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the baby from bad bacteria","Dendritic cells transport lactic acid cells from the intestine to the breasts","C-section babies miss out on the mother's vaginal bacteria, affecting their immunity",1,{"id":37,"data":38,"type":39,"maxContentLevel":19,"version":35},"97991269-5612-4c15-887e-40f7eaf5f8d5",{"type":39,"intro":40},10,[41,42],"How does vaginal delivery help a newborn's gut microbiome?","What are the long-term health impacts of being born via C-section?",[44,69,102,107],{"id":45,"data":46,"type":35,"maxContentLevel":19,"version":20,"reviews":49},"501e7b5b-2de2-4cd8-b636-8d02ab7dda45",{"type":35,"markdownContent":47,"audioMediaId":48},"The first 24 hours of life are crucial for the development of the gut microbiome, and the mode of delivery – vaginal or Caesarean-section – can impact the long-term health of the child. Before childbirth, the microbiota is basically sterile.\n\nOur first exposure to bacteria, fungi, and other crucial microorganisms, has historically been through the mother’s birth canal, where, like intrepid explorers, pioneering species of bacteria begin to populate the baby’s body in a process known as **colonization**.\n\nThe bacterial cells that are most abundant in the mother’s vagina are bacteria that produce lactic acids, called *Lactobacilli*. These are friendly bacteria which crowd out the bad bacteria (pathogens) in the baby’s developing digestive tract.","ca5bf1d4-ca26-403c-88df-b0efb29e45c2",[50,60],{"id":51,"data":52,"type":53,"version":35,"maxContentLevel":19},"897b37c9-cbe5-4f05-a42a-6655a836cd97",{"type":53,"reviewType":25,"spacingBehaviour":35,"binaryQuestion":54,"binaryCorrect":56,"binaryIncorrect":58},11,[55],"Where do babies typically get their first exposure to crucial microorganisms?",[57],"The mother's birth canal",[59],"Inside the womb",{"id":61,"data":62,"type":53,"version":25,"maxContentLevel":19},"1bb28827-8eb3-4f7e-8e51-c5909c57f4bd",{"type":53,"reviewType":25,"spacingBehaviour":35,"binaryQuestion":63,"binaryCorrect":65,"binaryIncorrect":67},[64],"Which of these terms refers to the friendly bacteria found in a baby's developing digestive tract before birth?",[66],"Lactobacilli",[68],"Listeria",{"id":70,"data":71,"type":35,"maxContentLevel":19,"version":25,"reviews":74},"e88a4937-dd9f-4f8c-bebf-d8b2edf04018",{"type":35,"markdownContent":72,"audioMediaId":73},"The same lactic-acid producing bacteria – *Lactobacilli* – that dominate in the vagina are also present in the mother’s breast milk, along with another beneficial bacteria, called *Bifidobacteria*. These bacteria – along with lactic acid cells – are transported between different parts of the body.\n\n![Graph](image://d372247b-0bad-4728-baad-453c0a4b0c71 \"A baby breastfeeding. Image: David Leo Veksler, CC BY-SA 2.0 \u003Chttps://creativecommons.org/licenses/by-sa/2.0>, via Wikimedia Commons\")\n\nIn the case of lactic acid cells, the journey takes them from the large intestine, through the blood stream, to the breasts. This movement relies on dendritic cells, which pluck them up and carry them where they need to be. The main function of dendritic cells is engulfing pathogens, as part of the immune system, but they serve this secondary function too.","ae034756-c42b-405d-b239-54f71907302a",[75,84,93],{"id":76,"data":77,"type":53,"version":35,"maxContentLevel":19},"6fa1dde9-0675-40e6-8732-cdc880a1bb66",{"type":53,"reviewType":25,"spacingBehaviour":35,"binaryQuestion":78,"binaryCorrect":80,"binaryIncorrect":82},[79],"Lactobacilli and which other beneficial bacteria is present in breast milk?",[81],"Bifidobacteria",[83],"A. muciniphila",{"id":85,"data":86,"type":53,"version":35,"maxContentLevel":19},"0825cfc9-c78e-45d7-8b87-2d4f60696422",{"type":53,"reviewType":19,"spacingBehaviour":35,"multiChoiceQuestion":87,"multiChoiceCorrect":89,"multiChoiceIncorrect":91,"multiChoiceMultiSelect":6,"multiChoiceRevealAnswerOption":6},[88],"Which of these are examples of good bacteria that may be found in a mother's breast milk?",[90],"Both of these",[81,66,92],"Neither of these",{"id":94,"data":95,"type":53,"version":35,"maxContentLevel":19},"dd980ace-50d3-471f-bf3c-c35e62ac5cc6",{"type":53,"reviewType":25,"spacingBehaviour":35,"binaryQuestion":96,"binaryCorrect":98,"binaryIncorrect":100},[97],"Which of these comes with birth canal delivery of babies?",[99],"Exposure to valuable microbes",[101],"Reduced exposure to viruses",{"id":103,"data":104,"type":35,"maxContentLevel":19,"version":19},"7462e381-4c4e-4ceb-9d0b-c3a377b8bea2",{"type":35,"markdownContent":105,"audioMediaId":106},"Because of this link between immune cells and lactic acid cells, evolutionary biologist Alanna Collen believes that the cross-talk between gut, vaginal and breast milk microbes helps to prime a newborn baby’s immune system after childbirth.\n\nVaginal delivery provides a *valuable microbial starter pack*, gifting the new-born a generous sprinkling of the founding colonies for her own microbiome as she journeys through the birth canal.