June 29, 2025 • 56 mins
Today on the podcast we chat with the amazing Dr Emma Beckett.
This chat blew me away. The knowledge and how Dr Emma imparts it for families is remarkable!
The first 1000 days on an infants life, from conception - a child’s second birthday are a time of rapid growth, especially for the gut and immune system. It also lays the building blocks for lifelong health.
Dr Emma and I chat about this. We discuss the gold standard of breast feeding, however, for some families that isn’t possible, so we discuss how Mums and Dads can help supplement an infants diet through microbiome and immune development through other means.
Infections are one of the most common reason infants are brought in to a health care setting. Supporting gut and immune health through nutrition can help reduce this concern and build long term resilience in little ones.
Nurses play a hugely important role in this area. Through guidance and support, we can assist families to navigate feeding issues and concerns.
Understanding the science around well-researched formula ingredients, such as prebiotics, helps reassure families that they are caring for their infants in a safe way when it comes to deciding on ways to feed their infants.
The prebiotics you need to look for in are formula are the following:
Galacto-oligosaccharides
Fructo-oligosaccharides
Also printed as scGOS/lcFOS
These are the most researched prebiotic blend globally.
www.tendernessfornurses.com.au
Dr Emma Beckett - Food & Nutrition Scientist
Stay Ahead with the Latest in Infant Immunity
The first 1,000 days—from conception to age two—are vital for building a strong immune system. Emerging research highlights the key role of prebiotics in supporting gut health and reducing infection risk during this time.
Gain access to Dr Emma's Immunity Guide " Understanding the role of prebiotics in childhood immunity" and 2 additional evidence-based resources to help you:
- Understand the science behind prebiotics and immunity
- Stay current with the latest research and formulations
- Strengthen your paediatric practice
Register NOW 👉
https://nutricia.com.au/paediatrics/education/healthed-infant-immunity/
Sponsored by Nutricia. This episode was created independently by the presenters/speakers and the views expressed herein are those of the presenters/speakers, not of Nutricia. This content is intended for healthcare professionals. Medical professionals should rely on their own skill and assessment of individual patients.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:05):
Appogia production.
Speaker 2 (00:10):
Hi everyone, thank you for tuning back into Tenantus for Nurses.
I suspec Woodbine here this season. I am so excited
to announce that the podcast is being supported by Nutritia,
which is a global leader in medical nutrition. They understand
the needs of nurses in the nutrition space and for
over one hundred and twenty five years have provided products
(00:31):
to support child health. Some of Nutrita's pediatric brands include
Neo Kate Junior for children who have food allergies and
app to Grow for those fussy eaters. And those of
us who have children know many kids who go through
the phases of definite fussiness. For more information and resources,
visit the nutritiona Pediatrics hub at nutritia dot com dot
(00:54):
au forward slash Pediatrics. I just want to say a
huge thank you to Nutritia. Their desire to support nurses
is truly appreciated, and they are allowing me to continue
this podcast so that we can all grow as nurses.
This season, we have some amazing speakers in the pediatric
space which I cannot wait to share with you all. Hi,
my name's Beck Woodbine and welcome to Tenderness for nurses.
Speaker 1 (01:17):
I'm grateful for the person that I have the opportunity
to be, so I hit it and parked it for
Nelly four years. We always have free will, We always
get to choose. We are autonomous.
Speaker 2 (01:32):
Hi everyone, thank you for tuning back in to Tenderness
for Nurses. My name's beck Woodbine and I'm a nurse
practitioner and today we have the fabulous doctor Emma Beckett
chatting with us, and we're actually talking about immunity in
the first thousand days of a child's life. We'll be
touching on a few other bits and pieces along the way,
(01:54):
but I'm really excited about this conversation. When I speak
to my clients that have come in or have skin
issues around because they've just had a barb or about
to have a barb, and one of the things that's
always discussed is feeding. It's just one of those things
that mums always tend to ask other mums, how are
you feeding?
Speaker 1 (02:13):
You know you're getting some sleep.
Speaker 2 (02:15):
And I think it's a really great conversation to have
in that we don't judge mums for whatever choices they make.
We all know that breast is best, but sometimes for
whatever reasons, whether you have to go back to work,
Buba isn't feeding well, mum's not making enough milk. There
could be so many different circumstances that sometimes mums do
(02:37):
have to make the choice of bottle feeding. And that's
where the conversation with doctor Emma is coming in, and
we're going to unpack this a little bit so that
you all have a little bit more knowledge so that
we can all be supportive of each other, whether that
is breastfeeding, which we know is the ultimate choice and
the one that we should all be going for the
gold standard, but if you can't, it's all about making
(02:58):
good decisions for your bubba. So welcome Emma, how are you?
Hello and wonderful, thank you for having me. So why
don't you explain a little bit of your background for
people that are listening today.
Speaker 3 (03:12):
So I'm a food nutrition scientist, biomedical scientist, communicator and educator.
So I'm a very multifaceted professional and I love that
because it gives me an opportunity to look at interactions
and intersections between different sciences. I got interested in immunology
because I'm a child of two geologists, and geology is
(03:34):
a very slow science and so when I started my
BioMed degree, I got very fascinated by the small things
that happened quickly in the body that you couldn't see.
Then I moved into nutrition as I got further into
my career because I realized there's no immunology without nutrition.
If you're giving vaccines to a malnourished baby, that's not
(03:56):
going to be very helpful. And so nutrition for me
was the science that helped everyone. And then I got
into nutrition communication because I realized my point knowing all
these things, if we can't share them with people in
a way that can actually change what they're doing and
change the world for the better. So I've ended up
in this messy space where I'm kind of not a
specialist anymore. I'm a generalist with overlapping specialties. But I
(04:19):
feel like it's a very powerful space to help people.
Speaker 1 (04:21):
Oh my god, that's like a nurse practitioner.
Speaker 2 (04:24):
We know a little bit about a lot in our
specialties that we've segue into. Yes, we know more, but
we know a little bit about a lot. Some thing's
a lot about a lot. But that's exactly what the
space that nurse practitioners did in is where you are currently.
Speaker 3 (04:39):
And the power is sharing it with people, right, which
is another thing that nurse practitioners specialize in, because the
information is nothing if we can't get it to people
in a way that actually works for them.
Speaker 1 (04:51):
Yeah, dissemination is paramount in healthcare.
Speaker 2 (04:54):
I am quite fascinated by you because you add a
really quirky spin to nutrition to education. Got a huge
following on social media. Why did it become so paramount
to you to start sharing this information about immunity and
(05:14):
immunology and babies.
Speaker 3 (05:18):
Firstly, there's a lot of bad information out there, and
there's a lot of beautiful people talking stories about inflammation
that aren't quite correct. They might have kind of a
root in science that then gets spun into something a
little bit more confusing. So it's important to be your
whole self in communication because there's a lot of people
(05:39):
using a lot of parts of their lives as hooks
to share non scientific information. But for me, this whole
story of immunity and particularly early life immunity, if I
think about my values as a communicator and as a scientist,
it's very much centered around fairness and that first thousand
(06:01):
days of life is about programming. It's a out setting
the scene. It's about laying the foundations. I've always been
interested in things in my career about how do we
level that playing field and make sure everyone gets a
good go or everyone gets the chance to be the
best version of themselves possible, And so by sharing nutrition
information in my own way, I hope to be a
(06:23):
part of doing better in that space.
Speaker 2 (06:27):
I did many years ago a stint at Logan Hospital,
which back in those days was lower socioeconomic area.
Speaker 1 (06:35):
And I'm not a midwife.
Speaker 2 (06:36):
I was working the operating theaters there but knew some
of the midwives and I remember them saying some of
these young girls would come in and they would encourage
breastfeeding because it was free, but they knew that the
minute they left the hospital they were going to bottle
feed these babies.
Speaker 1 (06:54):
I used to.
Speaker 2 (06:55):
Do some lists in the dental area. These mums would
come in with bottles full of coke, and the baby
would be in having all their teeth removed like a toddler,
and then the new bub would be there sitting in
the prem with the coke, and I really felt we
let them down and if there had have been products
(07:18):
or education more strongly around that area, would have they
continued to be making the same mistakes or is that
all they knew? And now that we've got social media
and that ability to disseminate good information, surely we should
be doing that. But then how do you know what's
good information and what's not good information?
Speaker 3 (07:39):
I think you've hit on something really important there. In nutrition,
it's not just what we say, it's what we don't say.
And if we don't fill the gaps, then people need
to fill those gaps for themselves. And we spend a
lot of time talking about what's perfect and what's best,
and we just hope that people find their way to
perfect and best and come on that journey with us.
(08:01):
And that's true in early life nutrition, and that's true
in adult and childhood and everything else nutrition. So I
think there's a lot of power in talking about, even
if it's not perfect, how do we make the best
of it, and what are our choices that we can
make that fit within people's circumstances that actually support them
(08:21):
where they are. So meeting people where they're at, I
think is a really important thing, not just in nutrition
but in healthcare generally.
Speaker 2 (08:28):
Couldn't agree with you more so, sometimes you just have
to assume that someone knows nothing and just break it
down for them and give it to them in a
kind manner, of course. But I know when I had
my son major issues, total refusal to eat in and
out of hospital, fed with a naser gastric tube, and
then at the end wouldn't even feed from a bottle. Thankfully,
(08:51):
I had great people around me, and I was four
months we were actually starting to feed him food because
you just total refusal to drink. But what happens if
people don't have those people around them.
Speaker 3 (09:04):
It's a really good question, because if you don't have
that support, it's very difficult to know where to get
that information from. And we often rely on instinct or
we rely on what people around us are telling us.
But knowing how quickly medicine changes, how quickly science changes,
if we're just relying on the kindness of strangers or
(09:27):
the kindness of family members, we can get left behind
quite quickly and not be doing what's best in our situation.
So it is really difficult. And being able to share
good quality information and get it to people in a
way that they can use, I think it's so important.
Speaker 2 (09:41):
So you're currently working on a website for healthcare professionals
to get information about feeding, whether that be mixed feeding
or bottle feeding. And we know breast is best, and
we are absolutely two hundred and ten percent promoting that.
We are just talking in this podcast in relation to
(10:02):
those families where they might choose mixed feeds or they
might choose another option such as formula feeding. So we
are not disparaging breastfeeding. But for those of us who
have had to go back to work early done some
mixed feeding, it's good to get that information. And you've
been working on a website in relation to that, haven't you.
Speaker 3 (10:24):
Yeah, So the website for health professionals, and we've got
a fact sheet specifically for nurses that's a guide to
help in the conversations, because if you're empowered as a professional,
then you can empower people that you work with. And
it's about, as you said, not comparing different types of feeding,
but knowing everything that is in the toolkit so that
(10:45):
the optimal decisions can be made to support immunity in
that early life. Because if we lay that foundation right
early on, then we don't just reduce the risk of
infection and gastro intestinal upsets and those kinds of things
that are very important in early life. We're laying a
foundation for immunity for the rest of our lives as well.
(11:09):
So knowing that breast is best if formula is required,
that not all formulas are created equal. They're all going
to have the basic nutrients that you need. But we
know now that nutrition is so much more than just
essentral nutrients. So it's not just about having the building
blocks to create the things that grow a baby and
(11:31):
keep that gut healthy and that immune system thriving, but
it's about the biological signals that are sent. And there's
different things in different formulas, and particularly bioactive compounds like prebiotics,
that can change the way those formulas influence the immune system.
(11:52):
And knowing that selecting a formula that has those prebiotics
is going to give you that better outcome for immunity
can help reassure a mum that she is making the
right decision, because we hear a lot about breast milk
being important for those immune factors that are communicated from
the mum to the bub but it's not just the
(12:12):
direct communication of immune factors that impact the baby's immune system.
