#332 | The Hidden Power of the Infant Microbiome: Optimizing Exposure in Birth & Breastfeeding

In this episode, filmmaker and microbiome advocate Toni Harman joins us to explore the groundbreaking science behind establishing the infant microbiome—and why the earliest moments of life matter so much for lifelong health. Toni shares her personal journey from an unexpected C-section to uncovering how birth methods, antibiotics, and feeding choices shape immunity, metabolism, and risk of chronic disease over our lifetime.

Key Points Discussed Include:

• Why vaginal birth, skin-to-skin contact, and early exclusive breastfeeding are the gold standard for seeding a healthy microbiome;
• How C-section birth changes microbial exposure—introducing hospital and staff microbes instead of the mother’s;
• Why even a single bottle of formula can shift the gut microbiome, and how exclusive breastfeeding and skin-to-skin can help restore balance;
• The fascinating recent research about vaginal seeding during C-sections...is it actually effective?
• The impact of newborn exposure to maternal gut microbes at birth;
• How the microbiome begins to “lock in” by age 2–3, and ways to keep building resilience through early childhood.

Buckle up for some mind-blowing ideas in this episode! As always, Mother Nature has the perfect, albeit a little dirty, plan! 

Microbirth Film

Instagram: Toni Harman

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Transcript

I'm Cynthia Overgard, owner of HypnoBirthing of Connecticut, childbirth advocate and postpartum support specialist. And I'm Trisha Ludwig, certified nurse midwife and international board certified lactation consultant. And this is the Down To Birth Podcast. Childbirth is something we're made to do. But how do we have our safest and most satisfying experience in today's medical culture? Let's dispel the myths and get down to birth.

Hello, I'm Toni Harman, um, I'm a filmmaker, I'm a content creator, and I'm passionate about this subject of the infant microbiome, and we're about to launch our new film, and it's just this whole new world of microbes. And I want parents in particular to care about microbes, but birth professionals and clinicians, because I think this is such world changing information that everyone needs to know about it and care.

Toni, how did you get into this? Why? What made you become so passionate about the infant microbiome?

Okay, so long, short, long story short, I'm a filmmaker, and we've just just made a horror film, actually, that we sold to a Hollywood studio. So we thought we're off to Hollywood. And when I say we, it's my partner, Alex and I. So Alex is my partner. We live together, been together for 30 years, and we make films together, and we sold our film, and then I discovered I was pregnant, which is fantastic and wonderful, but it took us on this other direction. And as filmmakers, I wanted to be really prepared. So I took two different antenatal classes and a separate breastfeeding class, and I had made a really simple birth plan. I wanted to have a home birth, if possible, with midwives, and I wanted to have skin to skin and breastfeed, and as sometimes happens, I ended up four failed inductions, emergency C section.  I was taken off to the recovery room. Hadn't held my baby. My baby was brought to me 45 minutes later, wrapped up really, really tightly in a towel so there's no skin to skin contact. There was, there was no support for breastfeeding. And within an hour of my baby being born, someone, they didn't introduce themselves. I don't even who they were. Never seen them before. Someone came in and said, your baby needs to feed. Here's a cup of infant formula, and I felt pressured to give my baby this formula, and there was no support for breastfeeding to establish anything. And from that point on, I kept topic, and my milk supply never got established. I tried to breastfeed. It never really kind of I did breastfeed, but it just wasn't. Didn't produce much milk. Also, I felt so this is to start this, this despite all my, my perspiration, my my, my two antenatal glasses, two different sets of antenatal glasses, or my breastfeeding class, um. And so it was like, Okay, what happened there, then? So that question, so we, we was we probably, possibly not like any other people we, we go to experts as a filmmaker, but my background is in documentary filmmaking, so it's like, right, okay, I'm going to ask, ask people what, what is going on with birth today? And then I uncovered this whole different side to birth, and that I didn't realize that I was led down a path I wasn't involved in the decision making processes. I ended up having for inductions, which I didn't really want. I ended up having a C section, which I didn't really want. I ended up formula feeding, which I didn't really want. And so we started interviewing experts, and then we came across this wonderful world of the microbiome, and we made a film called microbirth, which uncovered this, this new way of thinking that that C section, antibiotics and formula feeding are disrupting this critical process where mothers microbes are passed to their baby in at birth, and if you don't complete this process, if you don't have a microbirth, we called it, then this could increase the risk of allergies, asthma, diabetes, obesity, neurodevelopmental disorders. And sure enough, my not sure enough. Who knows why this could have happened, but my baby, my daughter, has asthma now, and I know now that having asthma early in life means that you are increased risk of 36 comorbidities associated with asthma. So it's like a pathway disease to all these other diseases. So asthma might not sound that serious, but now I know there's, there's a trajectory of ill health that that's been started upon. So you went diving into this work being prepared to face what I can only assume was a host of painful emotions like regret or remorse over how your own babies were born. I mean, was that part of this journey for you being prepared to feel some of those emotions?