\n\nBreastfeeding further encourages colonization of the baby’s gut microbiome by beneficial microbes, prevents colonization by bad bacteria, and trains the baby’s developing immune system to distinguish between friend and foe. So, what happens in the case of births by Caesarean-section?","b62a043f-96af-49df-97e7-dac45914cd17",{"id":108,"data":109,"type":35,"maxContentLevel":19,"version":25,"reviews":112},"a135e6a1-01a2-421f-8f78-d3036547039f",{"type":35,"markdownContent":110,"audioMediaId":111},"By skipping the trip through the birth canal, babies miss out on the bacterial starter pack from their mothers’ vaginal microbiota. These babies are first exposed to environmental microbes outside the birth canal. C-section delivery can have a lasting impact on the child’s immunity. They are more prone to developing infections and allergies. While you can match the microbiotas of the child’s gut with that of the mother’s vagina following a natural birth, the microbes of C-section babies cannot be matched with their mothers’.\n\nWhen microbiome researcher Rob Knight’s wife had to give birth by emergency C-section in 2012, Knight waited for the medical staff to leave the room, then used a swab to transfer vaginal microbiota from his wife to his daughter, to give his child the opportunity to benefit from her mother’s vaginal microbiota.","470f7e3b-b02d-4864-b08d-91844bc93cce",[113],{"id":114,"data":115,"type":53,"version":35,"maxContentLevel":19},"2ad34353-de1e-4956-b05c-7d3fe5bc3c69",{"type":53,"reviewType":19,"spacingBehaviour":35,"collapsingSiblings":116,"multiChoiceQuestion":120,"multiChoiceCorrect":122,"multiChoiceIncorrect":124,"multiChoiceMultiSelect":6,"multiChoiceRevealAnswerOption":6,"matchPairsQuestion":128,"matchPairsPairs":130},[117,118,119],"4c1ffd2d-d9a0-4909-b127-5bf139ffcc68","efccf43b-09ea-45c5-8f9e-24f9bd99c54f","60c4d04f-bd3a-44d3-accf-78348b0bc072",[121],"Which of the following most closely applies to Rob Knight?",[123],"Transferred vaginal microbiota to his daughter",[125,126,127],"Author of Missing Microbes","Commentator on obesity trends","Trying to develop a vaccine for cholera",[129],"Match the pairs below:",[131],{"left":132,"right":123,"direction":19},"Rob Knight",{"id":134,"data":135,"type":25,"version":19,"maxContentLevel":19,"summaryPage":137,"introPage":145,"pages":151},"b31ae3f8-fe3b-4997-a98a-63a9ac996d9b",{"type":25,"title":136},"The Impact of Birth Method on the Microbiome",{"id":138,"data":139,"type":19,"maxContentLevel":19,"version":35},"5c8b98c0-ac03-4ce6-8aeb-107dba8c7de9",{"type":19,"summary":140},[141,142,143,144],"Babies born via C-section have lower levels of IgA, an infection-fighting antibody","C-section births are linked to higher risks of asthma and type 1 diabetes due to different microbial exposure","Formula-fed babies are more prone to infections and chronic diseases compared to breastfed babies","The type of infant formula can influence a baby's gut bacteria, affecting their microbiome development",{"id":146,"data":147,"type":39,"maxContentLevel":19,"version":35},"fc302c67-04e7-4877-86cd-f0c89a2323fb",{"type":39,"intro":148},[149,150],"How does a C-section birth affect a baby's gut microbiome?","Why might formula-fed babies have different gut bacteria than breastfed babies?",[152,176,189],{"id":153,"data":154,"type":35,"maxContentLevel":19,"version":25,"reviews":157},"7c8e4942-35aa-418c-94de-bde0137721f1",{"type":35,"markdownContent":155,"audioMediaId":156},"C-sections can have a significant impact on the development of an infant’s immune system. Studies have found that babies born via C-section had lower levels of IgA, an antibody which helps protect against infection, compared to those delivered naturally. This suggests that exposure to maternal microorganisms during delivery is important for establishing a healthy immune system in newborns.\n\nFurthermore, research has also linked C-sections with increased risk of autoimmune diseases such as asthma and type 1 diabetes later in life due to differences in microbial composition at birth. It is thought that this could be because infants born by Caesarean section lack exposure to their mother’s vaginal microbiota which helps stimulate the development of regulatory T cells (Treg) – specialized white blood cells involved in controlling inflammation and preventing autoimmunity.","8eb50187-b2be-4bc1-8645-66ada20765ac",[158,167],{"id":159,"data":160,"type":53,"version":35,"maxContentLevel":19},"6fe813fd-e1ef-4b9c-8a40-220edbd46064",{"type":53,"reviewType":25,"spacingBehaviour":35,"binaryQuestion":161,"binaryCorrect":163,"binaryIncorrect":165},[162],"Babies born via C-section were found to have lower levels of which antibody?",[164],"IgA",[166],"AiG",{"id":168,"data":169,"type":53,"version":35,"maxContentLevel":19},"added69b-1b91-4aa5-bb86-1f1d4b7f8297",{"type":53,"reviewType":25,"spacingBehaviour":35,"binaryQuestion":170,"binaryCorrect":172,"binaryIncorrect":174},[171],"The development of which cells is stimulated by vaginal delivery of babies?",[173],"Regulatory T Cells",[175],"Regulatory B Cells",{"id":177,"data":178,"type":35,"maxContentLevel":19,"version":25,"reviews":181},"4aeee86f-4788-44ff-b022-796fd957c44e",{"type":35,"markdownContent":179,"audioMediaId":180},"These findings suggest that natural childbirth may be preferable when it comes to setting up a healthy microbiome and developing immunity early on in life, although further research is needed into how best we can support babies born via C-section so they too benefit from optimal gut health throughout their lives.