clinical Trials. ScienceDirect, 2023.
• Probiotics for Functional Constipation in Children: An Overview of Overlapping Systematic Reviews. PMC, 2024.
• Efficacy and Safety of Probiotics in Children with Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis. PMC, 2025.
• Axelrod CH, Saps M. The Role of Fiber in the Treatment of Functional Gastrointestinal Disorders in Children. Nutrients / PubMed, 2018.
• Use of Fibers in Childhood Constipation Treatment: Systematic Review with Meta-Analysis. PubMed, 2018.
• Alammar N et al. Herbs and Spices in the Treatment of Functional Gastrointestinal Disorders: A Review of Clinical Trials. PMC, 2018.
• Herbal Approaches to Pediatric Functional Abdominal Pain. PMC / MDPI Children, 2022.
• Herbal Medicines for Gastrointestinal Disorders in Children and Adolescents: A Systematic Review. PubMed, 2017.
• Kline RM et al. Enteric-Coated, pH-Dependent Peppermint Oil Capsules for the Treatment of Irritable Bowel Syndrome in Children. J Pediatr / PubMed, 2001.
• The Impact of Peppermint Oil on the Irritable Bowel Syndrome: A Meta-Analysis of the Pooled Clinical Data. PMC, 2019.
• Oral Zinc for Treating Diarrhoea in Children. Cochrane / PMC, 2017.
• Oral Zinc Supplementation for the Treatment of Acute Diarrhea in Children: A Systematic Review and Meta-Analysis. PMC, 2013.
• Zinc Supplementation for Acute and Persistent Watery Diarrhoea in Children: A Systematic Review and Meta-Analysis. PMC, 2024.
• Vitamin D Supplementation in Exclusively Breastfed Infants Is Associated with Alterations in the Fecal Microbiome. PMC, 2022.
• Maternal Vitamin D in Pregnancy and Infant's Gut Microbiota: A Systematic Review. PMC, 2023.
• Factors Influencing Development of the Infant Microbiota: From Prenatal Period to Early Infancy. PMC, 2022.
• Delivery Mode Is a Larger Determinant of Infant Gut Microbiome Composition at 6 Weeks than Exposure to Peripartum Antibiotics. PMC, 2024.
• Gut Microbiome and Breast-Feeding: Implications for Early Immune Regulation. PMC, 2022.
• Infant Gut Microbiota Colonization: Influence of Prenatal and Postnatal Factors, Focusing on Diet. PMC, 2023.
• Herbal Therapies in Functional Gastrointestinal Disorders: A Narrative Review and Clinical Implication. PMC, 2020.
• Treating Infants' Colic. PMC / NIH, 2006.
• Feeding of Dietary Botanical Supplements and Teas to Infants in the United States. PMC, 2021.
• The Importance of a Healthy Microbiome in Pregnancy and Infancy and Microbiota Treatment to Reverse Dysbiosis for Improved Health. PMC, 2023.
• The Role of Gut Microbiota in Pediatric Obesity and Metabolic Disorders: Insights from a Comprehensive Review. PMC, 2025.