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How the Microbiome Develops from Birth_Final

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>> Hi, I'm happy to be back to talk with you more about microbes. In this lecture, we're going to start all the way back at the beginning. We'll take a look at how the miracle of life is created with microbes. Before a baby even comes into this world, conditions are set up for its growth and development. This includes the development of a healthy microbiome in the gut and other areas of the mother's body. The gut is essential to healthy development of the digestive and immune systems, and it informs the body what to let in and what to keep out. Let's take a look at the mother's microbiome during pregnancy. When a woman is pregnant, the diversity of microbes in her gut starts to decline. However, it's in the third trimester that we see the biggest change. At this stage, the microbiome shifts into the profile of an obese or a high-inflammatory community filled with more proteobacteria and less Faecalibacterium, the bacteria that reduces inflammation. Experiments have been done to transfer the bacteria from women in the third trimester to mice that are free of germs. These mice were observed to immediately gain weight and become inflamed. They also experienced an increase in insulin resistance, which again suggests that microbes alone can influence metabolism. A baby inside of a mother's womb is protected from the outside world and totally dependent on the mother. There's good reason for this, the baby is part of the mother so that she can rely on her resources while, here, she develops their own abilities for basic functions. The mother's immune system is suppressed during this time so that her body doesn't mistake her little bundle of joy as a foreign invader. As a side note, this is why pregnant moms are instructed to limit foods that are more likely to contain pathogenic bacteria such as sushi and soft cheese. With the weakened immune system, the body is forced to respond to pathogens with inflammation. A pregnant woman is more susceptible to bacteria, but now that we know a mother passes not just her genes but also her bacteria onto her child, there may be a trend look toward how to bolster more of the healthy guys during pregnancy. The womb was long believed to be sterile, but it turns out this isn't the case. In fact, the colonization of the microbiome begins in the womb. We're still learning about the development in utero, but research suggests that the mother's health may affect the child's microbiome even before birth, even her dental health. In the third trimester, the mother's microbiome may be full of proteobacteria, but the fetus maintains a microbiome similar to the first trimester. Perhaps this is the first test that the bacteria can be resilient and not take on everything around them. When the baby is born, it's immediately exposed to more bacteria and many other factors that influence its development. The infant microbiota is shaped by three main factors, the birth process, whether natural or by c-section, diet including breast milk and the diet of the mother, and antibiotics or other environmental disturbances. Let's take a look at each of these in more detail. We'll start with the birth process. When a baby is born, it comes out covered in vaginal bacteria, mostly lactobacillus. This is the bacteria that's predominant in the mother's vagina, and it can survive oxygen. It's interesting to know that a child also comes out face down so that it requires a handful of bacteria from the mother's anus. This may not be the most appealing image, but it's a perfect combination of the microbes the baby needs to start developing its own community of beneficial bacteria. The initial bacteria that populate the gut are facultative anaerobes. These are bacteria that can handle oxygen but also quickly switch to the fermentation process, meaning they can breathe oxygen when it's removed. The reason for this is that a baby's gut contains oxygen. The first bacteria have the job of consuming that oxygen. This is all given that the baby is born naturally. In the US, one-third of all babies are born via caesarean section or c-section. We're now learning that c-sections provide the first alteration in the natural development of an infant microbiome. If a child is born via c-section, then the baby is covered in more proteobacteria, mostly staphylococcus and acinetobacter and less bifidobacterium. It may be that the baby picks up bacteria from the skin of the mother and possibly the waiting room or any other bacteria nearby, as these are common bacteria from those areas. Think about the concept of crowding out that you learned in the Health Coach Training Program, that can't be avoid. Bacteria are everywhere, so when it's not handed down from the mother through the natural birth process, the baby acquires whatever bacteria's nearby to make up for it. Babies born via c-section have a higher risk of autism, allergies, obesity, celiac disease, and cavities. Some researchers now believe that this may be partly due to microbiome they're missing out on from the journey through the birth canal. This isn't meant to vilify c-sections which have saved many babies and mothers over the years. The point is to explore the value and wisdom behind natural birth so that we may explore alternatives and replacements for these bacteria when natural birth isn't ideal or possible. That way babies born via c-section don't miss out on a potentially beneficial bacteria passed down from their mother. Rob Knight who is one of the top microbiome scientists and the co-founder of the American Gut, the largest microbiome citizen science