The infant microbiome and our effect on future generations
This year, I got a new online training and I loved it very much. The full title of the course is "The infant microbiome and epigenetics" but for sure the topics related to babies are inseparable and there are lots of topics that cover other aspects of birth and pregnancy that are concerning the infant microbiome. The whole course was great for me to be able to teach expectant couples how to prepare their baby's microbiome and the things they can do in early childhood.
Most of the knowledge and studies are new which means they are up to date. Honestly, I didn't know that many specialties are working and researching in this field. The speakers are very special and experienced about the recent and ongoing research.
So, what is this infant microbiome?
The infant microbiome is the set of bacteria we get during birth and is the most important thing to train our immune system and prevent our lifelong health. When in balance, microorganisms protect our body from disease. (asthma, allergies, IBD, IBS, auto-immune disorders, obesity, and even some cancers) The most important thing to start with is that it passes to the next generation. So whatever we get from our parents, we pass it on to our children. The researches show us that the variety of bacterias, and microbiomes are decreasing. So it is becoming less diverse which means we need to do something to change this. Unfortunately, it is becoming a part of the evolution since we pass what we have however it is never too late to preserve what we have and left. I believe it is also our, as parents, responsibility to protect this for our children and future generations. You will understand the reasons more as you read and as you understand how the system works.
During pregnancy, the vaginal flora starts to change. The number of a specific type of bacteria called Lactobacilli bacteria starts to increase. This is to get prepared for birth and breastfeeding. It forms the source of the microbes that are going to pass to the baby during vaginal birth and breastfeeding. The microbes start to pass to the baby when the amniotic sac opens. The baby starts to colonize with the mother's vaginal microbes. The bacteria go in contact with all of parts of the baby's body: skin, ears, nose, eyes, and mouth... Then when the baby's head is out, it gets the mother's fecal matter. Surprise! Poop is a normal part of birth. Babies born their faces turn to the mother's back, facing the mother's anus because of this reason. The babies’ guts start to colonize with these bacteria. Everything is designed so perfectly.
When the baby is born and goes to the mother's chest for skin-to-skin, the colonization continues. Microbes are everywhere, so the mother has them in her skin, in her mouth, eyes, ears, and inside her gut. So as the baby touches the mother's skin, she/he gets those microbes. You can see here the importance of skin-to-skin contact in the first hours affects everything. The benefits of skin-to-skin contact are countless and this is just one of the many. If you had taken any of my courses before or if you are a member of my newsletter list, following my IG account, you probably know how sensitive (or may call obsessed:) about skin-to-skin contact I am. It is the way you can assure your baby is getting a good start.
In the days following birth, as the baby keeps breastfeeding and touches around and puts many things in his/her mouth the training of the immune system continues as so in the following months. Note here that putting on gloves interrupts this and is not healthy. There is also another secret of breastfeeding. Breast milk has human milk oligosaccharides. They can not be digested by infants (nor grownups) You might think this is odd because nature doesn’t work that way mostly. There is always a reason why things had been created the way it is. And that’s true as you can see in this whole process. The sugars in the breastmilk are for feeding the friendly gut microbes. The researches show that the babies that are breastfed (or so given breast milk) are less likely to develop allergies compared to formula-fed infants.
The first year and early childhood environment and experiences are also important to get to complete the immune system's training. And to keep the diversity of microbes in our body, we need lifetime care.
Is it so important to go through these steps in order?
Yes! Because the research says with the first bacteria, the baby's immune system starts to learn what is a friend and what is a foe by providing some signals. If these signals can't be provided, the immune system can't distinguish between the signals and reacts to every environmental factor as a threat. Therefore, for optimal training, the bacteria should arrive in a certain order.
And what if I have a c-section or can't get to have skin-to-skin right away, is my baby's immune system ruined forever?
That was the question I had when I first started learning about infant microbiomes since I also accompany caesareans as well as vaginal births and I gave birth to my son via mother-baby-friendly c-section because of medical reasons. I directly related to this as a mother. I felt terrible at first while going through the course and as I learned about the ways to recover, I got relieved. Also, don't forget that this is a never-ending journey so even if you missed those times, you can still recover in many ways (you will see the recommendations below)
So the answer to the question is no but let's first see what happens in c-birth and then we will look at the ways to recover.
