May 11, 2022 • 35 mins
The gut and microbiome is increasingly being referred to as your “second brain,” with fascinating new research linking the microbiome to everything from behavior to skin health. In this episode, Shazi speaks with Dr. Jack Gilbert, Professor in Pediatrics at UCSD and Co-Founder of The Earth Microbiome Project and The American Gut Project, about the development of a baby’s microbiome and what parents can do ensure that their baby’s gut and microbiome is as diverse and healthy as possible, from breastfeeding to beneficial probiotics. He also explains what he’s learned about the link between gut health and behavior, from both his research and his personal experience raising his son, who was diagnosed with autism. Shazi also shares what she’s learned from her own experience with Zane – and what she’s learned about the link between the gut and his behavior. We also hear from Michelle Eggers and Leila Strickland, Co-Founders of BIOMILQ – and their work to create breast milk without the breast, to ensure that future generations of babies are better fed.
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Episode Transcript
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Speaker 1 (00:00):
The Healthy Baby Show is a production of My Heart
podcast network and Healthy baby dot Com. As soon as
the amniotics ruptures, this baby is flooded by microbial signatures
and other stimuli from the outside world. All of that
is learning, and it's immune education. There's so much about
(00:24):
having a baby that I wasn't prepared for, and I
feel like I've learned a lot. I want to let
you in on what I've discovered and save you the
time and effort, give you a shortcut through the hours
of research, correspondence with experts, the roller coaster of it all,
so that you can walk away with new knowledge that
you can act upon. Every episode, this is the Healthy
(00:47):
Baby Show. I'm Chassivas from you just heard Dr Jack Gilbert,
Professor and Pediatrics at UCSD. Dr Gilbert is also the
co founder of the Earth Microbiome Project and the American
(01:08):
Gut Project, and is authored more than three hundred peer
reviewed publications and book chapters on microbial ecology. I'm interested
in his research because it shows the link between the
gut and the brain and actually how your gut can
affect your behavior. It's not the first thing you think
of when someone says your child might have a d
h D or you get an ato some diagnosis, and
(01:31):
a lot of us don't realize that our gut is
like our second brain, and if we actually approach creating
holistic health for our bodies through our gut, we can
improve our brain health and improve behaviors in our children.
And it's like super fascinating. One of the most helpful
therapies for us has been focusing on Sane's gut because
as his gut health has improved, so has his behavior,
(01:54):
and it's something I think it's really cool to share
with new parents so they understand the importance of the
early year of how their baby's guts are developing and
why that's so cool. Dr Gilbert, thank you for being here.
My pleasure. I'd love to introduce listeners to the human microbiome,
specifically as it exists for an infant, and I would
(02:15):
just love for you to kind of break it down
for the uninitiated. The microbiome is literally just all of
the bacteria and fungi and viruses that live inside your body,
and each part of your body is its own ecosystem.
If you're thinking about our gut, it's really just a
tube that goes on the inside from our mouth to
our anus, kind of like a donut, and the inside
(02:37):
the doughnut hole is where the majority of microbial life lives.
The gut is around a pound of bacterial biomass and
an adult intestine, and so that's a lot of bacteria, right.
It's about thirty trillion bacterial cells living inside the intestine.
But there's also bacterial all over your skin, in the
respiratory tract, in the oral cavity, and your gentle tract.
(02:58):
Anywhere there's an outside aid entrance way into the body,
you'll find micro organisms. The bacteria that live on your
skin are very different from the ones that live in
your intestine. It can be as different as say, the
Serengetti ecosystem is to the rainforests of Brazil, and that
really helps us to understand links between that and human health.
(03:18):
That's so fascinating. I feel like there's this new research
using healthy bacteria from an area of healthy skin on
your body to possibly heal ezema in an area of
your body that is dis biotics, so to speak. I've
always heard of it as gut health, but it's so
interesting that it's now becoming skin health too. Yeah. Well,
on the skin, everything's in balance, right, everything is in equilibrium.
(03:39):
If it's healthy and a normal skin, you actually have
bacteria that have colonized it that are good at fighting
off other bacteria. Bacteria have been in warfare for four
billion years. They're continuously fighting, and they've evolved mechanisms to
kill each other and to defend against the bad bugs,
the same as during the intestine. But when those good
(04:00):
bugs go away, the bad bugs can thrive and that
can lead to immune disorders like exma on the skin. Yeah,
I've I've learned through my own experience that a truly
healthy gut can mean vibrancy in health, even developmentally, even
with behaviors. What do you think that the average new
parents should know about the development of a baby's microbiome.
(04:22):
Can you explain how and when they're first exposed to bacteria? Yeah,
I mean there's nuance, they're right. I mean, mother's immune
system during pregnancy is training the fetus is immune system directly, right,
there's a direct exchange of immune activity there. And what
we found quite interesting is that how mother's immune system
(04:44):
functions during pregnancy has a big impact upon the developmental
trajectory of the fetus and then postpart and the child.
So how healthy you eat during pregnancy can play a
big role in the functional traits that the child will develop.
And then postpart a, what we end up with is
a child that has a very limited bacterial community associated
(05:05):
with it and a moderately functioning immune system that needs
to be trained. So this baby that doesn't have bacteria
when it's in the womb, and as soon as the
amniotics act ruptures, it's flooded by microbial signatures and other
stimuli from the outside world. All of that is learning,
and it's immune education. It's seeing the bacteria from the
(05:27):
family pet or from the soil and plants outside, and
those bacteria are just stimulating the immune system. Anything you
feed the child breast milk, for example, which has a
good combination of probiotics and probiotics inside it, as well
as enabling the growth and structure of that microbial community
in the gut, on the skin, the oral cavity. You're
a gentle tract and to become more adept at creating
(05:52):
a microbial barrier against potentially pathogenic organisms. And you explain
what happens when babies are born vaginally versus c section
and what effect that might have on their microbiome. So
when a baby is born via C section, there can
be two different strategies. Number one, baby still wraps inside
the amniotic sac and you have a C section and
(06:14):
the baby comes out through the abdomen. There's also another
strategy where the baby's already ruptured the amniotic sac and
the baby is actually passed into the vaginal tract to
a certain extent and then needs an emergency C section
to actually be removed via the abdomen. So they're exposed
to the vaginal microbiotor, but they're not coming out of
the vaginal tract. And then you've got the third one,
(06:35):
which is straight vaginal delivery. And what we found is
that straight vaginal delivery has a very different signature to
babies that are, for all intents and purposes, experiencing the
vaginal microbiotor and the the signature, the microbial signature in
babies born via vaginal tract birth is gastro intestinal. The
proximity of the vagina to the anus during birth is
(06:56):
a lot more important than just passing through the vaginal tract.
So vaginal seeding, the vaginal seeding thing what they do
is they test you for group B strap. If you're negative,
you can put some guars into your vagina and one
the baby is given to you after the C section.
You can wipe that all over the baby's skin, in
their ears, in their eyes, and their nose, in their mouth,
(07:19):
and it gives them that initial anointing of your microbiome.
So vaginal seeding, even though we were proponents of it
as a experimental therapy, we didn't see it as having
any harm basis as long as the mother was properly
screened for sexually transmitted diseases which can cause severe infections
in the eyes and therefore blindness and children. As long
(07:41):
as that screening process have been done, then fashional seeding
could do no harm as far as we were concerned.
