The prevalence of childhood overweight and obesity has increased in most countries the last decades. Considering this in a simplistic way, we can say that obesity is the result of an imbalance between energy intake and energy expenditure. Moreover, the environment from conception to childhood could influence the child’s future health. The first 1000 days of life start with woman’s pregnancy, and offer a unique window of opportunity to contribute to obesity prevention. In light of the actual literature, the aim of our article is to discuss a proposal of 10 good practices to minimize obesity in the first 1000 days emerging from published science. (1) Both the mother’s and the father’s behaviors are important. A balanced diet with appropriate fat and protein intake, and favoring fruits and vegetables, is recommended for both parents during the conception period and pregnancy. Furthermore, overweight/obese women who are planning to become pregnant should reduce their weight before conception. (2) During pregnancy, at birth, and during early life, body composition measurements are crucial to monitor the baby’s growth. (3) Exclusive breastfeeding is recommended at the beginning of life until six months of age. (4) Four to six months of age is the optimal window to introduce complementary feeding. Until one year of age, breast milk or follow-on/commercial formula is the main recommended feeding source, and cow’s milk should be avoided until one year of age. (5) Fruit and vegetable introduction should begin early. Daily variety, diversity in a meal, and repeated exposure to the food, up to eight times, are efficient strategies to increase acceptance of food not well accepted at first. There is no need to add sugar, salt, or sugary fluids to the diet. (6) Respect the child’s appetite and avoid coercive “clean your plate” feeding practices. Adapt the portion of food and don’t use food as reward for good behavior. (7) Limit animal protein intake in early life to reduce the risk of an early adiposity rebound. Growing-up milk for children between one and three years of age should be preferred to cow’s milk, in order to limit intake and meet essential fatty acid and iron needs. (8) The intake of adequate fat containing essential fatty acids should be promoted. (9) Parents should be role models when feeding, with TV and other screens turned-off during meals. (10) Preventive interventions consisting of promoting physical activity and sufficient time dedicated to sleep should be employed. In fact, short sleep duration may be associated with increased risk of developing obesity. Based on literature reviews, and given the suggestions described in this manuscript, concerted public health efforts are needed to achieve the healthy objectives for obesity and nutrition, and to fight the childhood obesity epidemic.

BACKGROUND: Studies suggest that giving newly born preterm infants sustained lung inflation (SLI) may decrease their need for mechanical ventilation (MV) and improve their respiratory outcomes. METHODS: We randomly assigned infants born at 25 weeks 0 days to 28 weeks 6 days of gestation to receive SLI (25 cm H₂O for 15 seconds) followed by nasal continuous positive airway pressure (nCPAP) or nCPAP alone in the delivery room. SLI and nCPAP were delivered by using a neonatal mask and a T-piece ventilator. The primary end point was the need for MV in the first 72 hours of life. The secondary end points included the need for respiratory supports and survival without bronchopulmonary dysplasia (BPD). RESULTS: A total of 148 infants were enrolled in the SLI group and 143 in the control group. Significantly fewer infants were ventilated in the first 72 hours of life in the SLI group (79 of 148 [53%]) than in the control group (93 of 143 [65%]); unadjusted odds ratio: 0.62 [95% confidence interval: 0.38–0.99]; P = .04). The need for respiratory support and survival without BPD did not differ between the groups. Pneumothorax occurred in 1% (n = 2) of infants in the control group compared with 6% (n = 9) in the SLI group, with an unadjusted odds ratio of 4.57 (95% confidence interval: 0.97–21.50; P = .06). CONCLUSIONS: SLI followed by nCPAP in the delivery room decreased the need for MV in the first 72 hours of life in preterm infants at high risk of respiratory distress syndrome compared with nCPAP alone but did not decrease the need for respiratory support and the occurrence of BPD.

Late preterm infants account for the majority of preterm births. They are at an increased risk of neonatal mortality and morbidity and are less likely to initiate breastfeeding and to be exclusively breastfed at discharge compared to infants born at term. The aim of this study was to identify the facilitators and barriers to breastfeeding during hospital stays according to the experiences of mothers of late preterm infants. We conducted a cross-sectional questionnaire survey. Mothers who intended to breastfeed and had given birth to a newborn admitted to level I and II care, with a gestational age of 34 0/7 to 36 6/7 weeks, were enrolled. Sociodemographic data, neonatal variables, mode of feeding and feeding status at discharge were also collected. A total of 92 mothers who had given birth to 121 infants were enrolled. At discharge, any human milk was fed to 94 % of infants, with exclusively human milk being fed in 43 % of cases; exclusively formula was fed to 6 % of infants. In the multivariate analysis, having expressed breast milk was independently associated with an increased risk of being fed with either any human milk or formula only (OR = 2.73, 95 % CI 1.05–7.1, p = 0.039), whereas being encouraged to practice kangaroo mother care tended to have a protective effect (OR = 0.46, 95 % CI 0.2–1.06, p = 0.07). Based on the present findings, health care professionals should strive to fully implement breastfeeding support for mothers of late preterm infants who intend to breastfeed, in particular optimizing breast milk expression and promoting kangaroo mother care. Further studies are needed to gain further insight into the complex interplay of the factors that modulate breastfeeding outcome in late preterm infants.

Antibiotic therapy is one of the most important strategies to treat bacterial infections. The overuse of antibiotics, especially in the perinatal period, is associated with long-lasting negative consequences such as the spread of antibiotic resistance and alterations in the composition and function of the gut microbiota, both of which negatively affect human health. In this review, we summarize recent evidence about the influence of antibiotic treatment on the neonatal gut microbiota and the subsequent negative effects on the health of the infant. We also analyze the possible microbiome-based approaches for the re-establishment of healthy microbiota in neonates.

Background The aim of this study was to evaluate the association between red blood cell (RBC) transfusions on the risk of death, retinopathy of prematurity (ROP), bronchopulmonary dysplasia (BPD), and necrotizing enterocolitis (NEC) in very low birth weight (VLBW) infants. Study Design and Methods This is an observational study. Data were entered prospectively into the study database at the time of the first transfusion. Clinical characteristics, adverse events, and outcomes of the patients transfused in the first 28 days of life were compared with the population of VLBW infants not transfused during the same period. The association among birth weight, gestational age, comorbidities, and the number of transfusions was estimated with a Poisson regression model. The association between the composite outcome and the occurrence of death, ROP, or BPD separately considered and a set of covariates was estimated with a logistic regression model. Results We enrolled 641 VLBW infants, 42% of whom were transfused. Transfusions were associated with the risk of developing the composite outcome, independently from other conditions; this risk correlated with several transfusions ≥ 3 (odds ratio: 5.88, 95% confidence interval: 2.74–12.6). ROP and BPD were associated with several transfusions ≥ 3. Conclusion We observed an association between RBC transfusions and the composite risk of death or ROP, BPD, and NEC.