Background/Objectives: Disorders of gut–brain interaction (DGBI) include a spectrum of disorders with chronic/recurrent gastrointestinal symptoms, caused by dysregulation of microbiota–gut–brain interaction. Early-life events have been suggested as the main factors influencing the microbiota–gut–brain axis. We aimed to evaluate the prevalence of DGBI in 3-year-old children and its relationship with early-life events. Methods: The parents of children aged 3 years, who had been followed up in a well-baby clinic since they were 2 months old, were asked about any GI symptoms their child had experienced during the check-up visits between September 2023 and June 2024. The final diagnosis of DGBI was based on ROME IV criteria. Demographic data, including early-life factors, were collected. Results: Overall, 568 children (48.6% boys) were included, of whom 139 (24.5%) had symptoms consistent with at least one DGBI diagnosis. The most prevalent DGBI was functional constipation (20.4%), followed by colic (4.6%), infant regurgitation (2.8%), and dyschezia (1.6%). Approximately 48% of the children were breastfed for ≥6 months, and 21% were exposed to ≥1 antibiotic/antiviral drugs in the first year of life. DGBI prevalence was significantly higher in girls than in boys (28.1% vs. 20.7%; p = 0.041). Exclusive breastfeeding was the most significant protective factor against DGBI, particularly if performed for ≥3 months. Conclusions: Sex was the most significant factor affecting DGBI prevalence in children aged ≤3 years; breastfeeding offers the most effective protection against DGBI development.

Purpose: Egg oral immunotherapy (OIT) has demonstrated clinical efficacy; however, 10– 35% of patients discontinue treatment due to severe adverse reactions, particularly during the build-up phase. To improve safety, we developed an incremental egg OIT protocol with gradual dose escalation and an extended build-up period. This study aimed to evaluate the safety and efficacy of this protocol in children with egg allergy. Patients and Methods: We retrospectively reviewed children aged 1– 18 years with hen’s egg allergy confirmed by oral food challenge (OFC) who initiated an incremental egg OIT protocol at Songklanagarind Hospital between August 2023 and March 2025. Demographic characteristics, serum specific immunoglobulin E (sIgE) levels to egg white, egg yolk, and ovomucoid, and adverse reactions during OIT were collected and analyzed. Results: Fourteen patients were included; four underwent egg yolk OIT (EY-OIT) and ten underwent egg white OIT (EW-OIT). The median age was 44.5 months (IQR 31– 63) in the EY-OIT group and 29.5 months (IQR 22.5– 65.25) in the EW-OIT group. Mild adverse reactions occurred in 6 of 14 patients (43%). Reported reactions included active eczema and itchy throat in the EY-OIT group, and perioral erythema, active eczema, and acute urticaria in the EW-OIT group. No severe adverse reactions were observed during the OIT build-up and maintenance phases. Thirteen patients (92.9%) successfully escalated doses according to the protocol, and nine patients reached the target maintenance dose. Conclusion: An incremental egg OIT protocol demonstrated a favorable safety profile in children with egg allergy. No severe adverse reactions occurred during the OIT build-up and maintenance phases, and most patients tolerated gradual dose escalation as planned, supporting the feasibility of this approach in real-world clinical practice. Plain Language Summary: An incremental egg OIT strategy may offer a safer and more feasible approach to desensitization in children with egg allergy, with potential for broader implementation in routine clinical settings.

Background: Atopic dermatitis (AD) is the most common chronic inflammatory skin disease in childhood. Early identification of infants at high risk for AD may support preventive interventions and reduce the subsequent burden of allergic diseases. This study aimed to develop and evaluate prediction models for early-onset AD during the first two years of life. Methods: Prediction models were developed using data from a prospective cohort study of healthy infants aged 42–90 days enrolled at Songklanagarind Hospital between August 2020 and October 2021. Demographic and clinical characteristics were collected at baseline. AD was assessed at 12 and 24 months of age using the Hanifin and Rajka diagnostic criteria. Multivariable logistic regression models were constructed, with variable selection performed using stepwise and least absolute shrinkage and selection operator (LASSO) methods. Model performance was evaluated using sensitivity, specificity, area under the receiver operating characteristic curve (AUC), F1 score, and calibration plots. Results: Among 671 infants included in the analysis, 55 (8.2%) developed AD within the first two years of life. Higher household income and a family history of allergy were significantly associated with increased AD risk, whereas regular moisturizer use was significantly associated with reduced AD risk. The stepwise-selected model demonstrated lower sensitivity than the LASSO-selected model (68% vs. 74%) but higher specificity (75% vs. 66%) and AUC (74% vs. 67%). Both models were similar in F1 score (26%) and calibration. Conclusions: Prediction models based on early-life clinical factors demonstrated promising performance in identifying infants at risk of atopic dermatitis. These models may support early risk stratification and prevention-oriented counseling in infancy. Trial registration The present study is a secondary analysis of data derived from participants enrolled in the V114-032 (PNEU-ERA) clinical trial, which was prospectively registered at ClinicalTrials.gov (NCT04193215). The current cohort analysis evaluating prediction models for atopic dermatitis did not involve a separate interventional protocol.