Maternal perspectives on the use of probiotics in infants: a cross-sectional survey

Knowledge, Attitude, and Practice of Healthcare Professionals and Medical Students Regarding Probiotics and Prebiotics in Lahore, Pakistan: A Cross-Sectional Study

Objective This study aims to explore healthcare professionals' and medical students' knowledge and attitudes toward probiotics and prebiotics in various health conditions. It seeks to identify any obstacles associated with their use and gain insight into the healthcare community's perspectives on these supplements. Methods A descriptive cross-sectional study was conducted using a preformed questionnaire. Data was collected by a convenience sampling technique during October and November 2023. A total of 417 responses were collected, and the data analysis was performed using IBM SPSS Statistics for Windows, Version 20.0 (Released 2011; IBM Corp., Armonk, NY, USA). Results In the study, 198 participants (47.5%) were doctors, and 219 (52.5%) were medical students. Only 81 (37%) students had good knowledge about probiotics, while 36 (16.4%) had good knowledge about prebiotics. Poor knowledge was associated with a poor knowledge, attitude, and practice (KAP) score, indicating a link between knowledge, attitude, and practice. Similarly, only 96 (48.5%) doctors had good knowledge about probiotics, while 45 (22.7%) of them had good knowledge about prebiotics. The study found that a lack of knowledge was the primary barrier to the use of prebiotics and probiotics, as reported by 226 (54.4%) participants. The chi-square test showed no significant correlation between participants' demographics and their KAP. Conclusion The majority of respondents demonstrated poor knowledge and practices regarding probiotics and prebiotics, which can be attributed to insufficient awareness of their benefits. Education tools like curriculum and training programs should include evidence-based information to raise awareness among healthcare professionals about their benefits and address concerns associated with their use in treating patients.

Determination of microbiota awareness levels in women planning pregnancy

OBJECTIVE

It was recently discovered that the microbiota has a significant impact on pregnancy, gynecological, and neonatal health. However, studies indicate that people struggle to understand topics, such as microbiota, microbiome, probiotics, and prebiotics, or comprehend them inaccurately or incompletely. Understanding the human microbiota and probiotics that can regulate the microbiota helps women develop daily habits for both healthy nutrition and health protection. The aim of this study was to assess the microbiota awareness levels of women who are planning pregnancy.

METHODS

A cross-sectional descriptive study was carried out on 417 women who were planning pregnancy. Face-to-face interviews and questionnaires were used to collect research data. A microbiota awareness scale was used as a data collection tool.

RESULTS

The study found a statistically significant difference in the subdimension scores related to microbiota awareness, general information, product knowledge, chronic disease, and probiotic and prebiotic knowledge based on the educational status of the participants. The study concluded that the participants had a confusion about microbiota awareness, general information, product information, chronic disease, and probiotic and prebiotic subdimensions. Furthermore, it was found that the participants had only a partial understanding of the relationship between microbiota and diseases.

CONCLUSION

It is recommended that training programs focusing on the relationship between microbiota and health in women, such as "microbiota and its importance in women's health" and "microbiota and disease relationship," be organized and women would be encouraged to participate in these training programs.

Investigate the relationship between the microbiota awareness in first trimester and high risk pregnancy in Turkish women: cross-sectional study

BACKGROUND

It is suggested that pregnancy risks may be related to microbial dysbiosis, and it is known that knowledge on this subject is reflected in behaviors. The purpose of this study was to investigate whether microbiota awareness in the first trimester of pregnancy is associated with pregnancy-related risks.

METHODS

Within the scope of the study, the microbiota awareness scale was administered to 426 individuals in the first trimester of pregnancy, and information on any diagnosis related to high-risk pregnancy, gestational age, birth weight, and birth height of the newborn was obtained from their file records.

RESULTS

The mean total microbiota awareness score of individuals was 61.38 ± 11.00 (26.00-91.00). The microbiota awareness score (56.85 ± 11.65) was found to be lower in individuals diagnosed with high-risk pregnancy (p < 0.05) than in healthy subjects (63.64 ± 9.94). Moreover, in individuals with high-risk pregnancies, a positive correlation was found between the microbiota awareness score and newborn birth weight and height (p < 0.05).