project, had a child born via c-section, knowing the importance of early life microbiota, Dr. Knight and his wife took matters into their hands. They took a bacterial swab of the mother's vaginal bacteria and covered the baby in that swab. So far, this baby hasn't had any signs of developing allergies or any other disorders named above. This is only one case study, but major studies are now being conducted to understand the value of such a procedure which may very well become common place for all babies born via c-section. When a baby comes out, they're not quite ready for the world, the digestive system is incomplete, and their mucous lining is not fully formed. So with that said, let's talk about diet. Feeding is one of the first ways that a child is able to develop his or her microbial community. When a baby starts on breast milk, their bacterial community evolves. For a long time, it was perplexing why breast milk contained human milk oligosaccharides that couldn't be broken down by an infant's gut. What's the point of that? Human milk oligosaccharides, or HMOs for short, are the third most predominant ingredient in breast milk after fat and lactose. And guess what? They're also nature's most amazing pre-biotic. It would seem that breast milk has been built specifically to feed a baby's microbes. Breast milk also contains the momma's antibodies and immune molecules to protect against pathogens. The mother's passing along her protection and nurturing all in one perfect package. As the gut develops, the mucosal lining starts to thicken and growth and beneficial bacteria increases. For example, one species you may recognize from probiotics, bifidobacterium longum appears to feed on breast milk, and it uses that to out-compete other species of bacteria. Babies who feed on breast milk have more bifidobacterium and lactobacillus bacteria and twice the abundance of bacteria in general. The tipping point for an increase in diversity from breast milk really occurs when they're receiving more than 50% breast milk versus formula. If a baby is born premature, their microbiome will have a high level of proteobacteria, the bacteria is seen in the third trimester of birth, that's characteristic of lower diversity. These babies tend to be more susceptible to being colonized by pathogens. Again, the amount of beneficial bacteria is important because it takes up space in the microbiome that could otherwise be occupied by pathogens or non-beneficial bacteria. It's helpful to visualize this as parking spaces in the garage. There are only so many spots available for bad bacteria if good bacteria are already taking up most of the spots and the garage is near capacity. Over the first few months of life after birth, bacteria and microbiome development vacillate between what resembles in adult vaginal bacterial community and in adult fecal community. Every week or so, it makes large gains towards resembling the fecal community, and then bounces back like a ping-pong ball to a more vaginal community. The differences in the microbiota from week to week are much greater than the differences in healthy adults. The development of the gut microbiome contributes to the development of the immune system. This is where communication begins between the body and the immune system so that the body can recognize or overlook the healthy bacteria and keep an eye out for pathogens. Should this process not go according to plan, it can also set the body up for trouble later on such as allergies or autoimmune disease. The third factor that influences how an infant's bacterial community grows are external factors such as antibiotics. When the child is young, antibiotics can have a larger setback on development. For example, yeast is naturally occurring in the gut, but yeasts aren't targeted by antibiotics. So if you think about how this works, when bacteria are killed by antibiotics and a person doesn't have enough beneficial bacteria to take up the spaces, then yeast can overgrow. Here's an interesting tidbit, there's more and more growing evidence that colicky babies have an altered microbiome. These babies tend to have less diversity and microbiota that resembles the trimester, similar to premature babies. This is another area where probiotics may be an option to discuss with healthcare practitioners. As the baby develops and is introduced to bacteria, their mucous lining thickens to keep a barrier between the bacteria and the individual. When an infant switches to solid food, their microbiome switches again based on diet. Solid food spikes diversity within just one day because it feeds existing bacteria while also shepherding new bacteria into the gut. Around age of two, the bacterial community is closed to being fully developed. The child's gut is now fully prepared to take in other microbes from their food and the world. During this time, the body is developing bacterial communities all over, not just the gut. Other sites of the body such as the mouth, the skin, the nasal cavity, and anything exposed to the outside world are filled with bacteria. Different bacteria live in various conditions depending on various pH levels, water content, and level of oxygen. So what can you do with all this information? Let's go over three steps to promote a healthy microbiome from a young age. Step one, expose babies to healthy bacteria early on. We're talking about the good kind of bacteria. This starts before birth with the help of the mother. If possible, it's best for the mothers to monitor the health of their own microbiomes in regard to things such as dental health, maintaining a healthy weight, and so on. Because in infants, microbiome develops in the womb, it may be beneficial to avoid taking