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Benefits of Probiotics During Perinatal and Infant Period for Gastrointestinal Health

A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Pediatric Nutrition".

Deadline for manuscript submissions: 25 May 2025 | Viewed by 1278

Special Issue Editor


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Guest Editor
Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, 16126 Genoa, Italy
Interests: perinatal medicine; clinical nutrition; pediatrics; obstetrics and gynecology; neonatal microbiome sciences; neonatology

Special Issue Information

Dear Colleagues,

Probiotics, in particular, psychobiotics, are currently a great focus of interest but also a topic of division and scientific debate. These “pro-bios” live microorganisms are increasingly used in clinical practice, but sometimes with poor methodological knowledge. This is due to the few randomized clinical studies that use solid and standardized protocols based on the clinical picture of the patients.

The great world of probiotics and the modulation of nutrition are the two pillars in modulating what is called a “superorganism”, better known as microbiota. This large and dynamic organ is able to establish symbiotic relationships between colonies and with the host itself, determining its state of health.

In terms of prevention, the first thousand days of a newborn’s life are a window of opportunity for the modulation of its microbiota and consequently of its cognitive, social, and experiential development domains. But, to date, many questions are yet to be clarified, especially regarding the use of probiotics in premature babies. This Special Issue aims to draw attention and open the debate to questions that are still unresolved or unclear: If the first thousand days of life are essential, what can we do, even before, starting from the perinatal microbiome? Which probiotics are functional in the perinatal period and taken during breastfeeding? What impact do they have on the neurodevelopment of the unborn child and the newborn? Are probiotics effective in premature babies? Which ones? Will the effect of maternal nutrition and microbiota have an impact on the sense of taste in the newborn?

If, to date, we have focused a lot on the first 1000 days of life, I urge our colleagues to take a look a little further back, to the discovery of the placental microbiome and its regulation through maternal nutrition as it opens up new possibilities for research and development.

Dr. Valentina Biagioli
Guest Editor

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Keywords

  • psychobiotic
  • probiotics
  • preterm birth
  • perinatal nutrition
  • microbiota-gut-brain axis
  • human milk
  • fetal programming
  • neonatology

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Published Papers (3 papers)

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Research

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10 pages, 414 KiB  
Article
On the Knowledge and Prescription of Probiotics by Pediatric Providers: A Cross-Sectional Study
by Uzma Rani, Julie Ehrlich, Ghina Fakhri, Mohammed Doklaijah, Telisa Stewart, Winter Berry and Aamer Imdad
Nutrients 2025, 17(6), 963; https://doi.org/10.3390/nu17060963 - 10 Mar 2025
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Abstract
Objective: The therapeutic or prophylactic efficacy and safety of probiotics are not well established. The objective of this study was to assess the knowledge and practice of probiotic use in children among pediatric providers. Methods: This was a cross-sectional study of pediatric providers. [...] Read more.
Objective: The therapeutic or prophylactic efficacy and safety of probiotics are not well established. The objective of this study was to assess the knowledge and practice of probiotic use in children among pediatric providers. Methods: This was a cross-sectional study of pediatric providers. A survey was sent to the members of the American Academy of Pediatrics, New York Chapter 1. Results: We received 168 responses. Participants were mostly females (70%) and with MD or equivalent education (93%). About 50% of responders did not select the correct definition of probiotics and confused probiotics with prebiotics and synbiotics. About 97% of practitioners were asked about the merits of probiotics by families, and 60% of respondents had prescribed probiotics in their clinical practice. The most common indication for prescription was for treatment of antibiotic-associated diarrhea. When asked about their recommendation for a family who had already started probiotics, 66% of the providers recommended continuing the probiotics. There was a significant association between the frequency of probiotics prescription and the type of practice (p < 0.05). However, this association disappeared after adjusting for age, gender, education, and years of practice. The more experienced the practitioner, the lower the odds were of prescribing probiotics (p < 0.05). Conclusions: There was inadequate knowledge about probiotics among general pediatric providers. Of the pediatricians asked about probiotics, most recommended continuing them if a family was using probiotics for a specific condition. Studies with a larger nationally representative sample are required for future research. Full article
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Review