But what we found is that vaginal seating doesn't actually
seem to have a significant impact upon the immune system
of children. So I I did vaginal seeding, you didn't
know harm, but you may not have done anything beneficial either.
It's seems like it was not necessary. Well, which is
(08:01):
great because what we need to do is get to
the actual science and the research. Yeah, I've had many
years in the field of infant nutrition. And so I
do know that from a breast milk standpoint, there are
bacteria that see the gut, and that there are certain
oligo saccharites like certain sugars in the breast milk that
(08:24):
are designed to basically feed and grow what ends up
being a more diverse microbiome. And I've always been so
fascinated at the beauty of breast milk. I mean, it's
just like such an amazing substance. There's some really really
cool data coming out now from David Mills and colleagues
Uppert University of California, Davis, where they've demonstrated that a
(08:44):
lot of people in developed nations right like America, like China,
like Europe, are lacking a bacteria in breast milk and
in baby's gup that's incredibly abundant in developing nations. We
believe this bacteria may have been lost due to multigenerational
abuse of antibiotics and potentially due to differences in diet
and lifestyle characteristics. But very interesting in this bacteria BEFO,
(09:07):
the Bacterium Longman fantas when you add it into babies
that are born prematurely. In clinical trials demonstrates a significant
improvement in the digestion of breast milk and a significant
improvement in immune development in the gastro intestinal lining in
the gut wall. The immune cells look much stronger, much
more robust when being Fantas is there. And so we
(09:29):
think the advantas, as you pointed out, is incredibly good
at eating these complex sugars that are in breast milk,
and most of the other bugs aren't very good at
doing it. So if you add it back into the cycle,
right if mother doesn't have it, if we can add
it back in where we can break that cycle, and
then that child, if it's a girl, will grow up
(09:50):
with that being fantas in their microbime and then pass
it on to their child. You basically are saying that
the baby inherits the mother's microbiome. If rather than focusing
on what to do if you have a c section,
maybe it's focus on maternal health while you're pregnant and
find a way to add the b in fantas to
(10:12):
you know, a prenatal regime, and that way we are
frontloading the ability to have a stronger and more robust microbiome.
I fully agree that's a clinical trial question needs to
be done right. We need to determine if that works
right now, as far as I'm aware, nobody has done
that one experiment. We'll be back after a quick break.
(10:46):
Welcome back to the Healthy Baby Show. I would love
to share actionable information that is proven for women or
parents who are thinking about bringing your child into the world.
What would you think ink is actionable knowledge? We actually
wrote our book Dirt is Good to provide a guide
for actionable data because we were seeing so much suggestions
(11:10):
online from potentially people who meant well, just didn't understand
what the science was saying or push the frontiers of
science before we actually had information, and our editor, when
we sent them the first draft of this book, said, well,
this is all great, but nearly every one of these
questions you say, we don't really know how to answer
your question with actionable evidence, but here's what the science
(11:32):
currently says. So it's a really complex balancing act. We
need to do no harm, but we also need to
enable and empower people to be able to make decisions
for themselves that are evidence based. But when the evidence
actually isn't there, then you end up with just assumptive processes.
It's a very difficult balancing act. For example, you know, again,
(11:53):
I have an autistic son, right, I was. I was
going to ask us, we're part of a club that
is for very special members, tell me about your son.
You know. We moved over from England to the United
States when he was three years old, and he had
already been identified as being potentially on the spectrum under three.
But in England, the diagnosis mechanisms weren't in place to
(12:16):
necessarily say that he had autism at that age. And
so when we got over here, he went to a
few preschools and kind of very difficult, and then went
to kindergarten and they said, yeah, no, your son has autism,
and where let's go and get a diagnosis. And when
we did, and I had that diagnosis in hand, I
could speak to the doctors and say, yeah, okay, all
of the learning difficulties, all of the lack of speech,
(12:38):
all of the growth problems were driven by this one
particular spectrum of potential conditions. Right, As a scientist and
a dad who wants to fix things, I immediately went
out and going, okay, let me review the literature. I
read everything right, and I quickly found out that we
know less and still do than we should do in
(13:00):
order to help children with autism. It was devastating and
the science had gone off in awful ways. Millions and
millions of dollars spent trying to disprove Andrew Wakefield's theories
that vaccines cause autism, and those millions of dollars could
have been spent trying to actually help children who had autism,
rather than trying to disprove a theory based upon a
(13:21):
terribly inet experimental pipeline on six kids. It may be
very angry and that we ended up trying anything we
could find to help him, and it became incredibly difficult
to sort the week from the chaff in terms of
what was available and what would be effective and what
would do no harm. What we ended up with was
looking at supplements, and we found that children who have autism,
(13:45):
based on our own research, are missing a certain bacteria
in the intestine that helped to produce a compound which
stimulates the immune system in a beneficial way. They actually
do produce that compound, but they have other bacteria that
do it, and they also produce another chemical which actually
helps to make the immune system more inflamed. So they
end up with an inflamed gut, and that inflamed guts
(14:07):
tends to exacerbate inflammation throughout the body. I always say,
an inflamed gut is like an inflamed brain, and we
need to treat the gut. And it's very true. Right,
there's a link there. There is the link that it's
a similar tissue. I mean the whole body is the
same tissue. It's you know, every single cell is has
the same progenitor cell, right, so what's in an immune
(14:27):
system is the same throughout the body. With your scientists,
had you believe that certain bacteria can be beneficial to
children with artism? Yes, we believe that children with autism
could be provided beneficial bacterial probiotics. Remember, a probiotic has
a very particular definition. It's a living organism that when
(14:48):
applied in enough volume, actually has a beneficial outcome in
the child. I believe that those organisms do exist. I
believe that we need to add them and do the
trials to test if they have effective treatment and more children.
So I went out and I did my full background
research and spoke to companies and identified a product called
butter rate, which is a chemical normally produced by bacteria
(15:11):
in the guts are fatty acid, and it stimulates the
immune system and it helps the gut to grow strong
wall a strong lining. So I was like, okay, we
could try this. So we tried it and it was
a remarkable outcome in my son. He it's almost like
he woke up and we waited for three months. We
didn't tell anyone at the school that he was on anything,
and we went for an IP meeting and they said,
(15:32):
this is remarkable. Dylan seems like he is alert. He
seems more communicative. You can talk to people who's been
talking to his peers. He's been, you know, communicating more
effectively with teachers. And they said, we think we want
to take off some of his support mechanisms because we
think they might be hindering his ability to develop his
communication now and you know, he had a communication teacher
(15:54):
and where I was like, wow, this is fantastic. And
they said, do you know if anything's happened recently? I
said no, no, you know I did tell them for
six months because I had to go through this whole
process of stopping the treatment and then restarting it to
be sure that this was what was actually causing it,
because he could have just been growing up right, and
you know, ordered some symptoms do tend to decrease with age.
The thing that was the alarm moment for me, I
(16:16):
was seeing outside my house and he was walking home
from school, and he must have been seven or eight
years old, and it came up to me and he said,
he how was your day? And I was like, what
It'd never done that ever, never shown a positive interest
in anyone. Really wow, unprompted asking you a question, that's
(16:39):
like a parent to a child with autism who's had
an nonverbal child, that's like, that's a big day it was.
I was like, I was like, I'm sold. It was amazing.
