The perinatal nutritional environment impacts upon the health and well-being of mother and child also in the long term. The aim of the present study was to determine the safety and efficacy of perinatal probiotic-supplemented dietary counselling by evaluating pregnancy outcome and fetal and infant growth during the 24 months' follow-up. Altogether, 256 women were randomised at their first trimester of pregnancy into a control and a dietary intervention group. The intervention group received intensive dietary counselling provided by a nutritionist and were further randomised, double-blind to receive probiotics (Lactobacillus rhamnosus GG and Bifidobacterium lactis Bb12; diet/probiotics) or placebo (diet/placebo). Firstly, probiotic intervention reduced the frequency of gestational diabetes mellitus (GDM); 13 % (diet/probiotics) v. 36 % (diet/placebo) and 34 % (control); P¼ 0·003. Secondly, the safety of this approach was attested by normal duration of pregnancies with no adverse events in mothers or children. No significant differences in prenatal or postnatal growth rates among the study groups were detected. Thirdly, distinctive effects of the two interventions were detected; probiotic intervention reduced the risk of GDM and dietary intervention diminished the risk of larger birth size in affected cases; P¼0·035 for birth weight and P¼ 0·028 for birth length. The results of the present study show that probiotic-supplemented perinatal dietary counselling could be a safe and cost-effective tool in addressing the metabolic epidemic. In view of the fact that birth size is a risk marker for later obesity, the present results are of significance for public health in demonstrating that this risk is modifiable.

The reports on atopic diseases and microbiota in early childhood remain contradictory, and both decreased and increased microbiota diversity have been associated with atopic eczema. In this study, the intestinal microbiota signatures associated with the severity of eczema in 6-month-old infants were characterized. Further, the changes in intestinal microbiota composition related to the improvement of this disease 3 months later were assessed. The severity of eczema correlated inversely with microbiota diversity (r = -0.54, P = 0.002) and with the abundance of butyrate-producing bacteria (r = -0.52, P = 0.005). During the 3-month follow-up, microbiota diversity increased (P < 0.001) and scoring atopic dermatitis values decreased (P < 0.001) in all infants. This decrease coincided with the increase in bacteria related to butyrate-producing Coprococcus eutactus (r = -0.59, P = 0.02). In conclusion, the high diversity of microbiota and high abundance of butyrate-producing bacteria were associated with milder eczema, thus suggesting they have a role in alleviating symptoms of atopic eczema.

AIM:To investigate whether birch pollen allergy symptoms are linked with gut microbiota changes and whether probiotics have an effect on these. METHODS:Forty seven children with confirmed birch pollen allergy were randomized to receive either a probiotic combination of Lactobacillus acidophilus (L . a c i d o p h i l u s ) N C F M T M ( ATC C 7 0 0 3 9 6 ) a n dBifidobacterium lactis (B. lactis ) Bl-04 (ATCC SD5219) or placebo in a double-blind manner for 4 mo, starting prior to onset of the birch pollen season. Symptoms were recorded in a diary. Blood samples were taken for analysis of cytokines and eosinophils. Fecal samples were analysed for microbiota components, calprotectin and IgA. Nasal swabs were taken for analysis of eosinophils. RESULTS:The pollen season induced a reduction in Bifidobacterium , Clostridium and Bacteroides which could not be prevented by the probiotic intervention. During the intervention, significantly higher numbers of B. lactis 11.2 × 10 7 ± 4.2 × 10 7 vs 0.1 × 10 7 ± 0.1 × 10 7 bacteria/g feces (P < 0.0001) and L. acidophilus NCFM TM 3.5 × 10 6 ± 1.3 × 10 6 vs 0.2 × 10 6 ± 0.1 × 10 6 bacteria/g feces (P < 0.0001) were observed in the probiotic group compared to the placebo group. During May, there was a tendency for fewer subjects, (76.2% vs 95.2%, P = 0.078) to report runny nose, while during June, fewer subjects, 11.1% vs 33.3%, reported nasal blocking in the probiotics group (P = 0.101). Concomitantly, fewer subjects in the probiotic group had infiltration of eosinophils in the nasal mucosa compared to the placebo group, 57.1% vs 95% (P = 0.013). Eye symptoms tended to be slightly more frequent in the probiotic group, 12.5 d[interquartile range (IQR) 6-18] vs 7.5 d (IQR 0-11.5) (P = 0.066) during May. Fecal IgA was increased in the placebo group during the pollen season; this increase was prevented by the probiotics (P = 0.028). CONCLUSION:Birch pollen allergy was shown to be associated with changes in fecal microbiota composition. The specific combination of probiotics used was shown to prevent the pollen-induced infiltration of eosinophils into the nasal mucosa, and indicated a trend for reduced nasal symptoms.

Specific probiotics may enhance gut barrier function and aid in the development of immune responses. Thus, specific probiotics may afford protection against offending macromolecules in the gut and provide control for future infections by accelerated immunological maturation (ClinicalTrials.gov ID NCT01148667).

We found no evidence that the timing of the introduction of complementary feeding increased the risk of atopic eczema in a high-risk cohort, when parental suspicions were taken into account. Therefore, it seems that families with a history of allergy can safely comply with current feeding recommendations, although confirmation in further studies is warranted.