It's also things like prebiotics that are in the milk
or can be added to the formula as well.
Speaker 2 (12:22):
What is the difference between a prebiotic and a probiotic.
Speaker 3 (12:27):
So probiotics are when we add living bacteria, so the
bacteria is able to pass through digestion and colonize in
the gastro intestinal track.
Speaker 1 (12:38):
That's probiotic.
Speaker 3 (12:40):
Probiotic is a step before that because prebiotics feed those bacteria.
So if you're taking probiotics but you're not getting enough prebiotics,
you're potentially just throwing those bacteria down there and not
giving them what they need to survive. Prebiotics aren't digested
by us, but by the gut bacteria, and particularly the
(13:03):
good gut bacteria, the ones that producing all the things
that do stuff like strengthen our gush and help our
immune system.
Speaker 1 (13:11):
And so the probiotics could.
Speaker 3 (13:12):
Be things like fibers, complex sugars, or they could be
things like polyphenols, but the key thing is they're good
bacteria food.
Speaker 2 (13:20):
Probiotics in formulas are they're probiotics or you're looking at
just the prebiotics.
Speaker 3 (13:28):
So you can add probiotics two formulas as well, and
you'll often see formulas that have both a probiotic and
a prebiotic. The bulk of the evidence around improving immunity,
gut function in early life, reducing risk of infection in
early life comes from the prebiotics, not from the probiotics.
So the probiotics specifically is where the data says we're
(13:52):
seeing this benefit.
Speaker 1 (13:54):
And how does that work if it's food for the bacteria.
Speaker 3 (13:57):
So the bacteria are already seeded in the gastro intestinal tracts.
So baby is born with some microbiota that comes from mum,
and it's acquired from all around the environment. If you've
got a kid, you'll know they'll put anything in their mouth.
Speaker 1 (14:13):
Yep.
Speaker 3 (14:14):
And so the prebiotics are about feeding the good ones
and maintaining that balance in a beneficial way, as opposed
to adding things in.
Speaker 2 (14:24):
So let's go back a couple of steps. When you
are feeding a little one a pre biotic, you're helping
them avoid infections, colds, coughs, flues, gestros. What the number
one hospitalization for babies up to what too?
Speaker 1 (14:42):
Would that be?
Speaker 3 (14:42):
Yep? And infection up to three years is the number
one reason to see.
Speaker 2 (14:46):
A doctor any infection. We're talking respiratory, we're talking guard
we're talking anything. So if you then do your immunizations
and you've got these prebiotics on board as well as
your probiotics, does that mean that uptake of that vaccine
is going to be better.
Speaker 3 (15:02):
Yes, So it's it's important to remember that if we're
giving vaccines and we want them to have a good
immune response to protect the child for later, we need
that child to be nourished, so they need to have
all of the basic nutrients. But it's becoming more evident
(15:22):
that that early life programming is not just about the
vaccine in and of itself. It's not just about the
nutrition in and of itself. It's about the signaling that
occurs at the same time. So all these things are
interacting with each other, and we know throughout life that
what happens in the gut has a knock on effect
to all the other areas in the body, but particularly
(15:45):
for the immune system because the majority of our immune
cells are in the gut, and that makes sense because
that's where the body is exposed to so many things externally,
and so by making sure that we nurture that in
early life, we're part of making sure that balance works.
(16:05):
Because immunity is really tricky. You don't just want to
go immune response on. You want to go we're responding
to the right things in immunity, and we're not over
responding to self or to normal exposures, because that's when
autoimmune conditions, that's when allergies become a problem.
Speaker 1 (16:22):
So it's this really fine balance.
Speaker 3 (16:25):
And I don't say that to stress people out, as
in you're going to get it wrong, But it's about
balancing those responses for ongoing programming. So we want to
be able not to overreact, we want to react to
the right things, and we want to support all those
pathways to work at the same time, rather than just
focusing on one or the other.
Speaker 1 (16:44):
Let's say you're a new mum.
Speaker 2 (16:48):
You've breastfed for the first month six weeks, but just
because of financial concerns, you have to go back to
work and you're working part time, so you've made the
decision to mixed feed, and but will take the bottle?
I mean, I know my daughter totally refused the bottom. Also,
she was breastfeed the whole way through. Bub's taking the bottle.
(17:09):
The family's got itself sorted. What can you expect to
see by adding in a bubby formula that's got the
probiotics in it. Do you do a gentle start, do
you just go straight in and morning and night breastfeed
and in between you just do bottle Like how does
(17:30):
a parent do it? How do you add mixed feeding
to the regime.
Speaker 3 (17:35):
The introduction is going to depend on the situation for
the mum and bub We talk about when people are
introducing probiotics and fibers in adults, we always talk about
introducing it slowly because once you start feeding the gut bacteria,
they start fermenting, and fermenting creates gas, and so that
can be unpleasant when you're adapting.
Speaker 1 (17:56):
But when you're.
Speaker 3 (17:57):
Looking at introducing a probiotic in a formula, it's really
going to depend on the needs of introducing that for formula,
and the gastro intestinal environment and the social aspects of
things like gas are very different when.
Speaker 1 (18:12):
You're a child, absolutely, and so.
Speaker 3 (18:16):
Kids are allowed to have gas on and adults we
are socially less acceptable. So introducing the formula in a
way that's needed and having that probiotic there at the
same time is definitely the priority. So having the probiotic
is an excellent bonus that I would encourage, but getting
the formula in so the bubb is fed first is
(18:36):
obviously the most important step. And I've just realized I
keep saying prebiotics like as though you know that will
be written on the tin when you're looking at a formula,
and it's probably not going to say prebiotics on the
front of pack. And so what you want to be
looking for when you're looking for a prebiotic is in
the ingredients list. The number one performing in the data
(18:57):
of the probiotics are a combination that's called goss and
foss so galacto oligosaccharides and fructo oligo sachrides. So those
are really big words, but they'll be written out in full.
Galacto oligosacride and fructo oligosachride will be written out in
the ingredients list of these formulas.
Speaker 1 (19:17):
So that's really what you want to look for, amazing.
Speaker 2 (19:20):
So I will add those to the show notes so
that if you guys are interested or want to share
that information, they will be there for you what the
full name of the prebiotics are, so that it's there
in black and white for you.
Speaker 1 (19:34):
And I'll get doctor Emma to check it for us,
the role.
Speaker 2 (19:37):
Of the nurse in educating mums and dads and families
around good feeding habits.
Speaker 1 (19:46):
When does that start.
Speaker 3 (19:48):
I think the role of the nurse begins immediately, and
I don't think it ends. I think as one of
the most trusted professions and one of the most accessible
healthcare providers, there's a lot of incidental inquiries about these
kinds of things, dental conversations that happen, and I think
(20:08):
that's true throughout the entire lifespan, but it matters particularly
in early life because in early life we are laying
this foundation, but we're also laying a foundation about these
conversations and the fantastic role that nurses can play acknowledging
their scope of practice is not dietetics, it's not nutrition,
but being able to have kind and clear and empowering
(20:32):
conversations so that people can access that entire toolkit. It
helps parents feel supported, it helps baby be nourished, but
it also reinforces that role of nurses as that caring
an accessible profession because there's a lot of times where
people are not comfortable having these conversations because they're afraid
(20:52):
of being judged, and so if a nurse can have
these conversations without judgment and with kindness and backed by evidence,
then that reduces the fear of having these conversations again
with nurse in the future in a more empowering way.
So I cannot stress enough how much I think nurses
can play a really positive role in improving these outcomes
(21:14):
for babies and their parents.
Speaker 2 (21:17):
Since you have introduced and done research into prebiotic being
added into formulas, were you able to get a good
reading of the reduction of hospital visits or do some
research into that area of the impact it, you'd have.
Speaker 3 (21:32):
So there's data that shows reduction in infection rates, not
necessarily hospitalizations, not because that doesn't happen, but probably because
that's not been looked at yet. But there is the
reduction in infection rates, and there's a lot of data
for the actual functional changes that we know will have
(21:54):
a knock on effects. So it's important to remember in
science we don't always look at the end outcome directly.
Sometimes we're looking at the different functional and biological markers
long the way and then putting that together to be
able to make the recommendation for how things would and
could fit together. Because obviously that endpoint of infection is
(22:15):
a very complex one, but there's good data for things
like increasing good bacteria in the gastro intestinal tract. There's
good data for increasing the amount of IgA which is produced,
and that's the globulin is something that we're encouraging breastfeeding
for so getting that from mum. So that's one of
(22:37):
the anti bodies that's going to help protect bub against infections.
And we see improvements in things like staol consistency, stool frequency,
reductions in pH of the stool, which means we've got
more of the good metabolites being made by the gut bacteria.
(22:58):
And so if you put all that together, it makes
sense that this is going to reduce infection rates and
then hopefully that has a knock on effect of things
like hospitalization as well. But obviously we need to keep
collecting data.
Speaker 1 (23:11):
On those things. And how do you collect the data
is it through stool samples.
Speaker 3 (23:17):
So there's lots of different ways this research is done.
It can be through health records, it can be through
collecting stool samples, which again much easier in kids than
it is in adults, and obviously looking at the biomarkers,
looking at things like blood levels and those kinds of
things as well. So a lot of really wonderful parents
will have volunteered to be part of studies that look
(23:39):
at putting these probiotics into formula and showing these benefits.
And I think that's important to acknowledge because we can't
keep improving the science if we don't have people who
want to participate in the science. So I think that's
a really great role that these mums and bubs have
played to allow us.
Speaker 1 (23:56):
To keep growing.
Speaker 2 (23:56):
Actually, I just received a final questionnaire from the University
of Queensland for a longitudel study that I did with
my daughter about development. Totally forgot all about it until
I got the final questionnaire and it was like, oh
my goodness, I participated in something that went for twenty
five years.
Speaker 1 (24:13):
Pretty cool.
Speaker 3 (24:14):
It's so powerful and in a few years maybe someone's
doing a podcast sharing some new advice based on that study.
Is just so impactful, and I think that really highlights
what I was saying before about it's easy to take
for granted raising children because we've raised children for eons.
But as we learn more about the science, we can
(24:36):
do better for those children. And we live in different
environments now, and so we have different pressures to do
better for those children. And when I think about a
concept like prebiotics that's younger than me. Prebiotics has only
been a term since nineteen ninety five. So if we
relied on what my grandma told my mum, we really
(24:56):
could be missing a trick in supporting immune health and
in supporting parents.
Speaker 2 (25:02):
You spoke before about autoimmune ca conditions. Do the prebiotics
help long term with that, not just with kids but
with adults. Is the research looking into that currently directly?
Speaker 3 (25:16):
I wouldn't say that data is there yet, But again,
from that join the dot's perspective, and knowing what we know,
having a well programmed immune response to pathogens and priming
that gut microbiota to be biased in the positive direction
is very likely to have positive outcomes for other conditions
(25:38):
as well. But I wouldn't want to overstate that not
having that data yet. The data is really clear for
gut function, it's really clear for the gut bacteria. It's
really clear for the metabolites that are being produced. But
we do need to do more research to get that
direct evidence, because obviously when we're looking longer term, that
takes longer to get.
Speaker 2 (25:55):
Absolutely, it would be wonderful because the amount of autoimmune
conditions that are just spiking, it's phenomenal. And look, I
have my own ideas about that. I do think our
stressful life and not caring for ourselves impacts a lot
of that, But that's not science backed. That's just from
me talking to lots of people. It's interesting. A colleague
(26:18):
of mine is a specialist in a emergency department and
we were chatting the other week and he was quite surprised.