\n\nWe now know that formula feeding may pose health risks for babies. Mostly derived from cow’s milk, modern baby formulas are supplemented with many essential extras, but they don’t usually contain *immune cells and antibodies*, *oligosaccharides* or *live bacteria* that are found in breast milk.","707a8217-da58-4546-b9c0-ba06aae8138f",[182],{"id":183,"data":184,"type":53,"version":35,"maxContentLevel":19},"512f94b5-015c-467a-8820-e78118a7fc16",{"type":53,"reviewType":35,"spacingBehaviour":35,"activeRecallQuestion":185,"activeRecallAnswers":187},[186],"What is the primary ingredient for most modern-day baby formulas?",[188],"Cow's milk",{"id":190,"data":191,"type":35,"maxContentLevel":19,"version":19,"reviews":194},"72c654ec-0ee7-4670-bc27-9e14e66f2616",{"type":35,"markdownContent":192,"audioMediaId":193},"Formula-fed babies tend to be more prone to infections, and are at greater risk of developing eczema, asthma, leukemia, type I diabetes, appendicitis, tonsillitis, multiple sclerosis, rheumatoid arthritis, and obesity later in life.\n\nThe risk of obesity correlates with the length of time spent breast-feeding: one study found that the risk of children becoming overweight drops for each extra month of breast-feeding up to the age of nine months. Interestingly, research has also shown that the composition of infant formulas can affect the development of their microbiome.\n\nFor example, one study found that babies fed cow’s milk-based formulas had higher levels of Firmicutes bacteria than those fed soy-based formulas – this difference was not seen in breastfed infants. These findings suggest that different types of infant formula can influence microbial diversity during early life stages, so it is important to consider these factors when choosing a suitable option for your baby.","c7c40919-2ae0-457c-a0cb-d76ebffadb35",[195,204,213],{"id":196,"data":197,"type":53,"version":35,"maxContentLevel":19},"95e37057-7d94-4249-8de0-f0064ee01a9c",{"type":53,"reviewType":25,"spacingBehaviour":35,"binaryQuestion":198,"binaryCorrect":200,"binaryIncorrect":202},[199],"Which kind of baby formula leads to higher levels of the Firmicutes bacteria in children?",[201],"Cow's milk-based",[203],"Soy-based",{"id":205,"data":206,"type":53,"version":35,"maxContentLevel":19},"efc35253-3732-421f-bf99-b84b61904898",{"type":53,"reviewType":25,"spacingBehaviour":35,"binaryQuestion":207,"binaryCorrect":209,"binaryIncorrect":211},[208],"Which common health concern has been found to correlate with the length of time spent breast-feeding?",[210],"Obesity",[212],"Gastritis",{"id":214,"data":215,"type":53,"version":35,"maxContentLevel":19},"46ec728a-fca0-4e06-a70a-11ec65bbc48b",{"type":53,"reviewType":19,"spacingBehaviour":35,"collapsingSiblings":216,"multiChoiceQuestion":220,"multiChoiceCorrect":222,"multiChoiceIncorrect":224,"multiChoiceMultiSelect":6,"multiChoiceRevealAnswerOption":6,"matchPairsQuestion":228,"matchPairsPairs":229},[217,218,219],"87e7c09a-520f-4e47-ac60-df07361cbeda","ed9705e0-7c53-4556-a631-5d0aca6af86d","015e4d5d-ab1d-4a01-a99c-d043a9e5e1c6",[221],"Which of the following best describes microbial composition?",[223],"The types and amounts of microbes present",[225,226,227],"Estimated to affect 50% of world population by 2050","Co-existence of different species for mutual benefit.","Disruption of the normal balance of microbial communities.",[129],[230],{"left":231,"right":223,"direction":19},"Microbial composition",{"id":233,"data":234,"type":25,"version":25,"maxContentLevel":19,"summaryPage":236,"introPage":244,"pages":250},"f394a4d8-6e95-493a-b8ed-b6a0a9c40807",{"type":25,"title":235},"The Microbiome in Childhood and Adolescence",{"id":237,"data":238,"type":19,"maxContentLevel":19,"version":35},"d0a9de22-c11a-4fad-9df1-01199be752b3",{"type":19,"summary":239},[240,241,242,243],"The microbiome keeps evolving in kids beyond age 3","Pre-school and primary school kids' microbiota develop for at least another decade","Frequent antibiotics in young kids can harm their gut microbiota","Losing friendly gut microbes early can lead to obesity",{"id":245,"data":246,"type":39,"maxContentLevel":19,"version":35},"56d61bae-b3fd-4803-b12e-c0ee3a6b1cdf",{"type":39,"intro":247},[248,249],"How does the gut microbiome of a 6-year-old differ from that of a 3-year-old?","Why is early childhood considered a key window of vulnerability for gut microbiome development?",[251,266],{"id":252,"data":253,"type":35,"maxContentLevel":19,"version":25,"reviews":256},"39356ee4-f9d0-48d1-9b6b-0c3f780348c6",{"type":35,"markdownContent":254,"audioMediaId":255},"Since the explosion of interest in the human gut microbiome, there has been extensive commentary on the microbiotas of infants up to the age of 3 years and adults. The microbiota of pre-schoolers (3–6 years), primary-school children (6–12 years), and teenagers (12–18 years) have been largely overlooked.\n\nUntil recently, it was thought that the microbiota undergoes most of its development very early in life, and that by the age of three, the child’s microbiome resembles that of an adult. Recent studies suggest the microbiome continues to evolve beyond these early years.