It was the best best had had. We then went
through this trial and error process. We removed the treatment
and saw a decline. We added the treatment back in
(16:59):
and saw an improvement. We we kept him on that
treatment for about four and a half years until eventually
he as a more developed child twelve years old, decided
that he wanted to try not taking these pills in
the morning and see how he felt. He made that
decision for himself, which was a remarkable development anyway, and
he decided he didn't want it, and we explored the
(17:21):
rationality of that and made decisions about what we thought
was most appropriate. And you know, he's doing very well.
He has a strong I P plan. He's fourteen years
old in high school. Now he's developed the strategies he
needs in order to make his way through life. We're
finding it got a strong little man on our hands
down and self possessed. Did you ever consider exploring FMT
(17:44):
for Dylan. At the time when we were going through
this whole process, there were no clinical studies at all
to suggest that FMT fugal microbione transplants could be effective.
This is nine years ago. The only clinical study of
effect is run by a University of Arizona by some
very trusted colleagues, Rosea Crushma Nick Brown. It's a phenomenal scientist.
(18:06):
And that study, small study kids, did demonstrate a significant
improvement in the metrics we normally used to monitor childhood
development and cognitive performance and physiological response, and it seemed
to be stable over a period of two years. The
difficulties with that study there was no control group, so
(18:27):
no few children, which is very difficult to do. We're
given an f m T, so we can't be a
hundred percent sure if I take off my parent hat
and put my scientists hat on. I want to see
more data, and I want to see how it affects
children and adults with autism and see if it has
any beneficial outcome for them. I'll tell you my little
f m T story, because we went to a doctor
(18:48):
to learn how to do an f m T enema.
Saying was for he was nonverbal and it's kind of
like you're a well moment, but we took him. We
did the enimal literally took ten sets. The process was
taking a donor's fecal matter that was then blended into
a slurry, I guess, and then it was in a
big tube and basically we told Zane, We're going to
(19:10):
count to ten, and it was we count to ten
as you push it in. And then he kept it
inside him for a good amount of time. And then
we went back to the hotel where we were staying,
and I was laying with him in the bed and
I was wearing a bathing suit with the swimming pool,
and my bathing suit was wet, so I took it off.
So Zane and I were like face to face and
(19:31):
he was really near my breast, but he had stopped
breastfeeding a while ago, and he said, I want to
drink milk. Oh wow, I mean, I don't know. I
didn't make that up. It really did happen. It was
the day after his first f MT. It was a
huge huow. But who knows. I'm not going to suggest
that everyone should run out and do that. It's challenging
and it could possibly not be the right thing. But
(19:52):
there is a lot of buzz in the world. Yeah.
I mean, Peco macrobim transplants are being remarkable for the
treatment of recurrency to for sealed infections, and they've been
used for thousands of years in in aivertic medicine and
in Chinese medicine in order to help with those processes.
So you know, it's when we do feele microbi and
transplants in animals and in people we see cognitive changes.
(20:15):
So it makes sense to me that there would be
an impact, right. I think the difficulty with all of
it is demonstrating that that impact is effective and that
it's beneficial over the long term, and that it's better
than other treatments which would be less invasive, like a
pre supplement or a probiotic. We're in a bit of
(20:35):
the wild West, and people are trying, as you've done
and as I've done, to help our children in any
way we can, and that's what parents do, right, But
we have to also be careful about how we communicate
what's actually possible. It's hard when you're a desperate parent
that just wants to help your child. It's really hard
to not want to try things. I want to ask you,
what would you share with new parents now about what
(20:58):
things to feel good at at exposing your children too?
In terms of bacteria in the environment. All of the
current data that we have points to three things that
you really need to do as a parent, right. The
first is make sure the child eats a balanced, healthy diet, right.
Really hard. My kids silly mac and cheese. You know,
(21:19):
I can't be a food I've tried, but you know,
invariably the diverse set of foods as well need a
lot of fiber. It's really, really, really important to gastro
intestinal health and to everything else, which again, as you've experienced,
in autistic children, is an whole other kept the fish.
It's very difficult to get them to eat a diverse
food set but in neurotypical children, in most children, healthy
(21:43):
diet key and the other thing is interacting with the world. Right,
Fairy pets are great, great to learn responsibility and also
incredibly beneficial in all of our current associated research. But
cats seem to not do very much at all. Dogs
seem to be incredib be helpful. Right, we don't know
why I got no idea. We've got a lot of hypotheses,
(22:04):
but we're not too sure. Or growing up on a
farm can be really beneficial reduction that I could have
developing asthma. If you're physically interacting with the farm environment
in which you live, then the other one is just
getting outside and interacting with nature. So yes, that's hard
for a lot of people. But interacting with a window
box and showing a child how to plant with their
(22:25):
own food, go for walks, a little physical activity is
incredibly beneficial for the microbiome an incredibly beneficial for your
immune system. So we walk around the neighborhood with the kids,
go to the park, sit down on the grass, you know,
like do crazy things like stick your hands in the soil.
And if I had taken antibiotic, then the best way
of doing it is to eat a lot of fiber
(22:45):
and increase the amount of potentially even fermented foods which
consumed during and up to two weeks post antibiotic therapy.
If I have to give one to my children, I
try to the best of my ability to make them
eat more fruit and more lettuce and kim chi. Hit
the kimchi. Kimchi, Yeah, they don't. They like kim chi.
I love it. But I try sour kraut, which is
(23:05):
really interesting. It's like German kimchi. And so yeah, we
do everything we can to increase the fiber content and
the diversity of fighting nutrients which are present in their
diet in order to feed good bacteria so that they
can prevent the antibiotic resistant bad bacteria from growing when
a child's taken antibiotic. We'll be back after a quick break.
(23:31):
Welcome back to the Healthy Baby Show. I am a
cell biologist by training, so I was nearing the end
of my post doctoral fellowship out at Stanford University when
I became a mother and had my son and found
myself in the predicament of really struggling to produce enough
(23:52):
milk to feed him so that he could continue to grow.
The way that you would hope your healthy baby does.
That's Laylas Strickland. She co founded the early least stage
startup Biomilk with food scientists Michelle Eggers. Biomilk is on
emission to give mothers an alternative to formula if they're
having a challenge with breastfeeding. They're basically trying to create
(24:13):
breast milk without the breast. I'm so fascinated by this
that I became an investor because I believe this is
where the future of infant nutrition is heading. I talked
to both Leyla and Michelle about the benefits of human
milk and why they created bio milk. Here's Michelle. Human
milk Oligo sacarids are specifically designed to be the perfect
(24:33):
free biotic for microbiome development. They're evolutionarily designed to be
easily broke down by the gut microbiota that we know
are classically there through that fecal oral transplant kind of pathway,
so with a healthy gut, if you have visitous bacteria
growing as an infant, these human milk cologo sacrids, which
there are hundreds of in breast milk, have very specific
(24:54):
uses as they're broken down into smaller components that are
used for cognitive development, muscial skills development, and immunological development,
and HMOs are specific to humans. There are allig soccer
rides in bovine milk. They're just evolutionarily designed for baby cows,
not baby humans. So as we think about the way
(25:15):
we use these as prebiotics for our gut digestion, very
little even I think personally understood beyond just that they're useful.
And as Dr Gilbert and I discussed, breast milk is
one of the best ways to support your baby's gut health.
And yet the reality is that not every parent can
breastfeed or has the opportunity to breastfeed for an extended
(25:36):
period of time. In fact, four percent of moms in
the US turned a formula within the first six months
of life. If I've learned, so many mothers experience similar
things in those early days of motherhood. There's a very
fraud isolating, challenging time emotionally. But as a scientist, the
way that I kind of tried to get control over
(25:57):
this was dive into the literature and see what we know?