We just got chatting about different things that are presenting
at the adults emergency and he was saying that he
just can't get over autoimmune conditions, heart attacks, strokes, weird cancers,
(26:42):
brain tumors. He said, they're seeing things they've never seen before,
presenting in much younger demographics. And I said, Demma, what
do you think and he goes, I definitely think it's stress,
he said. I think it's our phones attached to our
ears all the time. People have the phone on their wrist,
there's never any downtime. And it sort of made me think,
(27:02):
you know, I think all of this impacts the gut
and impacts the brain. I just don't know if we're
feeding our bodies the right things to also be coping
with all of this stress, because I know if I
eat a good, healthy meal, look after myself properly, I
feel far better than if I eat fast food.
Speaker 1 (27:22):
Do you agree with that?
Speaker 2 (27:23):
Do you think food, the mind, stress all plays a
role in autoimmune conditions, in cancers, in tumors. I'm asking
not scientifically, I suppose just your personal belief. It's really
hard for me to separate personal tiberance. But we know
that the gut and the brain are connected in both directions,
(27:44):
and so what goes on in our brain affects our gut.
What goes in our gut affects our brain, What goes
on in our gut affects everything in our body. If
I was to pick the organ system that has the
biggest impact on health, it's always the gut. Knowing that
we live in this environment that, as you said, is
quite technological, it's quite hectic, there is a lot of
(28:07):
stress going on. Again goes back to how we can't
just keep doing what we've always done and keep giving
the advice that we've always given because science is always
going to be in flux with that change. So keeping
up with what we can do to optimize responses and
improve outcomes is always going to be important in nutrition
(28:29):
and in health sciences generally. But going back to you know,
stress and the impact of stress on the gut and
how then that leads to disease, I think this is
all the more reason of why we want to be
across the importance of that first thousand days of life.
So first thousand days of life being from conception to
(28:49):
two years of age in the child, because that is
the programming stage, That is the priming stage, and programming
and priming is going to determine how resilient we are
to these other stresses and these other exposures, because obviously
we keep getting exposed to things throughout our life. After formula,
after breastfeeding, we're transitioning into solids, which brings a whole
(29:13):
new set of exposures to the gastrointestinal track, brings a
whole new set of stresses in the brain as well.
And so no matter what we're doing at whatever life stage,
getting that foundation right first gives us the best chance
at those outcomes being what we want them to be later.
What are the things you do in my research beforehand
(29:33):
and you brought it up before about the phs stools.
Why is that so important in bubbers?
Speaker 3 (29:39):
Well, the PHR stool is important for everyone because it's
an indicator of overall functions. So stool should be slightly acidic,
so it shouldn't be too basic, it shouldn't be bang
on neutral, and it shouldn't be very acidic either. So
like everything in the body, you know how we have
our pH buffering in blood, and each of our organs
(30:01):
has their own pH environment, our gastrointestinal environm.
Speaker 1 (30:05):
It's an indicator of its overall health. It's pH.
Speaker 3 (30:09):
And one of the reasons why pH changes with the
health of that environment is because the good gut bacteria
are producing short chain fatty acids, so things like acetates
and propenoates and butyrates, and they're actually the signaling molecules
that go on to have those knock on effects that
cause benefits for the immune system and cause benefits for
(30:32):
the gut wall. So one of the reasons why keeping
your gut microbiome healthy is improving your health outcomes and
particularly your immune outcomes, is the gastrointestinal microbiome the bacteria
produce energy and produce metabolites that actually feed the wall
(30:53):
of the gut, So you don't need to be a
scientist to know that a healthy wall of the gut
is going to improve immune outcomes because it means the
right things are getting in and the right things are
being blocked out, having a nice exchange of information between
the inside and the outside of the body. So the
store pH is a marker of all that going on
(31:13):
and working appropriately.
Speaker 2 (31:15):
What age do you recommend for little ones to start
introducing solids? What is the most beneficial age?
Speaker 3 (31:22):
So from an age point of view, it's around six months.
There are physiological markers of children being ready in terms
of being able to hold their head up and the
way they can move their jaw and those reflexes, but
six months is key. It's important to remember though we're
very rarely going bam. We're done with breastfeeding and formula
feeding and now we're eating solids. It's a transition period
(31:46):
and that's another place where I think prebiotics are going
to prove to be important in formulas or coming from
breast milk, because there are probiotics in breast milk as well.
Because when we start introducing solids, we start introducing allergens
and we start introducing pathogen So there's going to be
(32:06):
bacteria on food, there's going to be bacteria on plates.
Speaker 1 (32:10):
Don't panic.
Speaker 3 (32:10):
I'm not saying they're unclean. There's bacteria everywhere, and those
meeting the immune system in the most optimal way, which
is supported by probiotics, is going to help with that
programming in that stage. So it's a high risk, high
reward stage when you do start introducing those solids, and
remembering we get probiotics in our solids as well, and
(32:31):
so introducing prebiotic rich solids can help support that stage
as well.
Speaker 2 (32:39):
So you would encourage if your breastfeeding still breastfeed, cut
it down to two three times day, If you are
still bottle feeded, continue the bottle feeds, but ad in
the solids as well and just slowly integrate them and
just one or two little things each week or if
the child shows interest. Would that be a fair statement.
Speaker 3 (33:00):
It's definitely a staged approach. It's definitely a transition, not
hard cut point, and it's going to be different for
every child. So I think one of the things that
we do wrong in nutrition generally, but particularly in early
childhood nutrition is. We make a lot of comparisons about
behaviors and stages and speeds and ways of doing things,
(33:22):
and there's lots of ways to get to the same endpoint,
and each of us is a very unique, very wonderful individual,
and that goes for our kids as well.
Speaker 2 (33:32):
I'm a little bit interested in the gut brain, how
it works together, and the impact that food has on mood.
Could you explain a little bit more about that.
Speaker 1 (33:44):
It's complicated.
Speaker 3 (33:45):
All of those things that I was talking about before,
in terms of the short chain fatty acids and the
signaling molecules and the immune system itself are all going
to have knock on effects to what goes on in
the brain, because the hormones that affect the gut affect
the brain. The hormones that affect the brain affect the
gut much and so knowing the beginning point in these
(34:08):
cycles is often quite difficult because if there's something going
on in the brain that can have consequences for digestion
and absorption and gastrointestinal microbioda. But if there's things going
on in any of those places as well, that will
have knock on effects for the brain and mood and
hunger and mental health and all of those things. So
(34:30):
the complexity of those signaling molecules and the nerves that
run from the gut to the brain and vice versa,
the complexity of those is it's really hard to come
up with definitive answers about do this get that result
or this one thing causes this other thing. And so
I think it's important when we're looking at this evidence
(34:54):
to take a step back and say, well, from a
holistic point of view, based on the evidence, what are
the best decisions we can make? And that's where you
come back to the evidence for nurturing that gastro intestinal
tract and nurturing that gastro intestinal microbiome through adding the
probiotics when necessary, but adding the probiotics so that they
(35:17):
have something to eat and they can be nourished in
the same way that our bodies are nourished.
Speaker 2 (35:21):
So if we aim to do this in that first
thousand days of life, we are setting our children up
to try and optimize their health moving forward.
Speaker 1 (35:33):
Is that a correct assumption.
Speaker 3 (35:35):
Yeah, it's about laying the foundation. This is not a
journey that ever ends. We do need to keep eating
well throughout our lives to help reduce our risk of
disease and to protect ourselves and to optimize those health
and wellbeing outcomes. But if you think about it as
you want to give your child the best jumping off point,
(35:56):
because that means it's less effort later, it's less of
a barrier to overcome, and so getting that program being
supported early it's a no brainer. It doesn't mean if
you've missed that window, it's over. It means that if
you can optimize that window, you improve chances and outcomes
(36:17):
later and there's less work to catch back up.
Speaker 1 (36:20):
So it is very important in the scheme of things.
Speaker 2 (36:23):
The research is now showing those first thousand days after
a bubba is born food wise is really important to
try and set them up with as many probiotics and
prebiotics to feed the probiotics.
Speaker 1 (36:38):
Is that right? That would be a fair assumption.
Speaker 3 (36:43):
Yeah, Like obviously there are entire societies and entire schools
of research that are dedicated to this first thousand days.
I don't think we want to be as overstated in
saying as many as possible, because it's about having the
right ratios and the right amounts. So it's not like
you need to add a probiotic formula and then find
(37:05):
extra ways to gm probiotics into your children. The formulas
are optimized to have the correct ratio, so if you
start adding too many probiotics, then you're going to be
displacing other things that you want to be getting in. So,
like everything in nutrition, it's not more is better, it's
about having those right ratios. And the research around these
(37:26):
probiotics in formulas, the most evidence is around the goss
and the foss that we talked about earlier, and a
nine to one ratio of those, and there's an optimal
amount to be adding because we don't obviously want to
be displacing the carbohydrates and the fats and all those
other great things that are in formula that nourishes baby
from a building blocks point of view, we don't want
(37:46):
to displace those with probiotics.
Speaker 2 (37:49):
After one of those shows on Netflix, and that was
saying to get the best gut health and probiotics and probotics,
you should be eating from this fast variety of food
in a week and something like sixty different nuts, seeds, greens, reds. Anyway,
I gave it a bit of a crack. I swear
(38:09):
to god, I was flat out and doing twenty cost
me a fortune.
Speaker 1 (38:14):
It tasted like crap. I was like, I can't do this.
Speaker 2 (38:19):
That's why I think, you know, the formula side of
thing is fantastic, And if you can use a product
that has that already scientifically proven amount and it's been
added in the correct way into a formula, is a
really great option. And don't do it like me where
I lasted two weeks and my bank balance took a
(38:40):
hit end I couldn't afford the brazil nuts anymore. It's
crazy and I got sucked into trying that. Don't get
me wrong, I get sucked into a lot of things.
But if I have a healthcare background and I thought
it would be worthwhile trying twenty thirty forty fifty different
fruits veggies, imagine how complex and confusing it must be
(39:02):
for someone that doesn't have that health background. I mean,
they must find it exceptionally confusing trying to work out
what is best for their family for themselves.
Speaker 1 (39:13):
And so this is hard.
Speaker 3 (39:14):
When we hear things in the world about what we
should eat and then trying to translate that in our
brains about what are the best decisions for our children
is quite difficult, So I think it's a couple of things.
Is the recommendation for that variety comes from the fact
that different things can act as prebiotics, and plants make
these things as part of plants protecting themselves from stresses.
(39:38):
So if we spread our variety, we get more types
of these things which could have functional benefits. But when
that target feels impossible, then we can start feeling like
we're failing and that this is too difficult, and that
can cause us to go, well, let's not do this
at all. And so I would definitely say those when
(40:00):
we talk about variety targets, those are arbitrary numbers, they're
not rules. But then when we translate that into the
data that we have for the infant formulas, the important
thing to remember is in breast milk there is a
whole bunch of naturally produced prebiotics that will be there.
It probably isn't possible with the science yet to mimic
(40:22):
that fully in the formula from a structural point of view,
but what the research looks to do is to mimic
that in a functional point of view.
Speaker 1 (40:33):
And so when the goss and the foss.
Speaker 3 (40:35):
When the galactoligosachrides and the fructologosachriides are added in that
nine to one ratio. That's what we're getting as close
to the functional benefits as we can with the science
so far.
Speaker 1 (40:48):
So it's not.
Speaker 3 (40:49):
Necessarily about having all the things, it's about how do
we get those functional benefits, possibly in a different way,
because in nutrition there's always more than one pathway to
the same outcome.
