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Nutrition Strategy for Maternal and Infant Wellbeing

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

Deadline for manuscript submissions: 5 December 2025 | Viewed by 6150

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Special Issue Editors

Dr. Stefania Triunfo

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Guest Editor

Department of Obstetrics and Gynecology, ASST Santi Paolo e Carlo-San Paolo University Hospital, 20142 Milan, Italy
Interests: fetal–maternal medicine; fetal programming; prediction and management of great obstetric syndromes; placental disease; prenatal diagnosis
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Dr. Giuseppe Banderali

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Guest Editor

Clinical Department of Pediatrics, San Paolo Hospital, ASST Santi Paolo e Carlo-San Paolo University Hospital, 20142 Milan, Italy
Interests: pediatric; dietary interventions; familial hypercholesterolemia; dyslipidemia; nutraceuticals
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

During pregnancy, eating a balanced variety and appropriate quantity of nutritious foods improves both obstetric outcomes and infant health, according to the well-established fetal programming hypothesis.

Nowadays, heterogeneity in dietary intakes, patterns, and behaviors related to socio-economic issues, cultural reasons, or changes in modern food offering represents a new challenge for specialists in fetal–maternal medicine and pediatrics. Additionally, the exposure to various environmental pollutants during pregnancy and in the early-life stages can affect both maternal health and reproductive health in children.

This upcoming Special Issue aims to present a series of articles covering dietary intake/patterns/behaviors and their relationship to undernutrition, overweight and obesity, hypertension, diabetes, metabolic syndrome, and suboptimal neurodevelopment. The main findings from these papers will provide solid evidence to underscore future policy making for nutritional improvements among populations at a childbearing age.

Dr. Stefania Triunfo
Dr. Giuseppe Banderali
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Nutrients is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

diet
nutrition
prevention
pregnancy
children
fetal programming
adverse outcomes
diabetes
hypertension
overweight
obesity
suboptimal neurodevelopment
metabolic diseases

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Published Papers (8 papers)

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Research

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20 pages, 2038 KiB

Open AccessArticle

Breastfeeding Experiences in Australian Mothers of Multiple Birth Infants

by Muja A. Gama, Jacki L. McEachran, Ashleigh H. Warden, Demelza J. Ireland, Donna T. Geddes, Sharon L. Perrella and Zoya Gridneva

Nutrients 2025, 17(10), 1669; https://doi.org/10.3390/nu17101669 - 14 May 2025

Viewed by 341

Abstract

Background/Objectives: Breastfeeding multiple birth infants (MBIs) poses unique challenges that require tailored support; however, research on these mothers’ experiences is limited. This study explored the breastfeeding journeys of Australian mothers of MBIs, highlighting barriers, facilitators, and support needs. Methods: Data were collected via an online survey (May–August 2024) and included quantitative data on breastfeeding initiation, duration, and challenges, as well as qualitative insights into mothers’ experiences. Thematic analysis was used to identify key themes, and statistical analyses were used to compare breastfeeding outcomes by parity. Results: While most mothers (87%) had an antenatal intention to breastfeed, they faced barriers such as latching difficulties (56%), inadequate milk supply (49%), and sore nipples (47%). Preterm births (58%) and neonatal unit admissions delayed the breastfeeding initiation. Most mothers (99%) used electric breast pumps to boost milk supply (68%) and enable expressed breast milk feeding by other caregivers (65% of mothers). While 72% were satisfied with hospital breastfeeding support and some mothers received excellent hands-on support, others felt neglected due to busy staff or conflicting advice. Mothers frequently reported that breastfeeding guidance was geared toward singletons, leaving them unprepared for the challenges of feeding multiples. Mothers’ suggestions for improving care included specialised guidance, better access to lactation support, and in-home practical support to alleviate the burden of feeding and expressing. Additionally, mothers reported that healthcare professionals should be trained to offer practical, non-judgemental support to help mothers navigate the elaborate challenges of breastfeeding MBIs. Conclusions: This study underscores the need for early postpartum support and tailored guidelines to enhance MBI breastfeeding outcomes and maternal-infant well-being. Full article

(This article belongs to the Special Issue Nutrition Strategy for Maternal and Infant Wellbeing)

