EPISODE 47

Part 1/2- The Infant Gut Microbiome & Breastfeeding. Interview with Evolve BioSystems.

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Episode Transcript

March 5, 2021

If your baby has colic, diaper rash, sleeplessness, gas, loose watery stools... listen up.

This is Maureen Farrell and Heather ONeal and this is The Milk Minute. We’re midwives and lactation professionals bringing you the most up-to-date evidence for all things lactation. So you can feel more confident about feeding your baby, body positivity, relationships, and mental health. Plus, we laugh a little or a lot along the way. So join us for another episode.

Heather: Welcome to another episode of The Milk Minute Podcast. Today we have two amazing scientists with us, Dr. Tracy Shafizadeh and Dr. Bethany Henrick. 


Maureen: And today we’re going to break the mold a little bit. We have a lot of information from these amazing scientists to give to you. So we’re, we’re just gonna skip some of our normal questions and awards and stuff. We really want to make sure that we have enough time for you guys to hear this stuff that we’re just geeking out about. 


Heather: Yeah. We’re talking about the infant gut microbiome today and how that relates to breastfeeding. So as you can imagine, it takes a minute to break down that complicated process. And let me tell you, it’s worth it.


Maureen: Yeah. And honestly, like, we’re just still scratching the surface on this. We could talk about this for 20 hours, but we won’t. Okay. Not this time, but we did want to start with a disclaimer. So while we are interviewing scientists, today, they’re scientists that work for a company that sells a product. 


Heather: Yeah. And we don’t normally promote products. We stay away from product based, anything for the most part, because there’s never a lot of great data backing the products and we don’t ever want to make a mistake and lead anybody astray or put our stamp of approval on something that hasn’t been fully vetted.


However, there is so much scientific evidence that is amazing, that has come out of Evolve BioSystems regarding their product Evivo. And my only regret is that I didn’t know about it when I had my kids so I could use it. And we are mostly talking about the science today, but also letting you all know about an option for a product that you can buy if you want to.


Maureen: Yeah. And really, again, we’re breaking the mold. Like we don’t, we don’t usually do this. It’s pretty obvious when we’re advertising for products and that we’re getting money from them. This is not that. Evivo is not paying us to come on here and say this. We really just have read the published research on this. And we have spoken to the researchers and we feel like this is something created to really help people. 


Heather: Right. And although it breaks from our traditional mold, we are willing to do that because we feel it is this important. So we hope that you all enjoy this episode and we hope most of all, that you get something out of it that can help your infant gut microbiome.


Maureen: All right. Let’s dive in.


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Maureen: Well, welcome to The Milk Minute Podcast . Could you guys do us the favor of introducing yourselves to us and our listeners?


Dr. Tracy Shafizadeh:  Absolutely. Thank you so much for having us. I’m Tracy Shafizadeh. I am the director of scientific communications for Evolve BioSystems and I am a nutritional scientist. 


Dr. Bethany Henrick, Ph.D.: And I’m Bethany Henrik. I’m the director of immunology and diagnostics at Evolve BioSystems. I’m trained as an immunologist and specialized in immune development in infants. And I also serve as an adjunct assistant professor at the University of Nebraska Lincoln. 


Heather: Well, dang, how did we end up in the presence of such elite people, Maureen?


Maureen: Oh, I don’t know. 


Heather: Oh, let me tell you. It’s because I came across an article about how the infant gut pH has changed in the past hundred years. And it scared me so much that I reached out to the person that helped write it and did the research on it because I just wanted to talk about baby poop.

And we ended up becoming fast phone friends and I have to say, I have never had more fun prepping for an interview than I did with this one. So thank you so much, ladies. Thank you. 

Maureen: Yeah. We’re so excited to have you to talk about the microbiome and baby poop and all the things that we totally geek out about.

And it’s, it’s like kind of rare that we like actually have a conversation about this where the other people don’t just stop talking. 

Heather: Yeah, I know. Well, they were joking saying that, you know, they’re not allowed to go to dinner parties together anymore because they ended up talking about baby poop and the infant gut microbiome, and everybody slowly starts backing away and leaving the room.