CONCLUSION

The poor microbiota awareness level in pregnant women is associated with high-risk pregnancy and neonatal growth status.

Pre- and Postnatal Determinants Shaping the Microbiome of the Newborn in the Opinion of Pregnant Women from Silesia (Poland)

Pre- and postnatal factors influence the formation of the newborn's microbiome as early as birth and the intrauterine period has a substantial impact on the composition of the baby's gastrointestinal microbiota and its subsequent development. This study intends to measure pregnant women's knowledge of the importance of microbiota for the health of the newborn. The sample was selected based on defined inclusion and exclusion criteria. The assessment of women's knowledge was assessed by the Kolmogorov-Smirnov and Kruskal-Wallis statistical tests. This study population comprised 291 adult pregnant women with a mean age of 28.4 ± 4.7 years. A total of 34% (n = 99), 35% (n = 101), and 31.3% (n = 91) were at the 1-3 trimester, respectively. The results showed that 36.4% of the women were aware that the intrauterine period changes the makeup of the gastrointestinal microbiota, whereas 5.8% exhibited awareness of the composition of the child's normal gut microbiota. Most of the women surveyed-(72.1%)-know that colonization of the tract occurs as early as the birth period. Women with student status (those who will pursue higher education in the future) and those who had given birth to the most children exhibited higher levels of knowledge.

A critical review of the recent concept of artificial mechanical uterus design in relation to the maternal microbiome: An Update to past researches

The microbiome in the female reproductive tract plays an essential role in immune modulation and reproductive health. However, various microbes become established during pregnancy, the balance of which plays a crucial role in embryonic development and healthy births. The contribution of disturbances in the microbiome profile to embryo health is poorly understood. A better understanding of the relationship between reproductive outcomes and the vaginal microbiota is needed to optimize the chances of healthy births. In this regards, microbiome dysbiosis refers to conditions in which the pathways of communication and balance within the normal microbiome are imbalanced due to the intrusion of pathogenic microorganisms into the reproductive system. This review summarizes the current state of knowledge on the natural human microbiome, with a focus on the natural uterine microbiome, mother-to-child transmission, dysbiosis, and the pattern of microbial change in pregnancy and parturition, and reviews the effects of artificial uterus probiotics during pregnancy. These effects can be studied in the sterile environment of an artificial uterus, and microbes with potential probiotic activity can be studied as a possible therapeutic approach. The artificial uterus is a technological device or biobag used as an incubator, allowing extracorporeal pregnancy. Establishing beneficial microbial communities within the artificial womb using probiotic species could modulate the immune system of both the fetus and the mother. The artificial womb could be used to select the best strains of probiotic species to fight infection with specific pathogens. Questions about the interactions and stability of the most appropriate probiotics, as well as dosage and duration of treatment, need to be answered before probiotics can be a clinical treatment in human pregnancy.

Parents' Perspective on Probiotics in Preschool Children: A Cross-sectional Survey

Introduction

The composition of the human gut microbiota, which can also be regulated by the consumption of probiotics, has a significant impact on host health. The main source of probiotics can be foods such as fermented foods, yogurts, fermented drinks and/or probiotic supplements. While parents play a critical role in ensuring the well-being of their children, this cross-sectional study is focused on parents' perspectives regarding the use of probiotics in the preschool period.

Methods

The self-administered online survey consisted of 24 questions arranged across two thematic sections. The final data analysis included 102 parents (96% F; 4% M), aged between 22 and 47. Their children were aged up to 6 years.

Results

The majority (52%) of the parents were familiar with the term 'probiotics' and 86.3% were including probiotics in their children's diet at the time of the survey. The main source was probiotic food (36.3%), of which yoghurt was the most commonly consumed (87.2%). The inclusion of probiotic supplements in a child's diet was positively correlated with parents' consumption and level of knowledge about the term 'probiotics'. Digestive tract-related disorders were the most frequently reported motive for the initial introduction of probiotics into children's diet.