\n\n![Graph](image://b2045a23-8b4a-41a4-8365-fe3d39d5802f \"Children eating ice cream. Image: Nationaal Archief, No restrictions, via Wikimedia Commons\")\n\nBased on the findings of several studies of the microbiota of pre-school and primary school children (up to the age of 12 years) around the world, it seems that the microbiota continues to develop for at least another decade. As new studies on the subject continue to emerge, so will opportunities for microbiome-based interventions to promote health among this age group, particularly through diet.","c79a24d8-1638-4f71-9abb-0ff7bbb3e85c",[257],{"id":258,"data":259,"type":53,"version":35,"maxContentLevel":19},"0fe984aa-97b6-447b-a4dd-4706d419c3f0",{"type":53,"reviewType":25,"spacingBehaviour":35,"binaryQuestion":260,"binaryCorrect":262,"binaryIncorrect":264},[261],"Which of these statements about microbiota is more accurate?",[263],"The child's microbiota continues to develop well beyond the early years",[265],"The child's microbiota reaches full maturity by the age of 3",{"id":267,"data":268,"type":35,"maxContentLevel":19,"version":25,"reviews":271},"fa19d160-d5ff-4db4-a4e4-a177b3e3f284",{"type":35,"markdownContent":269,"audioMediaId":270},"Some scientists speculate that exposing young children to pets and dirt is beneficial for their gut microbiota. However, **Martin Blaser** begs to differ, claiming that *'the microbes in our pets and farm animals are not deeply rooted in our human evolution.'*\n\nFar more important, says Blaser, are changes to the microbiota that occur when young children are prescribed antibiotics too frequently. In 2014, Blaser and his team were running more than twenty projects on mice and human subjects to test the effects of antibiotics on resident microbes and their hosts.\n\nThe results of their experiments on mice uncovered some key findings: early life is *'a key window of vulnerability'*, as young children have periods that are critical for their growth and development; and the loss of friendly gut microbes at this early stage of development drives obesity.","e24ddad0-50ff-46c0-b027-b9e7df7f3154",[272,281],{"id":273,"data":274,"type":53,"version":35,"maxContentLevel":19},"ac786f00-fe00-48b9-bb43-496d7e2ac93e",{"type":53,"reviewType":25,"spacingBehaviour":35,"binaryQuestion":275,"binaryCorrect":277,"binaryIncorrect":279},[276],"According to Martin Blaser, the early life is a ...",[278],"Key window of vulnerability",[280],"Time to stay protected",{"id":282,"data":283,"type":53,"version":35,"maxContentLevel":19},"2f284478-0018-457a-b96b-cdfab8c94cb4",{"type":53,"reviewType":25,"spacingBehaviour":35,"binaryQuestion":284,"binaryCorrect":286,"binaryIncorrect":288},[285],"Which of these statements is Martin Blaser more likely to agree with?",[287],"Overexposure to antibiotics poses a grave threat to the child's gut microbiota.",[289],"Exposure to pets and dirt is beneficial to the child's gut microbiota.",{"id":291,"data":292,"type":25,"version":25,"maxContentLevel":19,"summaryPage":294,"introPage":302,"pages":308},"2cc64314-c916-4e1e-9ea0-be4c3620e7ba",{"type":25,"title":293},"The Microbiome in Adulthood",{"id":295,"data":296,"type":19,"maxContentLevel":19,"version":35},"24696992-9c70-493b-bcdd-42e5acaf5994",{"type":19,"summary":297},[298,299,300,301],"Our gut microbes change dramatically in response to illness, injury, fever, stress, and diet","Critically injured patients experience significant microbiota changes within 72 hours of trauma","Stress, fever, and illness can disrupt gut microbes, leading to dysbiosis and disease","Heart disease, cancer, and stroke are linked to inflammation from an unhealthy lifestyle, not just old age",{"id":303,"data":304,"type":39,"maxContentLevel":19,"version":35},"2b55b69f-dd5b-4abb-be9c-2c8c68a8627d",{"type":39,"intro":305},[306,307],"How do changes in diet impact the balance of our gut microbiota?","What role does inflammation play in diseases like heart disease and cancer?",[309,314,340],{"id":310,"data":311,"type":35,"maxContentLevel":19,"version":25},"cbcca638-4a39-48a3-91a7-e5e7735fd089",{"type":35,"markdownContent":312,"audioMediaId":313},"In tandem with our progress into adulthood, our resident microbes evolve and adapt in response to changes in the environment. By this stage, our tiny companions are decidedly more a product of nurture than nature. As we subject our bodies to dramatic changes – *illness, injury, fever, stress and changes to our diet* – our microbes shapeshift and reshuffle in response to external stressors.\n\nOur tiny hitchhikers can’t seem to catch a break. When we injure ourselves, our bodies suffer trauma and inflammation. Studies of critically injured patients show that their microbiotas undergo significant changes in the first 72 hours following the trauma. These changes alter the diversity and composition of the microbiota.","5b6672c1-8d9a-42a2-8856-dd149d1b897d",{"id":315,"data":316,"type":35,"maxContentLevel":19,"version":25,"reviews":319},"2cc69bac-a183-4f39-9061-b1de98c82173",{"type":35,"markdownContent":317,"audioMediaId":318},"Stress, fever and illness can disrupt the microbial balance in the gut, leading to dysbiosis, and laying fertile ground for diseases to flourish. By the time we reach adulthood, diet is by far the factor with the greatest capacity to shift the microbial balance.