Child Care Research Articles

Gender Norms, Attitudes and Perceptions towards Male Involvement in Maternal Health in Kafue District, Lusaka

Male involvement in maternal health remains a major issue despite efforts by the international community. Despite the many benefits of male involvement in antenatal care there has been an observed low participation. Community gender norms, attitudes and perceptions towards male involvement in maternal health may affect the utilization of services offered by health facilities. The gap observed in many studies is that the attitude and perception of men regarding maternal health have largely been neglected. Therefore, this study sought to investigate the gender norms, attitudes and perceptions towards male involvement in maternal health in Kafue district of Zambia. The study adopted a descriptive research design. Both quantitative and qualitative paradigms were utilized in this study. A sample of 150 participants was used. Data was collected by the help of questionnaire and in-depth interviews. Results showed that respondents from Kafue were knowledgeable on antenatal care. Additionally, it was also revealed that respondents had a positive attitude towards male involvement in maternal health. However, due to gender norms their roles were limited when it came to delivery and child care. Nevertheless, the findings showed that men were involved in supporting their wives and helping out with house chores and providing money for antenatal care, skilled birth at a hospital, postnatal care, childcare and any necessities required for delivery. Men who were married were more likely to be involved in maternal health than men who were not married. The study also revealed that men were not comfortable with discussing their wives’ pregnancy with a health care provider due to lack of privacy. Findings suggested that there were many factors affecting male involvement in maternal health. Lack of messages and programs targeting men, health stuff attitude during delivery, gender norms such as men not being allowed to attend to women when in labor and hospital infrastructure were identified by the respondents as a cause to low male involvement. In this study, it was also revealed that men and women had a positive perception towards pregnancy being a shared responsibility, men supporting and caring for their wives during and after delivery. However, both men and women had a negative perception towards men’s presence in the delivery ward.

Twenty-five years of the United Nations General Comment number 12 on the human right to adequate food – malnutrition continues to surge

The human right to adequate food is one of the most fundamental human rights crucial for the sustenance of the planet, and the prosperity of all people. It is firmly established in international human rights instruments and is clarified in the United Nations’ General Comment 12 (GC 12). However, deep vulnerabilities and deprivation of the right to adequate food in the form of hunger, food insecurity and malnutrition have persisted in many parts of the world. The climate-induced disasters also continues to devastate many communities, thereby depriving them of their rights including adequate food. This commentary provides a broader perspective on the 25 years of the GC 12 to stimulate further debate and actions to entrench human rights, especially the right to adequate food, at the centre of the food systems transformation and overall sustainable development agenda. This year 2024, marks 25 years of the Global Compact 12 on the human right to adequate food. While it is an important opportunity to celebrate this great achievement of engraining this right into the wider sphere of global reference at the United Nations level, the domestication in countries into actions that concretely address the problem of hunger and malnutrition has been slow in many countries. The world is now faced with the grim realities of starving populations arising from unnecessary and unjust wars, and food continues to be used as a weapon of war against international law and human imagination. Worse still, in the current environment of climate change and its adverse effects on food systems, SDG2 (Zero hunger by 2030), seems unrealistic. Finally, it is no longer a question of providing carbohydrates, as the need to address quality, safety, nutrition and cultural acceptability is ever so pressing. Going forward, there is a need to accelerate advocacy efforts, research and policy formulation that fully operationalise GC 12 in country-level food systems and nutrition interventions. Realization of the right to adequate food benchmarks in GC 12 should certainly be the penultimate of such interventions as strategic food reserves, poverty and hunger reduction programmes, humanitarian disaster preparedness, contingency funding, social protection and child care among others.

Receipt of social services intervention in childhood, educational attainment and emergency hospital admissions: longitudinal analyses of national administrative health, social care, and education data in Wales, UK

