Functional gastrointestinal disorders in Turkish infants: impact of feeding practices, sleep quality, and maternal depression.

Abstract

Functional gastrointestinal disorders (FGIDs) significantly impact infant well- being and healthcare utilization, yet comprehensive data using updated Rome IV criteria in Turkish populations remains limited. Our objective was to determine the prevalence and characteristics of FGIDs in Turkish infants and examine associations with feeding patterns, sleep quality, and maternal depression. A cross-sectional study was conducted in a tertiary hospital between February and August 2020. A total of 459 infants aged 1-12 months were enrolled. FGIDs were diagnosed according to Rome IV criteria. Feeding characteristics, sleep quality assessed by the Brief Infant Sleep Questionnaire, and maternal depression measured using the Edinburgh Postnatal Depression Scale were recorded through face-to-face interviews. Comparisons were primarily performed between infants with and without FGIDs. Multivariable logistic regression adjusted for infant age was used to evaluate the association between feeding type and FGIDs. At least one FGID was identified in 53.2% of infants (n=244). Co-occurrence of multiple FGIDs was observed in 92 infants. Infants with FGIDs were significantly younger than those without FGIDs with a median age of 3 months (interquartile range [IQR]: 2-5) vs 6 months (IQR: 3-9) (p<0.001). Poor sleep was markedly more prevalent among infants with FGIDs compared to those without (45.1% vs 22.3%, p<0.001). Mothers of infants with FGIDs had higher depression scores than mothers of infants without FGIDs (median: 7.0 [IQR: 4-11] vs 5.0 [3-10], p=0.030). In multivariable logistic regression analysis adjusted for infant age, the overall feeding model was not statistically significant (p=0.240); however, mixed breast milk and formula feeding was associated with increased FGID risk compared to exclusive breastfeeding (adjusted odds ratio: 2.16, 95% confidence interval: 1.17-3.98, p=0.014). FGIDs affect over half of Turkish infants and are associated with sleep disturbances and maternal depressive symptoms. Mixed breast-formula feeding independently increased FGID risk after age adjustment. Integrated care approaches addressing feeding practices, sleep quality, and maternal mental health are warranted.