What is this milk? Why is it so important that
I feed it to my baby? Why might my body
be struggling to produce enough of it? What's going on?
So the more I combed through the literature, I had
a couple of observations. One was that milk production is
a spatially controlled cell based process very similar to the
(26:19):
processes I had already been studying as a graduate student
in postdoc, so I had a pretty good intellectual basis
to understand how that process works. It's also just unfortunately
pretty neglected field of research, at least as far as
human lactation is concerned, in human milk biosynthesis. And I
found myself in a good position to start to make
some hypotheses and some ideas about how perhaps if you
(26:40):
wanted to grow the cells that produce milk outside the body,
you might be able to do that in a way
that would let you collect the product that they make.
And if you could do that, what would that mean
for babies and for families? Why is human milk the
best for growing a little human? Bovine based infant formulas
and now plant based and soy based infant formulas have
(27:02):
really been groundbreaking and life changing and life saving products
in many cases, But those products are always going to
be formulated from a starting material that really can't capture
the biological complexity of human milk, which has really been
developed over two hundred million years of evolutionary pressure to
be ideal for providing the baby with all the things
(27:25):
they need, not just from a nutritional standpoint, but also
from a signaling standpoint, helping the intestine closure so that
baby can properly absorb nutrients, brain development, lung development, all
the systems in the body are affected. And so when
you're starting to make an infant formula from something that
fundamentally can't achieve the right proportions or even provide some
(27:46):
of the theoretical components, you're just never going to be
able to achieve anything close to what human milk can
do in the baby's body. So let's talk about biomelk
and why it is the answer for breast milk. It
it's not just like it's like the best formula in
the world. It is breast milk. Can you guys explain
(28:08):
this because it's very difficult to understand, like, how do
you create human milk without the breast. We're always very
careful to say it's not breast milk because it's not
directly from a breast. You know, we're still strong proponents
of if you can breastfeed exclusively and you're having a
beautiful journey doing so, like power to you. And so
our technology was, to Layla's credit, really thinking about how
(28:32):
do you discontinue the process of lactation from the need
of being in a human breast to instead creating the
environment outside of a human breast where human memory epithelial
cells the cell line the mammary gland and produce a
majority of the macround micronew chance of breast milk can
construct into a three D manner where they can synthesize
and produce milk outside of the body. So it looks
(28:54):
a lot like biologics production or something kind of this
world of vaccines that we're talking a lot about similar
level of biotech, but we're utilizing a human cell that
in the body as millions of years of evolution pre
program to lactate. So we just have to give it
the right environment where it knows it's top for our
its bottom zipper and tights to its neighbors and forms
(29:16):
a memory gland layer essentially pulls in nutrients from the
media that we feed it in a flow path similar
to how it would receive nutrients from the mother's bloodstream
and then secrete milk into a separate chamber so that
we can have a pure product that's not intermingling with
glucose and nutrients, hormones, the things that naturally would be
(29:37):
in the mother's bloodstream from her diet and body. Fundamentally,
when you start to break it down, it doesn't sound
that crazy. You know, it sounds like pigs flying and
you say, we're making human milk outside of the body
without a human But these cells are really powerhouses. They
can lactate incredibly efficiently, and so we've been learning a
lot in the last two years around what environment they
(29:59):
do best in, what stimulation they need, and how to
identify how to get the best compositionally stable product from
them with high levels of protein sugars. Fats were kind
of shepherds. We really take care of them to just
produce milk and then you know, handle that milk downstream
to make it a safe product for infants. But they
(30:20):
do a majority of the hard work. And fundamentally, we
get asked a lot why scientifically hasn't somebody else done
this before? And I really credit Layla to her intersectional
experience of being a mom and being a scientist, addressing
a problem that until recently there weren't women trained to
be able to address. Science was driven mainly by male
clinicians and researchers, and they weren't necessarily thinking about breast
(30:45):
milk production as a cellular process versus just it's something
women's bodies. Do you know you're creating something? So, you know,
do you call it the elixir of life? That you
can create the optimal like sort of life even when
any of us is breastfeeding, our diet and our nutrition
(31:06):
informs the quality of the milk that we produce. So
from an optimal standpoint, what is in the optimal human milk?
And how do you guys ensure that we get all
of these nutrients? Your question of sort of defining optimal
is actually a really interesting for our philosophical one that
(31:26):
we ponder a lot, because milk is so different from
one woman to the next, and even within the same
woman from morning tonight or even the beginning of her
feeding to the end of her feeding, the composition changes.
What's the genetic basis for really great milk production? When
women are able to be over producers, you know, those
very fortunate women who have a freezer full of milk.
(31:47):
We want to know what's the deal with that. Genetically
breast milk from the breast is really dynamic and highly variable,
and that variability is not necessarily sarily something that will
be able to replicate or capture are a manufacturing process.
And so we study closely what are the needs of
human infants at different stages in their growth and are
(32:08):
trying to set targets for nutrient composition and contents around
what we know to be important. And I just want
to add that breast milk is not very well understood
broadly throughout the field, and most of the research that's
been done over the last fifty to sixty years was
done by infant formula companies, which don't necessarily have a
(32:30):
benefit to share how breast milk is better than infant formula.
And so just even finding the ability to do large
scale compositional studies, and we're running us study ourselves right now,
so listening breast milk examples from the public to be
able to assess composition, because it's just not a space
that's regulated globally. No one says what should be in
(32:51):
breast milk, and the research that has been done is
usually pretty focused on very specific populations, not thinking about
the diversity of cell genetics and backgrounds that we all bring.
It's sometimes a little daunting as a thirty person startup
to feel responsible for defining restaurant on that level. So
we're always open to collaborations, research new spaces that we
(33:13):
can find ways to learn together, because factation science is
a woefully underfunded and understudied field. Well, I believe in you.
I also I've never been as hungry in my life
as I was when I was breastfitting out when I
was pregnant, and I think it's so critically important during
that time to make sure you have clean water and
clean food and a really deep stack of supplements that
(33:36):
you can trust, because it really does take a lot
to make that milk, and it is like a feat
of modern nature, and it is really difficult to do
it while you're working. So my hats off to you
guys for taking this on, and I can't wait to
see what comes next. One of the things that makes
me think about is just taking a long view of
(33:57):
the future. You know, if we're successful in our roles.
Future generations of babies will be better fed, will realize
the benefits of that better nutrition in the earliest days
of their lives, when their systems are really setting up
to function and unlocking human potential. Is what we really
think about. What we think about the long view of
the biotechnology that we're working with creating populations of people
(34:18):
who haven't been deprived of some of these really essential
building blocks from the earliest days, and the course that
that sets us on as a community of people. Well,
that's it for the show this week. Next week is
a very personal episode for me. We'll talk with two
of my mentors, the wonderful Lisa Ackerman and Dr Stephen Cowen,
(34:41):
about what happens when your child receives the neurological diagnosis.
This is something I've been through myself, and I wanted
to share what I've learned to help other parents through it,
and to let you all know, as truly gut wrenching
lee difficult as it can be, if this is your story,
or this becomes your story, it can act actually be
a hopeful one. So tune in and learn more about
(35:03):
what the research says. The Healthy Baby Show is a
production of I Heart podcast Network and healthy baby dot com,
where you can find a new line of the safest
baby essentials. The Healthy Baby Show is hosted by me
shasvas Ram. Our lead producer is Jennifer Bassett. Executive producers
are Nikki Etre, Anna Stump, shazivs Ram and James Violette.
