Somministrazione di probiotici in epoca perinatale e neonatale: quali evidenze?



Speciale ‘I Pinguini’ – Il Pediatra n.6/19, pagg. 54-57

Somministrazione di probiotici in epoca perinatale e neonatale: quali evidenze? 

Mariella Baldassarre*, Antonio Di Mauro**, Nicola Laforgia***

*Ricercatrice confermata, Dip. di Scienze Biomediche e Oncologia Umana- Sezione di Neonatologia e T.I.N., Università degli Studi “Aldo Moro”, Bari. AOU “Ospedale Policlinico”, Bari. E-mail:

**Dottore di Ricerca, Dip. di Scienze Biomediche e Oncologia Umana- Sezione di Neonatologia e T.I.N., Università degli Studi “Aldo Moro”, Bari.

AOU “Ospedale Policlinico”, Bari. E-mail:

*** Direttore U.O.C. di Neonatologia e T.I.N, Dip. di Scienze Biomediche e Oncologia Umana- Università degli Studi “Aldo Moro”, Bari.

AOU “Ospedale Policlinico”, Bari. E-mail:


  1. Hillman ET, Yao HLT, Nakatsu CH. Microbial Ecology along the Gastrointestinal Tract. Microbes Environ. 2017, 32, 300–313.
Baldassarre ME, Palladino V, Amoruso A et al. Rationale of Probiotic Supplementation during Pregnancy and Neonatal Period. 2018 Nov 6;10(11). pii: E1693.
  3. Pickard JM, Zeng MY, Caruso R, Núñez G. Gut microbiota: Role in pathogen colonization, immune responses, and inflammatory disease. Immunol. Rev. 2017, 279, 70-89.
  4. Calatayud M, Koren O, Collado MC. Maternal Microbiome and Metabolic Health Program Microbiome Development and Health of the Offspring. Trends Endocrinol Metab. 2019 Sep 4. pii: S1043-2760(19)30156-0.
  5. Mastromarino P, Capobianco D, Campagna G Correlation between lactoferrin and beneficial microbiota in breast milk and infant’s feces. Biometals. 2014 Oct;27(5):1077-86.
  6. Toscano M, de Vecchi E, Rodighiero V, Drago L Microbiological and genetic identification of some probiotics proposed for medical use in 2011.J Chemother. 2013 Jun;25(3):156-61.
  7. Kolacek S, Hojsak I, Canani RB et al. Commercial probiotic products: A call for improved quality control. A Position Paper by the ESPGHAN Working Group for Probiotics and Prebiotics. Pediatr. Gastroenterol. Nutr. 2017, 65, 117–124.
  8. Baldassarre ME, Bellantuono L, Mastromarino P et al. Gut and Breast Milk Microbiota and Their Role in the Development of the Immune Function. Pediatr. Rep. 2014, 2, 218–226.
  9. Carabotti M, Maselli MA, Severi C. The gut-brain axis: Interactions between enteric microbiota, central and enteric nervous systems. Ann. Gastroenterol. 2015, 28, 203–209.
  10. Cryan JF, Dinan TG. Mind-altering microorganisms: The impact of the gut microbiota on brain and behavior. Nat. Rev. Neurosci. 2012, 13, 701–712.
  11. Roman P, Rueda-Ruzafa L, Cardona D, Cortes-Rodriguez A. Gut brain axis in the executive function of autism spectrum disorder. Behav. Pharmacol. 2018, 29, 654–663.
  12. Foster JA, McVey Neufeld KA. Gut-brain axis: How the microbiome influences anxiety and depression. Trends Neurosci. 2013, 36, 305–312.
  13. Amaral FA, Sachs D, Costa VV et al. Commensal microbiota is fundamental for the development of inflammatory pain. Natl. Acad. Sci. USA 2008, 105, 2193–2197.
  14. Heijtz RD, Wang S, Anuar F et al. Normal gut microbiota modulates brain development and behavior. Proc. Natl. Acad. Sci. USA 2011, 108, 3047–3052.
  15. Arentsen T, Qian Y, Gkotzis S et al. The bacterial peptidoglycan-sensing molecule Pglyrp2 modulates brain development and behavior. Mol. Psychiatry 2017, 22, 257–266.
  16. De Palma G, Blennerhassett P, Lu J et al. Microbiota and host determinants of behavioural phenotype in maternally separated mice. Commun. 2015, 6, 7735.
  17. Desbonnet L, Garrett L, Clarke, G. et al. Effects of the probiotic Bifidobacterium infantis in the maternal separation model of depression. Neuroscience 2010, 170, 1179–1188.
  18. Savignac HM, Tramullas M, Kiely B et al. Bifidobacteria modulate cognitive processes 
in an anxious mouse strain. Brain Res. 2015, 287, 59–72.
  19. Leclercq SMian FMStanisz AM, et al. Low-dose penicillin in early life induces long-term changes in murine gut microbiota, brain cytokines and behavior. Nat Commun.2017 Apr 4;8:15062.
  20. Slykerman RFCoomarasamy CWickens K et al. Exposure to antibiotics in the first 24 months of life and neurocognitive outcomes at 11 years of age. Psychopharmacology (Berl).2019 May;236(5):1573-1582.
  21. Drossman DA. Functional gastrointestinal disorders: history, pathophysiology, clinical features, and Rome IV. Gastroenterology 2016;150:1262-79.
  22. Oświęcimska J, Szymlak A, Roczniak W, et al. New insights into the pathogenesis and treatment of irritable bowel syndrome. Adv Med Sci 2017;27;62:17-30.
  23. Zeevenhooven J, Koppen IJ, Benninga MA. The New Rome IV Criteria for Functional Gastrointestinal 
Disorders in Infants and Toddlers. Pediatr. Gastroenterol. Hepatol. Nutr. 2017, 20, 1–13.
  24. Salvatore S, Baldassarre ME, Di Mauro A et al. Neonatal Antibiotics and Prematurity Are Associated with an Increased Risk of Functional Gastrointestinal Disorders in the First Year of Life.J Pediatr. 2019 Sep;212:44-51
  25. Baldassarre ME, DiMauro A, Mastromarino P et al. Administration of a Multi-Strain Probiotic Product to Women in the Perinatal Period Differentially Affects the Breast Milk Cytokine Profile and May Have Beneficial Effects on Neonatal Gastrointestinal Function Symptoms. A Randomized Clinical Trial. Nutrients 2016, 8, 677.

Baldassarre ME, Di Mauro A, Tafuri S et al. Effectiveness and Safety of a Probiotic-Mixture for the Treatment of Infantile Colic: A Double-Blind, Randomized, Placebo-Controlled Clinical Trial with Fecal Real-Time PCR and NMR-Based Metabolomics Analysis

Sung V, D’Amico F, Cabana MD et al. Lactobacillus reuteri to Treat Infant Colic: A Meta-analysis. Pediatrics 2018, 141, e20171811.
Fiocchi A, Pawankar R, Cuello-Garcia C et al. World Allergy Organization-McMaster University Guidelines for allergic disease prevention (GLAD-P): Probiotics. World Allergy Organ J. 2015, 8, 4.
Allen SJ, Jordan S, Storey M et al. Dietary supplementation with lactobacilli and bifidobacteria is well tolerated and not associated with adverse events during late pregnancy and early infancy. Nutr. 2010, 140, 483–488.
  4. Kuitunen M, Kukkonen K, Savilahti E. Pro and prebiotic supplementation induces a transient reduction in hemoglobin concentration in infants. J. Pediatr. Gastroenterol. Nutr. 2009, 49, 626–630.