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Newborn Nutrition

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

Deadline for manuscript submissions: closed (20 July 2021) | Viewed by 38987

Special Issue Editor

1. Department of Internal Medicine and Therapeutics, University of Pavia, 27100 Pavia, Italy
2. Department of Pediatrics, Buzzi Children’s Hospital, 20157 Milano, Italy
Interests: pediatrics; pediatric endocrinology; obesity; metabolic syndrome; telemedicine; digital health; exercise; disability; preventive medicine; translational research
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Good nutrition in the earliest stages of fetal development, at birth, and through infancy, is essential for survival, physical growth, mental development, and health. Newborn nutrition and early childhood stimulation interventions represent part of an integrated life-cycle approach to prevent communicable and noncommunicable diseases. This Special Issue “Newborn Nutrition” aims to publish  original research articles and reviews of the scientific literature in order to explore  the latest findings on nutrition in term and preterm babies, to consider the role of newborn nutrition as key determinants of well-being across the entire lifespan, and to propose novel nutritional interventions to prevent chronic diseases.

Dr. Valeria Calcaterra
Guest Editor

Manuscript Submission Information

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Keywords

  • newborn
  • nutrition
  • prevention
  • human health
  • nutrition intake
  • programming
  • diet
  • chronic disease

Published Papers (9 papers)

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Editorial

Jump to: Research, Review, Other

3 pages, 206 KiB  
Editorial
Nutritional Surveillance for the Best Start in Life, Promoting Health for Neonates, Infants and Children
Nutrients 2020, 12(11), 3386; https://doi.org/10.3390/nu12113386 - 04 Nov 2020
Cited by 12 | Viewed by 2381
Abstract
This Special Issue aims to examine the crucial role of nutritional status starting from pregnancy in modulating fetal, neonatal and infant growth and metabolic pathways, with potential long-term impacts on adult health. Poor maternal nutritional conditions in the earliest stages of life during [...] Read more.
This Special Issue aims to examine the crucial role of nutritional status starting from pregnancy in modulating fetal, neonatal and infant growth and metabolic pathways, with potential long-term impacts on adult health. Poor maternal nutritional conditions in the earliest stages of life during fetal development and early life may induce both short-term and longer lasting effects; in particular, an increased risk of noncommunicable diseases (NCDs) and other chronic diseases such as obesity, which itself is a major risk factor for NCDs, is observed over the lifespan. Poor maternal nutrition affects the fetal developmental schedule, leading to irreversible changes and slowdown in growth. The fetus limits its size to conserve the little energy available for cardiac functions and neuronal development. The organism will retain memory of the early insult, and the adaptive response will result in pathology later on. Epigenetics may contribute to disease manifestation affecting developmental programming. After birth, even though there is a limited evidence base suggesting a relationship between breastfeeding, timing and type of foods used in weaning with disease later in life, nutritional surveillance is also mandatory in infants in the first year of life. We will explore the latest findings on nutrition in early life and term and preterm babies, as well as the role of malnutrition in the short- and long-term impact over the lifespan. Focusing on nutritional interventions represents part of an integrated life-cycle approach to prevent communicable and non-communicable diseases. Full article
(This article belongs to the Special Issue Newborn Nutrition)