I think it's a way as maybe it's being kind of a filmmaking side of things, but it's a way to process how I felt. Yeah. So if I could get to the kind of the truth of it, I could work it out, work out what happened and and then this, this, this unseen world of the microbiome. And I've never heard of microbiome, and I had my paper. I never knew anything about this, the bacterial ecosystem that is so precious, that is so critical. Didn't know anything about it. So then we after, after microbirth, we set up an online school. We've got 45,000 health professionals in our school now, a couple of books, and we got a new film coming out, and we've interviewed, gosh, maybe over 100 different scientists in all different fields, asking the same question, does it matter how a baby is born and fed? And it turns out, it really does matter. And I feel like I've got this weight of responsibility to inform other parents and other health I'm not a health professional myself, but to inform health professionals and clinicians that they need to take into account this whole other bacterial ecosystem. Cos when a baby is born, it's not just the the human baby, it's their their ecosystem that's also born at the same time. And if you can set the baby's microbiome up how it's supposed to be set up, and now I know how to restore a baby's microbiome if they're born by C section. Um, so, and there's simple things you can do, which anybody can do. So if you it's, it's kind of, if you know about it, then you there's things you can do. So that's, that's the the weight of responsibility on my shoulders is to tell parents that there's things they can do so they can have their child, can have a trajectory towards health.

Can you begin Tony by describing the difference in the microbiome in a baby who's born vaginally versus a baby born by C section --

-- and also please explain what the microbiome is.

Okay, I'll go I'll go right to the start. Okay, so your microbiome, so when you look at me, I'm Tony, but you see me as human, and I'm trillions of of human cells, but I also am trillions of microorganisms that live on and in me. So they're bacteria, viruses, archaea, bacteria. You know, there's a whole smorgasbord of of microorganisms that live on and in me, and they're really important for your health. They're help important for digestion, metabolism, the immune system. There's a brain, gut connection. So they're just really important to all these different elements of of health as human health, and what happens during vaginal birth is a mother. So a mother has her own unique set of microbes that she passes to her baby during vaginal birth and from skin to skin and breastfeeding. So you have these, your unique set of microbes that you have. Every mother has a unique set of microbes, and they're passed to the baby during vaginal birth. And those microbes come from the vagina, from her gut, from her skin. And those first colonizers, those first microbes, they colonize the baby's gut microbiome, and so those so the baby, when the baby's born, hopefully the baby will get a good lick of the mum's bum on the way out. And that's brilliant, because that's exposure to mum's gut microbes. So if you've seen a baby born, and you guys have, you'll know the baby comes out on their licking and sucking, and all of those microbes go in, into the baby's mouth and swallow, they go to the gut, and then it's really important for those microbes to be fed really quickly. And this is the amazing, amazing thing, right? So there are special sugars in breast milk, which are which? Each mother has a unique set of these special sugars. They're called HMOs. And those HMO sugars are there to feed the microbes in the baby's gut. So the through breastfeeding, the baby gets these, these, this, this set of HMO sugars in breast milk, and they feed the baby's microbiome in the gut, which means they colonize quickly, and so you really want the gut colonized by the right set of microbes, because they're the ones that will train the infant immune system. So vaginal, birth, skin, skin, and breastfeeding, that sets the development the optimal development of the infant microbiome. Okay, so with C section, that doesn't happen, because the baby comes out, doesn't come out through the vagina, comes out through the sunroof, so it comes out through the abdomen. And so the first microbes that the baby's going to be exposed to aren't that. Aren't necessarily the mum's microbes from her vagina and her gut. They're going to be the those first microbes are likely to be the from the skin of people in the operating theater. So maybe there's 12 different people in the operating theater, and they've all got microbes around them, and they're the ones that are going to colonize the infant gut, and maybe some pathogens. If you were born in hospital, some pathogens are in there too. And if that baby, if the mother has been exposed to antibiotics, which she would have done if she's having a C section, or maybe she's tested positive for Group B strep, so those antibiotics will wipe out some of the mum's microbes in before they get to the baby, and if the babies are formula fed, those that that baby's not going to have the the mum's unique set of sugars, which are going to help feed those microbes in the baby's gut.

