Search Results (100)

Background/Objectives: Diencephalic syndrome (DS) is an uncommon pediatric disorder presenting with severe failure to thrive despite adequate caloric intake and preserved linear growth. First characterized by Russell, this condition predominantly affects infants under 12 months and remains diagnostically challenging. Methods: We performed a comprehensive literature review examining clinical presentation, underlying pathophysiology, associated pathology, diagnostic approaches, and long-term outcomes of DS. Results: DS typically manifests in the first year of life with profound cachexia, normal or increased appetite, preserved height velocity, and characteristic features including hyperactivity, euphorism, and visual pathway involvement. Low-grade gliomas of the hypothalamic–chiasmatic region, particularly pilocytic astrocytomas, represent the predominant underlying pathology. The pathophysiological mechanisms remain incompletely understood but likely involve complex dysregulation of hypothalamic energy homeostasis. While overall survival exceeds 90% at five years, most patients experience significant long-term morbidity including visual impairment, multiple endocrine deficiencies, and hypothalamic obesity. Diagnostic delays averaging 11 months contribute to irreversible complications. Conclusions: Early recognition of DS is essential to prevent permanent visual loss and optimize outcomes. Multidisciplinary management incorporating chemotherapy as first-line treatment for underlying gliomas has improved survival while reducing radiation-associated toxicities. However, survivors face substantial lifelong sequelae requiring comprehensive monitoring and intervention. Future research should focus on elucidating precise pathophysiological mechanisms, developing targeted molecular therapies, and improving management of hypothalamic obesity and other late effects. Full article

Background: Obesity is a chronic disease that has negative health consequences for children. Peer support models have been used to manage chronic diseases like diabetes; however, little is known about how a peer support intervention might promote healthy infant growth to prevent pediatric obesity. The aim of this project was to explore parental perspectives on how a peer support intervention might be developed to support healthy infant weight gain and nutrition. Methods: Data were collected from November 2022 to October 2023 at a single pediatric primary care clinic. Semi-structured interviews explored parents’ perspectives of how a peer parent coach could promote healthy infant nutrition and growth. Interviews focused on (1) common infant feeding and nutrition questions, (2) the role and importance of peer support during the newborn period, and (3) strategies for addressing and facilitating connections to food-related resources and addressing food insecurity. Results: A total of 18 interviews were conducted. Average parental age was 32.1 years (range 20–46 years). Thirty-three percent of the participants identified as Black, 28% identified as White, 11% identified as Asian, and the remaining identified as Other or preferred not to report. Half of the sample reported a household income of <$20,000, 67% reported having public insurance, and 11% reported household food insecurity. Themes that emerged included: peer parent coaches can (1) provide emotional support to families with young infants, (2) education focused on infant nutrition, and (3) facilitate connections with nutrition resources. Participants also noted the importance of understanding a family’s unique culture when counseling on infant growth and nutrition. Conclusions: Multiple themes were identified about how a peer support intervention could support healthy infant nutrition and growth. Future work should test the feasibility and acceptability of a peer support intervention to promote healthy infant weight gain. Full article

Gestational obesity, defined as obesity during pregnancy or a pre-pregnancy BMI ≥30, is a growing global health challenge with profound implications for both maternal and offspring health. This narrative review synthesizes current evidence on the mechanistic pathways by which maternal obesity affects pregnancy outcomes and intergenerational health trajectories. For mothers, gestational obesity increases the risk of gestational diabetes, hypertensive disorders, cesarean delivery, and postpartum weight retention. Offspring exposed to maternal obesity face higher risks of obesity, metabolic syndrome, cardiovascular disease, and neurodevelopmental disorders, many of which persist across the lifespan. The underlying mechanisms include metabolic dysregulation, insulin resistance, chronic inflammation, oxidative stress, and alterations in placental function. Epigenetic modifications, such as DNA methylation, histone changes, and non-coding RNA expression, play central roles in fetal programming, while maternal gut dysbiosis and alterations in breast milk microbiota further shape infant health outcomes. Importantly, maternal obesity not only influences pregnancy and early life but also perpetuates an intergenerational cycle of obesity and related comorbidities. Preventive strategies targeting preconception and prenatal health, combined with interventions to optimize lactation and maternal diet, may mitigate long-term risks. Future research should prioritize longitudinal and mechanistic studies to refine interventions aimed at disrupting the transmission of obesity-related disease across generations. Full article