Speaker 2 (41:01):
What if mum has a really poor diet and is
breastfeed what happens.
Speaker 3 (41:06):
Then The quality of breast milk depends on mum's diet,
so that is really important. But also creating breast milk
that is of quality is a priority in mum's body.
And so if mom isn't looking after her diet, she
could be sacrificing her health outcomes in later life, things
(41:28):
like bone health, for example, for the health of her
child now. So definitely, it's like on the planes when
they say you need to put your mask on first
before helping infants. In children, you do need to be
looking after yourself in parenting, not just when you're breastfeeding,
but parents do need to be looking after themselves as
well so that they can be looking after their children.
(41:50):
And that's also about role modeling, Yeah, because we don't
want kids to be growing up seeing that mum doesn't eat,
or mum only eats once the kids are eaten and
eats the leftovers off their plates, or those kinds of things.
That's not setting up good cycles of role modeling for
children in the future.
Speaker 2 (42:06):
And this is coming a little bit off baby topic,
but it is something that I'm interested in as a
lot of my clients have had gastric bypass surgery or
the sleeve. Now I know this isn't your specialty, but
in my mind, particularly gastric bypass where it bypasses the
(42:26):
gut altogether, how much of the good pre and probiotics
are actually work in the gart compared to the intestine.
Speaker 1 (42:37):
Is that going to be a huge issue you think
down the track.
Speaker 3 (42:41):
So I think this is an example of it depends. Unfortunately,
the answer is almost always it depends in nutrition. So
when we have banding or bypass, we're skipping the top
part of the gastro intestinal tract and we've still got
the function in the lower part of the gastro intestinal tract.
So there's some studies that will show benefits for gut
(43:05):
health post those kinds of interventions, and there's others that
will show harms to gastrointestinal health that comes post those interventions,
and that's probably down to what is the nutrition like
and what is the care like post intervention, because like anything,
just doing the intervention is one thing, and then it's
(43:26):
how do we maintain and support the body in the
best way post that.
Speaker 1 (43:32):
If you have an.
Speaker 3 (43:33):
Intervention like a gastric sleeve or a banding or bypass,
and then you don't change your diet, you're probably not
going to see any benefits to your gut health, and
you might see harms to your gut health. But if
you use that as a jumping off point to improve
nourishment and keep adding prebiotics and keep adding probiotics and
not doing the things that will damage gut bacteria, which
(43:56):
is alcohol and junk food and smoking, then it's very
likely you'll see a beneficial effect. And so it will
definitely be different outcomes for different situations, and again it's
about getting the support to make sure that you can
do the things that are going to optimize those outcomes.
Speaker 2 (44:14):
With nurses doing shift work, you know, with the largest
demographic workforce, with women in it, A lot of them
are mums and working night like I did night duties.
Sleep How important is sleep with nutrition?
Speaker 1 (44:29):
Sleep's very important with nutrition.
Speaker 3 (44:31):
So sleep is when your body is processing everything that
you've eaten throughout the day into repair, development, maintenance in
your body. And sleep is also going to impact hormones,
it's going to impact gut function, and that's going to
have a knock on effect for microbiome and all these
(44:51):
other things that we have been talking about. So sleep
is definitely important. But that said, some people are in
situations where they're sleep will be disrupted because of night shifts,
because of crying baby, because of other care as responsibilities,
and so knowing that that will have an impact and
(45:11):
that we do want to optimize those outcomes through sleep
where possible, But knowing that even in the context of
poor sleep or disrupted sleep or shift work, you can
still make the best choices to support your health. So,
knowing that people will have different pressures and different risks
because of those sleep related challenges, we want to fix
(45:35):
those challenges first if we can, but we still want
to make the best decisions possible on top of that
in that context, because like we said, right at the beginning.
Speaker 1 (45:44):
Perfection is not a thing.
Speaker 3 (45:45):
We're never all going to be in the situation where
we're all getting the perfect amount of sleep and eating
the perfect amount of things and living the perfect lives,
And so what decisions can we make? And if you're
not sleeping well, making those decisions can feel harder. So
this isn't going to be a one size fits all approach.
It's not going to be a if we all put
in the same amount of effort, we all get the
(46:07):
same outcomes. This will be different for all of us,
and we can walk those journeys with kindness for ourselves
and kindness.
Speaker 1 (46:14):
For each other. That is so true.
Speaker 2 (46:16):
If you are a family member that has a child
that doesn't sleep, how does that impact the child gut wise?
If they're just like my son did not sleep for
three years. We were flat out having him have an
hour in one go. He was a nightmare and by
the end of three years, I was a basket case.
(46:38):
Decided not to have any more children. But what would
have the impact been on him and his gut health?
Because they never found out what was wrong. They thought
it might have been silent reflux. He was in that
hospital fed with a tube. It was very complex and
no one could ever give us an answer.
Speaker 1 (46:58):
Even to this day.
Speaker 2 (46:59):
He's funny with certain foods that could have had a
huge impact on his gut health and his immunity. And
is that a correct assumption, do you think, Emma.
Speaker 1 (47:11):
So it's hard to say.
Speaker 3 (47:12):
I don't think we've got the data on sleep and
stress and those kinds of things in children. It's been
studied well in adults, but obviously, for ethical reasons and
practical reasons, that's a lot harder to study in children.
I think one of the really important things to remember,
and we've talked a lot about doing our best and
optimizing and giving the best jumping off point, but the
(47:34):
human body is a very complex and robust organism. Even
if we've missed a window, or even if we've had
a window disrupted by ill health or by whatever else,
that doesn't mean we need to beat ourselves up about
the fact that those things happen. And from each decision
(47:56):
making point, we can just strive to make the best
decision based on the best evidence in the circumstances we
find ourselves in, even though from a scientific point of view,
unpicking what that means, what the consequences are can feel important.
It's important not to let those circumstances get in the
way of making your next best decision in the next
(48:20):
decision making moment. I think that's what happens when it
comes down to, you know, the breast is best conversation.
We can't let that get in the way of making
the next decision when that's not possible for whatever reason,
whether it's work, whether it's biological function, whether it's adoption,
whatever it is. We can't let that history get in
the way of decision making moving forward, because that's just
(48:42):
being a slave to history rather than being optimistic and
being prepared for the future.
Speaker 2 (48:48):
I think we've come a long long way because when
I was talking to my mum about this, I was
not breastfed.
Speaker 1 (48:55):
I was fed carnation milk. That's what they did.
Speaker 2 (48:58):
And I'm don't tell anyone like fifty four ish.
Speaker 1 (49:03):
But that's what they had.
Speaker 2 (49:05):
Just didn't have other things, certainly not saying it was
the best, but it was the best that they knew
at that time, so they just did the best they could.
And it was a bit frowned upon back then to breastfeed,
and I don't know why it was probably how no
one wanted to see breast.
Speaker 1 (49:21):
It was rude. I don't know, and then.
Speaker 2 (49:23):
It has evolved and evolved, and then when I had
my kids, it was certainly breast is best. You do
your best, and then when that doesn't happen, then you
go down other pathways, which is still current. It's just
that there's more current evidence around if you can't breastfeed,
that there are some better choices in formulas, and it's
(49:46):
just important to have that knowledge around what those decisions are.
So when I was reading the information around the prebiotics
and the big names, and I had to look in
the chemist and had to look at some of the
tins and things like that, it was very interesting when
I interviewed doctor Elizabeth and she said, there's little information
(50:07):
out there for parents to look at how to actually
bottle feed appropriately. So like me, a lot of people
are just going off the tin, Whereas now you have
helped work on this website, this information line for people
to have some really great evidence based information on how
(50:29):
to feed a little one that might be doing mixed
feeding might be bottled only due to whatever reason. And
I think that is such a fantastic thing for healthcare
professionals to be able to recommend.
Speaker 1 (50:44):
It feels to me like this is way overdue.
Speaker 3 (50:47):
And I think it comes down to sometimes in nutrition
we're making decisions for survival, and that sounds like you're
on the carnation milk. My mum was bottle fed as well.
She was adopted at a very young age. She then
managed to breastfeed. I think nine of the ten siblings
that I have, the premes needed to be fed from
(51:08):
a milk bank, but the rest of them she breastfed.
And so sometimes we're making those decisions for survival, but
sometimes we're in a position where we can make those
decisions for thriving. And I think that's where looking for
the right formula and in this case specifically the ones
that have the goss and the foss those prebiotics added,
(51:28):
that's a decision for thriving that sets bub up for
fewer challenges in the rest of their life. And so,
you know, whatever that jumping off point is, we can
start making those decisions, hopefully in that thriving sense, and
less of them in the survival sense as we move
forward with that better science and with that less stigma
that by not having those conversations around the choices. We
(51:53):
are leaving it up to people to make their own decisions.
It's either perfect or figure it out yourself. And we
can definitely do better in having those conversations in the
middle ground and the other options as well.
Speaker 1 (52:05):
Ground.
Speaker 2 (52:05):
Isn't it supporting whatever your choice is and disseminating the
correct information that is evidence based, that is researched, so
that we can set those bubbies up for life to
thrive and also set the parents up. There's nothing better
as a parent than seeing your little one happy, smiling, thriving, eating,
(52:29):
being fed and happy in that milk drunk sort of situation.
It's one of the most beautiful moments as a parent
because you feel accomplished. And whether that be from breast
milk or from a bottle, there is just nothing better
to see a little baby so satisfied that they just
pass out from being fed. But I just think that
(52:52):
we as healthcare professionals really need to support the families
in our care and not be judgmental. Everyone is doing
the best they can and sometimes they don't know what's better,
and maybe we in a very kind and considerate way
to seminate that information or point them in the right direction,
(53:12):
where really smart people like doctor Emma have worked really
hard with research to work out what is best for
bubbs in the first thousand days. Why wouldn't we just
jump on that and share that information and go to
that website and tell our colleagues about it, and tell
our midwives about it and just support each other. I
(53:32):
think that's the best thing we can do as healthcare practitioners, because,
oh my god, it is tough out there.
Speaker 3 (53:38):
I think that is a really beautiful way of putting it,
because yes, there's science for this, but there's also all
the stressful and negative emotions that can be attached to
this as well. So being able to balance the science
and the society and the parent and bob needs, I
think is a really powerful and empowering space to be
and so glad to have been a small part of it.
Speaker 2 (53:58):
Thank you so much, doctor Emma. I am in awe
of your skill set and your skin.
Speaker 1 (54:09):
I swear to God.
Speaker 2 (54:10):
If that's pre and probiotics, I'm getting onto them. Doctor
Emma has the most amazing skin, and as you guys know,
dermatology is my specialty, so I've been sitting and.
Speaker 1 (54:18):
Looking at it in all it is flawless.
Speaker 2 (54:21):
So if ever there is a really great reason to
have a good diet and pre and probiotics, just have
a look at your skin.
Speaker 3 (54:29):
Amazing skin is a great way to get people interested
in nutrition because it's very hard to imagine cardiovascular disease
outcomes and bone outcomes in your eighties. But you can
see your skin as well, and what you see on
the outside is often a reflection of what's going on
on the inside.
Speaker 2 (54:45):
Well, your skin looks remarkable. Thank you so much for
taking the time to chat. It's such a huge topic.
Like it's a huge topic and very on point at
the moment because people really are wanting to do the
best for their loved ones. So thank you so much
for the research you do, for the work you do,
and also for working so hard on getting an amazing
(55:07):
website for families and healthcare professionals. I can't wait to
share it, so thank you, Thank.
Speaker 1 (55:13):
You so much.