\n\n![Graph](image://045eae76-775b-4057-ad64-97eb3337dade \"A plate of salad. Image: fir0002  flagstaffotos [at] gmail.com\t\tCanon 20D + Canon 17-40mm f/4 L, GFDL 1.2 \u003Chttp://www.gnu.org/licenses/old-licenses/fdl-1.2.html>, via Wikimedia Commons\")\n\nAs our human cells start showing signs of their collective age, so too do our microbial passengers. Many of us have come to associate old age with ill health, but emerging medical research suggests that the top three leading causes of death in 2005–heart disease, cancer and stroke– are not diseases of old age, but rather, *diseases of inflammation*.","586381b0-ff46-419e-94f2-dce523685292",[320,329],{"id":321,"data":322,"type":53,"version":35,"maxContentLevel":19},"ca68721f-2b39-43d7-b21f-cf456f2c4028",{"type":53,"reviewType":25,"spacingBehaviour":35,"binaryQuestion":323,"binaryCorrect":325,"binaryIncorrect":327},[324],"Which of these has the greater impact on a human's microbes during adult years?",[326],"Nurture",[328],"Nature",{"id":330,"data":331,"type":53,"version":35,"maxContentLevel":19},"cf3a124a-c4a0-4221-ab42-16d2e8c962f6",{"type":53,"reviewType":19,"spacingBehaviour":35,"multiChoiceQuestion":332,"multiChoiceCorrect":334,"multiChoiceIncorrect":336,"multiChoiceMultiSelect":6,"multiChoiceRevealAnswerOption":6},[333],"Which of these is a factor responsible for changes to the adult's microbiota?",[335],"All of these",[337,338,339],"Illness","Stress","Diet",{"id":341,"data":342,"type":35,"maxContentLevel":19,"version":25,"reviews":345},"3a5ab7bf-18a2-4107-a0a9-d42d7dc2dc51",{"type":35,"markdownContent":343,"audioMediaId":344},"According to Alanna Collen, the processes of heart tissue hardening (heart disease), uncontrollable multiplication of cells (cancers) and sudden bursting of blood vessels (strokes) are not entirely related to the advancement in age. She postulates instead that it is the *'modern insults'* of an unhealthy lifestyle that leads to inflammation, and results in these catastrophes.\n\nIf we look after our microbes, then we can – in theory – mitigate the extent of damage caused by inflammation.","892b5c22-8a44-4f24-a2c4-7db4de79135b",[346],{"id":347,"data":348,"type":53,"version":35,"maxContentLevel":19},"916168c2-8173-427f-87dc-113d453e1ac7",{"type":53,"reviewType":20,"spacingBehaviour":35,"clozeQuestion":349,"clozeWords":351},[350],"Research suggests that the top three leading causes of death – heart disease, cancer and stroke – are diseases of inflammation.",[352],"inflammation",[354,484,563,637],{"id":23,"data":24,"type":25,"version":20,"maxContentLevel":19,"summaryPage":27,"introPage":36,"pages":355},[356,398,438,467],{"id":45,"data":46,"type":35,"maxContentLevel":19,"version":20,"reviews":49,"parsed":357},{"data":358,"body":361,"toc":396},{"title":359,"description":360},"","The first 24 hours of life are crucial for the development of the gut microbiome, and the mode of delivery – vaginal or Caesarean-section – can impact the long-term health of the child. Before childbirth, the microbiota is basically sterile.",{"type":362,"children":363},"root",[364,371,384],{"type":365,"tag":366,"props":367,"children":368},"element","p",{},[369],{"type":370,"value":360},"text",{"type":365,"tag":366,"props":372,"children":373},{},[374,376,382],{"type":370,"value":375},"Our first exposure to bacteria, fungi, and other crucial microorganisms, has historically been through the mother’s birth canal, where, like intrepid explorers, pioneering species of bacteria begin to populate the baby’s body in a process known as ",{"type":365,"tag":377,"props":378,"children":379},"strong",{},[380],{"type":370,"value":381},"colonization",{"type":370,"value":383},".",{"type":365,"tag":366,"props":385,"children":386},{},[387,389,394],{"type":370,"value":388},"The bacterial cells that are most abundant in the mother’s vagina are bacteria that produce lactic acids, called ",{"type":365,"tag":390,"props":391,"children":392},"em",{},[393],{"type":370,"value":66},{"type":370,"value":395},". These are friendly bacteria which crowd out the bad bacteria (pathogens) in the baby’s developing digestive tract.",{"title":359,"searchDepth":25,"depth":25,"links":397},[],{"id":70,"data":71,"type":35,"maxContentLevel":19,"version":25,"reviews":74,"parsed":399},{"data":400,"body":402,"toc":436},{"title":359,"description":401},"The same lactic-acid producing bacteria – Lactobacilli – that dominate in the vagina are also present in the mother’s breast milk, along with another beneficial bacteria, called Bifidobacteria. These bacteria – along with lactic acid cells – are transported between different parts of the body.",{"type":362,"children":403},[404,421,431],{"type":365,"tag":366,"props":405,"children":406},{},[407,409,413,415,419],{"type":370,"value":408},"The same lactic-acid producing bacteria – ",{"type":365,"tag":390,"props":410,"children":411},{},[412],{"type":370,"value":66},{"type":370,"value":414}," – that dominate in the vagina are also present in the mother’s breast milk, along with another beneficial bacteria, called ",{"type":365,"tag":390,"props":416,"children":417},{},[418],{"type":370,"value":81},{"type":370,"value":420},". These bacteria – along with lactic acid cells – are transported between different parts of the body.",{"type":365,"tag":366,"props":422,"children":423},{},[424],{"type":365,"tag":425,"props":426,"children":430},"img",{"alt":427,"src":428,"title":429},"Graph","image://d372247b-0bad-4728-baad-453c0a4b0c71","A baby breastfeeding. Image: David Leo Veksler, CC BY-SA 2.0 \u003Chttps://creativecommons.org/licenses/by-sa/2.0>, via Wikimedia Commons",[],{"type":365,"tag":366,"props":432,"children":433},{},[434],{"type":370,"value":435},"In the case of lactic acid cells, the journey takes them from the large intestine, through the blood stream, to the breasts. This movement relies on dendritic cells, which pluck them up and carry them where they need to be. The