0:00:00.991,0:00:04.132
Now, I know it might be easy to think

0:00:04.132,0:00:06.413
that microbes are bad,

0:00:06.413,0:00:08.373
especially for infants,

0:00:08.373,0:00:11.488
but research has in fact[br]proven the opposite.

0:00:12.323,0:00:15.649
And the truth might be[br]a little bit more complex,

0:00:15.649,0:00:18.595
but it's actually way more interesting.

0:00:19.770,0:00:22.011
It seems that we need microbes

0:00:22.011,0:00:25.025
to be programmed for good health,

0:00:25.025,0:00:27.066
but not just any microbes,

0:00:27.066,0:00:29.410
we need the right combination.

0:00:29.410,0:00:32.158
With succeed best with[br]the little microbial bodies

0:00:32.158,0:00:35.973
we have adapted to coexist with[br]during evolution.

0:00:37.043,0:00:39.239
And I guess it won't surprise you

0:00:39.239,0:00:43.507
to learn that we start acquiring[br]that right combination right at birth.

0:00:43.507,0:00:46.178
Well, at least, some of us do.

0:00:46.178,0:00:49.773
Babies born by C-section[br]and babies born vaginally

0:00:49.773,0:00:51.016
aren't the same

0:00:51.016,0:00:54.271
when it comes to microbial start to life,

0:00:54.444,0:00:57.665
and after birth there are countless

0:00:57.665,0:01:00.610
different early life[br]events and circumstances

0:01:00.610,0:01:04.477
that further modulate the way[br]the gut microbiota is developing,

0:01:04.477,0:01:08.602
such as the medications that might be[br]prescribed for the infant or the mother,

0:01:08.602,0:01:12.992
number of pets and siblings in the family,

0:01:12.992,0:01:15.043
as well as level of hygiene at home,

0:01:15.043,0:01:20.015
and, in this case, it's actually better[br]if it's not that perfectly clean

0:01:20.208,0:01:21.075
all the time.

0:01:21.075,0:01:24.311
And also nutrition,[br]both mothers and infants.

0:01:24.311,0:01:29.192
All of these events[br]and circumstances play a huge role

0:01:29.192,0:01:33.861
in the gut microbial development[br]and that has a huge impact

0:01:33.861,0:01:37.492
on the lifelong health of that baby.

0:01:37.492,0:01:41.988
And I'm not talking about[br]small health implications here.

0:01:41.988,0:01:44.040
I'm talking about the big stuff.

0:01:44.040,0:01:46.626
Microbes we acquire or do not acquire

0:01:46.626,0:01:51.357
affect our livelihood of developing[br]diseases like obesity, diabetes,

0:01:51.357,0:01:54.640
and even some cancers.

0:01:54.640,0:01:57.121
Since many of these[br]early life events I just listed

0:01:57.121,0:01:59.676
are such that we cannot affect them,

0:01:59.676,0:02:02.044
they are inevitable,

0:02:02.044,0:02:04.770
for example C-sections[br]have been invented to save lives,

0:02:04.770,0:02:06.586
and they do that daily,

0:02:06.586,0:02:10.520
and most medications are prescribed[br]for a valid reason,

0:02:10.520,0:02:13.165
especially for infants, and so on.

0:02:13.165,0:02:16.138
That is why we have to learn

0:02:16.138,0:02:19.798
how to protect the health of these babies

0:02:19.798,0:02:23.012
after the occurrence[br]of such early life events

0:02:23.012,0:02:26.079
that might disrupt their gut[br]microbial development.

0:02:26.730,0:02:31.596
I work as a researcher

0:02:31.596,0:02:31.846
and as a technical lead[br]of an infant health platform,

0:02:31.846,0:02:35.748
and the question I'm trying[br]to find a solution every day at work,

0:02:35.748,0:02:39.512
and the same question[br]I'm aiming to answer in this talk,

0:02:39.512,0:02:42.028
is how can we make sure

0:02:42.028,0:02:45.749
that all babies get the same shot[br]at lifelong health,

0:02:45.749,0:02:47.988
no matter how they're born

0:02:47.988,0:02:51.373
or what early life events they encounter.

0:02:51.600,0:02:54.125
Seems like a noble cause, right?

0:02:54.125,0:02:57.023
Great.

0:02:57.213,0:02:57.889
So let's figure this out.

0:02:57.889,0:03:03.173
To begin, remember how I said that we need[br]the right combination of microbes.