Can I jump in with it? I don't want to check your train of thought, but I'm really captivated by the fact that you just said, anyone in the room during that surgery, their microbiome is going to go into that baby just by exhaling near the baby.

Well, this is it, right? So, so you're, you're there, Cynthia, you're Trisha, so you're there, but around you are a cloud of microorganisms, right? So if I, if I walk into a room, my cloud of microorganisms that live around me follow me into the room, which I find really amazing, because you can go into that is amazing. It's like that character in Charlie Brown, right? He had like a cloud of like dust around him or something. So we actually have that around us. Is it from exhaling? Well, it's just within, within us, on us. It's just this kind of community, yeah, around us, but it's in the air around our bodies. It's in the air so your your skin has microbes that kind of lift off. So, so the so if you're born by C section, if you imagine a screen, so the mum is at the top end, breathing and her microbes at the top end, and then there's a screen. And then the kind of surgery happens beyond the screen. So all those people in the surgery room, in the operating theater, kind of mostly beyond the screen. Those people are going to have this cloud of microbes usually related to the skin of the people in the operating theater, so they're the ones that going to be the first arrival in the gut.

Is that not somewhat beneficial to the baby for getting exposure to good bacteria? Or is that absolutely not beneficial? I mean, babies were always born around some kind of community of people, maybe not strangers. But is there a benefit to that, as long as those people aren't sick with, you know, bacterial infections or not?

Not really, because the baby's supposed to get the mother's microbes. We have evolved over millennia for for with this unique set of microbes that we passed to our baby at birth, and you want your baby to have your microbes, you and your partner's microbes. You share microbes with your partner in your and in your home, because they're the ones you want the the immune system once it's trained to recognize. So those first colonizers, the mums microbes. They're really important. They're they're the mums, cos they're the ones that you want the immune system to recognize as friendly. If you get these microbes from strangers in the operating theater, and there might be pathogens in the operating theater, they're not your family, usually, but the the people on the other side of the curtain and are strangers you don't want, and you don't want the skin microbes to be the first ones necessarily, to colonize your baby's gut, you want the ones from your vagina and from your gut.

And isn't it? Is it true also Tony that the initial bacteria that colonizes a baby's gut must be specific to the vagina and the rectum, that it's not a bacteria that necessarily lives on the skin, so even just like the skin to skin, can't necessarily provide that bacteria and that what we're seeing today is that many adults are missing this bacteria in their gut microbiome that really can only be given to the baby. Well, not only, but initially, is given to the baby at birth. There are ways to supplement with it later, but they must come through that vaginal birth canal in order to get this initial bacteria. And it sounds like what you're saying is it's kind of time sensitive. It's not that you can't adjust and adapt later and help develop this microbiome through supplementation, and I'm sure other things that you're going to speak to us about, but it really seems like the moments of birth are critical that the first exposure is a particular kind of bacteria.

