Introduction: Infantile colic is a picture of abdominal discomfort, defined by Wessel and included in the Rome III criteria. Although considered benign somewhat related inflammatory markers, causing a disorder in infants and a major anxiety in their family. Lately the use of probiotics such as Lactobacillus reuteri have been successful in other European populations.
Objective: Microbiota modulates intestinal inflammatory response and depends on genetic and environmental factors. We proposed a pilot study to try to reproduce the European results in our population.
Method: Observational prospective study of symptoms associated with colic in 17 healthy infants who were prescribed L. reuteri DSM 17938, indication approved by the Spanish Regulatory Food Agency. In all the written and informed consent of relatives was obteined. Follow-up clinical data using questionnaires and two physical visits to control and determination of calprotectin in feces. Statistical analysis with Stata v11 program chi 2 test and linear regression analysis.
Results: Evolution of clinical parameters such as time crying and infant discomfort were lower as the weeks passed. The perception of improvement and the reduction of faecal calprotectin levels also showed a parallel evolution. The height and weight were not affected.
Conclusions: The use of L. reuteri clearly improves symptoms and reduces infant family anxiety, and the values of intestinal inflammatory markers. Its use does not interfere with the development of weight-height patients. Studies are necessary with larger populations to confirm these initial data.

Introduction: The postnatal period is important for intestinal microbiota establishment, which is involved with the intestinal development, prevention of pathogens colonization, digestion and synthesis of nutrients, as well as immune and neuronal systems maturation. Intestinal colonization takes place during the first days of life, being influenced by the method of delivery, type of lactation, and the environment. Furthermore, the microbiota composition and functionality might be influenced by maternal and neonatal diet. The objective of this review was to present scientific evidence published during the last years regarding the role of delivery methods, type of lactation, supplementation with pre and probiotics on neonatal intestinal microbiota composition.
Methods: In this work, more than 19 articles published dur­ing the last 15 years and obtained from different specialized databases (NCBI, Web of Science, Elsevier Journal, Science Direct) are included. We have analysed studies related to humans.
Results: The method of delivery and type of lactation might modify the intestinal microbiota in new-borns. Supplementation with probiotics increased the Bifidobacterium and Lactobacillus genera. More studies are needed to evaluate the effects of probiotics in the development and functionality of intestinal microbiota in the newborns. Supplementation with prebiotics may induce the production of secondary metabolites that are able to modulate the newborn epigenome's.
Conclusions: More studies are needed to elucidate the exact mechanisms that modifies in the microbiota composition and describe personalized nutritional strategies to enhance the newborn development.

Mastitis represents the main medical reason for precocious weaning. Generally, acute mastitis is easily diagnosed, in contrast to the subacute o subclinical ones. Milk cultures and antibiograms would facilitate a rational treatment of the different types of mastitis; however, the services of Microbiology that routinely perform microbiological analyses of human milk are very scarce at present. In this context, the objective of this article is to associate each type of mastitis with its etiological agents, its characteristic symptoms and the most adequate therapeutic approach. This therapeutic proposal is basically directed to those cases in which milk cultures and antibiograms are not possible and/or those in which is not possible to wait for the results in order to initiate the treatment.

Breast milk is the best food for the neonate because it provides a unique combination of proteins, carbohydrates, lipids, minerals and vitamins that ensures the correct growth and development of infants. In addition, it also contains bioactive compounds responsible for a wide range of beneficial effects, such as the promotion of immune system maturation and protection against infections. Among these bioactive agents, probiotic bacteria have recently been isolated from human milk. The present report reviews the beneficial effects of these bacteria both in animal models and in clinical trials. The promotion of immune system maturation and defence against infections, as well as the anti-inflammatory properties, are among the major health effects of these bacteria. The isolation of probiotic bacteria with beneficial effects for the host provides scientific support for the supplementation of infant formula with these bacteria, in order to advance toward the main target of these formula, to mimic the functional effects observed in breastfed infants.

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.

The design of probiotics specifically targeted to the infant population is attractive to both the medical community and the industrial sector since they could facilitate the creation of a safe and efficient barrier against pathogenic microorganisms and, in addition, they can contribute to the maturation of the gut-associated lymphoid tissue. At present, there is scientific evidence supporting the beneficial effect of certain probiotic strains on infant health, particularly in relation to the reduction in the duration and/or severity of diarrheal episodes associated with acute infectious gastroenteritis, including those secondary to antibiotic therapy. On the other hand, some strains may exert preventive and therapeutic effects on atopic eczema and other allergic diseases, although additional clinical studies will be required before probiotics can be used for the treatment of such conditions on a widespread basis.