BackgroundResearch consistently finds poorer health and educational outcomes for children who have experienced out-of-home care relative to the general population. Few studies have explored differences between those in care and those in receipt of intervention from social services but not in care. Children receiving social services interventions often experience Adverse Childhood Experiences (ACEs), and deprivation, which are known to negatively impact outcomes. We aimed to estimate the association of different social services interventions with educational outcomes and hospital admissions, while adjusting for ACEs and deprivation.MethodsWe linked retrospective, routinely collected administrative records from health, education, and social care to create a cohort via the Secure Anonymised Information Linkage (SAIL) databank in Wales, UK. We analysed data for children and household members (N = 30,439) across four different groups: [1] no social care intervention; [2] children in need but not in care (CIN); [3] children on the Child Protection Register but not in care (CPR); [4] children in care - i.e. removed from the family home and looked after by the local authority (CLA). Our primary outcome was education outcomes at age 16 years. Secondary outcomes were all cause emergency hospital admissions, and emergency admissions for external causes/injuries.ResultsChildren in receipt of social services intervention were more likely to not attain the expected level upon leaving statutory education at age 16 after adjusting for ACEs and other characteristics (for children who had been in out-of-home care (conditional OR: 1·76, (95%CI) 1·25 − 2·48), in need (2·51, 2·00–3·15) and those at risk (i.e., on the child protection register) (4·04, 2·44 − 6·68). For all-cause emergency admissions, all social care groups were at greater risk compared to children in the general population (children in care (conditional HR: 1·31, 1·01–1·68), children in need (1·62, 1·38 − 1·90), and children at risk (1·51, 1·11 − 2·04).ConclusionsAll groups receiving social service intervention experience poorer educational and health outcomes than peers in the general population. Children who remain with their home parents or caregivers but are identified as ‘in need’ or ‘at risk’ by social care practitioners require further research. Integrated support is needed from multiple sectors, including health, educational and social care.

Clinical Outcomes of Pediatric Cancer Patients with COVID-19: A Cross-Sectional Study

Background: Considering the widespread COVID-19 pandemic and its impact, especially on children, particularly those with cancer, in terms of transmission risk, mortality, and the occurrence of the disease based on various studies in different countries, we decided to conduct this study to improve the care of children with cancer regarding COVID-19. Materials and Methods: A descriptive cross-sectional study with a confirmed diagnosis of COVID-19 consisted of obtaining 20 mL of blood samples from the participants in a random manner. Diagnostic examinations, including CT scans, chest X-rays, and a range of hematologic and blood tests, such as complete blood count, ESR, CRP, and D-Dimer, were performed on all patients. Results: This study contains 26 males and 12 females. The mean age of the patients was 3.81 ± 6.35 years. The majority of cancer patients with COVID-19 were diagnosed with Acute Lymphoblastic Leukemia (ALL) (47.7%). The most common symptoms of COVID-19 in the patients were fever (73.7%), cough (39.5%), and nausea/vomiting (21.1%). 40.4% of the patients had pathological findings suggestive of COVID-19 on their chest CT scans. 60.52% of the patients had an elevated Erythrocyte Sedimentation Rate (ESR), and 73.68% had an elevated C-reactive protein (CRP) level. Conclusion: Despite the outcomes of COVID-19 in most children with cancer in this study, children with cancer still experience risks from COVID-19, and it is unclear how delays and interruptions in cancer treatment and direct damage from the virus may impact long-term outcomes in these patients.

Core psychosocial insights, challenges, and opportunities in the orthopedic surgery care of children and adolescents

Purpose: This is the second phase in an investigation of the psychosocial impact of orthopedic surgery on adolescents. What are the core psychosocial factors that shape the experience of adolescent patients aged 11–18 who are undergoing orthopedic surgery? Methods: Two 43-question surveys (preoperative and postoperative) were developed as modified versions of the survey used in phase 1. The preoperative survey was administered 2 weeks before surgery. The postoperative survey was administered 6 weeks later. Responses were collected from free-response and Likert-scale questions exploring patient–physician relationships, office visits/hospital stays, family, peers, academics, sports, and surgical expectations. The survey was administered prospectively to patients aged 11–18 undergoing limb lengthening/reconstruction, pediatric, spine, sports, or hand/upper extremity orthopedic surgery. In all, 135 patients were identified; 105 were enrolled and completed both surveys. Results: There were some statistically significant changes in responses to questions regarding office visits/hospital stays, patient–physician relationships, friends/community, academic performance, and expectations for surgical experience throughout the perioperative period. There were no statistically significant changes in responses to questions regarding the role of parent/family and sports. There was no statistically significant difference between the female and male genders or between age groups in any of the domains. Overall statistical significance in this study did not consistently correlate to clinical significance. Conclusion: Adolescents require psychosocial support from their surgeons, caregivers, and peers in addition to respect for their independence and personal needs. Level of evidence: Level II.

