Women experience dramatic physiological and immune changes during pregnancy, including alterations in the vaginal and gut microbiome populations.
Based on this, researchers at the Nestlé Research Centre in Switzerland and the Philippines General Hospital conducted a study to examine the impact of a maternal nutritional supplement enriched with probiotics during pregnancy and early lactation on the incidence of infant diarrhoea.
Pre- and post-natal probiotics
They recruited 208 healthy pregnant women between 24 and 28 weeks of gestation and randomly assigned them to three groups: one group received no supplementation (68 women), another received two daily servings of an oral supplement containing 7.9g of protein, multivitamins and minerals, and the last group received the same supplementation enriched with the probiotics Lactobacillus rhamnosus and Bifidobacterium lactis (70 women in each supplementation group).
This lasted from the third trimester of pregnancy until at least two months after delivery. The researchers then observed that in the 12 months after delivery, there was no significant difference in the incidence of infant diarrhoea between the three groups.
Additionally, the mean maternal weight gain at the time of delivery was comparable across the groups, even though the supplemented groups had a higher caloric intake.
There were also no statistically significant differences among the groups when it came to the incidence of pregnancy-related or foetal adverse outcomes. However, in all the groups, the mean age-based weight, length, BMI and head circumference scores fell below the WHO's median values.
Furthermore, the infants in the combined supplemented groups had gained more weight and height than those in the non-supplemented group at 12 months.
Geography and genetics
The researchers acknowledged several limitations of the study. Firstly, they had not monitored supplement intake after the two-month postnatal period, or assessed the effects of continued supplementation on growth in breastfed infants.
Secondly, they also did not examine the potential impact of supplements on breastmilk composition, which could have "provided insights on the effect observed on infant growth".
They added that the lack of weight gain in the supplemented mothers (whether or not they had taken probiotics) did not necessarily apply to the general population, as it could be related to a genetic trait unique to the Filipino women in the study.
Furthermore, the study population consisted only of women in their third trimester of pregnancy and living in the greater Manila region, therefore limiting the generalisability of the findings to all stages of pregnancy and to the entire country.
They concluded: "Oral maternal nutritional supplements formulated with or without Lactobacillus rhamnosus and Bifidobacterium lactis during the last trimester of pregnancy and through the first two months of exclusive breastfeeding were well tolerated and safe for mothers, foetus and infants.
"Even though in the present study no difference in (the) incidence of infant diarrhoea was observed between the three groups, the analysis of combined supplemented groups showed beneficial effects of maternal supplementation on infant weight and length gains at 12 months of age."
Source: BMC Pregnancy and Childbirth
https://doi.org/10.1186/s12884-018-1828-8
"Effect of maternal supplement beverage with and without probiotics during pregnancy and lactation on maternal and infant health: a randomized controlled trial in the Philippines"
Authors: Jacinto Mantaring, et al.