(35:26):
Mastering and sound designed by Carl Catle and Dan Bowza,
Additional writing and research by Julia Weaver. Our theme music
is by Anna Stump and Hamilton's Lighthouser. Additional music from
Blue Dot Sections
The Healthy Baby Show is a production of My Heart
podcast network and Healthy baby dot Com. As soon as
the amniotics ruptures, this baby is flooded by microbial signatures
and other stimuli from the outside world. All of that
is learning, and it's immune education. There's so much about
(00:24):
having a baby that I wasn't prepared for, and I
feel like I've learned a lot. I want to let
you in on what I've discovered and save you the
time and effort, give you a shortcut through the hours
of research, correspondence with experts, the roller coaster of it all,
so that you can walk away with new knowledge that
you can act upon. Every episode, this is the Healthy
(00:47):
Baby Show. I'm Chassivas from you just heard Dr Jack Gilbert,
Professor and Pediatrics at UCSD. Dr Gilbert is also the
co founder of the Earth Microbiome Project and the American
(01:08):
Gut Project, and is authored more than three hundred peer
reviewed publications and book chapters on microbial ecology. I'm interested
in his research because it shows the link between the
gut and the brain and actually how your gut can
affect your behavior. It's not the first thing you think
of when someone says your child might have a d
h D or you get an ato some diagnosis, and
(01:31):
a lot of us don't realize that our gut is
like our second brain, and if we actually approach creating
holistic health for our bodies through our gut, we can
improve our brain health and improve behaviors in our children.
And it's like super fascinating. One of the most helpful
therapies for us has been focusing on Sane's gut because
as his gut health has improved, so has his behavior,
(01:54):
and it's something I think it's really cool to share
with new parents so they understand the importance of the
early year of how their baby's guts are developing and
why that's so cool. Dr Gilbert, thank you for being here.
My pleasure. I'd love to introduce listeners to the human microbiome,
specifically as it exists for an infant, and I would
(02:15):
just love for you to kind of break it down
for the uninitiated. The microbiome is literally just all of
the bacteria and fungi and viruses that live inside your body,
and each part of your body is its own ecosystem.
If you're thinking about our gut, it's really just a
tube that goes on the inside from our mouth to
our anus, kind of like a donut, and the inside
(02:37):
the doughnut hole is where the majority of microbial life lives.
The gut is around a pound of bacterial biomass and
an adult intestine, and so that's a lot of bacteria, right.
It's about thirty trillion bacterial cells living inside the intestine.
But there's also bacterial all over your skin, in the
respiratory tract, in the oral cavity, and your gentle tract.
(02:58):
Anywhere there's an outside aid entrance way into the body,
you'll find micro organisms. The bacteria that live on your
skin are very different from the ones that live in
your intestine. It can be as different as say, the
Serengetti ecosystem is to the rainforests of Brazil, and that
really helps us to understand links between that and human health.
(03:18):
That's so fascinating. I feel like there's this new research
using healthy bacteria from an area of healthy skin on
your body to possibly heal ezema in an area of
your body that is dis biotics, so to speak. I've
always heard of it as gut health, but it's so
interesting that it's now becoming skin health too. Yeah. Well,
on the skin, everything's in balance, right, everything is in equilibrium.
(03:39):
If it's healthy and a normal skin, you actually have
bacteria that have colonized it that are good at fighting
off other bacteria. Bacteria have been in warfare for four
billion years. They're continuously fighting, and they've evolved mechanisms to
kill each other and to defend against the bad bugs,
the same as during the intestine. But when those good
(04:00):
bugs go away, the bad bugs can thrive and that
can lead to immune disorders like exma on the skin. Yeah,
I've I've learned through my own experience that a truly
healthy gut can mean vibrancy in health, even developmentally, even
with behaviors. What do you think that the average new
parents should know about the development of a baby's microbiome.
(04:22):
Can you explain how and when they're first exposed to bacteria? Yeah,
I mean there's nuance, they're right. I mean, mother's immune
system during pregnancy is training the fetus is immune system directly, right,
there's a direct exchange of immune activity there. And what
we found quite interesting is that how mother's immune system
(04:44):
functions during pregnancy has a big impact upon the developmental
trajectory of the fetus and then postpart and the child.
So how healthy you eat during pregnancy can play a
big role in the functional traits that the child will develop.
And then postpart a, what we end up with is
a child that has a very limited bacterial community associated
(05:05):
with it and a moderately functioning immune system that needs
to be trained. So this baby that doesn't have bacteria
when it's in the womb, and as soon as the
amniotics act ruptures, it's flooded by microbial signatures and other
stimuli from the outside world. All of that is learning,
and it's immune education. It's seeing the bacteria from the
(05:27):
family pet or from the soil and plants outside, and
those bacteria are just stimulating the immune system. Anything you
feed the child breast milk, for example, which has a
good combination of probiotics and probiotics inside it, as well
as enabling the growth and structure of that microbial community
in the gut, on the skin, the oral cavity. You're
a gentle tract and to become more adept at creating
(05:52):
a microbial barrier against potentially pathogenic organisms. And you explain
what happens when babies are born vaginally versus c section
and what effect that might have on their microbiome. So
when a baby is born via C section, there can
be two different strategies. Number one, baby still wraps inside
the amniotic sac and you have a C section and
(06:14):
the baby comes out through the abdomen. There's also another
strategy where the baby's already ruptured the amniotic sac and
the baby is actually passed into the vaginal tract to
a certain extent and then needs an emergency C section
to actually be removed via the abdomen. So they're exposed
to the vaginal microbiotor, but they're not coming out of
the vaginal tract. And then you've got the third one,
(06:35):
which is straight vaginal delivery. And what we found is
that straight vaginal delivery has a very different signature to
babies that are, for all intents and purposes, experiencing the
vaginal microbiotor and the the signature, the microbial signature in
babies born via vaginal tract birth is gastro intestinal. The
proximity of the vagina to the anus during birth is
(06:56):
a lot more important than just passing through the vaginal tract.
So vaginal seeding, the vaginal seeding thing what they do
is they test you for group B strap. If you're negative,
you can put some guars into your vagina and one
the baby is given to you after the C section.
You can wipe that all over the baby's skin, in
their ears, in their eyes, and their nose, in their mouth,
(07:19):
and it gives them that initial anointing of your microbiome.
So vaginal seeding, even though we were proponents of it
as a experimental therapy, we didn't see it as having
any harm basis as long as the mother was properly
screened for sexually transmitted diseases which can cause severe infections
in the eyes and therefore blindness and children. As long
(07:41):
as that screening process have been done, then fashional seeding
could do no harm as far as we were concerned.
But what we found is that vaginal seating doesn't actually
seem to have a significant impact upon the immune system
of children. So I I did vaginal seeding, you didn't
know harm, but you may not have done anything beneficial either.