Speaker 3 (55:14):
I've thoroughly enjoyed the conversation, and all the best conversations
meander you don't know where they're going to go. Well,
I will say lots of other people have worked on
this research, in this website, these resources, not just me
so shout out to the entire team who have brought
this information together so that it can be practical.
Speaker 1 (55:30):
Thank you guys all so much, and thank you Doctor Emma.
Thank you.
Speaker 2 (55:37):
This season, I am so excited to announce that the
podcast is being supported by Nutritia, which is a global
leader in medical nutrition. They understand the needs of nurses
in the nutrition space and for over one hundred and
twenty five years have provided products to support child health.
Some of Nutritiona's pediatric brands include Neo Kate Junior for
(55:59):
children who have food allergies, and app to Grow for
those fussy eaters. And those of us who have children
know many kids who go through the phases of definite fussiness.
For more information and resources, visit the NUTRITIONA Pediatrics hub
at nutritia dot com dot au forward slash pediatrics. I
just want to say a huge thank you to Nutritia.
(56:21):
Their desire to support nurses is truly appreciated, and they
are allowing me to continue this podcast so that we
can all grow as nurses.
Appogia production.
Speaker 2 (00:10):
Hi everyone, thank you for tuning back into Tenantus for Nurses.
I suspec Woodbine here this season. I am so excited
to announce that the podcast is being supported by Nutritia,
which is a global leader in medical nutrition. They understand
the needs of nurses in the nutrition space and for
over one hundred and twenty five years have provided products
(00:31):
to support child health. Some of Nutrita's pediatric brands include
Neo Kate Junior for children who have food allergies and
app to Grow for those fussy eaters. And those of
us who have children know many kids who go through
the phases of definite fussiness. For more information and resources,
visit the nutritiona Pediatrics hub at nutritia dot com dot
(00:54):
au forward slash Pediatrics. I just want to say a
huge thank you to Nutritia. Their desire to support nurses
is truly appreciated, and they are allowing me to continue
this podcast so that we can all grow as nurses.
This season, we have some amazing speakers in the pediatric
space which I cannot wait to share with you all. Hi,
my name's Beck Woodbine and welcome to Tenderness for nurses.
Speaker 1 (01:17):
I'm grateful for the person that I have the opportunity
to be, so I hit it and parked it for
Nelly four years. We always have free will, We always
get to choose. We are autonomous.
Speaker 2 (01:32):
Hi everyone, thank you for tuning back in to Tenderness
for Nurses. My name's beck Woodbine and I'm a nurse
practitioner and today we have the fabulous doctor Emma Beckett
chatting with us, and we're actually talking about immunity in
the first thousand days of a child's life. We'll be
touching on a few other bits and pieces along the way,
(01:54):
but I'm really excited about this conversation. When I speak
to my clients that have come in or have skin
issues around because they've just had a barb or about
to have a barb, and one of the things that's
always discussed is feeding. It's just one of those things
that mums always tend to ask other mums, how are
you feeding?
Speaker 1 (02:13):
You know you're getting some sleep.
Speaker 2 (02:15):
And I think it's a really great conversation to have
in that we don't judge mums for whatever choices they make.
We all know that breast is best, but sometimes for
whatever reasons, whether you have to go back to work,
Buba isn't feeding well, mum's not making enough milk. There
could be so many different circumstances that sometimes mums do
(02:37):
have to make the choice of bottle feeding. And that's
where the conversation with doctor Emma is coming in, and
we're going to unpack this a little bit so that
you all have a little bit more knowledge so that
we can all be supportive of each other, whether that
is breastfeeding, which we know is the ultimate choice and
the one that we should all be going for the
gold standard, but if you can't, it's all about making
(02:58):
good decisions for your bubba. So welcome Emma, how are you?
Hello and wonderful, thank you for having me. So why
don't you explain a little bit of your background for
people that are listening today.
Speaker 3 (03:12):
So I'm a food nutrition scientist, biomedical scientist, communicator and educator.
So I'm a very multifaceted professional and I love that
because it gives me an opportunity to look at interactions
and intersections between different sciences. I got interested in immunology
because I'm a child of two geologists, and geology is
(03:34):
a very slow science and so when I started my
BioMed degree, I got very fascinated by the small things
that happened quickly in the body that you couldn't see.
Then I moved into nutrition as I got further into
my career because I realized there's no immunology without nutrition.
If you're giving vaccines to a malnourished baby, that's not
(03:56):
going to be very helpful. And so nutrition for me
was the science that helped everyone. And then I got
into nutrition communication because I realized my point knowing all
these things, if we can't share them with people in
a way that can actually change what they're doing and
change the world for the better. So I've ended up
in this messy space where I'm kind of not a
specialist anymore. I'm a generalist with overlapping specialties. But I
(04:19):
feel like it's a very powerful space to help people.
Speaker 1 (04:21):
Oh my god, that's like a nurse practitioner.
Speaker 2 (04:24):
We know a little bit about a lot in our
specialties that we've segue into. Yes, we know more, but
we know a little bit about a lot. Some thing's
a lot about a lot. But that's exactly what the
space that nurse practitioners did in is where you are currently.
Speaker 3 (04:39):
And the power is sharing it with people, right, which
is another thing that nurse practitioners specialize in, because the
information is nothing if we can't get it to people
in a way that actually works for them.
Speaker 1 (04:51):
Yeah, dissemination is paramount in healthcare.
Speaker 2 (04:54):
I am quite fascinated by you because you add a
really quirky spin to nutrition to education. Got a huge
following on social media. Why did it become so paramount
to you to start sharing this information about immunity and
(05:14):
immunology and babies.
Speaker 3 (05:18):
Firstly, there's a lot of bad information out there, and
there's a lot of beautiful people talking stories about inflammation
that aren't quite correct. They might have kind of a
root in science that then gets spun into something a
little bit more confusing. So it's important to be your
whole self in communication because there's a lot of people
(05:39):
using a lot of parts of their lives as hooks
to share non scientific information. But for me, this whole
story of immunity and particularly early life immunity, if I
think about my values as a communicator and as a scientist,
it's very much centered around fairness and that first thousand
(06:01):
days of life is about programming. It's a out setting
the scene. It's about laying the foundations. I've always been
interested in things in my career about how do we
level that playing field and make sure everyone gets a
good go or everyone gets the chance to be the
best version of themselves possible, And so by sharing nutrition
information in my own way, I hope to be a
(06:23):
part of doing better in that space.
Speaker 2 (06:27):
I did many years ago a stint at Logan Hospital,
which back in those days was lower socioeconomic area.
Speaker 1 (06:35):
And I'm not a midwife.
Speaker 2 (06:36):
I was working the operating theaters there but knew some
of the midwives and I remember them saying some of
these young girls would come in and they would encourage
breastfeeding because it was free, but they knew that the
minute they left the hospital they were going to bottle
feed these babies.
Speaker 1 (06:54):
I used to.
Speaker 2 (06:55):
Do some lists in the dental area. These mums would
come in with bottles full of coke, and the baby
would be in having all their teeth removed like a toddler,
and then the new bub would be there sitting in
the prem with the coke, and I really felt we
let them down and if there had have been products
(07:18):
or education more strongly around that area, would have they
continued to be making the same mistakes or is that
all they knew? And now that we've got social media
and that ability to disseminate good information, surely we should
be doing that. But then how do you know what's
good information and what's not good information?
Speaker 3 (07:39):
I think you've hit on something really important there. In nutrition,
it's not just what we say, it's what we don't say.
And if we don't fill the gaps, then people need
to fill those gaps for themselves. And we spend a
lot of time talking about what's perfect and what's best,
and we just hope that people find their way to
perfect and best and come on that journey with us.
(08:01):
And that's true in early life nutrition, and that's true
in adult and childhood and everything else nutrition. So I
think there's a lot of power in talking about, even
if it's not perfect, how do we make the best
of it, and what are our choices that we can
make that fit within people's circumstances that actually support them
(08:21):
where they are. So meeting people where they're at, I
think is a really important thing, not just in nutrition
but in healthcare generally.
Speaker 2 (08:28):
Couldn't agree with you more so, sometimes you just have
to assume that someone knows nothing and just break it
down for them and give it to them in a
kind manner, of course. But I know when I had
my son major issues, total refusal to eat in and
out of hospital, fed with a naser gastric tube, and
then at the end wouldn't even feed from a bottle. Thankfully,
(08:51):
I had great people around me, and I was four
months we were actually starting to feed him food because
you just total refusal to drink. But what happens if
people don't have those people around them.
Speaker 3 (09:04):
It's a really good question, because if you don't have
that support, it's very difficult to know where to get
that information from. And we often rely on instinct or
we rely on what people around us are telling us.
But knowing how quickly medicine changes, how quickly science changes,
if we're just relying on the kindness of strangers or
(09:27):
the kindness of family members, we can get left behind
quite quickly and not be doing what's best in our situation.
So it is really difficult. And being able to share
good quality information and get it to people in a
way that they can use, I think it's so important.
Speaker 2 (09:41):
So you're currently working on a website for healthcare professionals
to get information about feeding, whether that be mixed feeding
or bottle feeding. And we know breast is best, and
we are absolutely two hundred and ten percent promoting that.
We are just talking in this podcast in relation to
(10:02):
those families where they might choose mixed feeds or they
might choose another option such as formula feeding. So we
are not disparaging breastfeeding. But for those of us who
have had to go back to work early done some
mixed feeding, it's good to get that information. And you've
been working on a website in relation to that, haven't you.
Speaker 3 (10:24):
Yeah, So the website for health professionals, and we've got
a fact sheet specifically for nurses that's a guide to
help in the conversations, because if you're empowered as a professional,
then you can empower people that you work with. And
it's about, as you said, not comparing different types of feeding,
but knowing everything that is in the toolkit so that
(10:45):
the optimal decisions can be made to support immunity in
that early life. Because if we lay that foundation right
early on, then we don't just reduce the risk of
infection and gastro intestinal upsets and those kinds of things
that are very important in early life. We're laying a
foundation for immunity for the rest of our lives as well.
(11:09):
So knowing that breast is best if formula is required,
that not all formulas are created equal. They're all going
to have the basic nutrients that you need. But we
know now that nutrition is so much more than just
essentral nutrients. So it's not just about having the building
blocks to create the things that grow a baby and
(11:31):
keep that gut healthy and that immune system thriving, but
it's about the biological signals that are sent. And there's
different things in different formulas, and particularly bioactive compounds like prebiotics,
that can change the way those formulas influence the immune system.
(11:52):
And knowing that selecting a formula that has those prebiotics
is going to give you that better outcome for immunity
can help reassure a mum that she is making the
right decision, because we hear a lot about breast milk
being important for those immune factors that are communicated from
the mum to the bub but it's not just the
(12:12):
direct communication of immune factors that impact the baby's immune system.
It's also things like prebiotics that are in the milk
or can be added to the formula as well.
Speaker 2 (12:22):
What is the difference between a prebiotic and a probiotic.
Speaker 3 (12:27):
So probiotics are when we add living bacteria, so the
bacteria is able to pass through digestion and colonize in
the gastro intestinal track.
Speaker 1 (12:38):
That's probiotic.
Speaker 3 (12:40):
Probiotic is a step before that because prebiotics feed those bacteria.
So if you're taking probiotics but you're not getting enough prebiotics,
you're potentially just throwing those bacteria down there and not
giving them what they need to survive. Prebiotics aren't digested
by us, but by the gut bacteria, and particularly the
(13:03):
good gut bacteria, the ones that producing all the things
that do stuff like strengthen our gush and help our
immune system.
Speaker 1 (13:11):
And so the probiotics could.
Speaker 3 (13:12):
Be things like fibers, complex sugars, or they could be
things like polyphenols, but the key thing is they're good
bacteria food.
