Diet and physical activity before and during pregnancy affect short- and long-term health of mother and child. Breastfeeding period is also a demanding time for the mother. There are clear data supporting the influence of the first thousand days in the life of a child in her future health and in the risk of chronic diseases. Nutrition is one of the major influences during this period. Nutrition advice during the pre-conception period as well as during pregnancy may enhance future health in the siblings. There is a need for certain nutrients more than increased energy requirements. Pediatricians have an important role as public health agents and needs to know how to provide accurate nutrition advice during pregnancy and lactation. This document attempts to fill this information gap and to develop appropriate protocols and counselling materials on maternal nutrition.

We present a case of a 6-day newborn attended at the health center, whose mother was contaminated with Streptococcus agalactiae or group B (GBS) during pregnancy and had received four doses of ampicillin intrapartum. The reports did not mention the presence of GBS or anything regarding intrapartum antibiotic prophylaxis. The newborn had jaundice so we sent him to the hospital and he was admitted to neonatal service for phototherarapy with bilirubin of 23.1 mg/dL and was discharged with bilirubin of 10 mg/dL and normal physical examination and laboratory and breast feeding well established. After discharge, at 13 days old, we took urine culture to discard contamination by SGB and the 15th day of age was confirmed and diagnosed as a newborn contaminated by SGB and began treatment with oral amoxicillin for 10 days, and good health controls and normal subsequent urine cultures.

In this part, the application of probiotics in preterm neonates and pregnant and lactating women is reviewed. There are few studies on the administration of probiotic strains to preterm infants, but, in general, they indicate that the rates of necroti­zing enterocolitis and septicemia are lower among those receiving probiotics. In addition, the probiotic strains used in studies of this type have been shown to be safe in these immunocompromised hosts. In fact, the rapid spread of the kangaroo mother method, in which preterm infants are exposed to the commensal and probiotic bacteria existing in human milk, confirms the benefits derived from early contact with such bacterial agents. With respect to preterm infants with short bowel syndrome, it proves surprising that the administration of D-lactate-producing lactobacilli leads to a more rapid alleviation of the symptoms when compared with strains that exclusively produce L-lactate. Finally, pregnant and lactating women constitute a population in which the use of probiotics seems particularly interesting since the modulation of their gastrointestinal, mammary and/or urogenital microbiotas may have an important impact on the health of the mother-infant dyad.