0:00:01.500,0:00:03.934
Now, I know it might be easy to think

0:00:03.958,0:00:05.851
that microbes are bad,

0:00:05.875,0:00:08.268
especially for infants,

0:00:08.292,0:00:11.125
but research has in fact[br]proven the opposite.

0:00:12.375,0:00:15.393
And the truth might be[br]a little bit more complex,

0:00:15.417,0:00:18.542
but it's actually way more interesting.

0:00:19.500,0:00:21.851
It seems that we need microbes

0:00:21.875,0:00:24.000
to be programmed for good health,

0:00:25.083,0:00:26.809
but not just any microbes,

0:00:26.833,0:00:29.226
we need the right combination.

0:00:29.250,0:00:31.934
We succeed best[br]with the little microbial bodies

0:00:31.958,0:00:35.708
we have adapted to coexist with[br]during evolution.

0:00:36.875,0:00:38.518
And I guess it won't surprise you

0:00:38.542,0:00:43.226
to learn that we start acquiring[br]that right combination right at birth.

0:00:43.250,0:00:45.458
Well, at least some of us do.

0:00:46.667,0:00:49.684
Babies born by C-section[br]and babies born vaginally

0:00:49.708,0:00:50.976
aren't the same

0:00:51.000,0:00:54.143
when it comes to microbial start to life,

0:00:54.167,0:00:58.559
and after birth there are[br]countless different early life events

0:00:58.583,0:00:59.893
and circumstances

0:00:59.917,0:01:04.059
that further modulate the way[br]the gut microbiota is developing,

0:01:04.083,0:01:09.184
such as the medications that might be[br]prescribed for the infant or the mother,

0:01:09.208,0:01:12.351
number of pets and siblings in the family,

0:01:12.375,0:01:14.184
as well as level of hygiene at home,

0:01:14.208,0:01:16.184
and, in this case, it's actually better

0:01:16.208,0:01:19.083
if it's not that perfectly[br]clean all the time.

0:01:20.542,0:01:23.809
And also nutrition,[br]both mothers and infants.

0:01:23.833,0:01:28.768
All of these events[br]and circumstances play a huge role

0:01:28.792,0:01:31.268
in the gut microbial development

0:01:31.292,0:01:35.833
and that has a huge impact[br]on the lifelong health of that baby.

0:01:37.167,0:01:40.684
And I'm not talking about[br]small health implications here.

0:01:40.708,0:01:43.143
I'm talking about the big stuff.

0:01:43.167,0:01:46.226
Microbes we acquire or do not acquire

0:01:46.250,0:01:51.268
affect our likelihood of developing[br]diseases like obesity, diabetes

0:01:51.292,0:01:52.833
and even some cancers.

0:01:54.000,0:01:57.101
Since many of these[br]early life events I just listed

0:01:57.125,0:01:59.476
are such that we cannot affect them,

0:01:59.500,0:02:00.934
they are inevitable,

0:02:00.958,0:02:04.268
for example C-sections[br]have been invented to save lives,

0:02:04.292,0:02:06.351
and they do that daily,

0:02:06.375,0:02:10.143
and most medications[br]are prescribed for a valid reason,

0:02:10.167,0:02:13.018
especially for infants, and so on.

0:02:13.042,0:02:16.143
That is why we have to learn

0:02:16.167,0:02:18.684
how to protect the health of these babies

0:02:18.708,0:02:22.143
after the occurrence[br]of such early life events

0:02:22.167,0:02:25.042
that might disrupt their gut[br]microbiota development.

0:02:26.542,0:02:27.893
I work as a researcher

0:02:27.917,0:02:31.268
and as a technical lead[br]of an infant health platform,

0:02:31.292,0:02:35.518
and the question I'm trying[br]to find a solution to every day at work,

0:02:35.542,0:02:39.309
and the same question[br]I'm aiming to answer in this talk,

0:02:39.333,0:02:41.809
is how can we make sure

0:02:41.833,0:02:45.101
that all babies get the same shot[br]at lifelong health,

0:02:45.125,0:02:50.208
no matter how they're born[br]or what early life events they encounter.

0:02:51.375,0:02:53.333
Seems like a noble cause, right?

0:02:54.125,0:02:55.393
Great.

0:02:55.417,0:02:57.101
So let's figure this out.

0:02:57.125,0:03:02.500
To begin, remember how I said that we need[br]the right combination of microbes?

0:03:04.333,0:03:06.434
Well, to get that combination right,

0:03:06.458,0:03:09.934
we need to receive those microbes[br]that inhabit our bodies

0:03:09.958,0:03:11.583
in a certain order.

0:03:12.875,0:03:16.351
You can think of it[br]like a colonization march.