That's it, right? You've you've nailed it. So a baby is born with a naive immune system that has to be trained, has to learn to recognize what is friend, to be tolerated, what is foe. To be attacked. And that immune training happens in the first 612, months of of life. And that immune training, once it's set, that's it for life. You can't adjust. You can't you get no second chances. You have one chance to train your immune system. And the whole point of the microbiome is it, it comes in waves. You get your first colonizers, which set the conditions for the next set of microbes, which set the conditions for the next set of microbes, for the next set of microbes. So sure, you might be able to take probiotics later. That can be really, really helpful. But if you don't, if you don't have those microbes in the in the this critical window that surrounds birth, then that window closes and you'll have a male educated immune system. You're at risk of having a male educated immune system potentially for the rest of your life.

So Trisha was at my home birth for my second and another midwife was what would you say about a baby that was born vaginally, but there are other providers. There are other non family members present. So how does that story unfold as far as this?

Alright, so the the main, the main characters you want are, are your family, your immediate family members. I mean, if you and if you you and Cynthia, if you and Trisha are best mates, and you're in each other's houses the whole time, then it's kind of like you are a little family. 

I met her that day in labor, so that's not the case. So let's hear, walk us through it, though, for women listening, they have home births, even this is the other extreme, right, C sections. We're going to keep talking about. We're going to go going to go down that path of the most extreme intervention, C section, formula. But let's just say, for the women listening who had home births and just trying to balance out the benefit of that vaginal birth and the baby going right on the mother to the fact that a couple of strangers are also present, what is the impact of that from what you've found, I mean, let's call them strangers, if it's vaginal birth, and they're helping put the baby straight onto the mum's chest, and the mum has her own unique skin microbiome that wants to you, want to pass that to the baby directly. And skin to skin has many, many benefits. And so we Niels Bergman has been in our conferences, and he's a neuroscientist, and he suggests up to 16 hours of continuous skin to skin for the wiring of the baby in the mother's brain. So ideally you'd want the baby put skin to skin to get those skin microbes. And if it's a messy birth, and I've been to burst and then fantastically messy and dirty. And hopefully there'll be some, I've gotta say, like vaginal juices and maybe poo, and maybe it all just wiped on the mum's chest. And that's brilliant, because that that baby is hoovering up, he's sucking up those, those microbes from the mum's gut, which is which scientists seem to suggest that could be more important than vaginal microbes, even so, it's the exposure to the mum's poo is really, really important. So if the other people in the room are midwives and are standing back, have put the baby onto the mum's chest and standing back, great. And then ideally, you'd want to have the baby on the mum's chest for well, 16 hours, if possible. But if the mum isn't available for any reason, then the the the partner or the husband or the grandma, if the grandma lives with them, or her sibling, because they're all of those people in the home, they they will share the many of the same microbiome. I mean, the mum's most important. So ideally, it's gotta be the mum has has the skin to skin, because it's the mum that can breastfeed. But so, yeah, so it's kind of it's for the baby to be handled as little as possible by other people that aren't immediate family, because when the baby gets breast milk, that breast milk is going to perfectly serve the microbiome that that Mother has been exposed to, predominantly her own and those that she lives with.

That's it.

And is it also true though, that if the baby is born vaginally, it's not so significant. It's not as significant who is around or touching the baby, because that vaginal microbiome is going to be the predominant it's sort of going to out compete the other microbiomes. Whereas, if the baby is born by C section, and they don't have that predominant bacteria from the vagina and rectum, those bacteria can become the predominant and that's what we're trying to avoid. So if they're born vaginally, they're already protected, no matter who touches them or who's around. But it's a little bit more nuanced in that ideally, the mum wouldn't have taken multiple courses of antibiotics for. Through her life, because each time you take antibiotics, it kind of depletes your microbiome. So, so providing, not providing, ideally, the mum would have had eaten a healthy diet and have a good microbiome to pass on to her child. But you're right it, I mean, it is the kind of, it's, it's, it's exposure, ideally, to the mum's poo. That's the really critical thing, and that's why I never thought about this before. This is just the first time this is thought has ever coming to my mind. This is why babies are born face down. This is it. They're born facing the rectum. And sometimes there's a variation, sometimes they're born breech. Sometimes they're born posterior, but nature designed this so the baby's face and mouth would come out as close to the rectum as possible.