It's seems like it was not necessary. Well, which is
(08:01):
great because what we need to do is get to
the actual science and the research. Yeah, I've had many
years in the field of infant nutrition. And so I
do know that from a breast milk standpoint, there are
bacteria that see the gut, and that there are certain
oligo saccharites like certain sugars in the breast milk that
(08:24):
are designed to basically feed and grow what ends up
being a more diverse microbiome. And I've always been so
fascinated at the beauty of breast milk. I mean, it's
just like such an amazing substance. There's some really really
cool data coming out now from David Mills and colleagues
Uppert University of California, Davis, where they've demonstrated that a
(08:44):
lot of people in developed nations right like America, like China,
like Europe, are lacking a bacteria in breast milk and
in baby's gup that's incredibly abundant in developing nations. We
believe this bacteria may have been lost due to multigenerational
abuse of antibiotics and potentially due to differences in diet
and lifestyle characteristics. But very interesting in this bacteria BEFO,
(09:07):
the Bacterium Longman fantas when you add it into babies
that are born prematurely. In clinical trials demonstrates a significant
improvement in the digestion of breast milk and a significant
improvement in immune development in the gastro intestinal lining in
the gut wall. The immune cells look much stronger, much
more robust when being Fantas is there. And so we
(09:29):
think the advantas, as you pointed out, is incredibly good
at eating these complex sugars that are in breast milk,
and most of the other bugs aren't very good at
doing it. So if you add it back into the cycle,
right if mother doesn't have it, if we can add
it back in where we can break that cycle, and
then that child, if it's a girl, will grow up
(09:50):
with that being fantas in their microbime and then pass
it on to their child. You basically are saying that
the baby inherits the mother's microbiome. If rather than focusing
on what to do if you have a c section,
maybe it's focus on maternal health while you're pregnant and
find a way to add the b in fantas to
(10:12):
you know, a prenatal regime, and that way we are
frontloading the ability to have a stronger and more robust microbiome.
I fully agree that's a clinical trial question needs to
be done right. We need to determine if that works
right now, as far as I'm aware, nobody has done
that one experiment. We'll be back after a quick break.
(10:46):
Welcome back to the Healthy Baby Show. I would love
to share actionable information that is proven for women or
parents who are thinking about bringing your child into the world.
What would you think ink is actionable knowledge? We actually
wrote our book Dirt is Good to provide a guide
for actionable data because we were seeing so much suggestions
(11:10):
online from potentially people who meant well, just didn't understand
what the science was saying or push the frontiers of
science before we actually had information, and our editor, when
we sent them the first draft of this book, said, well,
this is all great, but nearly every one of these
questions you say, we don't really know how to answer
your question with actionable evidence, but here's what the science
(11:32):
currently says. So it's a really complex balancing act. We
need to do no harm, but we also need to
enable and empower people to be able to make decisions
for themselves that are evidence based. But when the evidence
actually isn't there, then you end up with just assumptive processes.
It's a very difficult balancing act. For example, you know, again,
(11:53):
I have an autistic son, right, I was. I was
going to ask us, we're part of a club that
is for very special members, tell me about your son.
You know. We moved over from England to the United
States when he was three years old, and he had
already been identified as being potentially on the spectrum under three.
But in England, the diagnosis mechanisms weren't in place to
(12:16):
necessarily say that he had autism at that age. And
so when we got over here, he went to a
few preschools and kind of very difficult, and then went
to kindergarten and they said, yeah, no, your son has autism,
and where let's go and get a diagnosis. And when
we did, and I had that diagnosis in hand, I
could speak to the doctors and say, yeah, okay, all
of the learning difficulties, all of the lack of speech,
(12:38):
all of the growth problems were driven by this one
particular spectrum of potential conditions. Right, As a scientist and
a dad who wants to fix things, I immediately went
out and going, okay, let me review the literature. I
read everything right, and I quickly found out that we
know less and still do than we should do in
(13:00):
order to help children with autism. It was devastating and
the science had gone off in awful ways. Millions and
millions of dollars spent trying to disprove Andrew Wakefield's theories
that vaccines cause autism, and those millions of dollars could
have been spent trying to actually help children who had autism,
rather than trying to disprove a theory based upon a
(13:21):
terribly inet experimental pipeline on six kids. It may be
very angry and that we ended up trying anything we
could find to help him, and it became incredibly difficult
to sort the week from the chaff in terms of
what was available and what would be effective and what
would do no harm. What we ended up with was
looking at supplements, and we found that children who have autism,
(13:45):
based on our own research, are missing a certain bacteria
in the intestine that helped to produce a compound which
stimulates the immune system in a beneficial way. They actually
do produce that compound, but they have other bacteria that
do it, and they also produce another chemical which actually
helps to make the immune system more inflamed. So they
end up with an inflamed gut, and that inflamed guts
(14:07):
tends to exacerbate inflammation throughout the body. I always say,
an inflamed gut is like an inflamed brain, and we
need to treat the gut. And it's very true. Right,
there's a link there. There is the link that it's
a similar tissue. I mean the whole body is the
same tissue. It's you know, every single cell is has
the same progenitor cell, right, so what's in an immune
(14:27):
system is the same throughout the body. With your scientists,
had you believe that certain bacteria can be beneficial to
children with artism? Yes, we believe that children with autism
could be provided beneficial bacterial probiotics. Remember, a probiotic has
a very particular definition. It's a living organism that when
(14:48):
applied in enough volume, actually has a beneficial outcome in
the child. I believe that those organisms do exist. I
believe that we need to add them and do the
trials to test if they have effective treatment and more children.
So I went out and I did my full background
research and spoke to companies and identified a product called
butter rate, which is a chemical normally produced by bacteria
(15:11):
in the guts are fatty acid, and it stimulates the
immune system and it helps the gut to grow strong
wall a strong lining. So I was like, okay, we
could try this. So we tried it and it was
a remarkable outcome in my son. He it's almost like
he woke up and we waited for three months. We
didn't tell anyone at the school that he was on anything,
and we went for an IP meeting and they said,
(15:32):
this is remarkable. Dylan seems like he is alert. He
seems more communicative. You can talk to people who's been
talking to his peers. He's been, you know, communicating more
effectively with teachers. And they said, we think we want
to take off some of his support mechanisms because we
think they might be hindering his ability to develop his
communication now and you know, he had a communication teacher
(15:54):
and where I was like, wow, this is fantastic. And
they said, do you know if anything's happened recently? I
said no, no, you know I did tell them for
six months because I had to go through this whole
process of stopping the treatment and then restarting it to
be sure that this was what was actually causing it,
because he could have just been growing up right, and
you know, ordered some symptoms do tend to decrease with age.
The thing that was the alarm moment for me, I
(16:16):
was seeing outside my house and he was walking home
from school, and he must have been seven or eight
years old, and it came up to me and he said,
he how was your day? And I was like, what
It'd never done that ever, never shown a positive interest
in anyone. Really wow, unprompted asking you a question, that's
(16:39):
like a parent to a child with autism who's had
an nonverbal child, that's like, that's a big day it was.
I was like, I was like, I'm sold. It was amazing.
It was the best best had had. We then went
through this trial and error process. We removed the treatment
and saw a decline. We added the treatment back in
(16:59):
and saw an improvement. We we kept him on that
treatment for about four and a half years until eventually
he as a more developed child twelve years old, decided
that he wanted to try not taking these pills in
the morning and see how he felt. He made that
decision for himself, which was a remarkable development anyway, and
he decided he didn't want it, and we explored the
(17:21):
rationality of that and made decisions about what we thought
was most appropriate. And you know, he's doing very well.