0:03:16.375,0:03:21.101
The very early microbes[br]that inhabit our bodies first

0:03:21.125,0:03:24.684
change the environment in the infant's gut

0:03:24.708,0:03:28.768
so that the next microbes[br]are able to move in,

0:03:28.792,0:03:30.684
kind of like the first invaders

0:03:30.708,0:03:33.059
come in first and set up[br]the infrastructure

0:03:33.083,0:03:35.208
for the other settlers to build upon.

0:03:36.292,0:03:39.059
Now, if babies are born via C-section,

0:03:39.083,0:03:43.101
that early phase of colonization[br]is greatly altered,

0:03:43.125,0:03:47.851
because instead of vaginal,[br]fecal and skin bacteria of the mother,

0:03:47.875,0:03:51.809
mainly only skin bacteria[br]enter the infant gut.

0:03:51.833,0:03:56.726
And that sets that colonization march[br]to a totally different tone,

0:03:56.750,0:04:02.601
and simply because that's different[br]to what we've adapted to during evolution,

0:04:02.625,0:04:08.226
that might cause some health disadvantages[br]for C-section-born babies later on.

0:04:08.250,0:04:11.184
We can take weight development[br]as an example here.

0:04:11.208,0:04:14.143
It has been already shown[br]in several studies

0:04:14.167,0:04:16.309
that gut microbiota composition

0:04:16.333,0:04:18.184
is associated to weight

0:04:18.208,0:04:20.518
as well as the likelihood[br]of developing diseases

0:04:20.542,0:04:24.226
like diabetes or cardiovascular diseases.

0:04:24.250,0:04:26.684
But now there are some indications

0:04:26.708,0:04:29.226
that you could already at infancy

0:04:29.250,0:04:31.726
see from a fecal sample of a baby

0:04:31.750,0:04:34.768
some microbes missing[br]from those individuals

0:04:34.792,0:04:38.250
who will later on develop[br]to be obese or overweight.

0:04:39.125,0:04:43.101
It has also been shown[br]that those same microbes

0:04:43.125,0:04:46.351
might be missing from babies[br]who are born by C-section

0:04:46.375,0:04:50.768
or who are predisposed to heavy loads[br]of antibiotics in early life.

0:04:50.792,0:04:52.434
And to kind of close this loop,

0:04:52.458,0:04:54.809
it has also been shown in some research

0:04:54.833,0:04:56.934
that babies born by C-section

0:04:56.958,0:05:01.018
or are prescribed with many,[br]many antibiotics early in life

0:05:01.042,0:05:05.143
are more likely to be obese[br]or overweight, even by 50 percent,

0:05:05.167,0:05:06.417
which is a lot.

0:05:07.500,0:05:09.768
Now, I know you might[br]be thinking at this point

0:05:09.792,0:05:14.268
that, oh no, I just had a C-section[br]or I was born via C-section

0:05:14.292,0:05:16.792
or my child had the antibiotics.

0:05:17.917,0:05:20.851
But I want you to not worry.

0:05:20.875,0:05:23.809
If these microbes are missing

0:05:23.833,0:05:26.143
or are lost for any reason,

0:05:26.167,0:05:29.309
they can be acquired later,

0:05:29.333,0:05:31.792
but the baby just needs[br]a little help with that.

0:05:32.708,0:05:37.500
One thing that has already for some time[br]been known to help is breastfeeding.

0:05:38.417,0:05:40.476
Breast milk is kind of miraculous:

0:05:40.500,0:05:43.601
in addition to containing[br]nutrients for the baby,

0:05:43.625,0:05:48.417
it seems to contain food[br]for the good microbes as well.

0:05:49.792,0:05:52.643
That's great for a breastfed baby,

0:05:52.667,0:05:56.684
but we all know that all babies[br]are not breastfed.

0:05:56.708,0:06:01.934
So what could we do to ensure that also[br]those babies who are not breastfed

0:06:01.958,0:06:04.393
could restore their microbiota development

0:06:04.417,0:06:08.143
after encountering[br]those disruptive early life events

0:06:08.167,0:06:11.893
that might disrupt[br]their gut microbiota development?

0:06:11.917,0:06:16.667
And now we get to the actual[br]solution part of this talk.

0:06:17.375,0:06:21.601
The research in this field[br]has been taking giant steps lately.

0:06:21.625,0:06:25.684
First, it was understood[br]that if there are some microbes missing,

0:06:25.708,0:06:27.976
they can be ingested.

0:06:28.000,0:06:32.059
We call the good microbes,[br]when they are ingested, probiotics,

0:06:32.083,0:06:33.643
and probiotics have been tested

0:06:33.667,0:06:36.434
in several clinical trials[br]during the years,

0:06:36.458,0:06:38.726
also in infants, with great effects,

0:06:38.750,0:06:41.875
such as reducing their risk[br]of eczema later in life.

0:06:43.458,0:06:45.976
Now, a second revolution was realized

0:06:46.000,0:06:49.101
when the eyes of researchers[br]were turned to breast milk.