And when you see a baby born their mouth, they come out squished, usually the mouth wide opens, and that is fantastic.

So but women don't believe they have actually any fecal matter on their bodies, you know, because they keep themselves clean. Are you saying there's so it's so minimal and it's so microscopic that that is still sufficient, and exactly what the baby needs, it's really a matter of microscopic bacteria that's just always there,
  in your perineum area, your perineal area will hopefully be pretty messy, even if you can't see it. Those bacteria a mum has are meant are destined for the baby and to not have mess and to be too clean. This is the kind of whole theory that people with really clean houses, you know, hospital clean houses that can also disrupt the microbiome, because it's we're supposed to be living in a microbial world, or our own microbes.

Why is there so much benefit, though, to the fecal matter that's such an that's such an unpleasant thought. It just sounds so gross and bad, like it's in any other point in life, it would not be a healthy thing to consume, and even in tiny, tiny, tiny amounts. Can you just convince us why that's so beneficial?

If you think about, okay, so think about how we have evolved as humans. And if you, you know, giving birth in a cave or in a mud hut, if you go back sort of way, way 1000s of years, and it's messy. There's kind of weird. There might not have particular access to to running water. They didn't have taps in olden times. And so we've, we have evolved to to be this kind of what to be, you know, clean, but not sterile. It's only in the last maybe 50 years when, well, maybe 80 years since we've been really moving into giving birth in hospital that we've we've become obsessed with with hygiene and to the and sterility, making everything sterile. And that's because in hospitals, you don't want to transmit microbes from one person to another, right? They're they're set up for to destroy microbes, to kill microbes, and that's a really, really good thing, because you don't want infections from each other. However, this is the whole thing that we've we've not understood the the microscopic processes happening during birth. And during birth is the moment when is the, I think the only time in life you're meant to transfer microbes to another person, from the mother to the baby.

I mean, the rectum is an extension of the digestive system, which is the microbiome, which is the whole thing that we're trying to replicate, replicate. So it makes perfect sense to me that the baby would need the exposure to whatever is in the gut, which ultimately comes out of the rectum, and to the baby. And then this is just evolution. Babies were exposed to that when they were born, and then that helped develop their microbiome. And now that's the microbiome they need, because that's the foundation of their immune system. And so yeah, it really makes sense. Why would we think that it would be the vagina which has a slightly different microbiome, which is an interesting point, and this is extremely eye opening, because there is such a trend to do vaginal seeding for babies who are born by C section. And this is sort of blowing that out of the water and saying that's not going to do anything for your baby, not anything. I mean, how can I do anything?

It might help. So there's research about vaginal seeding. So vaginal seedings is where you put a sterile swab inside the mother's vagina an hour prior to the surgery, when then take out and out prior to the surgery, and then when their baby's born, you wipe the baby's mouth skin with the swab. So the the the idea is that you get exposed to mums vaginal microbes, and that that might help with the skin microbiome. The research says it helps with the skin. Microbiome. Okay, so this, I'm going to say something which may may or may not freak you guys out, may or may not freak out your listeners, there's some really brilliant research coming out of Finland, where a Finnish researcher was looking at, okay, the gut microbiome seems to have makes such a a bigger difference to the development of the infant gut microbiome. So what she did, she did, instead of the vaginal seeding, she took a bit the mum's poo and mixed it with breast milk and then fed that to the baby. I read this study, and it was astonishing. It was really it was hard to stomach. And it's certainly not recommended that moms start making their own poo milkshakes, because obviously the it needs to be done very carefully. But it's evidence that this is the essential exposure. The fecal matter is the extent is the essential exposure, which happens naturally in vaginal birth, and you don't need to make a poo milkshake.

So Tony, wait, wait, wait, tell us what the study showed, but also tell us it's it's honestly unthinkable to me, no matter what you say next. But how little fecal matter was in how much breast milk I can't this is really tough. Let's hear it. What were the results and how? What was the ratio?