0:03:03.173,0:03:07.236
Well, to get that combination right,

0:03:07.236,0:03:10.216
we need to receive those microbes[br]that inhabit our bodies

0:03:10.216,0:03:13.186
in a certain order.

0:03:13.186,0:03:16.585
You can think of it[br]like a colonization march.

0:03:16.585,0:03:20.439
The very early microbes[br]that inhabit our bodies first

0:03:20.439,0:03:23.343
change the environment

0:03:23.343,0:03:24.943
in the infant's gut

0:03:24.943,0:03:26.708
so that the next microbes

0:03:26.708,0:03:29.288
are able to move in,

0:03:29.288,0:03:31.993
kind of like the first invaders

0:03:31.993,0:03:35.379
come in first and set up[br]the infrastructure

0:03:35.379,0:03:37.209
for the other settlers to build upon.

0:03:37.209,0:03:39.342
Now, if babies are born via C-section,

0:03:39.342,0:03:43.621
that early phase of colonization[br]is greatly altered,

0:03:43.621,0:03:47.973
because instead of vaginal,[br]fecal, and skin bacteria of the mother,

0:03:47.973,0:03:52.015
mainly only skin bacteria[br]enter the infant gut.

0:03:52.176,0:03:57.025
And that sets that colonization march[br]to a totally different tone,

0:03:57.025,0:04:02.653
and simply because that's different[br]to what we've adapted to during evolution,

0:04:02.653,0:04:08.417
that might cause some health disadvantages[br]for C-section born babies later on.

0:04:08.417,0:04:11.452
We can take weight development[br]as an example, here.

0:04:11.452,0:04:15.014
It has been already shown[br]in several studies

0:04:15.014,0:04:17.238
that gut microbial composition

0:04:17.238,0:04:18.628
is associated to weight

0:04:18.628,0:04:21.863
as well as the likelihood[br]of developing diseases

0:04:21.863,0:04:24.509
like diabetes or cardiovascular diseases.

0:04:24.509,0:04:27.497
But now there are some indications

0:04:27.497,0:04:31.908
that you could already at infancy

0:04:31.908,0:04:34.871
see from the fecal sample of a baby

0:04:34.871,0:04:36.290
some microbes missing[br]from those individuals

0:04:36.290,0:04:39.235
who will later on develop[br]to be obese or overweight.

0:04:39.235,0:04:43.204
It has also been shown[br]that those same microbes

0:04:43.204,0:04:46.886
might be missing from babies[br]who are born by C-section

0:04:46.886,0:04:49.719
or who are predisposed to heavy loads[br]of antibiotics in early life.

0:04:49.719,0:04:52.631
And to kind of close this loop,

0:04:52.631,0:04:55.777
it has also been shown in some research

0:04:55.777,0:04:57.329
that babies born by C-section

0:04:57.329,0:05:01.485
or are prescribed with many,[br]many antibiotics early in life

0:05:01.485,0:05:05.477
are more likely to be obese[br]or overweight, even by 50 percent,

0:05:05.477,0:05:07.657
which is a lot.

0:05:07.657,0:05:11.193
Now, I know you might[br]be thinking at this point

0:05:11.193,0:05:15.208
that, oh no, I just had a C-section[br]or I was born via C-section

0:05:15.208,0:05:17.231
or my child had the antibiotics.

0:05:17.231,0:05:21.077
But I want you to not worry.

0:05:21.077,0:05:24.033
If these microbes are missing

0:05:24.033,0:05:26.521
or are lost for any reason,

0:05:26.521,0:05:29.272
they can be acquired later,

0:05:29.272,0:05:32.538
but the baby just needs[br]a little help with that.

0:05:32.538,0:05:37.607
One thing that has already for some time[br]been known to help is breastfeeding.

0:05:38.026,0:05:41.608
Breast milk is kind of miraculous:

0:05:41.608,0:05:43.719
in addition to containing[br]nutrients for the baby,

0:05:43.719,0:05:48.818
it seems to contain food[br]for the good microbes as well.

0:05:49.116,0:05:52.369
That's great for a breastfed baby,

0:05:52.369,0:05:57.152
but we all know that all babies[br]are not breastfed.

0:05:57.152,0:05:59.740
So what could we do to ensure that also[br]those babies who are not breastfed

0:05:59.740,0:06:04.678
could restore their microbial development

0:06:04.678,0:06:08.858
after encountering those disruptive[br]early life events that might disrupt

0:06:08.858,0:06:11.910
their gut microbial development.

0:06:12.265,0:06:17.074
And now we get to the actual[br]solution part of this talk.