main function of dendritic cells is engulfing pathogens, as part of the immune system, but they serve this secondary function too.",{"title":359,"searchDepth":25,"depth":25,"links":437},[],{"id":103,"data":104,"type":35,"maxContentLevel":19,"version":19,"parsed":439},{"data":440,"body":442,"toc":465},{"title":359,"description":441},"Because of this link between immune cells and lactic acid cells, evolutionary biologist Alanna Collen believes that the cross-talk between gut, vaginal and breast milk microbes helps to prime a newborn baby’s immune system after childbirth.",{"type":362,"children":443},[444,448,460],{"type":365,"tag":366,"props":445,"children":446},{},[447],{"type":370,"value":441},{"type":365,"tag":366,"props":449,"children":450},{},[451,453,458],{"type":370,"value":452},"Vaginal delivery provides a ",{"type":365,"tag":390,"props":454,"children":455},{},[456],{"type":370,"value":457},"valuable microbial starter pack",{"type":370,"value":459},", gifting the new-born a generous sprinkling of the founding colonies for her own microbiome as she journeys through the birth canal.",{"type":365,"tag":366,"props":461,"children":462},{},[463],{"type":370,"value":464},"Breastfeeding further encourages colonization of the baby’s gut microbiome by beneficial microbes, prevents colonization by bad bacteria, and trains the baby’s developing immune system to distinguish between friend and foe. So, what happens in the case of births by Caesarean-section?",{"title":359,"searchDepth":25,"depth":25,"links":466},[],{"id":108,"data":109,"type":35,"maxContentLevel":19,"version":25,"reviews":112,"parsed":468},{"data":469,"body":471,"toc":482},{"title":359,"description":470},"By skipping the trip through the birth canal, babies miss out on the bacterial starter pack from their mothers’ vaginal microbiota. These babies are first exposed to environmental microbes outside the birth canal. C-section delivery can have a lasting impact on the child’s immunity. They are more prone to developing infections and allergies. While you can match the microbiotas of the child’s gut with that of the mother’s vagina following a natural birth, the microbes of C-section babies cannot be matched with their mothers’.",{"type":362,"children":472},[473,477],{"type":365,"tag":366,"props":474,"children":475},{},[476],{"type":370,"value":470},{"type":365,"tag":366,"props":478,"children":479},{},[480],{"type":370,"value":481},"When microbiome researcher Rob Knight’s wife had to give birth by emergency C-section in 2012, Knight waited for the medical staff to leave the room, then used a swab to transfer vaginal microbiota from his wife to his daughter, to give his child the opportunity to benefit from her mother’s vaginal microbiota.",{"title":359,"searchDepth":25,"depth":25,"links":483},[],{"id":134,"data":135,"type":25,"version":19,"maxContentLevel":19,"summaryPage":137,"introPage":145,"pages":485},[486,503,541],{"id":153,"data":154,"type":35,"maxContentLevel":19,"version":25,"reviews":157,"parsed":487},{"data":488,"body":490,"toc":501},{"title":359,"description":489},"C-sections can have a significant impact on the development of an infant’s immune system. Studies have found that babies born via C-section had lower levels of IgA, an antibody which helps protect against infection, compared to those delivered naturally. This suggests that exposure to maternal microorganisms during delivery is important for establishing a healthy immune system in newborns.",{"type":362,"children":491},[492,496],{"type":365,"tag":366,"props":493,"children":494},{},[495],{"type":370,"value":489},{"type":365,"tag":366,"props":497,"children":498},{},[499],{"type":370,"value":500},"Furthermore, research has also linked C-sections with increased risk of autoimmune diseases such as asthma and type 1 diabetes later in life due to differences in microbial composition at birth. It is thought that this could be because infants born by Caesarean section lack exposure to their mother’s vaginal microbiota which helps stimulate the development of regulatory T cells (Treg) – specialized white blood cells involved in controlling inflammation and preventing autoimmunity.",{"title":359,"searchDepth":25,"depth":25,"links":502},[],{"id":177,"data":178,"type":35,"maxContentLevel":19,"version":25,"reviews":181,"parsed":504},{"data":505,"body":507,"toc":539},{"title":359,"description":506},"These findings suggest that natural childbirth may be preferable when it comes to setting up a healthy microbiome and developing immunity early on in life, although further research is needed into how best we can support babies born via C-section so they too benefit from optimal gut health throughout their lives.",{"type":362,"children":508},[509,513],{"type":365,"tag":366,"props":510,"children":511},{},[512],{"type":370,"value":506},{"type":365,"tag":366,"props":514,"children":515},{},[516,518,523,525,530,532,537],{"type":370,"value":517},"We now know that formula feeding may pose health risks for babies. Mostly derived from cow’s milk, modern baby formulas are supplemented with many essential extras, but they don’t usually contain ",{"type":365,"tag":390,"props":519,"children":520},{},[521],{"type":370,"value":522},"immune cells and antibodies",{"type":370,"value":524},", ",{"type":365,"tag":390,"props":526,"children":527},{},[528],{"type":370,"value":529},"oligosaccharides",{"type":370,"value":531}," or ",{"type":365,"tag":390,"props":533,"children":534},{},[535],{"type":370,"value":536},"live bacteria",{"type":370,"value":538}," that are found in breast milk.",{"title":359,"searchDepth":25,"depth":25,"links":540},[],{"id":190,"data":191,"type":35,"maxContentLevel":19,"version":19,"reviews":194,"parsed":542},{"data":543,"body":545,"toc":561},{"title":359,"description":544},"Formula-fed babies tend to be more prone to infections, and are at greater risk of developing eczema, asthma, leukemia, type I diabetes, appendicitis, tonsillitis, multiple sclerosis, rheumatoid arthritis, and obesity later in life.",{"type":362,"children":546},[547,551,556],{"type":365,"tag":366,"props":548,"children":549},{},[550],{"type":370,"value":544},{"type":365,"tag":366,"props":552,"children":553},{},[554],{"type":370,"value":555},"The risk of obesity correlates with the length of time spent breast-feeding: one study found that the risk of children becoming overweight drops for each extra month of breast-feeding up to the age of nine months. Interestingly, research has also shown that the composition of infant formulas can affect the development of their microbiome.",{"type":365,"tag":366,"props":557,"children":558},{},[559],{"type":370,"value":560},"For example, one study found that babies fed cow’s milk-based formulas had higher levels of Firmicutes bacteria than those fed soy-based formulas – this difference was not seen in breastfed infants. These findings suggest that different types of infant formula can influence microbial diversity during early life stages, so it is important to consider these factors when choosing a suitable option for your baby.",{"title":359,"searchDepth":25,"depth":25,"links":562},[],{"id":233,"data":234,"type":25,"version":25,"maxContentLevel":19,"summaryPage":236,"introPage":244,"pages":564},[565,595],{"id":252,"data":253,"type":35,"maxContentLevel":19,"version":25,"reviews":256,"parsed":566},{"data":567,"body":569,"toc":593},{"title":359,"description":568},"Since the explosion of interest in the human gut microbiome, there has been extensive commentary on the microbiotas of infants up to the age of 3 years and adults. The microbiota of pre-schoolers (3–6 years), primary-school children (6–12 years), and teenagers (12–18 years) have been largely overlooked.",{"type":362,"children":570},[571,575,580,588],{"type":365,"tag":366,"props":572,"children":573},{},[574],{"type":370,"value":568},{"type":365,"tag":366,"props":576,"children":577},{},[578],{"type":370,"value":579},"Until recently, it was thought that the microbiota undergoes most of its development very early in life, and that by the age of three, the child’s microbiome resembles that of an adult. Recent studies suggest the microbiome continues to evolve beyond these early years.",{"type":365,"tag":366,"props":581,"children":582},{},[583],{"type":365,"tag":425,"props":584,"children":587},{"alt":427,"src":585,"title":586},"image://b2045a23-8b4a-41a4-8365-fe3d39d5802f","Children eating ice cream. Image: Nationaal Archief, No restrictions, via Wikimedia Commons",[],{"type":365,"tag":366,"props":589,"children":590},{},[591],{"type":370,"value":592},"Based on the findings of several studies of the microbiota of pre-school and primary school children (up to the age of 12 years) around the world, it seems that the microbiota continues to develop for at least another decade. As new studies on the subject continue to emerge, so will opportunities for microbiome-based interventions to promote health among this age group, particularly through diet.",{"title":359,"searchDepth":25,"depth":25,"links":594},[],{"id":267,"data":268,"type":35,"maxContentLevel":19,"version":25,"reviews":271,"parsed":596},{"data":597,"body":599,"toc":635},{"title":359,"description":598},"Some scientists speculate that exposing young children to pets and dirt is beneficial for their gut microbiota. However, Martin Blaser begs to differ, claiming that 'the microbes in our pets and farm animals are not deeply rooted in our human evolution.'",{"type":362,"children":600},[601,618,623],{"type":365,"tag":366,"props":602,"children":603},{},[604,606,611,613],{"type":370,"value":605},"Some scientists speculate that exposing young children to pets and dirt is beneficial for their gut microbiota. However, ",{"type":365,"tag":377,"props":607,"children":608},{},[609],{"type":370,"value":610},"Martin Blaser",{"type":370,"value":612}," begs to differ, claiming that ",{"type":365,"tag":390,"props":614,"children":615},{},[616],{"type":370,"value":617},"'the microbes in our pets and farm animals are not deeply rooted in our human evolution.'",{"type":365,"tag":366,"props":619,"children":620},{},[621],{"type":370,"value":622},"Far more important, says Blaser, are changes to the microbiota that occur when young children are prescribed antibiotics too frequently. In 2014, Blaser and his team were running more than twenty projects on mice and human subjects to test the effects of antibiotics on resident microbes and their hosts.",{"type":365,"tag":366,"props":624,"children":625},{},[626,628,633],{"type":370,"value":627},"The results of their experiments on mice uncovered some key findings: early life is ",{"type":365,"tag":390,"props":629,"children":630},{},[631],{"type":370,"value":632},"'a key window of vulnerability'",{"type":370,"value":634},", as young children have periods that are critical