In cesarean baby doesn't pass through the vagina so can't be exposed to the mother's vaginal flora and fecal matter which means the baby can't get the full set. Another aspect is that the mother is most commonly prescribed antibiotics which affect her microbiome and so the baby's. It is also more likely that the mother doesn't get to have skin-to-skin after a cesarean delivery which also affects the process. What if the baby can't have these microbes in a certain order? Baby has a different set of microbiomes which is associated with increased rates of future illnesses.
Ways to recover
*Learn about mother-baby friendly or so-called gentle cesarean and make sure your doctor supports that procedure.
*Request skin-to-skin! (which means right after birth and uninterrupted for at least a couple of hours)
*Breastfeed exclusively.
*Continue to breastfeed skin-to-skin in the first weeks.
*There is also a method called swab-seeding. It is this idea that if gauze is placed in the mother's vagina before the surgery and if the baby's face is wiped with it right after the baby is born, then the baby can get the vaginal flora. This wouldn't replace the whole scenario of a vaginal birth but can contribute to the optimal training of the immune system. Although many families are adding this to their birth preferences, it is still ongoing research and is not evidence-based yet.
What is our role in the infant microbiome then?
It starts even before pregnancy with forming the habits to have a healthy set of microbiomes.
Here are the tips for pregnancy:
*Have a balanced diet with a variety of foods: fresh fruits and vegetables, unprocessed, high-fiber, and fermented foods. What you eat affects the formation of your flora.
*Try to avoid the use of antibiotics and use it carefully only if prescribed by your obstetrician. Using probiotics when using antibiotics helps to preserve the friendly microbes. We know that antibiotics affect the microbial flora of our body.
*Be cautious when using antibacterial products since they also kill friendly microbes.
*Check your lifestyle. A healthy lifestyle means healthy microbial flora. Exercising is a part of a healthy lifestyle. Be cautious about your exposure to toxins.
*Learn and practice breathing exercises, relaxations, and mindfulness to reduce chronic stress.
Tips for birth:
*Try to avoid cesarean if possible (check the cesarean section above)
*Learn about skin-to-skin and request it!
*Breastfeed right after birth and learn the healthy ways to establish breastfeeding.
*Get a childbirth education class to be able to learn and implement all of the above.
Tips for early infant years:
*Let your baby expose to nature &pets
*Be cautious about the use of antibacterial products (they also kill the friendly microbes) too much hygiene is not good for your baby’s immune system:)
By implementing these and being informed about microbiomes, we can create a healthier society and future generations. We have a significant role as individuals and parents for a better world.
References
The Infant Microbiome and Epigenetics, Microbiome Course, Toni Harman, https://microbirth.teachable.com/p/microbirthonlinecourse
Van den Elsen, Garssen, Burcelin, & Verhasselt, Shaping the Gut Microbiota by Breastfeeding: The Gateway to Allergy Prevention, 2019, https://pubmed.ncbi.nlm.nih.gov/30873394/
Bäckhed F, Roswall J, Peng Y, Feng Q, Jia H, Kovatcheva-Datchary P, Li Y, Xia Y, Xie H, Zhong H, et al. Dynamics and Stabilization of the Human Gut Microbiome during the First Year of Life. (2015) Cell Host & Microbe. (2015) https://www.ncbi.nlm.nih.gov/pubmed/25974306
Mueller NT, Bakacs E, Combellick J, Grigoryan Z, Dominguez-Bello MG. The infant microbiome development: mom matters. Trends Mol Med. 2015 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4464665/
Crenshaw JT, Healthy Birth Practice #6: Keep Mother and Baby Together – It’s Best for Mother, Baby, and Breastfeeding, The Journal of Perinatal Education. (2014) Fall https://www.ncbi.nlm.nih.gov/pubmed/25411542
Guaraldi & Salvatori, Effect of Breast and Formula Feeding on Gut Microbiota Shaping in Newborns, 2012 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3472256/