0:06:49.125,0:06:51.434
That was logical, as, like I mentioned,

0:06:51.458,0:06:56.309
it was already known that breastfeeding[br]is able to support the healthy development

0:06:56.333,0:06:58.000
of gut microbiota.

0:06:59.750,0:07:03.476
There were these particles in breast milk

0:07:03.500,0:07:07.059
that were found already in the 1930s

0:07:07.083,0:07:09.601
called human milk oligosaccharides,

0:07:09.625,0:07:12.559
but their function remained a mystery

0:07:12.583,0:07:17.000
for decades and decades[br]after their initial discovery.

0:07:17.833,0:07:20.476
They were really puzzling for researchers,

0:07:20.500,0:07:24.226
as they are really abundant in human milk.

0:07:24.250,0:07:27.851
They are actually[br]the third-largest group of solids,

0:07:27.875,0:07:31.643
but they are not digestible[br]by humans, not even infants.

0:07:31.667,0:07:35.351
So why would mothers synthesize[br]something to breast milk,

0:07:35.375,0:07:38.143
use their resources to put something there

0:07:38.167,0:07:41.184
that is not utilizable by the infant?

0:07:41.208,0:07:43.643
Usually nature does not work that way.

0:07:43.667,0:07:44.934
Right?

0:07:44.958,0:07:48.726
So it was quite a revelation[br]when it was finally understood

0:07:48.750,0:07:50.934
what's the role of these particles,

0:07:50.958,0:07:56.351
and that it is to selectively feed[br]the microbes that are best for infants,

0:07:56.375,0:07:59.768
and that way to affect the infant health.

0:07:59.792,0:08:03.893
There are over a hundred[br]of different HMO structures,

0:08:03.917,0:08:08.708
and nowadays we are able to synthesize[br]some of them also in the lab,

0:08:10.000,0:08:12.393
and that enables us to package them up

0:08:12.417,0:08:15.643
with probiotics for children and infants

0:08:15.667,0:08:18.393
who are not able to receive them[br]from breast milk

0:08:18.417,0:08:20.559
to restore their microbiota

0:08:20.583,0:08:24.375
after encountering[br]disruptive early life events.

0:08:25.417,0:08:27.684
And that is the solution.

0:08:27.708,0:08:30.893
As a researcher, I must say at this point

0:08:30.917,0:08:33.851
that research in this field[br]is still ongoing

0:08:33.875,0:08:36.809
and a lot of work remains to be done.

0:08:36.833,0:08:40.226
That's a favorite sentence[br]of us scientists.

0:08:40.250,0:08:45.268
But we are taking steps[br]towards understanding better and better

0:08:45.292,0:08:49.018
which are the key missing microbes[br]in various situations

0:08:49.042,0:08:53.601
and what HMOs we should package[br]with which probiotics

0:08:53.625,0:08:59.583
to help restore the microbiota of that[br]particular baby in that particular case.

0:09:01.458,0:09:04.059
What I wish you to remember from this talk

0:09:04.083,0:09:08.809
is that, yes, vaginally born[br]breastfed baby has the microbiota

0:09:08.833,0:09:10.809
we have evolved to adapt to,

0:09:10.833,0:09:14.268
but in cases where that is not possible,

0:09:14.292,0:09:18.625
there are means to reduce[br]the negative health consequences.

0:09:21.083,0:09:25.893
Lastly, I wish you to imagine[br]a world for a while,

0:09:25.917,0:09:28.684
a world where there would be[br]such a health care system

0:09:28.708,0:09:31.476
that when you take your baby[br]to a health care check,

0:09:31.500,0:09:35.809
they would routinely monitor the gut[br]microbiota development of that baby,

0:09:35.833,0:09:38.476
and if any disruptions would be noted,

0:09:38.500,0:09:42.184
a tailor-made product[br]to restore the microbiota

0:09:42.208,0:09:43.500
would be prescribed.

0:09:44.583,0:09:47.518
I mean, how wonderful would that be,

0:09:47.542,0:09:52.101
if the onset of any chronic diseases[br]would be extremely rare

0:09:52.125,0:09:55.042
because of this preemptive[br]health care system?

0:09:56.458,0:09:58.167
Can you imagine such a world?

0:09:59.458,0:10:03.000
Do you believe that that kind[br]of future would be possible?

0:10:05.583,0:10:07.059
I do.

0:10:07.083,0:10:09.809
I believe in that future[br]and I want to contribute

0:10:09.833,0:10:11.750
in the unfolding of that future,

0:10:13.250,0:10:18.101
a future in which each baby[br]has an equal starting point for life

0:10:18.125,0:10:20.250
to be programmed for lifelong health.

0:10:21.208,0:10:22.476
Thank you.

0:10:22.500,0:10:25.125
(Applause)