Speaker 2 (13:20):
Probiotics in formulas are they're probiotics or you're looking at
just the prebiotics.
Speaker 3 (13:28):
So you can add probiotics two formulas as well, and
you'll often see formulas that have both a probiotic and
a prebiotic. The bulk of the evidence around improving immunity,
gut function in early life, reducing risk of infection in
early life comes from the prebiotics, not from the probiotics.
So the probiotics specifically is where the data says we're
(13:52):
seeing this benefit.
Speaker 1 (13:54):
And how does that work if it's food for the bacteria.
Speaker 3 (13:57):
So the bacteria are already seeded in the gastro intestinal tracts.
So baby is born with some microbiota that comes from mum,
and it's acquired from all around the environment. If you've
got a kid, you'll know they'll put anything in their mouth.
Speaker 1 (14:13):
Yep.
Speaker 3 (14:14):
And so the prebiotics are about feeding the good ones
and maintaining that balance in a beneficial way, as opposed
to adding things in.
Speaker 2 (14:24):
So let's go back a couple of steps. When you
are feeding a little one a pre biotic, you're helping
them avoid infections, colds, coughs, flues, gestros. What the number
one hospitalization for babies up to what too?
Speaker 1 (14:42):
Would that be?
Speaker 3 (14:42):
Yep? And infection up to three years is the number
one reason to see.
Speaker 2 (14:46):
A doctor any infection. We're talking respiratory, we're talking guard
we're talking anything. So if you then do your immunizations
and you've got these prebiotics on board as well as
your probiotics, does that mean that uptake of that vaccine
is going to be better.
Speaker 3 (15:02):
Yes, So it's it's important to remember that if we're
giving vaccines and we want them to have a good
immune response to protect the child for later, we need
that child to be nourished, so they need to have
all of the basic nutrients. But it's becoming more evident
(15:22):
that that early life programming is not just about the
vaccine in and of itself. It's not just about the
nutrition in and of itself. It's about the signaling that
occurs at the same time. So all these things are
interacting with each other, and we know throughout life that
what happens in the gut has a knock on effect
to all the other areas in the body, but particularly
(15:45):
for the immune system because the majority of our immune
cells are in the gut, and that makes sense because
that's where the body is exposed to so many things externally,
and so by making sure that we nurture that in
early life, we're part of making sure that balance works.
(16:05):
Because immunity is really tricky. You don't just want to
go immune response on. You want to go we're responding
to the right things in immunity, and we're not over
responding to self or to normal exposures, because that's when
autoimmune conditions, that's when allergies become a problem.
Speaker 1 (16:22):
So it's this really fine balance.
Speaker 3 (16:25):
And I don't say that to stress people out, as
in you're going to get it wrong, But it's about
balancing those responses for ongoing programming. So we want to
be able not to overreact, we want to react to
the right things, and we want to support all those
pathways to work at the same time, rather than just
focusing on one or the other.
Speaker 1 (16:44):
Let's say you're a new mum.
Speaker 2 (16:48):
You've breastfed for the first month six weeks, but just
because of financial concerns, you have to go back to
work and you're working part time, so you've made the
decision to mixed feed, and but will take the bottle?
I mean, I know my daughter totally refused the bottom. Also,
she was breastfeed the whole way through. Bub's taking the bottle.
(17:09):
The family's got itself sorted. What can you expect to
see by adding in a bubby formula that's got the
probiotics in it. Do you do a gentle start, do
you just go straight in and morning and night breastfeed
and in between you just do bottle Like how does
(17:30):
a parent do it? How do you add mixed feeding
to the regime.
Speaker 3 (17:35):
The introduction is going to depend on the situation for
the mum and bub We talk about when people are
introducing probiotics and fibers in adults, we always talk about
introducing it slowly because once you start feeding the gut bacteria,
they start fermenting, and fermenting creates gas, and so that
can be unpleasant when you're adapting.
Speaker 1 (17:56):
But when you're.
Speaker 3 (17:57):
Looking at introducing a probiotic in a formula, it's really
going to depend on the needs of introducing that for formula,
and the gastro intestinal environment and the social aspects of
things like gas are very different when.
Speaker 1 (18:12):
You're a child, absolutely, and so.
Speaker 3 (18:16):
Kids are allowed to have gas on and adults we
are socially less acceptable. So introducing the formula in a
way that's needed and having that probiotic there at the
same time is definitely the priority. So having the probiotic
is an excellent bonus that I would encourage, but getting
the formula in so the bubb is fed first is
(18:36):
obviously the most important step. And I've just realized I
keep saying prebiotics like as though you know that will
be written on the tin when you're looking at a formula,
and it's probably not going to say prebiotics on the
front of pack. And so what you want to be
looking for when you're looking for a prebiotic is in
the ingredients list. The number one performing in the data
(18:57):
of the probiotics are a combination that's called goss and
foss so galacto oligosaccharides and fructo oligo sachrides. So those
are really big words, but they'll be written out in full.
Galacto oligosacride and fructo oligosachride will be written out in
the ingredients list of these formulas.
Speaker 1 (19:17):
So that's really what you want to look for, amazing.
Speaker 2 (19:20):
So I will add those to the show notes so
that if you guys are interested or want to share
that information, they will be there for you what the
full name of the prebiotics are, so that it's there
in black and white for you.
Speaker 1 (19:34):
And I'll get doctor Emma to check it for us,
the role.
Speaker 2 (19:37):
Of the nurse in educating mums and dads and families
around good feeding habits.
Speaker 1 (19:46):
When does that start.
Speaker 3 (19:48):
I think the role of the nurse begins immediately, and
I don't think it ends. I think as one of
the most trusted professions and one of the most accessible
healthcare providers, there's a lot of incidental inquiries about these
kinds of things, dental conversations that happen, and I think
(20:08):
that's true throughout the entire lifespan, but it matters particularly
in early life because in early life we are laying
this foundation, but we're also laying a foundation about these
conversations and the fantastic role that nurses can play acknowledging
their scope of practice is not dietetics, it's not nutrition,
but being able to have kind and clear and empowering
(20:32):
conversations so that people can access that entire toolkit. It
helps parents feel supported, it helps baby be nourished, but
it also reinforces that role of nurses as that caring
an accessible profession because there's a lot of times where
people are not comfortable having these conversations because they're afraid
(20:52):
of being judged, and so if a nurse can have
these conversations without judgment and with kindness and backed by evidence,
then that reduces the fear of having these conversations again
with nurse in the future in a more empowering way.
So I cannot stress enough how much I think nurses
can play a really positive role in improving these outcomes
(21:14):
for babies and their parents.
Speaker 2 (21:17):
Since you have introduced and done research into prebiotic being
added into formulas, were you able to get a good
reading of the reduction of hospital visits or do some
research into that area of the impact it, you'd have.
Speaker 3 (21:32):
So there's data that shows reduction in infection rates, not
necessarily hospitalizations, not because that doesn't happen, but probably because
that's not been looked at yet. But there is the
reduction in infection rates, and there's a lot of data
for the actual functional changes that we know will have
(21:54):
a knock on effects. So it's important to remember in
science we don't always look at the end outcome directly.
Sometimes we're looking at the different functional and biological markers
long the way and then putting that together to be
able to make the recommendation for how things would and
could fit together. Because obviously that endpoint of infection is
(22:15):
a very complex one, but there's good data for things
like increasing good bacteria in the gastro intestinal tract. There's
good data for increasing the amount of IgA which is produced,
and that's the globulin is something that we're encouraging breastfeeding
for so getting that from mum. So that's one of
(22:37):
the anti bodies that's going to help protect bub against infections.
And we see improvements in things like staol consistency, stool frequency,
reductions in pH of the stool, which means we've got
more of the good metabolites being made by the gut bacteria.
(22:58):
And so if you put all that together, it makes
sense that this is going to reduce infection rates and
then hopefully that has a knock on effect of things
like hospitalization as well. But obviously we need to keep
collecting data.
Speaker 1 (23:11):
On those things. And how do you collect the data
is it through stool samples.
Speaker 3 (23:17):
So there's lots of different ways this research is done.
It can be through health records, it can be through
collecting stool samples, which again much easier in kids than
it is in adults, and obviously looking at the biomarkers,
looking at things like blood levels and those kinds of
things as well. So a lot of really wonderful parents
will have volunteered to be part of studies that look
(23:39):
at putting these probiotics into formula and showing these benefits.
And I think that's important to acknowledge because we can't
keep improving the science if we don't have people who
want to participate in the science. So I think that's
a really great role that these mums and bubs have
played to allow us.
Speaker 1 (23:56):
To keep growing.
Speaker 2 (23:56):
Actually, I just received a final questionnaire from the University
of Queensland for a longitudel study that I did with
my daughter about development. Totally forgot all about it until
I got the final questionnaire and it was like, oh
my goodness, I participated in something that went for twenty
five years.
Speaker 1 (24:13):
Pretty cool.
Speaker 3 (24:14):
It's so powerful and in a few years maybe someone's
doing a podcast sharing some new advice based on that study.
Is just so impactful, and I think that really highlights
what I was saying before about it's easy to take
for granted raising children because we've raised children for eons.
But as we learn more about the science, we can
(24:36):
do better for those children. And we live in different
environments now, and so we have different pressures to do
better for those children. And when I think about a
concept like prebiotics that's younger than me. Prebiotics has only
been a term since nineteen ninety five. So if we
relied on what my grandma told my mum, we really
(24:56):
could be missing a trick in supporting immune health and
in supporting parents.
Speaker 2 (25:02):
You spoke before about autoimmune ca conditions. Do the prebiotics
help long term with that, not just with kids but
with adults. Is the research looking into that currently directly?
Speaker 3 (25:16):
I wouldn't say that data is there yet, But again,
from that join the dot's perspective, and knowing what we know,
having a well programmed immune response to pathogens and priming
that gut microbiota to be biased in the positive direction
is very likely to have positive outcomes for other conditions
(25:38):
as well. But I wouldn't want to overstate that not
having that data yet. The data is really clear for
gut function, it's really clear for the gut bacteria. It's
really clear for the metabolites that are being produced. But
we do need to do more research to get that
direct evidence, because obviously when we're looking longer term, that
takes longer to get.
Speaker 2 (25:55):
Absolutely, it would be wonderful because the amount of autoimmune
conditions that are just spiking, it's phenomenal. And look, I
have my own ideas about that. I do think our
stressful life and not caring for ourselves impacts a lot
of that, But that's not science backed. That's just from
me talking to lots of people. It's interesting. A colleague
(26:18):
of mine is a specialist in a emergency department and
we were chatting the other week and he was quite surprised.
We just got chatting about different things that are presenting
at the adults emergency and he was saying that he
just can't get over autoimmune conditions, heart attacks, strokes, weird cancers,
(26:42):
brain tumors. He said, they're seeing things they've never seen before,
presenting in much younger demographics. And I said, Demma, what
do you think and he goes, I definitely think it's stress,
he said. I think it's our phones attached to our
ears all the time. People have the phone on their wrist,
there's never any downtime. And it sort of made me think,
(27:02):
you know, I think all of this impacts the gut
and impacts the brain. I just don't know if we're
feeding our bodies the right things to also be coping
with all of this stress, because I know if I
eat a good, healthy meal, look after myself properly, I
feel far better than if I eat fast food.
Speaker 1 (27:22):
Do you agree with that?
Speaker 2 (27:23):
Do you think food, the mind, stress all plays a
role in autoimmune conditions, in cancers, in tumors. I'm asking
not scientifically, I suppose just your personal belief. It's really
hard for me to separate personal tiberance. But we know
that the gut and the brain are connected in both directions,
(27:44):
and so what goes on in our brain affects our gut.