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12 pages, 600 KiB  
Review
Microbiome and Pregnancy Dysbiosis: A Narrative Review on Offspring Health
by Valentina Biagioli, Mariarosaria Matera, Luca Antonio Ramenghi, Raffaele Falsaperla and Pasquale Striano
Nutrients 2025, 17(6), 1033; https://doi.org/10.3390/nu17061033 - 15 Mar 2025
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Abstract
Background: Emerging evidence suggests that the maternal microbiome plays a crucial role in shaping fetal neurodevelopment, immune programming, and metabolic health. Dysbiosis during pregnancy—whether gastrointestinal, oral, or vaginal—can significantly influence pregnancy outcomes and long-term child health. Materials and Methods: The search was [...] Read more.
Background: Emerging evidence suggests that the maternal microbiome plays a crucial role in shaping fetal neurodevelopment, immune programming, and metabolic health. Dysbiosis during pregnancy—whether gastrointestinal, oral, or vaginal—can significantly influence pregnancy outcomes and long-term child health. Materials and Methods: The search was performed using databases such as PubMed, Scopus, and Google Scholar including research published from January 2000 to January 2025. The keywords used were “Fetal Programming”, “ Maternal Immune Activation”, “Maternal microbiome”, “Microbiota–Gut–Brain Axis”, and “Pregnancy Dysbiosis”. Results: The maternal microbiome undergoes substantial changes during pregnancy, with alterations in microbial diversity and function linked to conditions such as gestational diabetes, obesity, and preeclampsia. Pregnancy-related dysbiosis has been associated with adverse neurodevelopmental outcomes, including an increased risk of autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), and cognitive impairments in offspring. Conclusions: Understanding the intricate relationship between maternal microbiota and fetal health is essential for developing targeted interventions. Personalized microbiome-based strategies, including dietary modifications and probiotic supplementation, hold promise in optimizing pregnancy outcomes and promoting health in offspring. Full article
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Other

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39 pages, 10666 KiB  
Systematic Review
Probiotic Supplements Effect on Feeding Tolerance, Growth and Neonatal Morbidity in Extremely Preterm Infants: A Systematic Review and Meta-Analysis
by Sofia Söderquist Kruth, Emma Persad and Alexander Rakow
Nutrients 2025, 17(7), 1228; https://doi.org/10.3390/nu17071228 - 1 Apr 2025
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Abstract
Background/Objectives: Probiotic supplementation has been actively investigated in preterm populations to reduce the risk of necrotizing enterocolitis (NEC) and late-onset sepsis. Despite this, few studies have focused on clinically relevant feeding tolerance and growth outcomes, and there is an alarming lack of evidence [...] Read more.
Background/Objectives: Probiotic supplementation has been actively investigated in preterm populations to reduce the risk of necrotizing enterocolitis (NEC) and late-onset sepsis. Despite this, few studies have focused on clinically relevant feeding tolerance and growth outcomes, and there is an alarming lack of evidence surrounding extremely preterm infants (defined as birth before 28 weeks gestational age), those most at risk of severe comorbidities. We aimed to investigate whether probiotics improve feeding tolerance, neonatal growth and neonatal morbidity among extremely preterm infants. Methods: A literature search was conducted in Medline, Embase, Cochrane CENTRAL, Web of Science, and clinicaltrials.gov for ongoing trials. We included extremely preterm infants from randomized controlled trials and non-randomized trials with a concurrent control group. Two authors independently performed screening, data extraction and risk of bias assessment using the Risk of Bias 2 tool from Cochrane. The certainty of the evidence was assessed using GRADE. Results: Eleven RCTs and three non-randomized studies with a concurrent control group were included, analyzing a total of 14,888 extremely preterm infants. Meta-analyses revealed lower mean days to full enteral feeds (mean difference 1.1 days lower; 95% CI, 7.83 lower to 5.56 higher) and lower duration of parenteral nutrition (mean difference 2.4 days lower; 95% CI, 7.44 lower to 2.58 higher) in infants treated with probiotics; however, this was not statistically significant. There was a significant reduction in NEC (RR; 0.80, 95% CI; 0.68, 0.93) and all-cause mortality (RR; 0.56, 95% CI; 0.33, 0.93) in the probiotic group. All outcomes were graded at low or very low certainty of evidence. Conclusions: The findings indicate a trend towards a potential beneficial effect of probiotic supplementation in reducing feeding intolerance and a notable reduction of risk of NEC and all-cause mortality in infants receiving probiotics. Future RCTs will focus on feeding intolerance, and growth outcomes are warranted. Full article
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