Conclusions

Based on our study results, parents are familiar with probiotics and include them in their children's diet. However, an attempt should be made to close the gaps in parents' knowledge that our research identified. Further studies are needed to determine the recommended amount of probiotic foods, as well as strategies to educate parents about the benefits of including probiotic foods in their children's diet.

A real-world evaluation of an herbal treatment for infantile colic reported by 1218 parents in Israel

PURPOSE

Infantile colic (IC) or fussing and crying behavior of unknown cause, affects up to 20% of the infant population and is one of the major reasons for parents to seek medical advice. Therapeutic options are limited and the key component for IC management is parental support. Fennel-based herbal treatments were shown to significantly reduce crying time. The current study was designed to evaluate the parent perception of effectiveness of a fennel-based commercially-available herbal treatment for IC (BabyCalm, Hisunit Ltd., Israel) using a retrospective online survey.

DESIGN AND METHODS

This was a real-world observational, case-control retrospective study. Parents of babies with IC symptoms, who either used the herbal product for their baby or did not use any product were invited to participate in an online survey during August-December 2019. The primary outcome was the perceived level of treatment success and symptom improvement.

RESULTS

1218 parents of IC babies (48% females, 90% up to 3 months of age, 58% exclusively breast-fed) responded to the survey of whom 771 used the treatment. Significantly fewer IC-related symptoms were reported by parents who used the product compared to those that did not. Parents perceived the treatment as successful in 65% of the cases, reporting meaningful improvements within 30 min for 69%-79% of the symptoms.

CONCLUSIONS

The majority of parents perceived the herbal treatment as effective in rapid symptom reduction suggesting that this may provide a satisfactory solution for IC in the community.

Awareness of probiotics among dental practitioners of Puducherry-A cross-sectional questionnaire study

Background

The efficiency of probiotics in prevention and also treatment of oral infections including dental caries, periodontitis, halitosis is found to be appealing in the recent literature. Their antagonistic role in oral infections is mainly through formation of biofilm which needs documentation. Though the emergence and practice of oral probiotics is visualized for the past two decades, the consumption and knowledge level is found to be less among the community. Stronger source to spread scientific evidence to the community would be health professionals.

Aim

The current study is aimed at assessing the level of awareness of probiotics among dental practitioners of Puducherry thereby aid and assist in the beneficial practice of the same in the community.

Methods

The knowledge level was assessed through a cross sectional survey using closed ended questionnaire. Involves practicing dentists of Puducherry (n-173). A prevalidated questionnaire with 17 closed ended and one open ended question was employed as the research tool.

Results

The results revealed an acceptable knowledge in 77.4% and a greater level of knowledge in 20.8% of dentists. More number of studies are expected to fulfill the lacunae in the field of safety of usage and long term effects of probiotics.

Conclusion

Responses of the current study which was focused on dental practitioners revealed that the knowledge level is well above the acceptable level. There is no profound difference in the awareness level noticed among BDS and MDS practitioners..

Probiotic supplementation in healthy pre-school-aged children: Prevalence and predictors

AIM

Probiotics have been shown to prevent or treat a number of paediatric health problems; however, not much is known about how probiotics are used in the community. This study aimed to describe the prevalence and main predictors of probiotic supplementation among healthy pre-school-aged children.

METHODS

Parents of 4- or 5-year-olds residing in the Australian Capital Territory (ACT) were invited to complete a web-based questionnaire between February and May 2020. There were 469 responses concerning 494 children eligible for analysis. Prevalence was categorised as lifetime exposure and recent exposure. Predictors were determined through multiple logistic regression modelling.

RESULTS

Almost half (47.4%) of the children had ever been exposed to probiotics and 14.9% had taken probiotics in the previous month. The strongest predictors of lifetime probiotic exposure were parental lifetime probiotic use (OR 13.3; 95% CI 7.4-24.1) and an interaction between functional food consumption and parental lifetime probiotic use (OR 5.6; 95% CI 2.6-12.1). The strongest predictor of recent probiotic exposure was parental recent probiotic use (OR 13.3; 95% CI 5.7-30.8).