Okay, so this was a really small pilot study, and it needs to be replicated on a bigger scale. I can't remember it was. It was probably like four or six babies. So tiny, tiny, tiny study. So you can't And if anybody's listening to this. This is a research study, so not to be advised at home, don't worry about that the mums were were screened for pathogens and all of those types of things, so to make sure that the poo was safe to give to their babies, right? So, lots of caveats, okay, but the research found that the baby's microbiome for from being born by cesarean. I think it was cesarean was restored, you know. So it's going to be colostrum. Let's get to expressed first. So a little bit colostrum, little bit the mum's poo, mixed together and then given to the baby. So I mean, again, it's, it's a very, very small study. It needs to be replicated on a much larger scale, but the it had made a significant difference to the baby's microbiome, much more so than vaginal seeding. So vaginal seeding is particularly good for restoring the skin microbiome of a baby, but and it possibly might set the conditions for more microbes. But the other thing right again, just on this poo track, is that, so I mentioned that ideally, the mum is going to be covered in vaginal micro is going to be covered in poo. It's going to be like a smorgasbord of of stuff on her. And one of the scientists we've we've interviewed, said mums, mums are covered in a fecal veneer. So we're so just through the birth process, we we are covered in microscopic organisms related to our gut microbes. So so it's so even if a baby is born by cesarean, provided that there's there is this fecal veneer on the mum and the baby's still going to get some of those gut microbes through skin to skin.

What are things that women can do? I had a question about formula feeding, and then I'd like to know all the basically empowering things women can do if these babies did not and there's so many women listening whose babies didn't have this optimal scenario, even my own home birth was not optimal by this definition. So my first question is, I'm not sure if you have the research, if it exists, but what is the minimum amount of days on colostrum and or breast milk that makes the baby's gut basically whole? What's the minimum? Because some women only do a few days of colostrum and they switch to formula, or a couple weeks of breastfeeding and they switch to formula, where how quickly does this happen, and what's the minimum, as far as the optimal microbiome for the baby, okay,

I'm going to switch that around. Okay, every single drop of colostrum is amazing. It's increasingly beneficial, is what you're saying.

Even one bottle of formula can potentially disrupt the which is a really difficult message, and I don't mean so even one bottle of formula can disrupt the infant gut microbiome. And it can take, I think it's up to two weeks for the gut microbiome to restore. So, but if you're exclusively breastfed, yep, so it says it's as you. Much is that soon, or as much colostrum or as breast milk as possible? It is a difficult message.

It is a difficult message, but it's an extremely important message. And if a mother has had and if a mother's baby has had formula in the first few days, they want to know this, because there are things that they can do later on to help with that gut microbiome. But I want to emphasize the point that babies are designed specifically for colostrum and nothing else in those first few days, their gut needs just that they don't need anything else, and the problem like you experienced is that the hospital will just come in and say your baby needs to eat, and it's not true. They need colostrum. They do need intake. They can't have nothing. They can't get dehydrated. That is always a risk if they're getting zero colostrum. But there are ways to get the baby colostrum, and I think we should hold a extremely high bar for giving formula to a baby in the first three days of life.

I agree. And I don't know how you feel, but I would love to see maybe more education about antenatal expressing of colostrum. So if you know you're going to have a C section, and perhaps it's breastfeeding after cesarean. Can does research suggesting that it's harder to establish breastfeeding. Maybe if you had little kind of syringes of colostrum that you expressed antenatally Late in, late in your pregnancy. So after, you know, say, 3637 weeks, maybe that could help so that your baby, however your baby is born, wherever your baby is born, you have a kind of a emergency backup that maybe you keep in the freezing and you defrost. I don't know how you feel about that. There's an ibclc, just this idea of maybe that can help this, this gap between, mean, I know myself, it it is hard to breastfeed without breast, without support, and you do need the supportive partner. You need the staff in the hospital to support your choices, actively support your choices.