Community Health Workers Linking Clinics and Schools and Asthma Control

Childhood asthma is characterized by pervasive disparities, including 3-fold higher hospitalization rates and 7-fold higher death rates for Black children compared with White children. To address asthma disparities, one must intervene in all lived environments. To determine if a community health worker (CHW) intervention to connect the primary care, home, and school for low-income minoritized school-aged children with asthma and their caregivers improves asthma control. This study was a hybrid effectiveness/implementation trial using a 2 × 2 factorial, cluster randomized clinical trial design of 36 schools crossed with participant-level randomization into a clinic-based CHW intervention. The study was conducted from May 2018 to June 2022. The intervention took place in primary care offices, homes, and 36 West Philadelphia, Pennsylvania, public and charter schools. Children aged 5 to 13 years with uncontrolled asthma were recruited from local primary care practices. Asthma management, trigger remediation, and care coordination occurred in school, home, and primary care settings. Children were followed up for 12 months. The Yes We Can Children's Asthma Program, Open Airways For Schools Plus, and school-based asthma therapy were implemented. Improvement in asthma control, as measured by the Asthma Control Questionnaire, comparing the mean difference between groups 1 year after randomization with their baseline (difference in differences). Both primary care and school interventions were dramatically disrupted by the COVID-19 pandemic; therefore, stratified analyses were performed to assess per-protocol intervention efficacy before the pandemic disruptions. A total of 1875 participants were approached, 1248 were excluded, and 1 was withdrawn. The 626 analyzed study participants (mean [SD] age, 8.7 [2.4] years; 363 male [58%]) self-identified as Black race (96%) and non-Hispanic ethnicity (98%). Although all groups had statistically significant improvements in asthma control from baseline to 12 months (P- group: -0.46; 95% CI, -0.58 to -0.33; P+ group: -0.57; 95% CI, -0.74 to -0.44; S- group: -0.47; 95% CI, -0.58 to -0.35; S+ group: -0.59; 95% CI, -0.74 to -0.44), none of the difference-in-differences estimates from the primary prespecified models showed a clinically meaningful improvement in asthma control. Analysis from the prepandemic interval, however, demonstrated that children in the combined clinic-school intervention had a statistically significant improvement in asthma control scores compared with control (-0.79; 95% CI, -1.40 to -0.18). This randomized clinical trial provides preliminary evidence that connecting all lived environments for care of children can be accomplished through linkages with CHWs.

Role of children's hospices in caring for children, young people and families.

Children's hospices are central to specialist palliative care provision for the increasing number of children and young people with life-limiting conditions and their families. These hospices provide holistic care through a range of services, including ongoing care from the point of diagnosis, at the end of life and into bereavement. This article outlines the services provided by children's hospices, while dispelling misconceptions that they exclusively provide care at the end of life. It also explains how these services have developed and evolved as a result of technological advances. It is useful for nurses to be aware of the role of children's hospices, so that they can support the effective care of children and young people with life-limiting conditions and their families.

Prediction values of fat-soluble vitamin of growth retardation in children aged 1–6 years

BackgroundRetardation among children is a persistent global health concern. Vitamin deficiency in childhood may contribute to growth retardation; however, its causal effects are not fully understood.ObjectiveHere, we aimed to explore the prediction values of fat-soluble vitamin levels on GR in children aged 1–6 years.Methods614 children aged from 1 to 6 years at Nantong Maternal and Child Care Health Hospital between January 2021 and December 2022 in this retrospective observational study participated in the assessment of developmental status and blood detection of vitamin from peripheral blood (PB). The relationship between vitamin levels and GR was analyzed by Multivariable logistic regression analysis.ResultsDevelopmental assessment results showed that 132 cases from 614 with growth retardation (21.50%). Statistical analysis showed children with GR were more likely to be males (59.45% vs. 40.55%, p = 0.191). The age of children with GR was significantly higher than those without GR (p < 0.01). Importantly, the levels of various fat-soluble vitamins in GR individuals were significantly lower than those in normal individuals. ROC analysis showed that vitamin E, vitamin A and 25(OH) D3 were less effective in predicting GR model (AUC: 0.87, 0.74, and 0.65,). However, the combination of vitamin E, vitamin A and 25(OH)D3 with age was effective in predicting GR. (AUC: 0.84, 0.77, 0.75).ConclusionThe combination of 25(OH)D3, Vitamin E, Vitamin A with age may have good predictive performance for children GR aged 1–6 years.

Collaborative Online International Learning With Prelicensure Nursing Students: Teaching Family-Centered Care Through a Global Perspective.