Objective: This revision of the Community Directive on infant formulae and follow-on formulae analyzes the amendments befallen after the proposal of the Scientific Committee on Food of the EU, the industry position and the recommendations of an ESPGHAN leaded International Expert Group, ending as a result in the final adopted European and International norms.

Methodology: Comparison between the Directive 91/321/EEC, modified by the Directive 96/4/EC, the report of the Scientific Committee on Food of 2003 and the recommendations of the International Expert Group of 2005 with Directive 2006/141/EC and Codex Standard 2007.

Conclusions: The adoption of both new norms has allowed the regulation of the befallen scientific and technical developments over the respectively last 10 and 25 years in composition, labelling, presentation and advertising of these formulae. However some controversies remain and they will probably be matter of future reviews.

The coming into effect of the new regulation on functional foods will only allow the introduction of nutritional and health claims that are scientifically substantiated. Probiotics are an important category of functional foods that are taken into consideration in this regulation. However, the possible introduction of new probiotic strains, as well as their use in sectors other than the food industry, makes it necessary to establish additional considerations, such as the regulation of novel foods. In 2002, within the framework of the FAO/WHO, an expert consultation group worked to define (i) the amount of scientific evidence necessary to make health claims concerning probiotic foods, (ii) the means necessary for their regulation and labeling, and (iii) the criteria for the evaluation of their efficacy and safety. Although, as yet, there is no international consensus on these aspects, the recommendations of this consultation group have been transferred to the Codex Alimentarius Commission for their consideration within the framework of the regulations of both functional foods and novel foods. In the context of probiotics, as part of the functional foods, the new regulation points out the need to define the dose-effect relationships, the specific beneficial effect of each probiotic, the target population, and the safety issues, to date, only regulated in probiotics for animal feed. The standardization of the criteria for evaluating the efficacy and safety of probiotics, as well as the establishment of solid correlations between in vitro and in vivo trials, constitute challenges for the scientific community, the producers and the regulatory authorities. Overall, the regulations adopted will contribute to the harmonization of the criteria for commercialization of functional foods and those containing probiotics and to the protection of consumers' rights by communicating the health claims in a normalized format.

In this part, two of the factors that may favor the development of infectious mastitis are highlighted: the interactions between the immune system of the host and the mastitis-causing bacterial strain and the use of antibiotics without a rational basis. In some women, the immune response is insufficient to avoid an intramammary infection. On other occasions, staphylococci may alter the normal immune response by means of the production of superantigens. Moreover, some bacterial strains could evade the immune system through molecular mimetics with the host. The second predisposing factor is the use of certain antibiotics during the last trimester of pregnancy, labor and/or lactation. A small percentage of the staphylococci and streptococci that colonize the mammary gland during pregnancy and lactation are resistant to antibiotics. When inadequate antibiotic therapy is applied, resistant strains are selected that grow without competition and reach abnormally high concentrations, a process that leads to infectious mastitis. Subsequently, the procedure for obtaining milk samples for microbiological analysis is described and other conditions that should be taken into account for the differential diagnosis are discussed. Finally, a variety of therapeutic options are presented, from antibiotics and anti-inflammatory agents to probiotics and bacteriocins.

Obesity is one of the main public health problems due to its fast prevalence increase and co-morbidities with several diseases, as the metabolic syndrome, diabetes and cardiovascular diseases. Social changes associated to high intake of energy-dense food and low physical activities have created an obesogenic environment worldwide. In this context, the identification of new factors involved in the regulation of the energy balance has mainly the aim of developing more efficient intervention strategies.

The intestinal microbiota is considered a new factor involved in the body weight regulation and in diseases associated with obesity through its influence in the metabolic and immunologic functions of the host. The intestinal microbiota and some probiotics also regulate the subject's immunological functions, protecting from infections and chronic inflammation processes. Instead, disorders in the intestinal ecosystem (dysbiosis) and endotoxemia might be inflammatory factors responsible for developing insulin resistance and body weight gain. Based on the relations between the intestinal microbiota, the metabolism and immunity, the use of dietary strategies to modulate the microbiota, based on probiotics and prebiotics, is likely to contribute to the control of the metabolic disorders more efficiently.