And we have that same experience talking about breastfeeding and vaginas. So we totally get you and we appreciate having you here. So let’s start with the obvious question. Why do you guys love baby poop so much? And what got you so interested in it that you decided to dedicate the majority of your life’s work to it?

Dr. Tracy Shafizadeh: That is a great question. It’s funny that you say you don’t get invited because of the terminology that you use in mixed company. And I would say that Bethany and I get to use words that turns most people off, but we use them all day long, including baby poop. So I’ll let Bethany comment on what really got her hooked, but myself as a nutritional scientist and my focus was on intestinal development of infants in my doctoral research. 

And really being able to see firsthand, as a scientist, truly the magic, that breast milk, human breastmilk and mammalian breast milk, actually, how it works in the infant gut and all of the processes that it, it not only starts in the infant gut from, from the moment the baby first, consumes breast milk, but then all the way through the development in those early stages of the first six months of life. It really was remarkable. It was a turning point in my career. 

Yeah. And that was, I’m going to say 15 years ago. What I didn’t know is that I would then come  back to be able to join this company, Evolve BioSystems, which is dedicated to understanding the infant gut microbiome, which seems very niche, but it is the collection of microorganisms in the infant gut and specifically the role of a particular bacteria, Bifidobacterium infantis and why it’s important and what it does in the infant gut. 

It truly is an incredible story that we can’t wait to share with you today. And a very important part of the development of the infant and the trajectory for lifelong health. 

Dr. Bethany Henrick, Ph.D.: And my intro into breastmilk was, well when I was born, but that’s a different story. I actually did my PhD in understanding the immune components of breast milk and looking at how infants are protected by specific innate immune factors in breast milk, from HIV transmission, from their mother. And that’s really what got me into understanding human milk and realizing what a miraculous mucosal fluid it is and why it’s so miraculous is that it’s the only food that has ever evolved to provide all of the nutrition that humans need.

And so that alone is just spectacular. And I had to know more. Aside from being breastfed until I was three years old, which my family still jokes about that I did my PhD in breast milk. But I went on to join the Foods for Health Institute at University of California Davis and their sole mission is to understand breastfeeding because of that premise, that it is the only food that evolved to feed humans.

And through that research, when I was there doing my post-doc, we came up with some really good findings. So the findings were primarily that there is a very large component of human milk, it’s actually the third largest solid component of human milk, that babies cannot digest on their own. They’re called human milk oligosaccharides or HMO’s for short.

And when we started looking at babies in the population, now this is in Northern California, we couldn’t find any bacteria that could consume all of these HMO’s. That led us down a path, years of research, NIH funded research to find this particular organism. And we found it, which is Bifidobacterium longum, subspecies infanticide, or B infantis for short, and realized that the population had actually lost it.

So babies are no longer born with this really important bacteria that consume these HMO’s in breast milk. And we’ll get into that a little more, but because we were so compelled by our findings at the Foods for Health Institute at UC Davis  the five founders started a company and this is the spin-out company of Evolve BioSciences.

Evolve BioSystems, sorry. So I actually left the university to follow the science and see how the changing the composition of the microbiome I’m putting this really important symbiont back into babies would improve their health. 

Heather: I have so many follow-up questions because I’m so excited to talk about all of this and it’s our podcast and we can do what we want. So let’s go down a quick rabbit hole. So I want to talk about these HMO’s quickly because I think a lot of people, and I’m, I’m speculating here, I think the majority of people think that an HMO is an additive that you can put in things because we see it on canisters of formula. We see it as something that’s just another supplement that baby needs.

So this is not the case. HMO’s are very special. Can you briefly tell us why HMO’s are special and why just throwing that on the side of a can is not the same thing? 

Dr. Bethany Henrick, Ph.D.: Okay. Sure. So what we know from our research is that there are 200 different HMO’s. So, we’ve been able to characterize 200 different unique, complex sugars in human milk.

So that alone negates, just putting one or two in an infant formula. There is a very complex body of these HMO’s. Even though we use the umbrella term, HMO’s. There’s 200 different structures. So that’s first. The second piece. And I think this is an even more important piece, is that the amount of HMO that they put in formula today is a fraction of what’s in human milk.