What goes in our gut affects our brain, What goes
on in our gut affects everything in our body. If
I was to pick the organ system that has the
biggest impact on health, it's always the gut. Knowing that
we live in this environment that, as you said, is
quite technological, it's quite hectic, there is a lot of
(28:07):
stress going on. Again goes back to how we can't
just keep doing what we've always done and keep giving
the advice that we've always given because science is always
going to be in flux with that change. So keeping
up with what we can do to optimize responses and
improve outcomes is always going to be important in nutrition
(28:29):
and in health sciences generally. But going back to you know,
stress and the impact of stress on the gut and
how then that leads to disease, I think this is
all the more reason of why we want to be
across the importance of that first thousand days of life.
So first thousand days of life being from conception to
(28:49):
two years of age in the child, because that is
the programming stage, That is the priming stage, and programming
and priming is going to determine how resilient we are
to these other stresses and these other exposures, because obviously
we keep getting exposed to things throughout our life. After formula,
after breastfeeding, we're transitioning into solids, which brings a whole
(29:13):
new set of exposures to the gastrointestinal track, brings a
whole new set of stresses in the brain as well.
And so no matter what we're doing at whatever life stage,
getting that foundation right first gives us the best chance
at those outcomes being what we want them to be later.
What are the things you do in my research beforehand
(29:33):
and you brought it up before about the phs stools.
Why is that so important in bubbers?
Speaker 3 (29:39):
Well, the PHR stool is important for everyone because it's
an indicator of overall functions. So stool should be slightly acidic,
so it shouldn't be too basic, it shouldn't be bang
on neutral, and it shouldn't be very acidic either. So
like everything in the body, you know how we have
our pH buffering in blood, and each of our organs
(30:01):
has their own pH environment, our gastrointestinal environm.
Speaker 1 (30:05):
It's an indicator of its overall health. It's pH.
Speaker 3 (30:09):
And one of the reasons why pH changes with the
health of that environment is because the good gut bacteria
are producing short chain fatty acids, so things like acetates
and propenoates and butyrates, and they're actually the signaling molecules
that go on to have those knock on effects that
cause benefits for the immune system and cause benefits for
(30:32):
the gut wall. So one of the reasons why keeping
your gut microbiome healthy is improving your health outcomes and
particularly your immune outcomes, is the gastrointestinal microbiome the bacteria
produce energy and produce metabolites that actually feed the wall
(30:53):
of the gut, So you don't need to be a
scientist to know that a healthy wall of the gut
is going to improve immune outcomes because it means the
right things are getting in and the right things are
being blocked out, having a nice exchange of information between
the inside and the outside of the body. So the
store pH is a marker of all that going on
(31:13):
and working appropriately.
Speaker 2 (31:15):
What age do you recommend for little ones to start
introducing solids? What is the most beneficial age?
Speaker 3 (31:22):
So from an age point of view, it's around six months.
There are physiological markers of children being ready in terms
of being able to hold their head up and the
way they can move their jaw and those reflexes, but
six months is key. It's important to remember though we're
very rarely going bam. We're done with breastfeeding and formula
feeding and now we're eating solids. It's a transition period
(31:46):
and that's another place where I think prebiotics are going
to prove to be important in formulas or coming from
breast milk, because there are probiotics in breast milk as well.
Because when we start introducing solids, we start introducing allergens
and we start introducing pathogen So there's going to be
(32:06):
bacteria on food, there's going to be bacteria on plates.
Speaker 1 (32:10):
Don't panic.
Speaker 3 (32:10):
I'm not saying they're unclean. There's bacteria everywhere, and those
meeting the immune system in the most optimal way, which
is supported by probiotics, is going to help with that
programming in that stage. So it's a high risk, high
reward stage when you do start introducing those solids, and
remembering we get probiotics in our solids as well, and
(32:31):
so introducing prebiotic rich solids can help support that stage
as well.
Speaker 2 (32:39):
So you would encourage if your breastfeeding still breastfeed, cut
it down to two three times day, If you are
still bottle feeded, continue the bottle feeds, but ad in
the solids as well and just slowly integrate them and
just one or two little things each week or if
the child shows interest. Would that be a fair statement.
Speaker 3 (33:00):
It's definitely a staged approach. It's definitely a transition, not
hard cut point, and it's going to be different for
every child. So I think one of the things that
we do wrong in nutrition generally, but particularly in early
childhood nutrition is. We make a lot of comparisons about
behaviors and stages and speeds and ways of doing things,
(33:22):
and there's lots of ways to get to the same endpoint,
and each of us is a very unique, very wonderful individual,
and that goes for our kids as well.
Speaker 2 (33:32):
I'm a little bit interested in the gut brain, how
it works together, and the impact that food has on mood.
Could you explain a little bit more about that.
Speaker 1 (33:44):
It's complicated.
Speaker 3 (33:45):
All of those things that I was talking about before,
in terms of the short chain fatty acids and the
signaling molecules and the immune system itself are all going
to have knock on effects to what goes on in
the brain, because the hormones that affect the gut affect
the brain. The hormones that affect the brain affect the
gut much and so knowing the beginning point in these
(34:08):
cycles is often quite difficult because if there's something going
on in the brain that can have consequences for digestion
and absorption and gastrointestinal microbioda. But if there's things going
on in any of those places as well, that will
have knock on effects for the brain and mood and
hunger and mental health and all of those things. So
(34:30):
the complexity of those signaling molecules and the nerves that
run from the gut to the brain and vice versa,
the complexity of those is it's really hard to come
up with definitive answers about do this get that result
or this one thing causes this other thing. And so
I think it's important when we're looking at this evidence
(34:54):
to take a step back and say, well, from a
holistic point of view, based on the evidence, what are
the best decisions we can make? And that's where you
come back to the evidence for nurturing that gastro intestinal
tract and nurturing that gastro intestinal microbiome through adding the
probiotics when necessary, but adding the probiotics so that they
(35:17):
have something to eat and they can be nourished in
the same way that our bodies are nourished.
Speaker 2 (35:21):
So if we aim to do this in that first
thousand days of life, we are setting our children up
to try and optimize their health moving forward.
Speaker 1 (35:33):
Is that a correct assumption.
Speaker 3 (35:35):
Yeah, it's about laying the foundation. This is not a
journey that ever ends. We do need to keep eating
well throughout our lives to help reduce our risk of
disease and to protect ourselves and to optimize those health
and wellbeing outcomes. But if you think about it as
you want to give your child the best jumping off point,
(35:56):
because that means it's less effort later, it's less of
a barrier to overcome, and so getting that program being
supported early it's a no brainer. It doesn't mean if
you've missed that window, it's over. It means that if
you can optimize that window, you improve chances and outcomes
(36:17):
later and there's less work to catch back up.
Speaker 1 (36:20):
So it is very important in the scheme of things.
Speaker 2 (36:23):
The research is now showing those first thousand days after
a bubba is born food wise is really important to
try and set them up with as many probiotics and
prebiotics to feed the probiotics.
Speaker 1 (36:38):
Is that right? That would be a fair assumption.
Speaker 3 (36:43):
Yeah, Like obviously there are entire societies and entire schools
of research that are dedicated to this first thousand days.
I don't think we want to be as overstated in
saying as many as possible, because it's about having the
right ratios and the right amounts. So it's not like
you need to add a probiotic formula and then find
(37:05):
extra ways to gm probiotics into your children. The formulas
are optimized to have the correct ratio, so if you
start adding too many probiotics, then you're going to be
displacing other things that you want to be getting in. So,
like everything in nutrition, it's not more is better, it's
about having those right ratios. And the research around these
(37:26):
probiotics in formulas, the most evidence is around the goss
and the foss that we talked about earlier, and a
nine to one ratio of those, and there's an optimal
amount to be adding because we don't obviously want to
be displacing the carbohydrates and the fats and all those
other great things that are in formula that nourishes baby
from a building blocks point of view, we don't want
(37:46):
to displace those with probiotics.
Speaker 2 (37:49):
After one of those shows on Netflix, and that was
saying to get the best gut health and probiotics and probotics,
you should be eating from this fast variety of food
in a week and something like sixty different nuts, seeds, greens, reds. Anyway,
I gave it a bit of a crack. I swear
(38:09):
to god, I was flat out and doing twenty cost
me a fortune.
Speaker 1 (38:14):
It tasted like crap. I was like, I can't do this.
Speaker 2 (38:19):
That's why I think, you know, the formula side of
thing is fantastic, And if you can use a product
that has that already scientifically proven amount and it's been
added in the correct way into a formula, is a
really great option. And don't do it like me where
I lasted two weeks and my bank balance took a
(38:40):
hit end I couldn't afford the brazil nuts anymore. It's
crazy and I got sucked into trying that. Don't get
me wrong, I get sucked into a lot of things.
But if I have a healthcare background and I thought
it would be worthwhile trying twenty thirty forty fifty different
fruits veggies, imagine how complex and confusing it must be
(39:02):
for someone that doesn't have that health background. I mean,
they must find it exceptionally confusing trying to work out
what is best for their family for themselves.
Speaker 1 (39:13):
And so this is hard.
Speaker 3 (39:14):
When we hear things in the world about what we
should eat and then trying to translate that in our
brains about what are the best decisions for our children
is quite difficult, So I think it's a couple of things.
Is the recommendation for that variety comes from the fact
that different things can act as prebiotics, and plants make
these things as part of plants protecting themselves from stresses.
(39:38):
So if we spread our variety, we get more types
of these things which could have functional benefits. But when
that target feels impossible, then we can start feeling like
we're failing and that this is too difficult, and that
can cause us to go, well, let's not do this
at all. And so I would definitely say those when
(40:00):
we talk about variety targets, those are arbitrary numbers, they're
not rules. But then when we translate that into the
data that we have for the infant formulas, the important
thing to remember is in breast milk there is a
whole bunch of naturally produced prebiotics that will be there.
It probably isn't possible with the science yet to mimic
(40:22):
that fully in the formula from a structural point of view,
but what the research looks to do is to mimic
that in a functional point of view.
Speaker 1 (40:33):
And so when the goss and the foss.
Speaker 3 (40:35):
When the galactoligosachrides and the fructologosachriides are added in that
nine to one ratio. That's what we're getting as close
to the functional benefits as we can with the science
so far.
Speaker 1 (40:48):
So it's not.
Speaker 3 (40:49):
Necessarily about having all the things, it's about how do
we get those functional benefits, possibly in a different way,
because in nutrition there's always more than one pathway to
the same outcome.
Speaker 2 (41:01):
What if mum has a really poor diet and is
breastfeed what happens.
Speaker 3 (41:06):
Then The quality of breast milk depends on mum's diet,
so that is really important. But also creating breast milk
that is of quality is a priority in mum's body.
And so if mom isn't looking after her diet, she
could be sacrificing her health outcomes in later life, things
(41:28):
like bone health, for example, for the health of her
child now. So definitely, it's like on the planes when
they say you need to put your mask on first
before helping infants. In children, you do need to be
looking after yourself in parenting, not just when you're breastfeeding,
but parents do need to be looking after themselves as
well so that they can be looking after their children.
(41:50):
And that's also about role modeling, Yeah, because we don't
want kids to be growing up seeing that mum doesn't eat,
or mum only eats once the kids are eaten and
eats the leftovers off their plates, or those kinds of things.
That's not setting up good cycles of role modeling for
children in the future.