Background/Objectives: Human breast milk is a mammary gland secretion with a dynamic composition, containing important bioactive factors for infant growth. Epigenetic factors, like microRNAs, are found in breast milk and can regulate gene expression and, thus, infant growth. Obesity is, among others, a major global health concern with long-term consequences, making its prevention during early life a public health priority. Maternal lifestyle factors, including diet and body weight status, may influence infant growth patterns and susceptibility to obesity. The aim of this review is to explore the hypothesis that miRNA content in breast milk might be influenced by maternal obesity, eventually affecting the obesity risk in offspring. Methods: This systematic review was carried out in line with the PRISMA 2020 statement and included observational (cohort) studies that met the inclusion criteria and compare the expression of miRNAs in OW/OB lactating mothers and associate this to the obesity development in the offspring. Results: According to the included studies, the most common miRNAs are miR-148a, miR-30 family, and miR-let7 family, with miR-30b and miR-let7a among the most discussed that participate in adipogenesis. Some of these miRNAs secreted in breast milk pass on a genetic predisposition for obesity to the next generation, while others provide a protective role against obesity in the offspring. Conclusions: Eventually, even though individual miRNAs may fluctuate, the overall miRNA profile remains stable. The findings underscore the importance of balanced maternal nutrition and optimal health during lactation, both for supporting healthy infant development and for potentially reducing the risk of obesity later in life. Full article

Background: Childhood obesity has reached epidemic levels in developed countries and is an emerging concern in developing regions. Children with excess weight are more likely to maintain this condition over time into adulthood and face a higher risk of developing metabolic disorders such as type 2 diabetes, hypertension, metabolic dysfunction-associated liver disease, and dyslipidemia. Early identification of obesity risk is, therefore, a key public health challenge. Methods: This is an observational, prospective, single-center cohort pilot study in 66 mother–infant dyads recruited at the Gynecology and Obstetrics Service of the Virgen de la Arrixaca University Hospital (Murcia, Spain). The primary objective is to identify early-life, non-invasive biomarkers associated with increased adiposity by integrating multi-omics approaches and analyzing maternal–infant interactions. Pregnant women will be enrolled during the third trimester and will undergo a baseline visit at 38 weeks of gestation for clinical and anthropometric assessment. Buccal swabs and fecal samples will be collected at baseline and in the peripartum period for epigenetic (DNA methylation), metagenomic, and metabolomic analyses. Infants will be evaluated at birth and followed at 6 months, 1 year, 2 years, and 3 years. Each visit will include detailed anthropometric measurements, along with collection of buccal swabs and fecal samples for multi-omics profiling. Conclusions: This multidisciplinary study aims to assess how maternal factors influence infant epigenetic and microbial patterns, and their relation to adiposity development. Early identification of such biomarkers may guide personalized prevention strategies and reduce the long-term burden of obesity-related comorbidities. Full article

Background/Objectives: Gestational diabetes mellitus (GDM) and maternal obesity are major global health gestation-related conditions associated with several adverse maternal and neonatal outcomes. GDM is a common gestational metabolic disorder, presented usually during the second or third trimester of pregnancy with maternal hyperglycemia due to insulin intolerance. Maternal obesity, defined as a BMI of a woman during gestation ≥ 30 kg/m², has been associated with maternal complications such as GDM, fetal macrosomia and others. Methods: The presented article is a narrative review. The aim of this study was to review scientific evidence and conduct a comprehensive analysis of GDM and maternal obesity (“diabesity”) and its immediate and late complications for both maternal and fetal/offspring wellbeing. Results: This review highlighted that gestational hyperglycemia results in oxidative and nitrogen stress development and that maternal obesity may have an impact similar to maternal diabetes, as it may cause fetal macrosomia and cardiometabolic complications later in life. Conclusions: Optimal diabetic control is responsible for the prevention of oxidative stress in diabetic pregnancies. Similarly, pregnant women should exercise regularly, receive folic acid supplementation and avoid excess weight gain during pregnancy. Breastfeeding during the first months of life has a positive impact on weight monitoring in infants born to mothers with diabesity and may be crucial in the prevention of obesity and metabolic syndrome later in life. Full article