So the FDA and EFSA has approved adding these synthetic HMO’s to formula at very low levels. So like less than two grams per liter. And if you compare that to human milk, human milk is on average about 15 to 16 grams per liter, but goes up as high as 25 grams per liter. So when baby’s consuming infant formula, even though we’ve called them, we call it pixie dust that they add these HMO’s into a formula, but the thing is that it’s cost prohibitive to put in enough that we find the same amount that we find in human milk. That’s one thing. And then it is cost-prohibitive and no one has yet developed a way to put all 200 HMO’s into a formula. 

Dr. Tracy Shafizadeh: So I’m just going to add there what Bethany said. Just because the only reason I’d like to add something in there is because, as Bethany described, if you can imagine, if there are 200 different components that make up this group of HMO’s that naturally occurs in breast milk, but you only pick one or two and put them in at very low levels, you can imagine that the result and how that affects the microbiome is going to be very different. 

So even though the idea is that formula companies are saying, look, we have HMO’s too. It’s not going to result in the same composition of the infant gut microbiome, the way that as human milk composition of HMO’s would.

And so that’s the part that I just want to be very thoughtful as a scientist and in terms of infant health. Let’s make sure we know exactly what we’re doing when we sprinkle a little bit of HMO’s in formulas. Is that really achieving the same health outcomes and the same goals as what human milk is designed to do?

Maureen: Right. Something to think about. Yeah. 


Dr. Bethany Henrick, Ph.D.: And actually can I add to that Tracy? Because it’s a really good point. It’s a critical point to understanding how B infantis works. B infantis colonizes the baby’s gut by consuming HMO’s and if you don’t have enough HMO’s then B. infantis is not going to be the predominant bacteria that is in the gut. Which historical data suggests it should be. 

So it really is the combination of HMO’s with B. infantis that is the perfect kiss in this case. You can’t just have one without the other. 

Maureen: So we’ve kind of hinted at it here and there in the last couple minutes, but can we take a step back and kind of just briefly describe what a microbiome is? You know, how do we get it? Do we pass it onto our children? Things like that. Like take a little bit of a broad perspective in case some of our listeners are like eh, I’ve heard that word. I don’t totally know what it is. 


Dr. Tracy Shafizadeh: Okay. There are so many parts to this story that I would consider my favorite, but I really think this is my favorite part of the story.

So the infant gut microbiome, basically when babies are born, they have very, very few microorganisms in their intestines. We call them a blank slate because basically they get to start their microbiome the day they’re born. And depending on which type of bacteria start that microbiome for the baby, will actually put them on a different path toward lifelong health or disease.

And just to take even one step back, the microbiome is, as I mentioned previously, a collection of microorganisms that live in and on our body. Right now, we’re talking about the gut microbiome. So in the colon of every human on this planet, there are trillions of microorganisms that live there and do very important things for your body.

Sometimes good, sometimes bad. So when a baby is born and they pass through the birth canal, preferably, but we’ll talk about that in a minute. When they pass through the birth canal, they are starting to pick up microorganisms from mom. So if you can imagine, there’s all types of microorganisms that are in the vaginal canal and then mom’s gut microbiome, okay, hold on to your hats is my favorite part. 

So when baby is passing through the birth canal, they’re actually going to be exposed to some of mom’s gut microbes, because moms often poop during labor and delivery. It happens. Nobody wants it to, we’re all worried. What’s that going to look like? But it happens.

And that is a biological mechanism of exposing babies to mom’s gut microbes. So if mom has B. infantis in her gut microbiome, that’s a really efficient and effective way to make sure baby, in a fecal oral transfer method, gets inoculated with B. infantis as well. Now you can imagine if a baby doesn’t pass through the birth canal and is instead delivered by C-section, they miss the opportunity to get exposed to mom’s microbes. 

And if you think about an environment where a C-section takes place, usually in a hospital environment. And instead baby’s first microbes are whatever are on the surfaces of the hospital or on people’s skin when they’re touching. Cause our skin also has its own microbiome and those are the microbes that then become baby’s first microbiome or microorganisms, which are very different and serve a very different purpose, not always a healthy purpose, for babies.