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13 pages, 506 KiB

Open AccessArticle

Ramadan During Pregnancy and Offspring Age at Menarche in Indonesia: A Quasi-Experimental Study

by Van My Tran, Reyn van Ewijk and Fabienne Pradella

Nutrients 2025, 17(9), 1406; https://doi.org/10.3390/nu17091406 - 22 Apr 2025

Viewed by 312

Abstract

Background/Objectives: Animal models have suggested a link between maternal nutrition and offspring pubertal onset. Due to ethical and practical concerns, human studies on this topic remained scarce and focused on extreme nutritional shocks in high-income settings, such as Dutch famine. This paper expands on these findings by investigating the effects of a milder form of nutritional alteration during pregnancy—Ramadan fasting—in a middle-income context, Indonesia. We use offspring age at menarche (AAM) as an indicator of pubertal timing and female reproductive health. Our research has broader implications beyond the Muslim community, as intermittent fasting during pregnancy is also widely practiced by non-Muslims, e.g., meal-skipping. Methods: We used data from the Indonesian Family Life Survey (1993–2014, n = 8081) and Indonesian Demographic and Health Surveys (2002–2007, n = 13,241). OLS and Cox regressions were applied to compare the AAM of female Muslims who were prenatally exposed to Ramadan and those of female Muslims who were not. Exposure was determined based on the overlap between pregnancy and a Ramadan. We further subdivided this overlap into trimester-specific categories, adjusting for urban–rural residence, birth month, birth year, birth year squared, and survey wave. Results: No associations between Ramadan during pregnancy and AAM were found, irrespective of the pregnancy trimester overlapping with Ramadan. These results were stable when we restricted the sample to women with shorter recall periods and younger women at the time of survey. Conclusions: While subtle restrictions in maternal nutrition during pregnancy are critical for offspring health, the impact on menarcheal onset might be limited. Full article

(This article belongs to the Special Issue Nutrition Strategy for Maternal and Infant Wellbeing)

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15 pages, 1413 KiB

Open AccessArticle

The Relationship Between Fiber Intake and Gut Bacterial Diversity and Composition During the Third Trimester of Pregnancy

by Lindsay T. Schwartz, Jillian G. Ladouceur, Madeleine M. Russell, Shiyi Y. L. Xie, Sihan Bu, Jean M. Kerver and Sarah S. Comstock

Nutrients 2025, 17(5), 773; https://doi.org/10.3390/nu17050773 - 22 Feb 2025

Viewed by 1059

Abstract

Background/Objectives: High fiber (34–36 g/day) diets are recommended during pregnancy due to inverse associations with constipation and adverse pregnancy health outcomes, including pre-eclampsia and gestational diabetes. However, the mechanism for this protective effect is poorly defined. Fiber may be protective due to its impact on the composition and function of specific bacteria within the pregnancy gut microbiome. The purpose of this analysis was to investigate whether a sub-sample of cohort study participants in their third trimester met daily dietary fiber and vegetable intake recommendations and, in turn, how this impacted bacterial composition and butyrate-producing genes within the gut microbiome. Methods: Pregnant participants (n = 52) provided stool samples and survey data, which were used to calculate fiber and vegetable intake. Genomic DNA was extracted from the stool samples, followed by PCR to amplify the V4 region of the 16S rRNA gene. Amplicons were sequenced and mapped to the RDP reference. Quantitative real-time PCR was used to measure the abundance of bacterial genes for butyrate production. Results: Of the pregnant participants in this sample, 84.7% and 92.3% failed to meet recommendations in the Dietary Guidelines for Americans for dietary fiber and vegetable intake, respectively. All four participants who met the vegetable recommendation were a subset of those who met the fiber recommendation. The participants who met the pregnancy fiber recommendation had gut microbiotas with greater alpha diversity (Shannon and Inverse Simpson) than those who did not. However, there was no association between dietary fiber intake and the abundance of bacterial genes for butyrate production. Conclusions: This research suggests that general fiber intake during pregnancy has a modest association with the gut bacterial community. These preliminary results demonstrate a need to improve fiber intake during pregnancy. Further, studies that measure the relationship between dietary intake of specific types of fiber and associations with specific gut bacterial community members and their functions are needed. Full article

(This article belongs to the Special Issue Nutrition Strategy for Maternal and Infant Wellbeing)

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11 pages, 506 KiB

Open AccessArticle

Effect of Supplementation with a Specific Probiotic (Bifidobacterium bifidum PRL2010) in Pregnancy for the Prevention of Atopic Dermatitis in Children: Preliminary Results of a Randomized Trial

by Caterina Anania, Viviana Matys, Simona Marra, Daniela De Canditiis, Francesca Olivero, Carlo Carraro, Anna Giugliano, Anna Maria Zicari and Maria Grazia Piccioni

