During early life, the human microbiota contributes to the development of immune, metabolic, and neurological functions. Antibiotic exposure, inflammation, and dietary changes can alter microbial community structure and function, with potential implications for pediatric health. In April 2026, the symposium "Pediatric Microbiota: Evidence and Future" was held in Mexico City, bringing together experts to discuss current advances in pediatric microbiome research. This conference report summarizes the major topics and perspectives presented during the symposium. Several presentations examined how microorganisms and microbial metabolites are transferred from mother to infant. The speakers also discussed the contribution of colostrum immunoglobulins, particularly IgA, to early microbial colonization. Sessions reviewed evidence supporting probiotic use in pediatric gastrointestinal disorders and explored the microbiota-gut-brain axis in autism spectrum disorder and sleep regulation. In addition, speakers discussed the interactions among diet, starch digestion, microbial fermentation, and metabolic health, and their associations with obesity, insulin resistance, and cardiometabolic risk. Important knowledge gaps were identified in pediatric oncology, where evidence remains limited regarding the microbiome's influence on cancer susceptibility, immune responses, treatment outcomes, and therapy-related toxicities. Participants agreed that the field would benefit from longitudinal studies in well-characterized pediatric cohorts, particularly in Latin America, as well as from studies examining biological mechanisms through multi-omics approaches. This research could eventually inform precision nutrition and microbiome-based interventions, but the evidence discussed at the symposium was not considered sufficient to support their routine clinical use.