This review explores the maternal gut microbiome’s role in shaping neonatal neurodevelopmental outcomes following perinatal asphyxia (PA), a leading cause of infant mortality and disability with limited therapeutic options beyond hypothermia. We synthesized current evidence on microbiome-mediated neuroprotective mechanisms against hypoxic-ischemic brain injury. The maternal microbiome influences fetal development through bioactive metabolites (short-chain fatty acids, indole derivatives) that cross the placental barrier, bacterial antigen regulation, and infant microbiome colonization. These pathways activate multiple protective mechanisms: anti-inflammatory signaling via NF-κB suppression and regulatory T cell expansion; antioxidant defenses through Nrf2 activation; neural repair via BDNF upregulation and neurogenesis; and oxytocin system modulation. Animal models demonstrate that maternal dysbiosis from high-fat diet or antibiotics exacerbates PA-induced brain damage, increasing inflammatory markers and hippocampal injury. Conversely, probiotic supplementation, dietary fiber, and specific interventions (omega-3, resveratrol) reduce neuroinflammation and oxidative injury. Human studies link maternal dysbiosis-associated conditions (obesity, gestational diabetes) with adverse pregnancy outcomes, though direct clinical evidence for PA severity remains limited. Understanding the maternal microbiome-fetal brain axis opens therapeutic avenues, including prenatal probiotics, dietary modifications, and targeted metabolite supplementation to prevent or mitigate PA-related neurological sequelae, potentially complementing existing neuroprotective strategies. Full article

The gut microbiota plays a crucial role in early-life development, influencing various aspects of health and disease. Dysbiosis, an imbalance in the gut microbiota, has been linked to multiple health conditions, including allergies, asthma, and obesity. In early life, the gut microbiota plays a key role in the development and maturation of the immune system. Probiotics, live microorganisms that confer health benefits when administered in adequate amounts, have emerged as a potential treatment approach for dysbiosis in early life. Dysbiosis can alter the resistance to pathogens, promoting atopic diseases, food sensitization, and infections such as necrotizing enterocolitis (NEC). Probiotics have been shown to modulate the composition and function of the gut microbiota in the perinatal and infant periods. They can increase the abundance of beneficial bacteria, such as Bifidobacteria and Lactobacilli, and reduce the levels of potentially harmful bacteria. Not all probiotics are created equal. The effects of probiotics can vary depending on the specific strain used. Probiotics have also been investigated for their potential benefits in other areas of infant health, such as reducing the risk of respiratory infections and improving growth and development. This review aims to analyze the current data in the literature and to evaluate the health benefits of probiotic administration in early life. Several studies have investigated the use of probiotics in preventing or treating allergic diseases, such as eczema and food allergies. While some studies have shown promising results, more research is needed to fully understand the benefits and risks of probiotics in early life. In conclusion, using probiotics to prevent dysbiosis-related conditions may be considered a method of ‘programming’ the individual for optimal health maintenance. Full article

Sheep milk is a rich source of bioactive compounds with significant potential in functional foods and biomedical applications. It contains high levels of proteins, peptides, and fatty acids with numerous health-promoting properties for the human body. Key components such as lactoferrin, proline, orotic acid, and conjugated linoleic acid (CLA) support the prevention and treatment of chronic diseases such as diabetes, cardiovascular disease, obesity, cancer, and neurodegenerative disorders. Bioactive peptides from sheep milk regulate blood glucose levels by inhibiting enzymes such as dipeptidyl peptidase-IV (DPP-IV) and α-glucosidase, while conjugated linoleic acid improves lipid metabolism and reduces inflammation. The high-quality proteins in sheep milk are essential for tissue regeneration and maintaining muscle mass, which is particularly beneficial for the elderly and infants who are allergic to cow milk. Recently, there has been an increasing interest in hydrogel dressings enriched with bioactive substances from sheep milk, which support wound healing by supporting collagen synthesis, reducing inflammation, and having antimicrobial properties. Such hydrogels are particularly promising for the treatment of chronic wounds, burns, and diabetic ulcers, making them a valuable tool in regenerative medicine. The aim of this manuscript is to review the current reports on bioactive components of sheep milk and their potential for biomedical applications. Full article