Heather: So for parents that are like, “Oh my gosh, I had a C-section, my baby’s doomed,” you know, are there other ways that the gut gets colonized after?


Dr. Tracy Shafizadeh: Yeah. Good question. Great question. Because we know up to 30% of babies are born by C-section. The research does show that there are long-term health implications of being delivered by C-section. Higher rates of asthma, eczema, some of the longer term allergic and auto inflammatory and immune disorders.

However, if we think about, let’s go to maybe somewhere outside of the U. S. Maybe somewhere in a developing country where there’s a little bit more interaction with the environment and maybe a little less sanitation. Then the idea that you bring a baby home and they’re exposed to many other microbes that are in the environment.

We call this a thicker fecal veneer. There’s a little bit more poo everywhere in some places, right? And therefore there is the ability for a baby to get both a vertical transfer, from mom to baby during delivery, but also horizontal transfer, just from their environment. And that actually is a really healthy thing.

In the U. S. we are so worried about “germs” as we’d like to call them. And we are sanitizing everything. The idea that a baby born in the U.S. who doesn’t get B. infantis from their mom is going to just naturally pick it up in the environment is actually quite low. And that’s exactly why Evolve BioSystems was started.

We now know so much more about B. infantis that we actually wanted to make sure there was a way to repopulate babies gut with B. infantis. We wanted to make sure that babies born by C-section or babies that were exposed to antibiotics during labor and delivery did not then start out on a path that would lead to worse health later in life.

We wanted to make sure all babies had the access and the ability to have a healthy infant gut microbiome from the beginning. And one way to do that is to put B. infantis back into baby’s gut. And that’s exactly why we started the company that we have today. 

Heather: Okay. And do you have any t-shirts for sale that say get your fecal veneer here?


Dr. Tracy Shafizadeh: Oh my goodness. Yeah, that’s awesome. 


Heather: I’m going to need that shirt. So this microbiome serves multiple purposes, is what I’m hearing, and over time continues to serve multiple purposes. And when a baby is first born, and you’re introducing breast milk, how does this microbiome, assuming that B. infantis is in there. You know, say the baby came out vaginally, face down, and got in contact with some of that B. infantis.

It’s now colonized with that. And then the breast milk starts to flow. What is that relationship like between the B. infantis in the microbiome and the breast milk that’s being introduced? And how does that become such a magical thing for baby? 

 

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Dr. Bethany Henrick, Ph.D.: So just before we get into that answer, I’d like to address one thing that you said. So what we’re finding, our research is showing now is that mums that are having babies do not have B. infantis. So it’s no longer in our population. A recent study we have out in scientific reports last month showed that 97% of babies do not have B infantis in the U S. So what that suggests strongly is that the mums don’t have it to pass it on.

So even if babies are being born vaginally, mum has the perfect delivery and then right away they’re getting breast milk, they don’t have, they’re not colonized with B. infantis for it to proliferate. But let’s for a moment, assume that they did pass on B. infantis because it was a really great vaginal birth and they got breast milk right away.

Well, the first thing that we’ve seen is that. B infantis proliferates or grows really abundantly in the microbiome of infants that are breastfed. It actually makes up on average about 85% of the total amount of bacteria in the baby. Now the reason it can do that is it’s the only strain of bacteria that can consume all of the HMO’s found in human milk.

So it’s essentially starving out any other bacteria, or strains of bacteria, that can consume a little bit like a monosaccharide or one of the sugars off of an HMO. When it proliferates at that level, so it’s 85%, let’s say. It’s pushing out the bad bacteria. The bacteria that Tracy mentioned, babies are often exposed to in the hospital, those typically are pathogenic bacteria.

They carry virulence factors. They carry antibiotic resistant genes. Very often they’re Enterobacteriaceae family, the E-coli of the world. So these particular bacteria, the E-coli, they produce endotoxins, or these toxins, that actually promote inflammation in the gut.