Nutrients 2025, 17(4), 673; https://doi.org/10.3390/nu17040673 - 13 Feb 2025

Cited by 1 | Viewed by 1041

Abstract

Background: Atopic dermatitis (AD) is a chronic inflammatory skin disease characterized by the appearance of recurrent eczematous lesions and intense itching. The World Allergy Organization (WAO) suggested the administration of probiotics in pregnant women at high risk of allergies in their children. Objectives: Our study aims to evaluate the role of administering the Bifidobacterium bifidum strain PRL2010 during pregnancy and breastfeeding in preventing and/or reducing the severity of AD manifestations in children. Methods: It is a monocentric, randomized, double-blind, placebo-controlled trial with probiotic/placebo administration since the 36th week of gestation to mothers with atopy or a family history of atopy; the effects were evaluated over the first 12 months of the children’s lives. Results: No severe adverse effects due to probiotic intake were reported in our cohort. Although proportionally fewer children with AD were in the probiotic group, the statistical analysis showed no significant differences between the probiotic and placebo groups. However, infants who developed the most severe forms of AD in the probiotic group showed a better clinical course during follow-up compared to those in the placebo group. Conclusions: In conclusion, administering the probiotic Bifidobacterium bifidum strain PRL2010 during pregnancy and breastfeeding is safe and potentially beneficial; further large-scale studies may confirm its usefulness in improving the clinical manifestation of AD in children with a family history of atopy. Full article

(This article belongs to the Special Issue Nutrition Strategy for Maternal and Infant Wellbeing)

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14 pages, 877 KiB

Open AccessArticle

Impact of Vitamin D Deficiency on Gestational Diabetes and Pregnancy Outcomes Across Diverse Ethnic Groups: A Retrospective Cohort Study

by Sushant Saluja, Navin Sugathan, Roopa Krishnamurthy and Edward B. Jude

Nutrients 2025, 17(3), 565; https://doi.org/10.3390/nu17030565 - 2 Feb 2025

Viewed by 1230

Abstract

Background: Vitamin D deficiency is linked to adverse pregnancy outcomes like gestational diabetes mellitus (GDM), but its effects across ethnic groups are unclear. This study examines the relationship among vitamin D levels, glucose tolerance, GDM prevalence, and neonatal outcomes in a multi-ethnic cohort of pregnant women. Methods: We conducted a retrospective analysis of 252 pregnant women from antenatal clinics between 2018 and 2022. Participants were divided into four groups based on serum vitamin D levels: severely deficient (<25 nmol/L), deficient (25–50 nmol/L), insufficient (51–75 nmol/L), and sufficient (>75 nmol/L). The analysis included multivariate linear regression models adjusted for age, ethnicity, BMI, gestational diabetes status, and seasonality. An area under the receiver operating characteristic (AUROC) analysis identified the vitamin D threshold linked to an increased GDM risk. Results: Women classified as severely deficient had higher fasting glucose levels (5.73 ± 1.24 mmol/L) than those in other groups (p = 0.003, adjusted). The AUROC analysis identified a vitamin D threshold of 45 nmol/L associated with an elevated GDM risk (AUROC = 0.78, CI: 0.70–0.85). South Asian women had lower vitamin D levels (41.17 ± 18.03 nmol/L vs. 45.15 ± 16.75 nmol/L) and higher glucose tolerance test (GTT) levels than Caucasian women, despite having lower BMIs. Moreover, vitamin D levels positively correlated with neonatal birth weight (p = 0.02). Conclusions: There is a strong link between vitamin D deficiency and increased GDM risk, especially among South Asian women. These findings underscore the need for targeted interventions to improve vitamin D levels in high-risk ethnic groups. Full article

(This article belongs to the Special Issue Nutrition Strategy for Maternal and Infant Wellbeing)

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13 pages, 240 KiB

Open AccessArticle

Prenatal Breastfeeding Intention Is Consistently Associated with Breastfeeding Duration Among WIC-Participating Women

by Christopher E. Anderson, Fu-Chi Yang and Shannon E. Whaley

Nutrients 2024, 16(24), 4289; https://doi.org/10.3390/nu16244289 - 12 Dec 2024

Viewed by 818

Abstract

Background/Objective: The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) provides breastfeeding support to participating women in low-income households. This study aimed to determine the relationships between prenatal maternal and household characteristics and breastfeeding duration, as well as whether these characteristics modify associations of prenatal breastfeeding intention with breastfeeding duration. Methods: This is a prospective cohort study of pregnant respondents to Los Angeles County (LAC), California, WIC surveys conducted between 2005 and 2020 (n = 1014). Associations of prenatal breastfeeding intention with duration (months) of any or fully breastfeeding, determined by WIC infant food package issuance, were assessed with linear regression models. Results: Most women reported the intention to breastfeed (67.7%) and perceived breastfeeding support during pregnancy from WIC and family/friends was associated with breastfeeding intention (both p-values < 0.0001). Stronger breastfeeding intention, lower maternal BMI, greater maternal age, greater maternal education, paternal cohabitation and employment, and greater breastfeeding support from family/friends were associated with longer duration of any or fully breastfeeding in multivariable models. Stronger breastfeeding intention was more strongly associated with longer duration of any breastfeeding among women with lower BMI (interaction p-value 0.03). Conclusions: Breastfeeding support from WIC is an important contributor to stronger breastfeeding intention. Given the robust association of breastfeeding intention with breastfeeding duration, regardless of maternal and household characteristics, WIC breastfeeding support during pregnancy represents an important mechanism to improve breastfeeding outcomes in this population. Further research is needed to understand the directionality of associations between breastfeeding support and intention among WIC participants. Full article