Speaker 2 (42:06):
And this is coming a little bit off baby topic,
but it is something that I'm interested in as a
lot of my clients have had gastric bypass surgery or
the sleeve. Now I know this isn't your specialty, but
in my mind, particularly gastric bypass where it bypasses the
(42:26):
gut altogether, how much of the good pre and probiotics
are actually work in the gart compared to the intestine.
Speaker 1 (42:37):
Is that going to be a huge issue you think
down the track.
Speaker 3 (42:41):
So I think this is an example of it depends. Unfortunately,
the answer is almost always it depends in nutrition. So
when we have banding or bypass, we're skipping the top
part of the gastro intestinal tract and we've still got
the function in the lower part of the gastro intestinal tract.
So there's some studies that will show benefits for gut
(43:05):
health post those kinds of interventions, and there's others that
will show harms to gastrointestinal health that comes post those interventions,
and that's probably down to what is the nutrition like
and what is the care like post intervention, because like anything,
just doing the intervention is one thing, and then it's
(43:26):
how do we maintain and support the body in the
best way post that.
Speaker 1 (43:32):
If you have an.
Speaker 3 (43:33):
Intervention like a gastric sleeve or a banding or bypass,
and then you don't change your diet, you're probably not
going to see any benefits to your gut health, and
you might see harms to your gut health. But if
you use that as a jumping off point to improve
nourishment and keep adding prebiotics and keep adding probiotics and
not doing the things that will damage gut bacteria, which
(43:56):
is alcohol and junk food and smoking, then it's very
likely you'll see a beneficial effect. And so it will
definitely be different outcomes for different situations, and again it's
about getting the support to make sure that you can
do the things that are going to optimize those outcomes.
Speaker 2 (44:14):
With nurses doing shift work, you know, with the largest
demographic workforce, with women in it, A lot of them
are mums and working night like I did night duties.
Sleep How important is sleep with nutrition?
Speaker 1 (44:29):
Sleep's very important with nutrition.
Speaker 3 (44:31):
So sleep is when your body is processing everything that
you've eaten throughout the day into repair, development, maintenance in
your body. And sleep is also going to impact hormones,
it's going to impact gut function, and that's going to
have a knock on effect for microbiome and all these
(44:51):
other things that we have been talking about. So sleep
is definitely important. But that said, some people are in
situations where they're sleep will be disrupted because of night shifts,
because of crying baby, because of other care as responsibilities,
and so knowing that that will have an impact and
(45:11):
that we do want to optimize those outcomes through sleep
where possible, But knowing that even in the context of
poor sleep or disrupted sleep or shift work, you can
still make the best choices to support your health. So,
knowing that people will have different pressures and different risks
because of those sleep related challenges, we want to fix
(45:35):
those challenges first if we can, but we still want
to make the best decisions possible on top of that
in that context, because like we said, right at the beginning.
Speaker 1 (45:44):
Perfection is not a thing.
Speaker 3 (45:45):
We're never all going to be in the situation where
we're all getting the perfect amount of sleep and eating
the perfect amount of things and living the perfect lives,
And so what decisions can we make? And if you're
not sleeping well, making those decisions can feel harder. So
this isn't going to be a one size fits all approach.
It's not going to be a if we all put
in the same amount of effort, we all get the
(46:07):
same outcomes. This will be different for all of us,
and we can walk those journeys with kindness for ourselves
and kindness.
Speaker 1 (46:14):
For each other. That is so true.
Speaker 2 (46:16):
If you are a family member that has a child
that doesn't sleep, how does that impact the child gut wise?
If they're just like my son did not sleep for
three years. We were flat out having him have an
hour in one go. He was a nightmare and by
the end of three years, I was a basket case.
(46:38):
Decided not to have any more children. But what would
have the impact been on him and his gut health?
Because they never found out what was wrong. They thought
it might have been silent reflux. He was in that
hospital fed with a tube. It was very complex and
no one could ever give us an answer.
Speaker 1 (46:58):
Even to this day.
Speaker 2 (46:59):
He's funny with certain foods that could have had a
huge impact on his gut health and his immunity. And
is that a correct assumption, do you think, Emma.
Speaker 1 (47:11):
So it's hard to say.
Speaker 3 (47:12):
I don't think we've got the data on sleep and
stress and those kinds of things in children. It's been
studied well in adults, but obviously, for ethical reasons and
practical reasons, that's a lot harder to study in children.
I think one of the really important things to remember,
and we've talked a lot about doing our best and
optimizing and giving the best jumping off point, but the
(47:34):
human body is a very complex and robust organism. Even
if we've missed a window, or even if we've had
a window disrupted by ill health or by whatever else,
that doesn't mean we need to beat ourselves up about
the fact that those things happen. And from each decision
(47:56):
making point, we can just strive to make the best
decision based on the best evidence in the circumstances we
find ourselves in, even though from a scientific point of view,
unpicking what that means, what the consequences are can feel important.
It's important not to let those circumstances get in the
way of making your next best decision in the next
(48:20):
decision making moment. I think that's what happens when it
comes down to, you know, the breast is best conversation.
We can't let that get in the way of making
the next decision when that's not possible for whatever reason,
whether it's work, whether it's biological function, whether it's adoption,
whatever it is. We can't let that history get in
the way of decision making moving forward, because that's just
(48:42):
being a slave to history rather than being optimistic and
being prepared for the future.
Speaker 2 (48:48):
I think we've come a long long way because when
I was talking to my mum about this, I was
not breastfed.
Speaker 1 (48:55):
I was fed carnation milk. That's what they did.
Speaker 2 (48:58):
And I'm don't tell anyone like fifty four ish.
Speaker 1 (49:03):
But that's what they had.
Speaker 2 (49:05):
Just didn't have other things, certainly not saying it was
the best, but it was the best that they knew
at that time, so they just did the best they could.
And it was a bit frowned upon back then to breastfeed,
and I don't know why it was probably how no
one wanted to see breast.
Speaker 1 (49:21):
It was rude. I don't know, and then.
Speaker 2 (49:23):
It has evolved and evolved, and then when I had
my kids, it was certainly breast is best. You do
your best, and then when that doesn't happen, then you
go down other pathways, which is still current. It's just
that there's more current evidence around if you can't breastfeed,
that there are some better choices in formulas, and it's
(49:46):
just important to have that knowledge around what those decisions are.
So when I was reading the information around the prebiotics
and the big names, and I had to look in
the chemist and had to look at some of the
tins and things like that, it was very interesting when
I interviewed doctor Elizabeth and she said, there's little information
(50:07):
out there for parents to look at how to actually
bottle feed appropriately. So like me, a lot of people
are just going off the tin, Whereas now you have
helped work on this website, this information line for people
to have some really great evidence based information on how
(50:29):
to feed a little one that might be doing mixed
feeding might be bottled only due to whatever reason. And
I think that is such a fantastic thing for healthcare
professionals to be able to recommend.
Speaker 1 (50:44):
It feels to me like this is way overdue.
Speaker 3 (50:47):
And I think it comes down to sometimes in nutrition
we're making decisions for survival, and that sounds like you're
on the carnation milk. My mum was bottle fed as well.
She was adopted at a very young age. She then
managed to breastfeed. I think nine of the ten siblings
that I have, the premes needed to be fed from
(51:08):
a milk bank, but the rest of them she breastfed.
And so sometimes we're making those decisions for survival, but
sometimes we're in a position where we can make those
decisions for thriving. And I think that's where looking for
the right formula and in this case specifically the ones
that have the goss and the foss those prebiotics added,
(51:28):
that's a decision for thriving that sets bub up for
fewer challenges in the rest of their life. And so,
you know, whatever that jumping off point is, we can
start making those decisions, hopefully in that thriving sense, and
less of them in the survival sense as we move
forward with that better science and with that less stigma
that by not having those conversations around the choices. We
(51:53):
are leaving it up to people to make their own decisions.
It's either perfect or figure it out yourself. And we
can definitely do better in having those conversations in the
middle ground and the other options as well.
Speaker 1 (52:05):
Ground.
Speaker 2 (52:05):
Isn't it supporting whatever your choice is and disseminating the
correct information that is evidence based, that is researched, so
that we can set those bubbies up for life to
thrive and also set the parents up. There's nothing better
as a parent than seeing your little one happy, smiling, thriving, eating,
(52:29):
being fed and happy in that milk drunk sort of situation.
It's one of the most beautiful moments as a parent
because you feel accomplished. And whether that be from breast
milk or from a bottle, there is just nothing better
to see a little baby so satisfied that they just
pass out from being fed. But I just think that
(52:52):
we as healthcare professionals really need to support the families
in our care and not be judgmental. Everyone is doing
the best they can and sometimes they don't know what's better,
and maybe we in a very kind and considerate way
to seminate that information or point them in the right direction,
(53:12):
where really smart people like doctor Emma have worked really
hard with research to work out what is best for
bubbs in the first thousand days. Why wouldn't we just
jump on that and share that information and go to
that website and tell our colleagues about it, and tell
our midwives about it and just support each other. I
(53:32):
think that's the best thing we can do as healthcare practitioners, because,
oh my god, it is tough out there.
Speaker 3 (53:38):
I think that is a really beautiful way of putting it,
because yes, there's science for this, but there's also all
the stressful and negative emotions that can be attached to
this as well. So being able to balance the science
and the society and the parent and bob needs, I
think is a really powerful and empowering space to be
and so glad to have been a small part of it.
Speaker 2 (53:58):
Thank you so much, doctor Emma. I am in awe
of your skill set and your skin.
Speaker 1 (54:09):
I swear to God.
Speaker 2 (54:10):
If that's pre and probiotics, I'm getting onto them. Doctor
Emma has the most amazing skin, and as you guys know,
dermatology is my specialty, so I've been sitting and.
Speaker 1 (54:18):
Looking at it in all it is flawless.
Speaker 2 (54:21):
So if ever there is a really great reason to
have a good diet and pre and probiotics, just have
a look at your skin.
Speaker 3 (54:29):
Amazing skin is a great way to get people interested
in nutrition because it's very hard to imagine cardiovascular disease
outcomes and bone outcomes in your eighties. But you can
see your skin as well, and what you see on
the outside is often a reflection of what's going on
on the inside.
Speaker 2 (54:45):
Well, your skin looks remarkable. Thank you so much for
taking the time to chat. It's such a huge topic.
Like it's a huge topic and very on point at
the moment because people really are wanting to do the
best for their loved ones. So thank you so much
for the research you do, for the work you do,
and also for working so hard on getting an amazing
(55:07):
website for families and healthcare professionals. I can't wait to
share it, so thank you, Thank.
Speaker 1 (55:13):
You so much.
Speaker 3 (55:14):
I've thoroughly enjoyed the conversation, and all the best conversations
meander you don't know where they're going to go. Well,
I will say lots of other people have worked on
this research, in this website, these resources, not just me
so shout out to the entire team who have brought
this information together so that it can be practical.
Speaker 1 (55:30):
Thank you guys all so much, and thank you Doctor Emma.
Thank you.
Speaker 2 (55:37):
This season, I am so excited to announce that the
podcast is being supported by Nutritia, which is a global
leader in medical nutrition. They understand the needs of nurses
in the nutrition space and for over one hundred and
twenty five years have provided products to support child health.
Some of Nutritiona's pediatric brands include Neo Kate Junior for
(55:59):
children who have food allergies, and app to Grow for
those fussy eaters. And those of us who have children
know many kids who go through the phases of definite fussiness.
For more information and resources, visit the NUTRITIONA Pediatrics hub
at nutritia dot com dot au forward slash pediatrics. I
just want to say a huge thank you to Nutritia.
(56:21):
Their desire to support nurses is truly appreciated, and they
are allowing me to continue this podcast so that we
can all grow as nurses.
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