for their growth and development; and the loss of friendly gut microbes at this early stage of development drives obesity.",{"title":359,"searchDepth":25,"depth":25,"links":636},[],{"id":291,"data":292,"type":25,"version":25,"maxContentLevel":19,"summaryPage":294,"introPage":302,"pages":638},[639,664,695],{"id":310,"data":311,"type":35,"maxContentLevel":19,"version":25,"parsed":640},{"data":641,"body":643,"toc":662},{"title":359,"description":642},"In tandem with our progress into adulthood, our resident microbes evolve and adapt in response to changes in the environment. By this stage, our tiny companions are decidedly more a product of nurture than nature. As we subject our bodies to dramatic changes – illness, injury, fever, stress and changes to our diet – our microbes shapeshift and reshuffle in response to external stressors.",{"type":362,"children":644},[645,657],{"type":365,"tag":366,"props":646,"children":647},{},[648,650,655],{"type":370,"value":649},"In tandem with our progress into adulthood, our resident microbes evolve and adapt in response to changes in the environment. By this stage, our tiny companions are decidedly more a product of nurture than nature. As we subject our bodies to dramatic changes – ",{"type":365,"tag":390,"props":651,"children":652},{},[653],{"type":370,"value":654},"illness, injury, fever, stress and changes to our diet",{"type":370,"value":656}," – our microbes shapeshift and reshuffle in response to external stressors.",{"type":365,"tag":366,"props":658,"children":659},{},[660],{"type":370,"value":661},"Our tiny hitchhikers can’t seem to catch a break. When we injure ourselves, our bodies suffer trauma and inflammation. Studies of critically injured patients show that their microbiotas undergo significant changes in the first 72 hours following the trauma. These changes alter the diversity and composition of the microbiota.",{"title":359,"searchDepth":25,"depth":25,"links":663},[],{"id":315,"data":316,"type":35,"maxContentLevel":19,"version":25,"reviews":319,"parsed":665},{"data":666,"body":668,"toc":693},{"title":359,"description":667},"Stress, fever and illness can disrupt the microbial balance in the gut, leading to dysbiosis, and laying fertile ground for diseases to flourish. By the time we reach adulthood, diet is by far the factor with the greatest capacity to shift the microbial balance.",{"type":362,"children":669},[670,674,682],{"type":365,"tag":366,"props":671,"children":672},{},[673],{"type":370,"value":667},{"type":365,"tag":366,"props":675,"children":676},{},[677],{"type":365,"tag":425,"props":678,"children":681},{"alt":427,"src":679,"title":680},"image://045eae76-775b-4057-ad64-97eb3337dade","A plate of salad. Image: fir0002  flagstaffotos [at] gmail.com\t\tCanon 20D + Canon 17-40mm f/4 L, GFDL 1.2 \u003Chttp://www.gnu.org/licenses/old-licenses/fdl-1.2.html>, via Wikimedia Commons",[],{"type":365,"tag":366,"props":683,"children":684},{},[685,687,692],{"type":370,"value":686},"As our human cells start showing signs of their collective age, so too do our microbial passengers. Many of us have come to associate old age with ill health, but emerging medical research suggests that the top three leading causes of death in 2005–heart disease, cancer and stroke– are not diseases of old age, but rather, ",{"type":365,"tag":390,"props":688,"children":689},{},[690],{"type":370,"value":691},"diseases of inflammation",{"type":370,"value":383},{"title":359,"searchDepth":25,"depth":25,"links":694},[],{"id":341,"data":342,"type":35,"maxContentLevel":19,"version":25,"reviews":345,"parsed":696},{"data":697,"body":699,"toc":718},{"title":359,"description":698},"According to Alanna Collen, the processes of heart tissue hardening (heart disease), uncontrollable multiplication of cells (cancers) and sudden bursting of blood vessels (strokes) are not entirely related to the advancement in age. She postulates instead that it is the 'modern insults' of an unhealthy lifestyle that leads to inflammation, and results in these catastrophes.",{"type":362,"children":700},[701,713],{"type":365,"tag":366,"props":702,"children":703},{},[704,706,711],{"type":370,"value":705},"According to Alanna Collen, the processes of heart tissue hardening (heart disease), uncontrollable multiplication of cells (cancers) and sudden bursting of blood vessels (strokes) are not entirely related to the advancement in age. She postulates instead that it is the ",{"type":365,"tag":390,"props":707,"children":708},{},[709],{"type":370,"value":710},"'modern insults'",{"type":370,"value":712}," of an unhealthy lifestyle that leads to inflammation, and results in these catastrophes.",{"type":365,"tag":366,"props":714,"children":715},{},[716],{"type":370,"value":717},"If we look after our microbes, then we can – in theory – mitigate the extent of damage caused by inflammation.",{"title":359,"searchDepth":25,"depth":25,"links":719},[],{"left":4,"top":4,"width":721,"height":721,"rotate":4,"vFlip":6,"hFlip":6,"body":722},24,"\u003Cpath fill=\"none\" stroke=\"currentColor\" stroke-linecap=\"round\" stroke-linejoin=\"round\" stroke-width=\"2\" d=\"m9 18l6-6l-6-6\"/>",{"left":4,"top":4,"width":721,"height":721,"rotate":4,"vFlip":6,"hFlip":6,"body":724},"\u003Cpath fill=\"none\" stroke=\"currentColor\" stroke-linecap=\"round\" stroke-linejoin=\"round\" stroke-width=\"2\" d=\"M4 5h16M4 12h16M4 19h16\"/>",1778179386192]