So by changing the microbiome by, by adding B. infantis, you’re making the populations that are potentially pathogenic, much smaller. So they’re still there, but the number of bacteria are much smaller and in their place, are these beneficial B. infantis strains. Specifically, B. infantis C001, which is a strain that does consume all of the HMO’s.

And there are data now showing that having high levels of these. B infantis strains are good for immune development, brain development, metabolic set point. That’s all happening in those first few months of life, of the baby’s life.

Heather: Hmm. So this B. infantis is digesting the HMO’s and then, correct me if I’m wrong because I am not a scientist like you, but the B. infantis is alive. And does it poop inside of your poop?

Dr. Bethany Henrick, Ph.D.: Yes, and that’s such a great thing. So, these HMO’s that are not consumable by infants are consumable by B. infantis and that’s what B. infantis uses to grow and proliferate at the levels we find, the 85% of the microbiome. Now you pointed out exactly right.

They do poop out. But we don’t say that, but it is kind of like bacteria poop. They poop out these metabolites that have a direct benefit to the host, to the human. The ones that are made most abundantly, the metabolites that are made most abundantly by B infantis consuming HMO’s are weak organic acids. They are known as acetate and lactate and those organic acids, they’re weak.

They’re not sulfuric acid or anything really strong, but they do change the biochemistry of the gut. And that’s part of the mechanism that changes the environment so pathogenic bacteria can’t thrive. They’re called both Bifidobacterium and lactobacillaceae are two taxa that are known as acidophilus.

Now. Big word, but what it means is that they’re happy in a more acidic environment. Bacteria like E coli, Klebsiella, Clostridium, they’re happy in a more neutral environment. So actually, the biochemistry of healthy infant gut that’s colonized with B. infantis and being breastfed should be slightly acidic.

And I think that’s a connection point between you and I, because you read our paper that showed that in the last hundred years, baby’s poop has been getting more and more neutral, more and more alkaline compared to what was reported a hundred years ago where baby’s poop was slightly acidic.

Heather: Yeah, but just more so than that, the reason this paper scared me is because I understand what the pH scale is. There’s not that many numbers on the pH scale. So when you say that it went from a five or was it five? A hundred years ago and now it’s six. That’s like, that’s big. That’s like the difference, if you’re talking about a stream or a river, that’s the difference between life and death for some organisms. Absolutely. So, I mean, to me that was like, that’s really big in a short amount of time. Right?

Maureen: Right. Well, and you hit the nail on the head. It’s the difference between life or death for certain organisms. And you know, the organisms in our gut determine our health. So, right.

Heather: And you know, more and more, we’re seeing the connection in between the gut and disease, you know, it’s like, I’m so glad that this research is being done and we are so happy to give it a platform because I would not be surprised at all if we found, you know, 50 years from now, every health professional out there in all of the different arms of health, came to the same conclusion at the same time that, would you believe it, it’s coming from the gut! Shocker, shocker. So TBD on that one. But you know, speaking of, you said before the moms aren’t passing this on and so this B. infantis that’s so important is not being passed vertically from mother to child or from parent to child. So that’s my generation, you know, that’s Bethany’s generation, that’s all of us. And I know I was a C-section baby. And you know, for those of you that don’t know, you get prophylactic antibiotics in the OR when you have a C-section, so you do get antibiotics, even if you didn’t see it happen, it happened. It’s protocol.

And so what happened in the eighties to us? You know, what was going on there? And like what, from the eighties to now, have you seen has been the biggest difference?

Dr. Bethany Henrick, Ph.D.: That’s longer than just one podcast, what happened in the eighties.

Dr. Tracy Shafizadeh: But the thing that we’re thinking of, you know, and I would say it started before the eighties, but  what’s really interesting about when we look historically at kind of these medical and dietary interventions that became more and more prevalent and starting back in the twenties all the way through till today. We think about the introduction of routine formula feeding, the introduction of antibiotic use. And it’s not just antibiotic s. You absolutely are correct. Antibiotics for surgery, for C-sections.

