# Maternal probiotics intake during pregnancy and exclusive colostrum breastfeeding are associated with a reduced risk of neonatal jaundice

## TL;DR

Taking probiotics during pregnancy and exclusive colostrum feeding may lower the risk of neonatal jaundice in newborns.

## Contribution

This study is the first to show a link between maternal probiotic use and exclusive colostrum feeding with reduced neonatal jaundice risk in a large cohort.

## Key findings

- Maternal probiotic intake during pregnancy was associated with a 22% reduced odds of neonatal jaundice.
- Exclusive colostrum feeding was linked to a 66% lower incidence of neonatal jaundice compared to other feeding modes.
- Mothers who increased or maintained probiotic intake had a significantly lower risk of neonatal jaundice in their infants.

## Abstract

Neonatal jaundice (NJ), characterized by significantly increased bilirubin levels, is a prevalent global neonatal condition affecting 60–80% of newborns. It imposes long-term adverse effects on neurodevelopment and overall health. Current clinical treatments, such as phototherapy, primarily focus on symptom management, whereas the preventive strategies for NJ remain largely lacking. Infant breastfeeding is associated with NJ. However, whether maternal probiotics use and infant colostrum feeding may reduce the NJ risk has yet to be determined and warrants further investigation in large-scale cohorts. Therefore, this study aimed to evaluate whether they have any preventive effect.

We investigated the relationship of maternal probiotic intake and baby feeding type with NJ onset using the CHILD cohort, a prospective birth cohort recruited 3624 mothers and 3542 paired infants. Probiotic intake during pregnancy and its patterns (increased, maintained, or decreased compared to preconception) were obtained via questionnaires. The NJ conditions (yes/no) and feeding modes (exclusive colostrum, formula-only, or mixed feeding) were collected from hospital birth records. Bivariate and multivariable logistic regressions were employed to evaluate the risk using adjusted odds ratio (AOR) with 95% confidence intervals (CI) after adjustment for confounders. P < 0.05 indicates statistical significance.

A total of 2596 healthy controls and 433 NJ cases with complete data were included from the CHILD cohort for analysis. Interestingly, probiotic intake during pregnancy was associated with a remarkably reduced odds of NJ (AOR 0.78 (0.61, 0.98), P = 0.041) compared to participants who never used probiotics. Neonates with exclusive colostrum feeding also had a significantly lower incidence of NJ than other feeding modes (AOR 0.34 with (95%CI) (0.27,0.44), P < 0.001). Further stratification analysis on probiotic intake showed that mothers who increased (AOR 0.53 (0.32, 0.89), P = 0.016) or maintained (AOR 0.44 (0.24, 0.80), P < 0.007) probiotic intake during pregnancy had a lower risk of NJ compared to those who decreased intake.

This cohort-based evidence highlights that maternal probiotic intake and exclusive colostrum feeding are important modifiable factors associated with reduced NJ risk.

Summary of the association of maternal probiotics use and exclusive colostrum feeding with neonatal jaundice (using the data from the CHILD longitudinal birth cohort). The figure is created using BioRender.com. CHILD, Canadian Healthy Infant Development; n, number of participants involved in the corresponding sections.

The online version contains supplementary material available at 10.1186/s12916-025-04516-x.