A Collaborative Online International Learning (COIL) experience was designed for prelicensure nursing students taking a pediatric course in the United States and in Brazil, to teach family-centered care to develop inclusive, global nursing practices. The purpose of this study is to describe prelicensure nursing student learning of family-centered care concepts facilitated by COIL. For data collection, six focus groups with 37 students were conducted across both universities. Data were analyzed using inductive qualitative analysis by each country separately and as a global team. Major themes included understanding the needs of families of children with chronic conditions as impacted by health systems, assigning meanings to family care of children with chronic conditions, applying concepts of family-centered care and self-reflection. Results suggest COIL is a feasible way for prelicensure nursing students to learn family-centered nursing care by operationalizing concepts, from real experiences and increasing cultural awareness.

Homoeopathy vs. conventional primary care in children during the first 24months of life-a pragmatic randomised controlled trial.

Homoeopathy, using conventional medicine as a safety backdrop, was more effective than conventional treatment in preventing sick days, sickness episodes, and respiratory illnesses in the first 24months of life. It necessitated fewer antibiotics and its overall cost was lower. This study supports homoeopathy, using conventional medicine as a safety backdrop, as a safe and cost-effective primary care modality during the first 2years of life. Clinical Trial Registry-India (2018/09/015641). https://ctri.nic.in/Clinicaltrials/login.php What is Known: • Due to their holistic nature, many Complementary and Alternative Medical (CAM) modalities are not readily amenable to assessment by head-to-head RCT for a given Indication. • We propose a pragmatic, RCT comparing homoeopathic with conventional medicineas a system. • Homoeopathic was apparently superior to conventional primary care in preventing sick days, sickness episodes, and respiratory illness episodes and was significantly associated with growth in height but not weight and required fewer antibiotics in children from birth to 24 months of age.

Exploratory Study on Various Types of Leisure Activities of Indian Mothers of Children with Autism Spectrum Disorder- A Qualitative Analysis

The purpose of this study was to identify the important components of leisure and to comprehensively assess various leisure time activities, that entail the overall well-being of mothers of children with autism spectrum disorder (ASD) with indispensable demanding care of children with autism. A cross-sectional design with interpretivism and an inductive approach on a sample of 61 mothers of children with ASD, in India was used to explore various leisure time activities. Mothers engaging in the leisure of individual choice for self-replenishment, social connectedness, and happiness in life despite the demanding care of the child with autism were identified. The face, content, and construct validity are maintained in its preliminary stage. This study aimed to explore various leisure activities in the lives of mothers of children with ASD. The 7 categories of Leisure activities (LA) are Entertainment activities, Outings, Social events, Sports and physical exercises, Homemaking and other fruitful involvements, Arts, and intellectuals, Resting and relaxation, as diversionary activities to energize, divert, and relax as fun and free-time identified in the context of Indian mothers.

A balancing act: successfully managing senior leadership roles and motherhood

ABSTRACT This paper presents the findings of a self-study exploring the experiences of women leaders, and the intersections of leadership work with roles as mothers. Drawing on narratives of women from across experiences of leading to support women in the workplace, to women who juggle leadership work and mothering, and women whose mothering involves caring for children with Special Educational Needs and Disabilities, we address the dearth in scholarship addressing these positionings and implications for women in leadership. Using self-study as a qualitative approach to bring together three current school leaders and an ex – principal, this study uses autobiographical experiences and shared reflections on blogs and materials accessed through our professional networks to contribute robust and rich analysis of personal narratives on the challenges and opportunities afforded to women in the state school context in England. We apply a conceptual framework of micro-meso barriers to consider the relationship between self and organisation level interactions. Findings contribute strategies from the personal to the organisational, with implications for the ways in which coaching, flexible working and an equitable approach to decision making can be utilised by schools to support and engage women without a sense of compromised leadership practice or motherhood priorities.