Research

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24 pages, 6290 KiB  
Article
Brain-Restricted Inhibition of IL-6 Trans-Signaling Mildly Affects Metabolic Consequences of Maternal Obesity in Male Offspring
Nutrients 2021, 13(11), 3735; https://doi.org/10.3390/nu13113735 - 23 Oct 2021
Cited by 3 | Viewed by 1941
Abstract
Maternal obesity greatly affects next generations, elevating obesity risk in the offspring through perinatal programming and flawed maternal and newborn nutrition. The exact underlying mechanisms are poorly understood. Interleukin-6 (IL-6) mediates its effects through a membrane-bound receptor or by trans-signaling (tS), which can [...] Read more.
Maternal obesity greatly affects next generations, elevating obesity risk in the offspring through perinatal programming and flawed maternal and newborn nutrition. The exact underlying mechanisms are poorly understood. Interleukin-6 (IL-6) mediates its effects through a membrane-bound receptor or by trans-signaling (tS), which can be inhibited by the soluble form of the co-receptor gp130 (sgp130). As IL-6 tS mediates western-style diet (WSD) effects via chronic low-grade inflammation (LGI) and LGI is an important mediator in brain–adipose tissue communication, this study aims at determining the effects of maternal obesity in a transgenic mouse model of brain-restricted IL-6tS inhibition (GFAPsgp130) on offspring’s short- and long-term body composition and epigonadal white adipose tissue (egWAT) metabolism. Female wild type (WT) or transgenic mice were fed either standard diet (SD) or WSD pregestationally, during gestation, and lactation. Male offspring received SD from postnatal day (P)21 to P56 and were metabolically challenged with WSD from P56 to P120. At P21, offspring from WT and transgenic dams that were fed WSD displayed increased body weight and egWAT mass, while glucose tolerance testing showed the strongest impairment in GFAPsgp130WSD offspring. Simultaneously, egWAT proteome reveals a characteristic egWAT expression pattern in offspring as a result of maternal conditions. IL-6tS inhibition in transgenic mice was in tendency associated with lower body weight in dams on SD and their respective offspring but blunted by the WSD. In conclusion, maternal nutrition affects offspring’s body weight and egWAT metabolism predominantly independent of IL-6tS inhibition, emphasizing the importance of maternal and newborn nutrition for long-term offspring health. Full article
(This article belongs to the Special Issue Newborn Nutrition)
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17 pages, 4296 KiB  
Article
The Functional DNA Methylation Signatures Relevant to Altered Immune Response of Neonatal T Cells with l-Arginine Supplementation
Nutrients 2021, 13(8), 2780; https://doi.org/10.3390/nu13082780 - 13 Aug 2021
Cited by 3 | Viewed by 2208
Abstract
l-Arginine is an important nutrient in the infant diet that significantly regulates the maturation of the immune system in neonates, including the maturation of CD4+ T cells. The biological activities of CD4+ T cells differ substantially between neonates and adults, [...] Read more.
l-Arginine is an important nutrient in the infant diet that significantly regulates the maturation of the immune system in neonates, including the maturation of CD4+ T cells. The biological activities of CD4+ T cells differ substantially between neonates and adults, and these differences may be governed by epigenetic processes. Investigating these differences and the causative processes may help understand neonatal and developmental immunity. In this study, we compared the functional DNA methylation profiles in CD4+ T cells of neonates and adults, focusing on the role of l-arginine supplementation. Umbilical cord blood and adult CD4+ T cells were cultured with/without l-arginine treatment. By comparing DNA methylation in samples without l-arginine treatment, we found that CD4+ T cells of neonatal cord blood generally showed higher DNA methylation than those of adults (average CpG methylation percentage 0.6305 for neonate and 0.6254 for adult, t-test p-value < 0.0001), suggesting gene silencing in neonates. By examining DNA methylation patterns of CpG dinucleotides induced by l-arginine treatment, we found that more CpG dinucleotides were hypomethylated and more genes appeared to be activated in neonatal T-cells as compared with adult. Genes activated by l-arginine stimulation of cord blood samples were more enriched regarding immune-related pathways. CpG dinucleotides at IL-13 promoter regions were hypomethylated after l-arginine stimulation. Hypomethylated CpG dinucleotides corresponded to higher IL-13 gene expression and cytokine production. Thus, DNA methylation partially accounts for the mechanism underlying differential immune function in neonates. Modulatory effects of l-arginine on DNA methylation are gene-specific. Nutritional intervention is a potential strategy to modulate immune function of neonates. Full article
(This article belongs to the Special Issue Newborn Nutrition)
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11 pages, 480 KiB  
Article
Factors Associated with the Use of Pasteurized Donor Milk for Healthy Newborns: Experience from the First Human Milk Bank in Vietnam
Nutrients 2021, 13(4), 1151; https://doi.org/10.3390/nu13041151 - 31 Mar 2021