He has a strong I P plan. He's fourteen years
old in high school. Now he's developed the strategies he
needs in order to make his way through life. We're
finding it got a strong little man on our hands
down and self possessed. Did you ever consider exploring FMT
(17:44):
for Dylan. At the time when we were going through
this whole process, there were no clinical studies at all
to suggest that FMT fugal microbione transplants could be effective.
This is nine years ago. The only clinical study of
effect is run by a University of Arizona by some
very trusted colleagues, Rosea Crushma Nick Brown. It's a phenomenal scientist.
(18:06):
And that study, small study kids, did demonstrate a significant
improvement in the metrics we normally used to monitor childhood
development and cognitive performance and physiological response, and it seemed
to be stable over a period of two years. The
difficulties with that study there was no control group, so
(18:27):
no few children, which is very difficult to do. We're
given an f m T, so we can't be a
hundred percent sure if I take off my parent hat
and put my scientists hat on. I want to see
more data, and I want to see how it affects
children and adults with autism and see if it has
any beneficial outcome for them. I'll tell you my little
f m T story, because we went to a doctor
(18:48):
to learn how to do an f m T enema.
Saying was for he was nonverbal and it's kind of
like you're a well moment, but we took him. We
did the enimal literally took ten sets. The process was
taking a donor's fecal matter that was then blended into
a slurry, I guess, and then it was in a
big tube and basically we told Zane, We're going to
(19:10):
count to ten, and it was we count to ten
as you push it in. And then he kept it
inside him for a good amount of time. And then
we went back to the hotel where we were staying,
and I was laying with him in the bed and
I was wearing a bathing suit with the swimming pool,
and my bathing suit was wet, so I took it off.
So Zane and I were like face to face and
(19:31):
he was really near my breast, but he had stopped
breastfeeding a while ago, and he said, I want to
drink milk. Oh wow, I mean, I don't know. I
didn't make that up. It really did happen. It was
the day after his first f MT. It was a
huge huow. But who knows. I'm not going to suggest
that everyone should run out and do that. It's challenging
and it could possibly not be the right thing. But
(19:52):
there is a lot of buzz in the world. Yeah.
I mean, Peco macrobim transplants are being remarkable for the
treatment of recurrency to for sealed infections, and they've been
used for thousands of years in in aivertic medicine and
in Chinese medicine in order to help with those processes.
So you know, it's when we do feele microbi and
transplants in animals and in people we see cognitive changes.
(20:15):
So it makes sense to me that there would be
an impact, right. I think the difficulty with all of
it is demonstrating that that impact is effective and that
it's beneficial over the long term, and that it's better
than other treatments which would be less invasive, like a
pre supplement or a probiotic. We're in a bit of
(20:35):
the wild West, and people are trying, as you've done
and as I've done, to help our children in any
way we can, and that's what parents do, right, But
we have to also be careful about how we communicate
what's actually possible. It's hard when you're a desperate parent
that just wants to help your child. It's really hard
to not want to try things. I want to ask you,
what would you share with new parents now about what
(20:58):
things to feel good at at exposing your children too?
In terms of bacteria in the environment. All of the
current data that we have points to three things that
you really need to do as a parent, right. The
first is make sure the child eats a balanced, healthy diet, right.
Really hard. My kids silly mac and cheese. You know,
(21:19):
I can't be a food I've tried, but you know,
invariably the diverse set of foods as well need a
lot of fiber. It's really, really, really important to gastro
intestinal health and to everything else, which again, as you've experienced,
in autistic children, is an whole other kept the fish.
It's very difficult to get them to eat a diverse
food set but in neurotypical children, in most children, healthy
(21:43):
diet key and the other thing is interacting with the world. Right,
Fairy pets are great, great to learn responsibility and also
incredibly beneficial in all of our current associated research. But
cats seem to not do very much at all. Dogs
seem to be incredib be helpful. Right, we don't know
why I got no idea. We've got a lot of hypotheses,
(22:04):
but we're not too sure. Or growing up on a
farm can be really beneficial reduction that I could have
developing asthma. If you're physically interacting with the farm environment
in which you live, then the other one is just
getting outside and interacting with nature. So yes, that's hard
for a lot of people. But interacting with a window
box and showing a child how to plant with their
(22:25):
own food, go for walks, a little physical activity is
incredibly beneficial for the microbiome an incredibly beneficial for your
immune system. So we walk around the neighborhood with the kids,
go to the park, sit down on the grass, you know,
like do crazy things like stick your hands in the soil.
And if I had taken antibiotic, then the best way
of doing it is to eat a lot of fiber
(22:45):
and increase the amount of potentially even fermented foods which
consumed during and up to two weeks post antibiotic therapy.
If I have to give one to my children, I
try to the best of my ability to make them
eat more fruit and more lettuce and kim chi. Hit
the kimchi. Kimchi, Yeah, they don't. They like kim chi.
I love it. But I try sour kraut, which is
(23:05):
really interesting. It's like German kimchi. And so yeah, we
do everything we can to increase the fiber content and
the diversity of fighting nutrients which are present in their
diet in order to feed good bacteria so that they
can prevent the antibiotic resistant bad bacteria from growing when
a child's taken antibiotic. We'll be back after a quick break.
(23:31):
Welcome back to the Healthy Baby Show. I am a
cell biologist by training, so I was nearing the end
of my post doctoral fellowship out at Stanford University when
I became a mother and had my son and found
myself in the predicament of really struggling to produce enough
(23:52):
milk to feed him so that he could continue to grow.
The way that you would hope your healthy baby does.
That's Laylas Strickland. She co founded the early least stage
startup Biomilk with food scientists Michelle Eggers. Biomilk is on
emission to give mothers an alternative to formula if they're
having a challenge with breastfeeding. They're basically trying to create
(24:13):
breast milk without the breast. I'm so fascinated by this
that I became an investor because I believe this is
where the future of infant nutrition is heading. I talked
to both Leyla and Michelle about the benefits of human
milk and why they created bio milk. Here's Michelle. Human
milk Oligo sacarids are specifically designed to be the perfect
(24:33):
free biotic for microbiome development. They're evolutionarily designed to be
easily broke down by the gut microbiota that we know
are classically there through that fecal oral transplant kind of pathway,
so with a healthy gut, if you have visitous bacteria
growing as an infant, these human milk cologo sacrids, which
there are hundreds of in breast milk, have very specific
(24:54):
uses as they're broken down into smaller components that are
used for cognitive development, muscial skills development, and immunological development,
and HMOs are specific to humans. There are allig soccer
rides in bovine milk. They're just evolutionarily designed for baby cows,
not baby humans. So as we think about the way
(25:15):
we use these as prebiotics for our gut digestion, very
little even I think personally understood beyond just that they're useful.
And as Dr Gilbert and I discussed, breast milk is
one of the best ways to support your baby's gut health.
And yet the reality is that not every parent can
breastfeed or has the opportunity to breastfeed for an extended
(25:36):
period of time. In fact, four percent of moms in
the US turned a formula within the first six months
of life. If I've learned, so many mothers experience similar
things in those early days of motherhood. There's a very
fraud isolating, challenging time emotionally. But as a scientist, the
way that I kind of tried to get control over
(25:57):
this was dive into the literature and see what we know?
What is this milk? Why is it so important that
I feed it to my baby? Why might my body
be struggling to produce enough of it? What's going on?
