The more we learn about infant microbiome, the more we realise how crucial this life stage is in ‘setting up the adult microbiome’ that the infant will have – pretty much for life!
We call it the ‘First 1000 days window’ – the period from conception to 2 years of age – in which the infants Microbiome develops dependent on various confounding factors, the main ones being;
- Mothers microbiome in pregnancy
- Birth mode & experience
- Feeding Method
- Antibiotics (and other medication) exposure
- The introduction of solid food
1/ Mums Microbiome in Pregnancy
Research is ‘conflicting’ at best about whether the placenta has its own microbiome and baby is exposed to bacteria in utero. Regardless, we know that dysbiosis (imbalanced microbiome) in Mum during pregnancy has links with complications such as pre-eclampsia, early membrane rupture, pre-term birth, gestational diabetes and GBS infection.
Learn more about this here
2/ Birth Mode & Experience
This is a really big part of the early stages of the infant microbiome development (really big!). This is the first ‘major’ exposure of bacteria and it begins during labour when the amniotic sac breaks and the baby makes its way down the birth canal.
The birth canal (in a healthy mum) is FULL of good bacteria (‘PRObiotics’) and a very specific kind too…
Really interestingly, the birth canal and vagina microbiome should only be dominated by the Lactobacilli family (and even then – only 4 species – very specific) as these are the ones we want baby exposed to at this stage.
Many things can ‘go wrong’ here. Firstly, we can have a ‘dysbiotic’ vagina microbiome to begin with. This can happen when there’s not enough of the good guys (Lactobacilli) so other microbes and/or pathogens (‘bad guys’) grow in their place – think Candida, Group B Strep (GBS), Gardnerella etc
Common if we’ve had issues in the past (previous GBS infection, Bacterial vaginosis or Thrush) or particularly if we’ve had antibiotics during pregnancy.
Secondly, we can be exposed to antibiotics again at this stage – think GBS, early membrane rupture, infection, pre-term birth, etc.
So even if you do have the vaginal birth – your vagina microflora may have been compromised.
C-section Delivery – this creates a very different kind of ‘first exposure’ for bubs. Depending on whether it’s an ‘elective’ (no labour) or ‘emergency’ (membrane rupture & labour and therefore some exposure to mum’s microbiome), research shows early colonisation bacteria is very different.
Two things happen here – the ‘lack of exposure’ to vaginal flora from the birth canal & the ANTIBIOTICS routinely given to prevent infection post-surgery.
Ways to remedy this & increase exposure to mum’s flora – SKIN-TO-SKIN – get your gear off and get baby on your chest ASAP – and if mums busy getting stitched up (!) – get in there DAD, your microbiome works too!
Better than that of the hospital theatre and nurses right!?
And the next most effective remedy – BREASTFEEDING – the ‘next stage’ of major influence over infant microbiome development. See below
Traumatic Birth experience
This needs to be mentioned here because unfortunately, it’s a common occurrence in the current health care / birth choices landscape. Understand that stress and trauma have major impacts on all outcomes, including the microbiome – both for mum and bub.
My advice; PREPARE & EMPOWER yourselves if you’re pre-birth & seek SUPPORT & RECOVERY if you’re post-birth and had a traumatic experience – healing is of the utmost priority.
Reach out, there are many resources. See references section below for an example.
3/ Feeding Method
Ok so breastfeeding is one of, if not THE MOST important consideration for developing the infant’s microbiome. It’s not just the live PRObiotic bacteria in the breastmilk – but also the PREbiotics, Human Milk Oligosaccharides (HMOs) that feed up and maintain a specific & controlled early microbiome. Learn more about HMOs here.
Breastmilk is not just ‘babies first food’ – it’s PERSONALISED NUTRITION for the baby, full of everything baby needs to grow and develop. We often acknowledge that a babies gut & immune system are immature when born – but it’s not just that – EVERY system is immature – skeletal, muscular (think floppy heads!), CENTRAL NERVOUS SYSTEM – yes think about that, that’s brain and spine – breast milk contains many components (not just FUEL);
- Growth factor
- Immune cells & antibodies
- Stem cells
- Neurotrophic factors (they’re the ones that grow the brain cells!)
Artificial formulas don’t just ‘not have’ these important components, they also have additional ‘free-sugars’ that feed a very different set of microbes in bubs. Research shows breastfed vs formula show a very different microbiome – and these changes have been linked to an increased risk of obesity amongst other factors.
I’m not talking about mums who can’t breastfeed (and unfortunately this is common too!) – I’m talking to mums who don’t know the risk – we need to make INFORMED choices.
And if you’re a mum having trouble with breastfeeding we have amazing resources available to get help. See references.
If you can’t breastfeed no matter what – and this DOES NOT make you a bad mum / failure etc – it HAPPENS, get some good quality probiotics (breastmilk strain) & prebiotics to add to the formula.
Get the help of a qualified health professional with this as ‘good quality’ can be hard to navigate in the supplement world!
4/ Antibiotics and Other Medications
Antibiotics are all TOO COMMON in pregnancy and breastfeeding and have far reaching implications for mum and baby. Not only do they take out the infection (or often used to prevent infection as a ‘just in case’) – but they also kill all the good flora – both in mum’s gut, breastmilk AND babies little immature gut.
This leaves mum and bubs at increased risk of MANY problems – and often these are very far reaching – recent research even suggested that infants exposed to antibiotics during child birth / early infancy are at increased risk of developing antibiotic resistance AND obesity later in life (it’s the changes to the microbiome from the antibiotics!)
Good quality PRObiotics have been shown to offset some of the damages and reduce the risk of associated complications.
Other medications such as acid suppressing drugs (Nexium, losec etc), anti-depressants, diabetic medications, steroids & even the regular use of nurofen & panadaol (!) have also been shown to disrupt the microbiome.
See a qualified health professional for alternatives to these medicines (there are many!) – as often they are prescribed unnecessarily, or a natural lower or no side effect option is available.
5/ The Introduction of Solid Food
This is the next ‘big’ influence on the infant’s microbiome development – but very interestingly – if you are still breast feeding this has the BIGGEST influence over when the microbiome matures to that of ‘adult type’
Thinking in evolutionary terms – we would usually have breastfed until 3-5 years of age – this would extend the time infants are developing their microbiome & associated systems.
So the longer you breastfeed the better!
With introducing solid food we’re introducing ‘other things’ that feed the microbiome, specifically;
- Plant food prebiotics > usually a GOOD influence, high in fibre, nutrient dense, low in sugar etc
- Processed carbohydrates > can be not so good! Think of processed rice cereal for example – nutrient poor (except for the added synthetic nutrients!) and high in sugar
When introducing solid foods think whole foods, vegetables & fruits, to begin with. Keep an eye out for the next article where we will delve into this topic in much more detail!