antibiotics while pregnant if possible. If a mother is unable to have a natural birth, she can look into swabbing her newborn with bacteria and providing probiotic supplements early on. As we mentioned, newborns quickly start to acquire bacteria that is often a collection of their mother's microbiome. Thanks to the way he or she is born and the bacteria present in their environment. Probiotics can help with diarrhea and colic and can also have a positive influence on height and weight. There are many formulas that are proven to be safe for children. Look for probiotics that are specific to children and have their mothers ask their pediatricians for a list of approved probiotics. Dosage is dependent on the severity of the condition, but higher dosage should only be taken under prescription from your practitioner. We'll go more into probiotics in an upcoming lecture. As babies grow, breastfeeding is ideal but in cases where that's not possible and awareness of the microbiome can send the client looking for natural alternatives and ways to develop diversity. There are six strains of bifidobacterium that have been isolated from human breast milk and are used in some infant probiotics. These are a great way to supplement when needed. Step two, minimize antibiotics in the early stages of a child's life. In the very young phases, the microbiome is more susceptible to disturbances and more susceptible to changes that occur from taking antibiotics. Early use of antibiotics can prevent probiotic bacteria from colonizing in the gut. And since the microbiome plays a huge role in training the infant's immune system, if possible, alternatives should be researched and antibiotics saved for extreme cases, only when necessary. If they're truly unavoidable, antibiotics should be followed up with good probiotics recommended by the pediatrician. Step three, introduce children to dietary fiber. As I just mentioned, a child's microbiome becomes fully developed and more adult-like around the same time that solid food is introduced. There are even some fun ways to get children involved in eating more fiber. First, introduce a variety of vegetables early. Children are largely influenced by habit and routine. The sooner you make vegetables a part of their daily staple, the more habitual it becomes. Use fruit as a sweet snack. Fruit is not only great for children but it can be offered as a sweet indulgence. A practice they can carry with them into adulthood, rather than candy fruit can be just as satisfying and framed as a sweet. Similar to educating children on how to do science experiments that involve growing plants, they can be taught early on about the garden in their gut and how to feed their microbiome with adequate fiber. This may seem foreign now, but as we learn more about the value of bacteria, this may be as common subject as brushing your teeth or eating your greens. By the end of a healthy development period and with the proper exposure, a diverse microbiome is formed with a full and intact mucosal lining. At this time, a child's microbiome becomes relatively stable. Diet and environmental disturbances will continue to have an effect on the system as we age, like when you switch from a plant-based diet to meat-based diet or vice versa, the microbiome changes instantly. This was useful in evolutionary sense as we humans were forced to adapt to abrupt changes in diet. However, these changes only seem to last while the diet is in effect. For the most part, the mucosal layer remains unchanged and plasticity occurs when needed for dietary changes. So to recap, the microbiome starts to develop in the womb, and the stage for this is set by the condition of the mother's bacterial profile. From day one, the three main factors that affect the development of the microbiome in babies are the birth process, the diet of the baby, and antibiotics or environmental disturbances. You can teach your clients to support healthy microbiome development in the early years by exposing their babies to healthy bacteria, minimizing antibiotic use unless absolutely needed, and introducing their young children to dietary fiber. These steps will help to promote diversity, creating good bacteria to help crowd out bad bacteria. This is the goal throughout all of life. As we age, our bacterial diversity declines to complete the evolutionary curve. The research is still in development, but it appears that the impressionable time in the development of the infant microbiome seems to be from the womb until 2 years of age. If better awareness is placed on this time period, we may be able to set up our children for better health and a better shot at avoiding some of the chronic diseases. Let's keep the conversation going in the Facebook group. Do you recall receiving numerous rounds of antibiotics as a child? How many of you ask your clients about their early life experiences when discussing their current health? This might provide some insight to what many think are unexplained symptoms. And remember, none of these suggestions or discoveries are meant to place any judgment on the choice of the mother or family. We're just looking at new information that still needs to be validated on a larger scale, but it's very interesting to consider. This can be useful when working with your clients. I look forward to hearing you share your experiences, and I'll see you soon.

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Duration: 17 minutes and 35 seconds
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Language: English
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Posted by: ninaz on Mar 21, 2018

How the Microbiome Develops from Birth_Final

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