Maternal health & the newborn microbiome

What is our microbiome? 

Our microbiome is comprised of microorganisms that live in a particular environment. The ‘gut microbiome’ is made up of trillions of microorganisms and their genetic material that inhabit our intestinal tract. These microorganisms, mainly comprising bacteria, are involved in functions critical to our health and wellbeing.

Why is our microbiome important?

Understanding where our microbiome originates is as important as knowing our genetic risk of heart disease or cancer. 

The development of our microbiome begins in utero when the fetus is exposed to maternal bacteria via the placenta. Your newborn’s immune system begins developing from about 20 weeks gestation. Colonisation of the newborn gut by beneficial maternal bacteria is important for the establishment and maintenance of the gut mucosal barrier. This protects the newborn from local and systemic inflammation as well as pathogens (microorganisms that can cause disease).

On the day your baby is born, microbiome colonisation begins to increase rapidly. Beneficial bacteria from the mother and environment colonise the newborns intestine, helping to digest food and strengthen their immune system. Their gut microbiome stabilises within the first 2-3 years of life, acquiring groups of bacteria that can persist for decades. Choices made by mum during preconception, pregnancy and in the postnatal period will lay the foundations for your little ones microbiome development and carry on into their adult life. The newborns microbiome is linked to brain development, asthma, allergies, obesity and more.

After 3 years of life the microbiome changes less drastically in response to external factors. Ecosystems cultivated on those foundations can be modified by our choices and circumstances. However, it may seem that in-utero and the first few years following birth determine the majority of the lifelong gut ecosystem.

We cannot always control the method of delivery, whether or not we can breastfeed and the timing of the delivery but we CAN control most of our environmental and lifestyle exposures. So let’s focus on the variables we CAN control and try to optimise our little ones gut microbiome through making healthy, educated and informed choices.

What factors influence the development of your baby's microbiome? 

• Maternal microbiome: infection, stress, disease
• Newborn feeding method: breastfed vs. formula fed
• Mode of delivery: vaginal birth vs. caesarean birth (birth is birth)
• Gestational age your baby is born
• Maternal and newborn antibiotic exposure
• Hospitalisation
• Environmental exposures (endocrine disruptors such as parabens, phthlates, chemicals, additives, GMOs etc)
• Genetics

An imbalance of bacteria (dysbiosis) in pregnancy can increase the risk of pre-eclampsia, gestational diabetes mellitus (GDM), preterm labour and infection.

Dysbiosis in Mum = Dysbiosis in baby.

This can lead to:

• Colic in the term infant
• Disease processes in the preterm infant, including sepsis and necrotising enterocolitis (where a portion of their bowel dies)
• Childhood atopy (allergies)
• Childhood obesity

As we now know, the baby’s gut microbiome will begin to be determined in your prenatal period all the way through to your postnatal period. So how can you optimise your baby's biome?

The following are great ways to boost your baby's gut health: 

• Breast feed: Your baby receives nutrients you consume through your breast milk. One of the complex sugars in human milk is indigestible in the newborn, but a perfect food for a subspecies of bacteria (probiotics) that protects their intestinal wall and boosts digestive/ immune system function. 40% of our baby’s good bacteria is linked to breast feeding, how incredible is that! 30% comes from the breast milk itself, and 10% comes from skin to skin with the direct transfer of good bacteria.
• Take probiotics: Research reveals that probiotics reduce the risk of childhood eczema and newborn colic. Your baby will absorb these through the placenta when you are pregnant or through breastfeeding. You can also invest in newborn probiotics if you want to go that step further. 
• Eat your fibre: Fibre is important as it contains prebiotics which feed/populate your probiotics (good bacteria). A diet rich in fibre increases the diversity of your gut bacteria, helps maintain the gut barrier and may lower the risk of autoimmune disease.
• Supplement with collagen: The microbiome is abundant on our skin and in the gut, where collagen is also plentiful. Alterations in the gut microbiome can lead to leaky gut syndrome which can lead to chronic inflammation and an imbalance of bacteria (dysbiosis). Collagen supplementation can help heal and strengthen the intestinal wall, preventing inflammation. 
• Delay baby's first bath: Early bathing may not only increase the risk of low blood sugar levels in your newborn, but could also interfere with early bacterial colonisation. Aim to wait for at least 24 hours. Your baby will have vernix on their skin which is a naturally occurring, white, creamy biofilm. Vernix provides a protective layer to the newborn skin and facilitates extra-uterine adaptation of skin in the first week postpartum, if not washed away after birth. It is a great natural moisturiser!
• Avoid unnecessary antibiotics: Antibiotics can drop overall species diversity, destroy commensal gut bacteria that benefit our health, and open the door for infections caused by bacteria like C.diff. Don't get me wrong, antibiotics are a life saving medication when used in the right setting... but always question why you or your little one needs them. That way you can make an informed, evidenced based decision.
• Skin to skin: This is crucial for your newborns microbiome development. It kick starts the immune system, provides bonding time for Mum and Dad and allows transfer of beneficial bacteria to your baby.
• Adopt a dog: This point I love, firstly because who doesn't love dogs and secondly, research reveals that babies raised in households with dogs, have a lower risk of developing asthma, eczema, allergic sensitisation and type 1 diabetes. What a great excuse to by a dog or 2!

Consuming prebiotics and probiotics during pregnancy, breastfeeding, and your postnatal period appears to be a safe and practical method to alter the maternal and neonatal microbiome, thus improving pregnancy and neonatal outcomes. 

Interesting fact: There is a strong hereditary component to infant eczema: if both parents have a history of eczema the newborns risk is 60–80%. Studies have shown that mothers who boost their probiotic intake during pregnancy, can reduce their child’s risk of allergies, such as eczema and asthma by up to 60%!

Take home:

Your baby's microbiome is predominately developed by 2-3 years of age. It is important to remember that we cannot always control the method of delivery, whether or not we can breastfeed and the timing of the birth but we CAN control most of our environmental and lifestyle exposures. So let’s be proactive, focus on the variables we CAN control, and try to optimise our little ones gut microbiome through making healthy, educated and informed choices.