But think of the number of moms, up to 30% of moms, who test positive for group B strep, which we’re all tested for before we go into labor and delivery. If you test positive, it’s very likely you are going to be given a prophylactic round of antibiotics for group B strep. So even if you’re one of those moms who happens to still have B. infantis in their microbiome, but if you test positive for group B strep, you’re going to get antibiotics. It’s going to get wiped out. No matter how baby is born, they’re not going to get B. infantis from you. And then a third, I would just say the convenience and the regularity of a C-section delivery has increased and in the eighties it really was quite, quite popular.

And I kinda, I feel like there’s this, it’s cumulative, but a generational loss of how many moms, how many of us were either formula fed, born by C-section ourselves, or have received antibiotics in the course of our lives? It’s estimated that women our age have undergone 20 rounds of antibiotics in their lifetime between when they’re born and when they give birth.

The likelihood that we have B. infantis still in our gut microbiome to pass on to our babies is just quite low. So I would say it’s a generational loss, cumulatively, of moms giving birth today that are just very unlikely to have B. infantis in their microbiome. So, therefore it kind of doesn’t even matter if baby’s born vaginally or by C-section anymore.

That’s why the paper that Bethany is mentioning says 97% of babies are estimated in the US to not have B. infantis. It’s not that 97% of babies are born by C-section. It’s that the likelihood of naturally picking this up from your mom is very, very low.

Maureen: Right. So, you know, we have these populations that do have B. infantis and those that don’t. You know, our country doesn’t, but you had mentioned before that we have these other places where, you know, most parents have it, most babies have it. So are they healthier than us? Are their babies healthier? Do they deal with all of the things that we very much normalized with babies like colic or gas or diaper rash and shitty sleep and you know, all of that stuff?

Dr. Tracy Shafizadeh: Yeah, I’ll answer that first and then I’d love Bethany to weigh in as well. It is a little bit complicated because we don’t have really great data on things like colic in developing countries. It’s anecdotal most of the time. But what we do know is that the work that was done previous to Evolve BioSystems, the workout of UC Davis, where they really were looking with their work with the Gates Foundation.

They were looking at places like Bangladesh, like Malawi, like Kenya and looking at the infant gut microbiome, not only from what does it look like compositionally? But what does it seem to be doing? And what are the, what is the populations there look like? Do they have the same levels of auto-immune inflammatory or allergic diseases later in life?

And the answer is, I wouldn’t say that a baby born in Bangladesh today is the poster child for the perfect healthy baby. They have other challenges. Infectious disease is something that they have to worry about. Diarrheal disease. But they don’t have the same rates of the longer term allergic and autoimmune disorders that we see in the US that are skyrocketing in places like the US.

And this is really where I would love for, for Bethany to weigh in, that the role of the microbiome and the programming and the developing of the immune system in the first few months of life really does dictate what path you will be on and what risks you have for developing these disorders later in life. And it just looks very different for babies in developing countries versus babies in the US. Bethany, you want to weigh in?

Dr. Bethany Henrick, Ph.D.: Yeah, I would just add, I mean, great overview. The only thing I would add is you can’t compare a developed country to a developing country. You know, the advent of modern medical techniques, whether better hygiene, better sanitation, better access to antibiotics.

Those all have a need and they really did help our population be healthier overall. It’s just, they’ve had unforeseen consequences, that we now realize, to the microbiome. And so you can’t directly compare the different countries, developed to developing, but one point that I will make,  that Tracy picked on being a baby born in Bangladesh. But from an immunological perspective people have looked at whether vaccines correlated, the efficacy of vaccines correlated with microbiome. And it was a study out of Bangladesh where babies do have natural B. infantis colonization still. And what they found for using vaccine efficacy, as a quantifier of health, they did show very strongly that babies that were colonized with B infantis early on, so, you know, in that first three months of life, they did have better vaccine responses at six months.

So that was their first paper. And then a follow on study at two months, or two years. Sorry. Showing that they retained a higher level of vaccine efficacy if they were colonized with B. infantis versus not early on.

So I think although we can’t compare directly, I would suffice to say that babies that are colonized with B. infantis early on, they do have better immunological programming, we’re showing that now in some recent papers, and are overall healthier. And whether that prevents or somehow plays a role in the development of auto immune and allergic diseases, we’re still researching that. That’s what some of our big studies are on because there is a link.