Yes, I'll just give you my quick opinion on that. I think it's great for mothers to practice hand expression in late pregnancy. I think it's actually a really important skill to have if you're planning to breastfeed. Knowing how to use your hands to get your own colostrum and milk out is probably the best tool you could possibly have to support breast milk production. Now, if you are expressing colostrum in late pregnancy and it's not happening easily, what I don't want is for those moms to worry that that means that they're not going to have colostrum after the baby is born. So I tell mothers to practice in the shower see what happens. If it's coming out easily, great, feel free to collect it and store it. You might never need it. You might never you might you might just discard it, or you might use it for something else, but if it's happening easily, go for it. And if it's not, please, don't worry, because after your baby is born, your colostrum levels are going to increase, and it can be a lot easier to get out after that time, but knowing how to do it is the most important thing, and you don't want to have to learn how to do that in the first 24 hours after birth. So just know how to get that colostrum out. If your baby isn't latching after birth, it's okay. You can hand express the colostrum, you can spoon feed the baby the colostrum. You can cup feed the baby the colostrum. There are ways to get that baby fed other than breastfeeding, and what we really don't want to do is just go straight to formula, which is just so commonly recommended, because we think it's harmless. We just think it's food and it's it is not harmless. It actually can be really detrimental.

Can we circle back to my question just for a second one, I want to confirm that you said. I've always known that even an ounce of formula changes the baby's gut completely. I thought it was a permanent change. But what I think I heard you say was that if the woman ends up going to exclusively breastfeeding, she can restore that baby's microbiome, and the gut can heal. You're nodding. So that's fantastic news. The question I was asking was, What about the baby that never has an ounce of formula? How long does nature have it so that like, how long does it take to build up that baby's optimal microbiome with the HMO was it called HMO in the milk. What does HMO stand for, and how long does that process take if the baby is only exclusively breastfed?

So HMO stands for Human Milk Oligosaccharides, and they are each mother has a unique set of the special. I mean, there's, it's really complex, but I try to explain it really quickly, so that you have these HMO sugars that are unique to each mother. There's, there's two different types. So some mothers are secreta mothers, they produce a certain type. Uh, of they're able to produce a certain type of HMO sugars. Other mothers are non secretors, um, they'll never produce that particular type of HMO. So it's just everyone has a unique set of of microbes, and it depends whether you're a secreter or a non secreter. Very technical, but so how long does it take? I mean, the sign, sorry, the scientists say as long as possible. So the World Health Organization would say six months. There's evidence that it still makes a difference up to a year, maybe even two years later of your exclusively breastfeeding. I'm not a I'm not a human milk scientist. I'm not an ibclc, so as long as possible, in terms of restoring the the infant gut microbiome. So that's the the best thing for if your baby's born by C section, or you're exposed to the baby's exposed to antibiotics, either through you taking antibiotics at birth or or because the baby has an infection that's given antibiotics. So the two things which are really, really good to restore the baby's microbiome are skin to skin, as much skin to skin as possible, and exclusive breastfeeding. And exclusive breastfeeding, ideally would be at the breast, as opposed to expressed milk, because even there's a slight difference between just putting the milk into a bottle. Can alter, can alter things in terms of the the it's it's kind of better for the baby if the if the mom is able to breastfeed at the at the breast. I guess what you're saying is, even a bottle is an intervention that has its own minor impact on that perfect, flawless substance with the HMOs and everything. And I know you're cringing. You're wincing to say because you don't want women to feel like, oh my gosh, enough already. Like this is the perfect world scenario, and we don't need to worry about that. We're just educating ourselves, right? We're not here to feel bad about every little, every little intervention, like the fact that I had Trisha and another lovely midwife at my birth. It's all good. It's all fine, right? I think the takeaways, they're things we can do, right? It's it made a sense that the bottle would have an impact on it. It is an intervention, and that one thing we always say is we don't have all the answers. Yet. In 50 years, we're going to know so much more, and we're still learning these things. So no surprise, there's some little impact of the bottle. That's okay, right? We can, we can have that. It makes sense. Nature never expected the milk to go anywhere else, but from the breast into the baby.