(This article belongs to the Special Issue Nutrition Strategy for Maternal and Infant Wellbeing)

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15 pages, 2044 KiB

Open AccessReview

Choline in Pregnancy and Lactation: Essential Knowledge for Clinical Practice

by E. J. Derbyshire

Nutrients 2025, 17(9), 1558; https://doi.org/10.3390/nu17091558 - 30 Apr 2025

Viewed by 420

Abstract

Background/Objectives: In 1998 choline was identified as an essential nutrient by the United States Institute of Medicine. Choline is known primarily for its roles in neurotransmitter production, cell membrane formation, and methyl and lipid metabolism. Since this discovery the relevance of choline to maternal, fetal, and infant health has been studied intensively. This narrative review provides a coherent update of the latest evidence for field clinicians and healthcare professionals. Methods: A PubMed/ScienceDirect search for human clinical evidence restricted to meta-analysis and systematic/review publications from the last 10 years was undertaken. Results: Meta-analysis and review publications highlight the importance of choline in supporting maternal health and fetal development during pregnancy by showing promising roles for choline in relation to neurological development, brain and liver function, reduced neural tube defect risk, and adverse pregnancy outcome risk. However, there are clear present-day gaps between habitual choline intakes and intake recommendations with the majority of pregnant and lactating women not meeting adequate intake recommendations for choline. This gap is anticipated to widen given transitions towards plant-based diets which tend to be lower in choline. Conclusions: Alongside folic acid recommendations, choline supplementation should be considered in dietary recommendations by clinicians during crucial life stages such as pregnancy and lactation when physiological demands for this critical nutrient substantially increase. Full article

(This article belongs to the Special Issue Nutrition Strategy for Maternal and Infant Wellbeing)

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34 pages, 1862 KiB

Open AccessSystematic Review

The Influences of Oral Probiotics on the Immunometabolic Response During Pregnancy and Lactation: A Systematic Review

by Valentin Nicolae Varlas, Laurențiu-Camil Bohîlțea and Nicolae Suciu

Nutrients 2025, 17(9), 1535; https://doi.org/10.3390/nu17091535 - 30 Apr 2025

Viewed by 381

Abstract

Background/Objectives: In recent years, due to the emergence of antimicrobial resistance, probiotics have been increasingly used during pregnancy and lactation with real maternal–fetal benefits. Probiotic intervention, especially multi-strain probiotics, due to their anti-inflammatory, metabolic, and immunomodulatory actions, can be performed prophylactically and therapeutically with promising results regarding maternal, fetal, and neonatal health. The administration of probiotics can modulate the maternal microbiome, regulate microflora imbalance in various conditions (overweight/obesity, gestational diabetes mellitus (GDM), preeclampsia, allergic diseases), and influence several reactions such as modulating the non-specific cellular immune system, metabolic processes, and inhibition of pathogens. This study aimed to analyze, based on available data, how the administration of probiotic supplements to women during pregnancy can modify immunometabolic responses to microbial dysbiosis to limit weight gain and the risk of obesity, to improve glucose homeostasis and reduce the risk of GDM, to prevent preeclampsia and its effects on maternal–fetal outcomes, and to reduce rates of atopic eczema and allergic diseases in infants. Methods: We performed a systematic search in MEDLINE/PubMed to identify studies that have investigated the effects of probiotic intervention on the immunometabolic response in pregnancy and lactation, especially in women with diabetes, overweight/obesity, preeclampsia, and allergic conditions. Results: Fifty-six RCT studies, totaling 15,044 women, matched the inclusion criteria, of which eight were for interventions on the immune response, twenty on allergic conditions, seven on obesity and excess weight gain in pregnancy, and twenty-one on GDM. Conclusions: Due to the heterogeneous structure and the size of the samples, the methodologies, formulations, moment of initiation, and study durations, future research is needed to establish their effectiveness and safety in pregnancy and lactation regarding maternal-fetal health and outcomes in childhood and adult life. Full article

(This article belongs to the Special Issue Nutrition Strategy for Maternal and Infant Wellbeing)

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