So the more I combed through the literature, I had
a couple of observations. One was that milk production is
a spatially controlled cell based process very similar to the
(26:19):
processes I had already been studying as a graduate student
in postdoc, so I had a pretty good intellectual basis
to understand how that process works. It's also just unfortunately
pretty neglected field of research, at least as far as
human lactation is concerned, in human milk biosynthesis. And I
found myself in a good position to start to make
some hypotheses and some ideas about how perhaps if you
(26:40):
wanted to grow the cells that produce milk outside the body,
you might be able to do that in a way
that would let you collect the product that they make.
And if you could do that, what would that mean
for babies and for families? Why is human milk the
best for growing a little human? Bovine based infant formulas
and now plant based and soy based infant formulas have
(27:02):
really been groundbreaking and life changing and life saving products
in many cases, But those products are always going to
be formulated from a starting material that really can't capture
the biological complexity of human milk, which has really been
developed over two hundred million years of evolutionary pressure to
be ideal for providing the baby with all the things
(27:25):
they need, not just from a nutritional standpoint, but also
from a signaling standpoint, helping the intestine closure so that
baby can properly absorb nutrients, brain development, lung development, all
the systems in the body are affected. And so when
you're starting to make an infant formula from something that
fundamentally can't achieve the right proportions or even provide some
(27:46):
of the theoretical components, you're just never going to be
able to achieve anything close to what human milk can
do in the baby's body. So let's talk about biomelk
and why it is the answer for breast milk. It
it's not just like it's like the best formula in
the world. It is breast milk. Can you guys explain
(28:08):
this because it's very difficult to understand, like, how do
you create human milk without the breast. We're always very
careful to say it's not breast milk because it's not
directly from a breast. You know, we're still strong proponents
of if you can breastfeed exclusively and you're having a
beautiful journey doing so, like power to you. And so
our technology was, to Layla's credit, really thinking about how
(28:32):
do you discontinue the process of lactation from the need
of being in a human breast to instead creating the
environment outside of a human breast where human memory epithelial
cells the cell line the mammary gland and produce a
majority of the macround micronew chance of breast milk can
construct into a three D manner where they can synthesize
and produce milk outside of the body. So it looks
(28:54):
a lot like biologics production or something kind of this
world of vaccines that we're talking a lot about similar
level of biotech, but we're utilizing a human cell that
in the body as millions of years of evolution pre
program to lactate. So we just have to give it
the right environment where it knows it's top for our
its bottom zipper and tights to its neighbors and forms
(29:16):
a memory gland layer essentially pulls in nutrients from the
media that we feed it in a flow path similar
to how it would receive nutrients from the mother's bloodstream
and then secrete milk into a separate chamber so that
we can have a pure product that's not intermingling with
glucose and nutrients, hormones, the things that naturally would be
(29:37):
in the mother's bloodstream from her diet and body. Fundamentally,
when you start to break it down, it doesn't sound
that crazy. You know, it sounds like pigs flying and
you say, we're making human milk outside of the body
without a human But these cells are really powerhouses. They
can lactate incredibly efficiently, and so we've been learning a
lot in the last two years around what environment they
(29:59):
do best in, what stimulation they need, and how to
identify how to get the best compositionally stable product from
them with high levels of protein sugars. Fats were kind
of shepherds. We really take care of them to just
produce milk and then you know, handle that milk downstream
to make it a safe product for infants. But they
(30:20):
do a majority of the hard work. And fundamentally, we
get asked a lot why scientifically hasn't somebody else done
this before? And I really credit Layla to her intersectional
experience of being a mom and being a scientist, addressing
a problem that until recently there weren't women trained to
be able to address. Science was driven mainly by male
clinicians and researchers, and they weren't necessarily thinking about breast
(30:45):
milk production as a cellular process versus just it's something
women's bodies. Do you know you're creating something? So, you know,
do you call it the elixir of life? That you
can create the optimal like sort of life even when
any of us is breastfeeding, our diet and our nutrition
(31:06):
informs the quality of the milk that we produce. So
from an optimal standpoint, what is in the optimal human milk?
And how do you guys ensure that we get all
of these nutrients? Your question of sort of defining optimal
is actually a really interesting for our philosophical one that
(31:26):
we ponder a lot, because milk is so different from
one woman to the next, and even within the same
woman from morning tonight or even the beginning of her
feeding to the end of her feeding, the composition changes.
What's the genetic basis for really great milk production? When
women are able to be over producers, you know, those
very fortunate women who have a freezer full of milk.
(31:47):
We want to know what's the deal with that. Genetically
breast milk from the breast is really dynamic and highly variable,
and that variability is not necessarily sarily something that will
be able to replicate or capture are a manufacturing process.
And so we study closely what are the needs of
human infants at different stages in their growth and are
(32:08):
trying to set targets for nutrient composition and contents around
what we know to be important. And I just want
to add that breast milk is not very well understood
broadly throughout the field, and most of the research that's
been done over the last fifty to sixty years was
done by infant formula companies, which don't necessarily have a
(32:30):
benefit to share how breast milk is better than infant formula.
And so just even finding the ability to do large
scale compositional studies, and we're running us study ourselves right now,
so listening breast milk examples from the public to be
able to assess composition, because it's just not a space
that's regulated globally. No one says what should be in
(32:51):
breast milk, and the research that has been done is
usually pretty focused on very specific populations, not thinking about
the diversity of cell genetics and backgrounds that we all bring.
It's sometimes a little daunting as a thirty person startup
to feel responsible for defining restaurant on that level. So
we're always open to collaborations, research new spaces that we
(33:13):
can find ways to learn together, because factation science is
a woefully underfunded and understudied field. Well, I believe in you.
I also I've never been as hungry in my life
as I was when I was breastfitting out when I
was pregnant, and I think it's so critically important during
that time to make sure you have clean water and
clean food and a really deep stack of supplements that
(33:36):
you can trust, because it really does take a lot
to make that milk, and it is like a feat
of modern nature, and it is really difficult to do
it while you're working. So my hats off to you
guys for taking this on, and I can't wait to
see what comes next. One of the things that makes
me think about is just taking a long view of
(33:57):
the future. You know, if we're successful in our roles.
Future generations of babies will be better fed, will realize
the benefits of that better nutrition in the earliest days
of their lives, when their systems are really setting up
to function and unlocking human potential. Is what we really
think about. What we think about the long view of
the biotechnology that we're working with creating populations of people
(34:18):
who haven't been deprived of some of these really essential
building blocks from the earliest days, and the course that
that sets us on as a community of people. Well,
that's it for the show this week. Next week is
a very personal episode for me. We'll talk with two
of my mentors, the wonderful Lisa Ackerman and Dr Stephen Cowen,
(34:41):
about what happens when your child receives the neurological diagnosis.
This is something I've been through myself, and I wanted
to share what I've learned to help other parents through it,
and to let you all know, as truly gut wrenching
lee difficult as it can be, if this is your story,
or this becomes your story, it can act actually be
a hopeful one. So tune in and learn more about
(35:03):
what the research says. The Healthy Baby Show is a
production of I Heart podcast Network and healthy baby dot com,
where you can find a new line of the safest
baby essentials. The Healthy Baby Show is hosted by me
shasvas Ram. Our lead producer is Jennifer Bassett. Executive producers
are Nikki Etre, Anna Stump, shazivs Ram and James Violette.
(35:26):
Mastering and sound designed by Carl Catle and Dan Bowza,
Additional writing and research by Julia Weaver. Our theme music
is by Anna Stump and Hamilton's Lighthouser. Additional music from
Blue Dot Sections
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