Prolonged breastfeeding (BF), as opposed to artificial infant formula feeding (FF), has been shown to prevent the development of obesity later in life. The aim of our narrative review is to investigate the missing molecular link between postnatal protein overfeeding—often referred to as the “early protein hypothesis”—and the subsequent transcriptional and epigenetic changes that accelerate the expansion of adipocyte stem cells (ASCs) in the adipose vascular niche during postnatal white adipose tissue (WAT) development. To achieve this, we conducted a search on the Web of Science, Google Scholar, and PubMed databases from 2000 to 2025 and reviewed 750 papers. Our findings revealed that the overactivation of mechanistic target of rapamycin complex 1 (mTORC1) and S6 kinase 1 (S6K1), which inhibits wingless (Wnt) signaling due to protein overfeeding, serves as the primary pathway promoting ASC commitment and increasing preadipocyte numbers. Moreover, excessive protein intake, combined with the upregulation of the fat mass and obesity-associated gene (FTO) and a deficiency of breast milk-derived microRNAs from lactation, disrupts the proper regulation of FTO and Wnt pathway components. This disruption enhances ASC expansion in WAT while inhibiting brown adipose tissue development. While BF has been shown to have protective effects against obesity, the postnatal transcriptional and epigenetic changes induced by excessive protein intake from FF may predispose infants to early and excessive ASC commitment in WAT, thereby increasing the risk of obesity later in life. Full article

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

Gestational diabetes mellitus (GDM) leads to increased lifelong cardiometabolic risk in both mothers and their offspring. The identification of effective strategies to contain the future risk of type 2 diabetes (T2D) and cardiovascular disease (CVD) is of utmost importance to reduce the burden of the disease. Breastfeeding (BF) is effective in reducing short- and long-term child morbidity. In recent years, BF has emerged as a candidate low-cost intervention to prevent future cardiometabolic complications both in mothers and infants exposed to GDM. The aim of this review is to provide an overview of the evidence about the possible metabolic benefits of BF for both mothers with a history of GDM and their offspring. Increasing evidence supports the positive effects of exclusive BF over formula feeding (FF) or mixed feeding on glucose homeostasis and the lipid profile in women with previous GDM in the early postpartum period. Studies with a longer observation suggest clear benefits of intensive and longer BF on the risk of diabetes and prediabetes in mothers after adjustment for confounders. In regards to infants, in most studies, the intensity and duration of BF are positively associated with slower infant growth curves compared with FF, indicating that the positive effect of BF on growth trends might contrast the increased risk of obesity and metabolic diseases observed in infants exposed to GDM. Considering these findings, a global effort should be made to support BF practice to possibly reduce cardiometabolic morbidity after GDM. Full article

Background/Objectives: Maternal vaccination and breastfeeding are important aspects of public health that should be recommended by medical staff caring for pregnant and postpartum women. We aimed to analyze factors affecting women’s likelihood of dual vaccination during pregnancy and their infant feeding strategies. Methods: A cross-sectional study was conducted with 953 Polish mothers. An online questionnaire was used and included questions on sociodemographic and obstetric variables, women’s attitudes towards COVID-19 and influenza vaccination, and breastfeeding practices. Results: COVID-19 vaccination was reported by 66.0%, influenza vaccination by 18.2%, and dual vaccination by 15.6% of Polish mothers. Increasing willingness to receive vaccines was significantly associated with older maternal age, lower BMI, living in urban areas with >100,000 residents, and high levels of knowledge regarding vaccination. No significant association between dual vaccination and neonatal feeding strategy was detected. The group of exclusively breastfeeding mothers, in comparison to formula- and mixed-feeding women, was characterized by having lower pre-pregnancy BMI and previous maternal experience. Conclusions: Rates of vaccination against seasonal influenza and dual (influenza and COVID-19) vaccination remain low among Polish mothers. The promotion of antenatal vaccination and reliable information about short- and long-term advantages related to breastfeeding are crucial to perinatal health care for the mother–infant dyad. Young, primiparous women who are overweight or obese should be targets of preventive programs focused on the health of the mother–infant dyad. Full article