And I think that's it. I think it's just, you know, even if there have been problems over the first days or weeks, just any amount of breast milk the baby's able to have, which is, is beneficial for that, that gut microbiome, probiotics can be useful, but it's it's really early days of kind of probiotic research, and because everybody has a unique microbiome, what might be good for one person might not be good for another. There's a kind of bit of a wild west out there in terms of which is the best probiotic, and it's a kind of marketing world, there's a couple which which there's really good evidence behind that may make a difference.

Can you name the particular bacteria that is the predominant bacteria in the baby's microbiome that they get exposed to in vaginal birth, that they might be missing in a C section birth, so bifidobacteria, traditionally has been passed from mother to baby. So in 1918, 99 tithier, Henry Tissier in France, found that the the intestines, the guts of breastfed infants had an abundance of what is now called bifidobacteria, and there's all different types of Bifido bacteria, although some rather worryingly, there's some research published a couple of weeks ago just saying that this, this type of bacteria may is disappearing in mums, and this is because of maybe multiple courses of antibiotics through their life, or that they've poor diet choices, or they've been born by cesarean themselves. So it's this is kind of on this mission at the moment to make people care about it. Because while we still have them, whilst most mothers still have them, hopefully there we can pass them on to our babies if we can.

And as for vaginal seating, would you say that it's not worth doing at all? Or, like, Sure, go ahead and do it if you're Group B strep negative, but you're not going to get optimal benefits. What is. A final message on vaginal seating for C section moms.

I mean, the it's not recommended anywhere, right? So at the moment, it's still a subject of ongoing research. There's been various studies published, and so that it's a bit of a mixed bag in terms of the study. Some say, yeah, it can make a difference. Some say it doesn't, doesn't really make that much difference. Some studies say it's, it's really good for your skin microbiome, for restoring the skin microbiome. So I would say for mums to do their own research, to look into, literally, just Google it, Google research, vaginal seeding. I think the the poo milkshake idea. I think that could potentially, I mean, not yet, because it's still a subject of ongoing research. I think that could have legs maybe, maybe it's not an idea that is palatable to most mums. Yet. I think myself, if I was going to have a baby and someone said, what about this idea of poo milkshake, even I would think, Oh, okay, that's a tough one. But again, it's just for for mums to do, to do their research and to to dive deep into the whole microbiome, to see the difference it makes, and to make their own choices be informed. That's what I would want moms to be. Are there any final tips for everyone, especially, probably almost anyone listening is going to think of how their situation was in optimal, like any other final tips or takeaways, or anything that people can do if they have three year olds, four year olds, five year olds, has that ship sailed, or is there something else the infant microbiome tends to kind of lock down by age two to three, so exposures before two to three make a bigger difference. You can still change it after the age of two to three, but it's just harder. It's just like your your bulk of it has as kind of is matured basically after the age of two to three. So things like getting a dog, exposure to a dog, really, really good getting outside. There's really good evidence about children playing outside in nature. Being exposed to nature is really good. Getting house plants in terms of your own microbiome. Mindfulness is really good. Kind of de stressing yourself, getting good, good quality sleep, drinking water, having a diet which is less or fewer Ultra processed foods, and just eating more whole foods, more plant foods, exercise is really good. Food microbiome, so moderate exercise. So there's research. So if you're pregnant, about walking 40 minutes moderate exercise four times a week makes a massive difference to your microbiome. That could just be going for a walk in nature four times a week. So there's things you can do. It's it's not all or nothing in terms of your the message is that whatever happens, however, when, whenever, wherever, your baby's born, ideally, skin to skin, and breastfeeding when possible. And if that's not possible, then it's it's more skin to skin. All of that is really, really good. And then to to be exposed to nature and to be a little less clean,  a little less clean.

Thank you for joining us at the Down To Birth Show. You can reach us @downtobirthshow on Instagram or email us at Contact@DownToBirthShow.com. All of Cynthia’s classes and Trisha’s breastfeeding services are offered live online, serving women and couples everywhere. Please remember this information is made available to you for educational and informational purposes only. It is in no way a substitute for medical advice. For our full disclaimer visit downtobirthshow.com/disclaimer. Thanks for tuning in, and as always, hear everyone and listen to yourself.