Time Unmasked: Illuminating the Hidden Dimensions of Economic Stratification during COVID-19 in the United States

This paper delves into the nuanced impact of the COVID-19 pandemic on time use activities in the United States, particularly examining gender and parental status differences. Drawing on data from the 2018–2022 American Time Use Survey, the study analyzes trends in six distinct time use categories: unpaid care work, leisure, employed activities, personal care, childcare, and household activities. The research sheds light on the evolving dynamics within households during the pandemic, emphasizing the potential implications for economic stratification and societal well-being. The COVID-19 pandemic completely disrupted established time use patterns, forcing a reconsideration of ‘traditional’ gender roles and caregiving responsibilities in certain countries. While early studies hinted at a temporary shift toward more equitable distribution of household activities, particularly childcare, this paper scrutinizes these trends over a more extended period. Despite the short-lived increases in fathers’ involvement in childcare during the pandemic, the study finds that the caregiving burden remained disproportionately on mothers and women. Notably, the analysis reveals persistent gender disparities in unpaid care work, with women and mothers spending a disproportionate amount of time on household activities, housework, and caring for children. This unequal distribution of caregiving responsibilities limits a women’s ability to engage in paid work activities, contributing to economic stratification and constraining their financial resources. While some activities demonstrated slight reductions in gender gaps, the overall picture suggests that the pandemic may not bring about lasting changes in how time is allocated within households.

Integrated care for children and young people with special health and care needs: a systematic review

ContextThere is a dearth of high-quality evidence on integrated, coordinated and cost-effective care for children with special health and care needs (CSHCN).ObjectiveTo assess the effectiveness of integrated/coordinated care models for...

DESAFIOS E RESILIÊNCIA: UMA ANÁLISE DAS DIFICULDADES ENFRENTADAS POR MÃES DE FILHOS NO ESPECTRO AUTISTA

The diagnosis of Autism Spectrum Disorder presents some challenges and singularities, the limitations in its development entail a series of demands and significant changes in the family's routine and child care. The objective of this article is to understand the difficulties and experiences faced by mothers with children diagnosed with Autism Spectrum Disorder (ASD). The expected results will be significant in highlighting the challenges faced by mothers of children with Autism Spectrum Disorder (ASD), including the emotional impact of the diagnosis, the need to access specialized resources, the burden of care and difficulties in social interaction. Based on the studies analyzed, we hoped to understand this complex and significant issue faced by mothers of children with ASD in the care process. Research will play a relevant role in the development of policies and support programs that can protect the feminine essence and promote quality of life for families in society.

Survey of GP registrars' training experience and confidence in managing children and adolescents with mental health conditions in primary care.

The aim of thisstudy is to assess General Practitioner (GP) trainees' training experience, and confidence in assessing and managing children and adolescents with common mental health conditions in primary care in Ireland. An online anonymous questionnaire was distributed to third and fourth year GP registrars enrolled in the Irish College of General Practitioners training schemes. The online questionnaire evaluated participants' training experiences and confidence levels in key areas of child and adolescent mental health in primary care. Sixty participants completed the survey out of 406, yielding a response rate of 14.8%. The majority (88%) reported no formal training or experience working in Child and Adolescent Mental Healthcare Services (CAMHS) during their GP training scheme. Responses indicated that many participants rated their competency, skills, and knowledge in essential areas of Child and Adolescent Mental Health as needing improvement. Similarly, their awareness of referral pathways and specialty services was below expectations, with poor perceived access to services. A large proportion (91.7%) expressed a definite need for further training in child and adolescent mental health disorders. The results highlight the need for enhanced training and support for GP trainees in the field of Child and Adolescent Mental Health, ensuring their ability to effectively and confidently address these common issues in primary care.

Investigating a novel population health management system to increase access to healthcare for children: a nested cross-sectional study within a cluster randomised controlled trial

BackgroundEarly intervention for unmet needs is essential to improve health. Clear inequalities in healthcare use and outcomes exist. The Children and Young People’s Health Partnership (CYPHP) model of care uses...

Acute Adrenal Insufficiency in Childhood: Etiopathogenesis, Clinical Picture, and Intensive Care