Heather: It sounds to me like the microbiome and the immune system go hand in hand, and one is kind of a direct reflection of the other. And the more research that’s done, the more it feels confirmed. I mean, am I right in saying that?

Dr. Bethany Henrick, Ph.D.: Yeah. I like to think of them as kind of Busan buddies, the microbiome and the immune system.

Heather: That was the most Canadian thing I’ve heard you say yet. The Busan buddies.

Dr. Bethany Henrick, Ph.D.: I need to get my Canadian flag out.

Maureen: Yes! It should be your backdrop.

Heather: Why wasn’t it out in the beginning? So all of these unforeseen consequences of the things we did in the eighties, in addition to the Fanny packs and the big scrunchies and the thick belts over cable knit sweaters, the C-sections, the antibiotics, the, you know, routine wiping out of the microbiome.

Is it too late for us? You know, is it one of those things that’s like, well, either, you know, try to eat healthy the best you can, but you still might end up with Hashimoto’s. You know, like what can we do? Help us.

Dr. Tracy Shafizadeh: Yeah, that is a great question. That’s that is what drives Bethany, myself, and every other member of our team every day is researching what is it that we can do to help put babies on a better lifetime trajectory? And we do now, we have amassed a tremendous amount of clinical data today showing that it is possible to restore B. infantis colonization in infants. And when you do that, there are a long list of benefits. You can see both acutely in the baby right away and also it looks like longer term.

Now we’ve only been doing this research of restoring B. infantis to the infant gut for about five years. We have a long way to go, to be able to show what lifetime benefits there are for babies. You can’t speed up time, unfortunately, but we are seeing very robust improvements in health metrics, both immediately and in the kind of one year mark, two year mark, and now we’re starting to look even farther out from there.

So the key though is, B. infantis, now that we were talking about this, you’re going to start seeing B. infantis pop up on labels everywhere, because now, you know, when you buy a new car, you see it everywhere on the road.

You’re starting to pay attention. B. infantis is becoming very popular in the microbiome and probiotic kind of space because of the research, ours and others, that are showing the important role. The issue is, is that every strain of B. infantis that is used in a product is slightly different.

And that’s where it gets really complicated, really fast, because you want people to be confident going out and saying, B. infantis is great. It’s important for my baby, likely that my baby doesn’t have it. So I’m going to now proactively use some kind of probiotic to restore it. That’s great. We want everyone to be thinking that way.

But you have to really look very closely at the research, the clinical research, and the label of a product that claims to have B. infantis. There are so many products or labels that will have a small asterisks next to B. infantis. And if you look at the fine print, It’ll say things like, well has been reclassified as a different bacteria cause we were wrong the first time, but we’re going to keep B. infantis on the label because it’s really a buzz word and we want people to pick it, but it’s not really B. infantis, so read carefully.

That’s a big problem in the probiotic industry is transparency of labeling. And also the difference between strains. So if you think about a strain, the way we describe it is, you have your bacteria, you have all the different taxa that Bethany has been talking about. When you get to B. infantis, then there are also strains of B. infantis.

If you think about it as the family dog, there are breeds of dogs and they can be very different. You can have a Chihuahua and you can have a great Dane. They’re both dogs, but they are different breeds. They do very different things. You would pick them for different reasons. Same with B. infantis.

The strains are very different and they act differently in the infant gut. The strain that we do research on is B. infantis EBC001. And it is now been shown genetically to have all of the genes and all of the enzymes required to metabolize the full complement of 200 HMO’s in breast milk.

It’s fully functional. That’s how we think about it. But there are other B. infantis strains out there that you could be giving your baby that actually don’t have many of those really important key enzymes that break down HMO’s. So you’re really not getting a lot of the benefits. So that’s one thing I would say is just be very thoughtful about exactly what you’re choosing.

And let the clinical science lead the way, because that’s where the evidence is. And that’s where the, the rigor is behind any product. And, and the next thing I would say is, if you have a C-section, it’s okay. It’s a saving intervention. If you don’t have a C-section and you need one, that would be way worse.