CONCLUSIONS

This study illustrates the high prevalence of probiotic exposure among healthy pre-school-aged children in the ACT and emphasises the relationship between parental use of probiotics and exposure in children. These findings will allow comparison and analysis of trends over time. Practitioners should be aware of the evidence for and against probiotics as these findings suggest a high level of acceptability among parents.

Maternal Intake of Probiotics to Program Offspring Health

PURPOSE OF REVIEW

Probiotics intake may be considered beneficial by prospective and pregnant mothers, but their effects on offspring development are incompletely understood. The purpose of this review was to examine recent pre-clinical and clinical studies to understand how maternal probiotics exposure affects offspring health outcomes.

RECENT FINDINGS

Effects were investigated in the context of supporting offspring growth, intestinal health, and gut microbiota, preventing allergic diseases, supporting neurodevelopment, and preventing metabolic disorders in pre-clinical and clinical studies. Most human studies focused on infancy outcomes, whereas pre-clinical studies also examined outcomes at adolescence and young adulthood. While still understudied, both pre-clinical and clinical studies propose epigenetic modifications as an underlying mechanism. Optimal timing of intervention remains unclear. Administration of selected probiotics to mothers has programming potential for sustaining life-long health of offspring. Administration protocols, specific windows of susceptibility, and individual-specific responses need to be further studied.

Symptomatic relief from at-home use of activated Bifidobacterium infantis EVC001 probiotic in infants: results from a consumer survey on the effects on diaper rash, colic symptoms, and sleep

The gut microbiome during infancy is directly involved in the digestion of human milk, development of the immune system, and long-term health outcomes. Gut dysbiosis in early life has been linked to multiple short-term ailments, from diaper dermatitis and poor stooling habits, to poor sleep and fussiness, with mixed results in the scientific literature on the efficacy of probiotics for symptom resolution. Despite the growing interest in probiotics for consumer use, observed symptomatic relief is rarely documented. This study aims to evaluate observed symptomatic relief from at-home use of activated Bifidobacterium infantis EVC001 in infants. Consumer feedback was collected over a 2-year period via a 30-day post-purchase online survey of B. infantis EVC001 (Evivo^®) customers. Outcome measures included observed changes in diaper rash, symptoms of colic, and sleep behaviours in infants fed B. infantis EVC001. A total of 1,621 respondents completed the survey. Before purchasing B. infantis EVC001, the majority of respondents visited the product website, researched infant probiotics online, or consulted with their doctor or other healthcare professional. Of the participants whose infants had ever experienced diaper rash, 72% (n=448) reported improvements, and 57% of those reported complete resolution of this problem. Of those who responded to questions about gassiness/fussiness, naptime sleep, and night-time sleep behaviours, 63% (n=984), 33% (n=520), and 52% (n=806) reported resolution or improvements, respectively. Although clinical data regarding probiotic use are often inconclusive for symptom resolution, home use of B. infantis EVC001 in infants improved diaper rash, gassiness/fussiness, and sleep quality within the first week of use in a significant number of respondents who engaged in a voluntary post-purchase survey. These outcomes may be a result of the unique genetic capacity of B. infantis EVC001 to colonise the infant gut highlighting the importance of strain selection in evaluating the effects of probiotic products.

Mothers' knowledge, attitudes and practices regarding probiotic use during pregnancy and for their infants in Turkey

OBJECTIVE

The current study was conducted to determine mothers' knowledge, attitudes and practices regarding probiotic use during pregnancy and for infants between 6 months and 2 years old.

DESIGN

The study had a cross-sectional design, and the data were collected using a Socio-demographic Information Form and a Probiotic Information and Attitude Form. The data were evaluated using frequency, percentage and χ2 tests.

SETTING

Two hospitals of one province in the central Black Sea Region, Turkey.

PARTICIPANTS

519 mothers with infants between 6 months and 2 years old who had been hospitalised in paediatric clinics participated in the study.