Introduction. Acute adrenal insufficiency (AAI) is a severe endocrinopathy whose victims include children and adolescents and which can be life-threatening despite its low incidence. Analysis of issues associated with intensive care of children with this pathology is of vital interest for pediatric anesthesiology and critical care medicine. The aim of this work was to assess current views on the etiopathogenesis, clinical pathology and intensive treatment of pediatric AAI.Materials and methods. The topic was researched by analyzing publications found in the Cochrane Library, PubMed and Medscape using the following search terms: “acute adrenal insufficiency, children and adolescents, intensive therapy, fluid management”, with 65 published sources chosen.Results and discussion. In AAI, caused by a sharp deficiency of cortisol (and mineralocorticoids), which triggers an inflammatory reaction, electrolyte imbalance and hemodynamic disorders. AAI presents with dehydration, nausea and vomiting, feelings of pain, hypotension, tachycardia, seizures and impaired consciousness up to coma. Laboratory tests in children often reveal hyperkalemia, hyponatremia, hypoglycemia and hypercalcemia. Intensive management of AAI in the ICU relies on parenteral corticosteroids (preferably intravenous hydrocortisone). Two or three days later, when the child is stable, they are switched to oral hormones. Meanwhile, fluid management is performed over 2 to 3 days to increase the circulating blood volume and relieve dehydration with crystalloid fluids.Conclusion. A clearer understanding of the etiopathogenesis, clinical manifestations and diagnostic features of AAI, along with knowledge of emergency care algorithms, will improve the quality of intensive therapy of pediatric patients with this condition.

Highlights From the 2023 Revision of Pediatric Tactical Emergency Casualty Care Guidelines.

In 2023 the Committee for Tactical Emergency Casualty Care (C-TECC) issued updated Pediatric Tactical Emergency Casualty Care (TECC) Guidelines (Guidelines) that focus on the delivery of stabilizing care of children who are the victims of high-threat incidents such as an active shooter event. The Guidelines provide evidence-based and best practice recommendations to those individuals and departments that specifically provide operational medical support to law enforcement agencies caring for children in this uniquely dangerous environment where traditional resources may not be available. This article highlights key takeaway points from the Guidelines, including several updates since the first version was released in 2013.The evidence base for the care of children in this environment is lacking, and medical care delivered in the high-threat environment is inconsistent and often not optimized for the care of infants and children. The Guidelines are supported from the existing literature base where possible, and where it is not, by consensus as to the current best practices as determined by iterative deliberations among the diverse and experienced group of stakeholders who are members of C-TECC. The Guidelines provide patient assessment and management information specific to the care of children in the following 3 dynamic phases of the high-threat environment: Direct Threat, Indirect Threat, and Evacuation. The phases represent a continuum of risk to the patient and the responder ranging from extreme (such as ongoing gunfire) to minimal (during movement toward definitive medical care).The high-threat environment is dynamic and there is competing safety, tactical/operational, and patient care priorities for responders when infants and children are injured. The Guidelines provide recommendations on the type of medical and psychological care that should be considered under each phase of threat and establishes the context for how and why to deliver (or potentially defer) certain interventions under some circumstances in order the maximize the opportunity for a good outcome for an injured pediatric patient. The Guidelines also emphasize the importance of synergizing hospital-based pediatric trauma care with those law enforcement and fire/emergency medical services that may provide field care to children under high-threat circumstances.

Gastrointestinal, Behaviour and Anxiety Outcomes in Autistic Children Following an Open Label, Randomised Pilot Study of Synbiotics vs Synbiotics and Gut-Directed Hypnotherapy.

Alterations of the microbiome-gut-brain (MGB) axis have been associated with autism spectrum disorder (ASD) and disorders of gut-brain interaction (DGBI). DGBI are highly prevalent in autistic children and are associated with worsening behaviour and anxiety. Treatments such as probiotics, prebiotics and gut-directed hypnotherapy (GDH) have shown efficacy in improving gut symptoms in children. The primary objective of the study was to compare changes in gastrointestinal (GI) scores following a 12-week intervention of synbiotics (prebiotic + probiotic) +/- GDH with a follow-up at 24 weeks. Secondary objectives included changes in behavioural and anxiety symptoms, while changes in gut microbiome composition were assessed as an exploratory objective. Children diagnosed with ASD aged 5.00-10.99 years (n = 40) were recruited and randomised (1:1) to a 12-week intervention of either synbiotics (SYN group) or synbiotics + GDH (COM group). Both the SYN and COM group experienced significant reductions in total GI scores post-intervention and at follow-up (p < 0.001), with no superiority of the COM treatment over the SYN treatment. The COM group showed beneficial reductions in anxiety scores (p = 0.002) and irritability behaviours (p < 0.001) which were not present in the SYN group. At follow-up, only those in the COM group maintained significant reductions in GI pain scores (p < 0.001). There were significant changes in gut microbiota such as increases in Bifidobacterium animalis and Dialister in both groups over time. In conclusion,synbiotics with or without GDH may help support standard care for autistic children who suffer comorbid DGBI. The trial was prospectively registered at clinicialtrials.gov on 16 November 2020 (NCTO4639141).