Cited by 4 | Viewed by 2695
Abstract
Background: Pasteurized donor milk (PDM) is typically prescribed to preterm or low birthweight newborns when their mother’s own milk is unavailable. In surplus, PDM is prescribed to meet the nutritional needs of healthy newborns in the first few days of life. However, its [...] Read more.
Background: Pasteurized donor milk (PDM) is typically prescribed to preterm or low birthweight newborns when their mother’s own milk is unavailable. In surplus, PDM is prescribed to meet the nutritional needs of healthy newborns in the first few days of life. However, its overuse can undermine efforts to promote and support breastfeeding, waste resources, and reduce the availability of PDM for at-risk newborns. We conducted this study to examine factors associated with the prescription and prolonged use (>48 h) of privately purchased PDM to healthy newborns. Methods: Prospective observational study of 2440 mothers of healthy, term, and normal birthweight newborns born at Da Nang Hospital for Women and Children between April and August 2019. In addition to the descriptive analysis, we performed multiple logistic regressions to examine factors associated with the prescription of PDM (n = 2440) and prolonged PDM use among those who used PDM (n = 566). Results: Twenty-three percent (566/2440) of healthy, term, and birthweight ≥2500 g newborns received PDM and were included in the study. The prevalence of PDM use was higher for cesarean births (OR: 2.05; 95% CI: 1.66, 2.55) and among male newborns (OR: 1.33; 95% CI: 1.09, 1.62), but lower for farmers or workers (vs. other jobs; OR: 0.71; 95% CI: 0.54, 0.93), family income <10 million VND (vs. ≥10 million VND; OR: 0.67; 95% CI: 0.55, 0.82), and duration of skin-to-skin ≥90 min (vs. <90 min; OR: 0.54; 95% CI: 0.39, 0.76). Prolonged PDM use (12.4% of 566 newborns who used PDM) was associated with the mother having a higher socioeconomic status job (professional, small trader or homemaker; OR: 4.00; 95% CI: 1.39, 12.5), being a first-time mother (OR: 3.39; 95% CI: 1.92, 6.01) or having a cesarean birth (OR: 2.09; 95% CI: 1.02, 4.28). Conclusions: The prescription and prolonged use of privately purchased PDM was associated with non-medical factors unrelated to the ability to breastfeed effectively. The findings suggest the need for improved breastfeeding communication, counseling and support skills for health staff, development, and application of strict criteria on PDM use for healthy newborns and better routine monitoring of PDM use over time. Full article
(This article belongs to the Special Issue Newborn Nutrition)
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12 pages, 684 KiB  
Article
Trends and Dynamics in the First Four Years of Operation of the First Human Milk Bank in Vietnam
Nutrients 2021, 13(4), 1107; https://doi.org/10.3390/nu13041107 - 28 Mar 2021
Cited by 15 | Viewed by 4492
Abstract
Background: Since 1979, the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) have recommended the use of pasteurized human milk from a human milk bank (HMB) to feed low birthweight (LBW) and preterm newborns as the ‘first alternative’ when mothers [...] Read more.
Background: Since 1979, the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) have recommended the use of pasteurized human milk from a human milk bank (HMB) to feed low birthweight (LBW) and preterm newborns as the ‘first alternative’ when mothers are unable to provide their own milk. However, they have not issued any guidelines for the safe establishment and operation of an HMB. This gap contributes to the demand for gathering experiences from HMB networks, especially those from lower-middle income countries. To fill this knowledge gap, this study examines the characteristics of donors, donation, pasteurization, and recipients during the first four years of operation in the first HMB in Vietnam. Methods: Data about the donors, donation, pasteurization, and recipients were extracted from the web-based electronic monitoring system of the HMB from 1 February 2017 to 31 January 2021. Results: In the first four years of operation there were 433 donors who donated 7642 L of milk (66% from the community) with an increased trend in the amount of donated milk, donation duration, and average amount of milk donated by a donor. Approximately 98% of the donated milk was pasteurized, and 82% passed both pre- and post-pasteurization tests. Although the pass rate tended to increase with time, a few dips occurred. Of 16,235 newborns who received pasteurized donor milk, two thirds were in the postnatal wards. The main reason for the prescription of pasteurized donor milk was insufficient mothers’ own milk in the first few days after birth. There was a decreased trend in the amount and duration of using pasteurized donor milk in both postnatal wards and the neonatal unit. Conclusions: The HMB has operated efficiently in the previous four years, even during the COVID-19 pandemic, to serve vulnerable newborns. Ongoing evidence-based adjustments helped to improve the operation to recruit suitable donors, to increase the access to and quality of raw donor milk, to improve the pasteurization process, and to meet the need of more newborns. Full article
(This article belongs to the Special Issue Newborn Nutrition)
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Review

