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What stuffed your gut?

What stuffed your gut?
Photo: What stuffed your gut?
Everyone is talking about the new discoveries that the billions of bugs in our gut (our gut microbiome) have a profound effect on our mental and physical health – and we are becoming aware that physical and mental health cannot be separated. People taking anti-depressants to keep up their levels of serotonin, for instance, need to realise that most of that happy hormone is made by bacteria in their gut, and that a disturbed gut microbiome can therefore mean depression and misery  as well as obvious local symptoms.

A healthy gut microbiome begins before and during birth, with the seeding of the gut by bacteria from the mother’s body. It continues after birth  as those bugs, and others from food and the environment, have to multiply and establish secure niches for themselves, in the process sculpting the developing infant gut in ways that increase their chance of survival. The process goes on over the first year or longer, but the beginning is critical, as the early colonisers have fortified and can defend themselves against competing bugs, having formed complex biofilms that make it hard to dislodge them completely. (A great article about biofilms can be found online at https://cosmosmagazine.com/life-sciences/microbial-gangs-are-organised-killers).
The balance and types of bugs present in the infant gut affects our lifelong chances of allergy, immune disorders, ill health and gut problems. Great concern is being expressed about antibiotics and surgical births in this regard, as research is showing they have negative consequences.  (Read Missing Microbes, by Martin Blaser).

However, as you might expect, the single most powerful influence postnatally is what goes into the gut every day: food.  Breastmilk, preferably from the child’s mother, is the necessary first food for all infants. This is because breastmilk provides not only a complex array of hundreds of different types of bugs, but also thousands of supportive immune factors, including stem cells, in a perfect mix of nutrients that are exactly what both those friendly bugs, and the baby’s body, need to grow and develop normally. And breastmilk can respond to the challenges of harmful bacteria by creating within days specific antibodies that target the enemy, as well as immediate armies of immune defenders. Breastfeeding is a bridge between the womb and the world.

Infant formula produces a gut microbiome radically different from that of the solely-breastfed baby: that has been known for a hundred years, and it remains true. Without breastmilk,  an abnormal gut microbiome is created, more pathogens are present – bugs that can cause serious disease - and they entrench themselves, shaping the baby’s gut to make it hard to dislodge them. We now know that such bugs and their toxic by-products can be implicated in many diseases, including sepsis, meningitis and autism. As well, they stimulate different growth trajectories for infants, programming them to develop abnormally, with obesity a common side effect from formula intake at recommended levels.

Astonishingly, very little care is taken to assist the development of the normal infant gut microbiome. Some parents think that from birth infant formula is just as good as breastmilk, deceived by misleading marketing puffing the inclusion in formula of both probiotics (bugs) and prebiotics (food for bugs). These have not been shown to match breastmilk’s effects, and can only be considered experimental, with the results not independently monitored or evaluated. Soon after birth many breastfed babies are fed such unsterile products. Within weeks most babies have been exposed to them, as exclusive breastfeeding is a rarity in communities where women go home to an unsupportive environment where infant formula use is usual. When supplementing with formula results in a diminished milk supply, many women are actively pressured to give up breastfeeding, and most do. Very few indeed, only the lucky who find breastfeeding easy, and those motivated by knowledge of the risks,  will reach the World Health Organisation’s recommended goal of exclusive breastfeeding to around 6 months and continued breastfeeding into the second year and beyond. So in western communities very few will produce babies with a normal healthy human microbiome.

Changing this begins with spreading awareness of the importance of the microbiome and of exclusive breastfeeding – or at worst, of exclusive human milk feeding. This means enabling and rewarding breastfeeding for women, not promoting it, and then leaving breastfeeding women to struggle in cultures where formula is seen as an equivalent choice - and where it is defended by trolls who insult healthworkers for doing their job of informing women of a few of the many many risks of not breastfeeding. (No one educates either mothers or healthworkers about the problems of infant formula itself!) I believe that vocal bottle bullies are now silencing public health messages. Is this just ignorance? Or might it be astro-turfing? (See http://tedxtalks.ted.com/video/Astroturf-and-manipulation-of-m)

The worst aspect of all this infant feeding damage is that it does not stop with the child. That child will create and/or gestate the next generation, and any harms will affect the health of children and grandchildren. But that’s another article, on epigenetics!

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Maureen Minchin

BA(Hons), MA (Melb), TSTC

Medical historian and health educator Maureen Minchin has been involved in global efforts to promote evidence-based infant feeding for decades, and is internationally recognised for her pivotal role in creating the lactation consultant profession. She has been a consultant to international bodies such as the World Health Organization WHO) and the United Nations Children’s Fund (UNICEF). She has educated health professionals, including through creating university-based courses in the UK and Australia. And she is an Editorial Board member for the open-access online International Breastfeeding Journal.

Maureen is also the author of Food For Thought: A Parent’s Guide to Food Intolerance and Breastfeeding Matters: what we need to know about infant feeding, as well as journal articles and background briefing papers for the WHO and USAID. Having three children in the 1970s, she experienced hospital practices that made breastfeeding difficult and allergy inevitable, with life-changing consequences for her children. She has since spent a lifetime providing advice and support to allergic families, while also working to improve health professionals’ education and training.

Recent articles by Maureen Minchin