And if you have antibiotic exposure, because you are, you do test positive for group B strep, that’s okay. And formula, of course, fed is best. We need to feed our babies. If you cannot breastfeed or you choose not to, formula is the next best thing. But there, as Bethany said, are unintended consequences to these and let’s make sure we put B. infantis back into baby very early on so that those immune programming steps and those metabolic programming steps do take place.

And that’s what I would say. Moms should not lose hope. There is a way to restore the infant gut microbiome very effectively. And that’s what we’re here to, to share today.

Advertisement: Hey guys, it’s Maureen here. And I wanted to let you know about my Etsy shop  I am an artist and a designer. And I have a shop where I make educational breastfeeding posters, shirts for birth workers, like for your favorite nurse or midwife, shirts for people who are lactating, mugs, stickers, all kinds of stuff.

Some of my birth paintings are on there. It’s an eclectic collection and it’s really beautiful. So, if you want to find that you’re going to go to etsy.com/shop/thewanderingwom6, except instead of a B it’s a six. So that’s the wandering wom6 with a six instead of a B.

Heather: Okay. We need to do a quick summary of what we’ve talked about. And I am willing to give it a try in layman’s terms, and I will look to you, Maureen, to help me if I get stuck. But this is how my parent brain, I’m just going to put my parent pants on and take my midwife pants off.

Maureen: I don’t know that they ever, aren’t they the same pair? They just, they like,

Heather: I have totally different pairs.

Maureen: I don’t know.

Heather: I don’t know either. I’m just totally making that up. So here’s how I see this. And so correct me if I’m wrong, please. So B. infantis is a very important strain of bacteria in colonizing the infant gut microbiome and if it’s given or received by the gut in the first 100 ish days of life, it actually becomes part of their immune system and they become colonized with it. Which means that there is less room in the, in the poop chute, in the gut house where all of the things live, in the gut for nasty bacteria to live.

And also this good bacteria, the B. infantis is also doing its own pooping inside of you, which makes the, your baby’s poop more acidic, which also protects the baby. Am I right so far? Okay.

Maureen: With the great descriptions there.

Heather: This is how, this is how my brain is understanding this.

Maureen: Poop chute, the poop and bacteria. Let’s go with it, Heather. What’s next?

Heather: Yes. And so, even though all of us that were born in the eighties might not be able to colonize ourselves now, and we’ve done a great job as a culture of killing this bacteria and basically making it extinct to our species in the United States, we can recolonize the next generation by using this probiotic.

Dr. Tracy Shafizadeh: You got it.

Dr. Bethany Henrick, Ph.D.: That’s the dream.

Dr. Tracy Shafizadeh:  We’ve been talking for an hour and I feel like you summarized it perfectly in 30 seconds, so, awesome job.

Heather: Oh, go on please.

Maureen: Nice. Yeah. Well, okay. Good summary. So, let’s end this episode by saying, this is not the end. Yeah. We have another one coming up. Heather, can you give us a quick, like idea of where do we, where are we going to go from here? I mean, it seems like we just talked about everything.

Heather: Well, yeah, I think part two, we need to talk about what it actually looks like. You know, you’re at the pediatrician’s office, how you can advocate for yourself with a pediatrician who might not know, or have the time to delve into this kind of research.

Maureen: Yeah, so we’re getting into the nitty gritty.

Heather: Yeah. We’re going to go nitty-gritty on the next one and you know, actual administration of it and what side effects, if there are any, and you know, just really walking a mile in the shoes of a parent who is going to be using, you know, the Evivo is your product name.

So I would really like to take that walk for parents so they can really understand what to expect. And then also Maureen’s going to take some cause she’s pregnant. We’ll talk about that in the next episode. Yeah. So we’ll talk about Maureen and what’s coming after that.

Maureen: So thank you guys for joining us. For this first episode, we really appreciate all that information. We hope everybody tunes in again next week.

Heather: Yeah. I feel totally honored. You all have blown my mind so many times. Every time we talk about this, I learned something new. So I know our listeners are going to be thankful because this is a very sensitive topic for a lot of people that struggle with these things and it’s nice to know that there’s a science backed to answer and we couldn’t appreciate you anymore. So thank you again.

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