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27 pages, 2000 KiB  
Review
Brown Adipose Tissue: New Challenges for Prevention of Childhood Obesity. A Narrative Review
Nutrients 2021, 13(5), 1450; https://doi.org/10.3390/nu13051450 - 24 Apr 2021
Cited by 12 | Viewed by 9757
Abstract
Pediatric obesity remains a challenge in modern society. Recently, research has focused on the role of the brown adipose tissue (BAT) as a potential target of intervention. In this review, we revised preclinical and clinical works on factors that may promote BAT or [...] Read more.
Pediatric obesity remains a challenge in modern society. Recently, research has focused on the role of the brown adipose tissue (BAT) as a potential target of intervention. In this review, we revised preclinical and clinical works on factors that may promote BAT or browning of white adipose tissue (WAT) from fetal age to adolescence. Maternal lifestyle, type of breastfeeding and healthy microbiota can affect the thermogenic activity of BAT. Environmental factors such as exposure to cold or physical activity also play a role in promoting and activating BAT. Most of the evidence is preclinical, although in clinic there is some evidence on the role of omega-3 PUFAs (EPA and DHA) supplementation on BAT activation. Clinical studies are needed to dissect the early factors and their modulation to allow proper BAT development and functions and to prevent onset of childhood obesity. Full article
(This article belongs to the Special Issue Newborn Nutrition)
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36 pages, 2441 KiB  
Review
Human Milk Microbiota and Oligosaccharides: A Glimpse into Benefits, Diversity, and Correlations
Nutrients 2021, 13(4), 1123; https://doi.org/10.3390/nu13041123 - 29 Mar 2021
Cited by 42 | Viewed by 7894
Abstract
Human milk represents a cornerstone for growth and development of infants, with extensive array of benefits. In addition to exceptionally nutritive and bioactive components, human milk encompasses a complex community of signature bacteria that helps establish infant gut microbiota, contributes to maturation of [...] Read more.
Human milk represents a cornerstone for growth and development of infants, with extensive array of benefits. In addition to exceptionally nutritive and bioactive components, human milk encompasses a complex community of signature bacteria that helps establish infant gut microbiota, contributes to maturation of infant immune system, and competitively interferes with pathogens. Among bioactive constituents of milk, human milk oligosaccharides (HMOs) are particularly significant. These are non-digestible carbohydrates forming the third largest solid component in human milk. Valuable effects of HMOs include shaping intestinal microbiota, imparting antimicrobial effects, developing intestinal barrier, and modulating immune response. Moreover, recent investigations suggest correlations between HMOs and milk microbiota, with complex links possibly existing with environmental factors, genetics, geographical location, and other factors. In this review, and from a physiological and health implications perspective, milk benefits for newborns and mothers are highlighted. From a microbiological perspective, a focused insight into milk microbiota, including origins, diversity, benefits, and effect of maternal diet is presented. From a metabolic perspective, biochemical, physiological, and genetic significance of HMOs, and their probable relations to milk microbiota, are addressed. Ongoing research into mechanistic processes through which the rich biological assets of milk promote development, shaping of microbiota, and immunity is tackled. Full article
(This article belongs to the Special Issue Newborn Nutrition)
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11 pages, 282 KiB  
Review
Literature Review and an Italian Hospital Experience about Post-Natal CMV Infection Acquired by Breast-Feeding in Very Low and/or Extremely Low Birth Weight Infants
Nutrients 2021, 13(2), 660; https://doi.org/10.3390/nu13020660 - 18 Feb 2021
Cited by 13 | Viewed by 3158
Abstract
Breastfeeding is recommended for all neonates due to a known variety of beneficial effects, but infants can be infected by cell-associated bacteria and viruses from breast milk, such as cytomegalovirus (CMV). The majority of CMV-seropositive breastfeeding women have a viral, self-restricted reactivation, can [...] Read more.
Breastfeeding is recommended for all neonates due to a known variety of beneficial effects, but infants can be infected by cell-associated bacteria and viruses from breast milk, such as cytomegalovirus (CMV). The majority of CMV-seropositive breastfeeding women have a viral, self-restricted reactivation, can shed the virus in the milk for about 12 weeks after delivery, and can transmit the infection to their offspring. Post-natal CMV-infected term infants are mainly asymptomatic, while very low birth weight (VLBW, <1500 g) and extremely low birth weight (ELBW, <1000 g) infants may present with severe disease, short-term sequelae ranging from abnormalities in laboratory indexes to sepsis-like syndrome, and long-term sequelae such as developmental problems. Thus, the use of thermally treated maternal milk for VLBW/ELBW infants may be indicated to prevent/reduce the risk of CMV transmission. Different techniques, with varying efficacy in eradicating CMV and maintaining the activity of biological compounds in milk are available: long/short pasteurization, freeze-thawing, the use of microwaves, and ultraviolet-C irradiation. In our NICU, the use of maternal raw milk is always strongly recommended for term/preterm infants, but to reduce risk of CMV transmission, freeze-thawing mother’s own milk is used in neonates with GA ≤ 30 weeks or/and weight ≤ 1000 g, usually regardless of serological maternal condition, as CMV screening is not routinely offered to pregnant women and the milk of seroimmune mothers is not evaluated for CMV reactivation, as its rate is similar to seroprevalence. Over the last 4 years, we had 10 VLBW/ELBW newborns in our NICU with late-onset sepsis and negative cultures. In these cases, the research of CMV DNA in neonatal urine or saliva, for the diagnosis of post-natal symptomatic infection (once congenital transmission has been excluded) may be useful and not invasive. The take-home message we would like to share is that acquired CMV infection should be considered in VLBW/ELBW infants breastfed by seropositive mothers and presenting severe symptoms—particularly sepsis with negative cultures. This could allow pediatricians to make better-quality diagnoses, perform supportive therapy, provide antiviral treatment if needed, or establish a “pre-emptive” therapy for these high-risk neonates. Full article
(This article belongs to the Special Issue Newborn Nutrition)