RESULTS

20·2 % of the mothers knew what a probiotic was, 33·1 % of them had knowledge of specific probiotic products and 49·7 % of them knew that breast milk contains probiotics. A statistically significant difference was found between mothers' knowledge of probiotics and probiotic products, and their ages, education, employment, income, family structure and whether they were actively breast-feeding (P < 0·05). A statistically significant difference was found between the mothers' knowledge that breast milk contains probiotics and their ages, education, employment, income, family structure, age of children and actively breast-feeding (P < 0·05).

CONCLUSION

The study found that the mothers' knowledge and practices regarding probiotics were inadequate, and that they traditionally used natural products in their daily lives. Evidence-based educational activities should be designed which include information about the definition of probiotics, and their benefits and disadvantages for mothers. Further studies are needed to determine the knowledge and attitudes of health professionals regarding the use of probiotics by mothers with infants and pregnant women.

Probiotic supplementation in well children: A scoping review

Probiotic supplements have been suggested as therapy for a range of health problems in children. This article aims to map the literature around probiotic use in well children, with a focus on prevalence. Using a scoping review methodology, we searched MEDLINE, CINAHL, HealthSource and SAGE, as well as Google and MedNar for grey literature, in July 2018. We followed the PRISMA extension for scoping reviews and used the Crowe Critical Appraisal Tool to assess articles for quality. Seven studies including a total of 24,742 children were identified. The prevalence of probiotic use ranged from 4% to 51%. The most common predictors of use were parental probiotic use, and higher maternal education and income. Only one small study reported the strains of probiotics used. Neither the reasons for using probiotics, nor parental perceptions of efficacy were adequately explored. Most parents obtained their information about probiotics from the Internet or family members. Despite the number of children in the community reported to have used probiotics, there are few well-designed and/or well-reported studies of prevalence, and inadequate data concerning the strains of probiotics used, reasons for their use and their perceived efficacy.

The future of probiotics in the preterm infant

Probiotic administration to preterm infants is not universal despite randomised trial data from >10,000 infants, significant observational data and multiple meta-analyses. Advocates point to reductions in necrotising enterocolitis and sepsis, 'sceptics' hold concerns over data quality/interpretation or risks. Issues revolve around different products, primary outcomes, uncertain dosing strategies and individual large 'negative' trials alongside probiotic associated sepsis and quality control concerns. We review concerns and how to move probiotic use forward. Surprisingly little is known about parental perspectives, vital to inform next steps. How to share information and decisions around probiotic use now, and how this impacts on future available strategies is discussed. We address placebo controlled trials and propose alternate designs, including head to head studies, using 'routine' data collection systems, opt out consents and 'learning technologies' embedded in health care systems. We also raise the importance of underpinning mechanistic work to inform future trials.

Why parents are skeptical about using probiotics preventively for small children: a Danish qualitative study

Background

Research on the health effects of probiotics continues to grow, but less is known about consumers’ perceptions of probiotic products and their health effects, and the impact of these perceptions on consumption. Particularly little is known about the way parents perceive probiotic consumption by small children, and whether parental willingness to use probiotics as a treatment differs from their willingness to use them preventively. The aim of this study was to explore how parents perceive probiotic consumption by their small children, and their willingness to use such products in treatment and prevention.

Methods

Semi-structured qualitative interviews with 17 Danish parents with at least one child aged 8–18 months. The interview guide centered on parental consumer practices and health-related attitudes both in general and in relation to probiotics. The data were coded in Nvivo and analyzed in a four-step analytical approach.

Results

Parents are willing to use probiotics as a treatment but are skeptical about preventive use. Some parents define probiotics as a kind of medicine they use only if their child is ill. Probiotics also conflict with parental understandings of their children as small, perfect parts of nature. Parents worry that probiotics may cause an imbalance in the vulnerable perfection of a small child.

Conclusion

The study shows that parental probiotic consumption practices are embedded in a cultural understanding of the child as both a perfect example of nature and vulnerable. Health authorities need to take this understanding into account if parents are to be successfully encouraged to use probiotics preventively.

Electronic supplementary material

The online version of this article (10.1186/s12906-018-2387-2) contains supplementary material, which is available to authorized users.