Background: Breastfeeding is widely regarded as the optimal method of infant nutrition. A notable benefit of breastfeeding is its potential to avert the development of childhood overweight and obesity. This assertion holds particular significance in the context of infants whose mothers have exhibited gestational diabetes, a condition that has been demonstrated to be associated with an increased risk of carbohydrate and/or fat disorders in offspring, potentially leading to the onset of overweight and obesity in later life. Objective: The objective of the present study was to examine the variations in the anthropometric dimensions of infants across three distinct time points during the initial year of life, with a particular focus on the correlation between infant feeding practices and the prevalence of gestational diabetes in maternal subjects. Additionally, this study encompassed an analysis of the disparities in anthropometric dimensions between infant males and females. Methods: The study population included 42 infants whose mothers had been diagnosed with gestational diabetes between the 24th and 28th week of pregnancy, as well as 28 infants of women without gestational diabetes. The infants’ dietary habits, including breastfeeding, mixed feeding, and formula feeding, were assessed, and their anthropometric measurements were obtained at three time points: 7 ± 1 weeks postpartum, 6 months ± 1 week postpartum, and 12 months ± 1 week postpartum. The infants were measured for weight, length, head circumference, and thickness of the subscapular skin fold. We also calculated their BMI and Ponderal Index, and the measurements were referenced to WHO centile grids. Results: At 7 ± 1 weeks postpartum, exclusively breastfed infants exhibited higher weight compared to those who were mixed-fed or formula-fed (p = 0.03). However, at 1 year of age, breastfed infants demonstrated significantly lower weight compared to formula-fed infants (p = 0.019). Furthermore, at 12 months, breastfed boys exhibited lower weight, length, BMI, and lower subscapular skinfold thickness compared to formula-fed infants. Conclusions: Breastfeeding has been shown to play a pivotal role in preventing obesity in children. In the initial postnatal period, infants who are fed breast milk exhibit a higher weight compared to those who are fed formula. However, by the age of 12 months, the weight of breastfed infants typically falls below that of formula-fed infants. Diabetes during pregnancy has been observed to have no impact on the anthropometric dimensions of infants up to the age of one. Nevertheless, further research is necessary to comprehensively assess the long-term implications of maternal GDM in their offspring. Full article

Background/Objectives: Complementary feeding (CF) influences future health outcomes. The aim of this study was to evaluate the impact of fortified whole grain infant cereal (WGIC), a complementary food, among 6- to 12-month-old infants on the nutrient density of the diet in three diverse settings: Brazil, the United Arab Emirates (UAE), and the US. Methods: Data from the Feeding Infants and Toddler Study (FITS), a collection of dietary intake studies based on 24-h-dietary recalls, from said countries was utilized. Nutrient intakes were calculated for infant cereal (IC) consumers and non-consumers. Diet modeling was applied to IC consumers to substitute their regular fortified IC with WGIC with improved fortifications. The study estimated the average nutrient density, mean adequacy ratio (MAR), and percentage inadequacy of the diet in both IC consumers and non-consumers. Results: The analyses indicated that infants who consumed IC had higher intakes of calcium, zinc, magnesium, iron, and vitamin D in the three countries. Reduced micronutrient inadequacies were observed among IC consumers, particularly in Brazil and the U.S. Diet modeling with WGIC revealed a significantly higher density of choline, magnesium, zinc, iron, fiber, and protein, as well as reduced inadequacies. The MAR was significantly improved in the three countries. Conclusions: This study underscores the potential of fortified WGIC in increasing the nutrient density of the complementary diet. The intrinsic nutrients in whole grain infant cereals (WGICs) significantly enhance the nutrient density of the complementary diet. Given that whole grains play a role in preventing childhood obesity, their inclusion during CF may be crucial. Full article