Other

12 pages, 812 KiB  
Brief Report
Mediterranean Diet and Lifestyle Habits during Pregnancy: Is There an Association with Small for Gestational Age Infants? An Italian Single Centre Experience
Nutrients 2021, 13(6), 1941; https://doi.org/10.3390/nu13061941 - 05 Jun 2021
Cited by 7 | Viewed by 3163
Abstract
Background. The small-for-gestational-age (SGA) in infants is related to an increased risk of developing Non-Communicable Diseases later in life. The Mediterranean diet (MD) is related to lower odds of being SGA. The study explored retrospectively the association between SGA, maternal MD adherence, lifestyle [...] Read more.
Background. The small-for-gestational-age (SGA) in infants is related to an increased risk of developing Non-Communicable Diseases later in life. The Mediterranean diet (MD) is related to lower odds of being SGA. The study explored retrospectively the association between SGA, maternal MD adherence, lifestyle habits and other SGA risk factors during pregnancy. Methods. One hundred women (16–44 years) with a pregnancy at term were enrolled. Demographic data, parity, pre-gestational BMI, gestational weight gain, pregnancy-related diseases, and type of delivery were collected. The MD adherence (MEDI-LITE score ≥ 9), physical activity level, and smoking/alcohol consumption were registered. SGA neonates were diagnosed according to the neonatal growth curves. Results. Women were divided into “SGA group” vs. “non-SGA group”. The MD was adopted by 71% of women and its adherence was higher in the “non-SGA group” (p = 0.02). The prevalence of pregnancy-related diseases (gestational diabetes/pregnancy-induced hypertension) was higher in the “SGA group” (p = 0.01). The logistic regression showed that pregnancy-related diseases were the only independent risk factor for SGA. Conclusions. MD may indirectly reduce the risk of SGA since it prevents and exerts a positive effect on pregnancy-related diseases (e.g., gestational diabetes and hypertension). The small sample size of women in the SGA group of the study imposes a major limitation to the results and conclusions of this research, suggesting however that it is worthy of further investigation. Full article
(This article belongs to the Special Issue Newborn Nutrition)
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