0:06:17.074,0:06:22.054
The research in this field[br]has been taking giant steps lately.

0:06:22.054,0:06:23.979
First, it was understood[br]that if there are some microbes missing,

0:06:23.979,0:06:28.156
they can be ingested.

0:06:28.156,0:06:32.381
We call the good microbes,[br]when they are ingested, probiotics,

0:06:32.381,0:06:36.579
and probiotics have been tested[br]in several clinical trials

0:06:36.579,0:06:39.079
during the years also in infants[br]with great effects

0:06:39.079,0:06:43.298
such as reducing their risk[br]of ?? later in life.

0:06:43.662,0:06:48.398
Now, a second revolution was realized

0:06:48.398,0:06:49.756
when the eyes of researchers[br]were turned to breast milk.

0:06:49.756,0:06:51.653
That was logical, as, like I mentioned,

0:06:51.653,0:06:57.031
it was already known that breastfeeding[br]is able to support the healthy development

0:06:57.031,0:06:59.231
of gut microbiota.

0:06:59.231,0:07:03.701
There were these particles in breast milk

0:07:03.701,0:07:07.400
that were found already in the 1930s

0:07:07.400,0:07:09.827
called human milk oligosaccharides,

0:07:09.827,0:07:12.811
but their function remained a mystery

0:07:12.811,0:07:18.288
for decades and decades[br]after their initial discovery.

0:07:18.288,0:07:20.895
They were really puzzling for researchers,

0:07:20.895,0:07:24.578
as they are really abundant in human milk.

0:07:24.578,0:07:28.287
They are actually[br]the third-largest group of solids,

0:07:28.287,0:07:30.529
but they are not digestible[br]by humans, not even infants.

0:07:30.529,0:07:32.043
So why would mothers synthesize[br]something to breast milk,

0:07:32.043,0:07:34.491
use their resources to put something there

0:07:34.491,0:07:41.775
that is not utilizable by the infant?

0:07:42.029,0:07:45.041
Usually nature does not work that way.

0:07:45.041,0:07:46.109
Right?

0:07:46.109,0:07:47.626
So it was quite a revelation

0:07:47.626,0:07:49.343
when it was finally understood

0:07:49.343,0:07:51.292
what's the role of these particles,

0:07:51.292,0:07:55.209
and that it is to selectively feed[br]the microbes that are best for infants,

0:07:55.209,0:08:00.088
and that way to affect the infant health.

0:08:00.088,0:08:04.276
There are over a hundred[br]of different HMO structures,

0:08:04.276,0:08:10.425
and nowadays we are able to synthesize[br]some of them also in the lab,

0:08:10.425,0:08:12.853
and that enables us to package them up

0:08:12.853,0:08:16.075
with probiotics for children and infants

0:08:16.075,0:08:18.746
who are not able to receive them[br]from breast milk

0:08:18.746,0:08:20.883
to restore their microbiota

0:08:20.883,0:08:24.719
after encountering disruptive[br]early life events.

0:08:25.617,0:08:27.937
And that is the solution.

0:08:27.937,0:08:30.520
As a researcher, I must say at this point

0:08:30.520,0:08:33.546
that research in this field[br]is still ongoing

0:08:33.546,0:08:37.392
and a lot of work remains to be done.

0:08:37.392,0:08:40.584
That's a favorite sentence[br]of us scientists.

0:08:40.584,0:08:45.508
But we are taking steps[br]towards understanding better and better

0:08:45.508,0:08:49.304
which are the key missing microbes[br]in various situations

0:08:49.304,0:08:55.402
and what HMOs we should package[br]with which probiotics to help restore

0:08:55.402,0:09:00.111
the microbiota of that particular baby[br]in that particular case.

0:09:01.669,0:09:05.023
What I wish you to remember from this talk

0:09:05.023,0:09:09.882
is that, yes, vaginally born[br]breastfed baby has the microbiota

0:09:09.882,0:09:11.474
we have evolved to adapt to,

0:09:11.474,0:09:14.434
but in cases where that is not possible,

0:09:14.434,0:09:19.156
there are means to reduce[br]the negative health consequences.

0:09:19.156,0:09:26.078
Lastly, I wish you to imagine[br]a world for a while,

0:09:26.078,0:09:29.091
a world where there would be[br]such a health care system

0:09:29.091,0:09:31.610
that when you take your baby[br]to a health care check,

0:09:31.610,0:09:36.474
they would routinely monitor the gut[br]microbiota development of that baby,

0:09:36.474,0:09:38.806
and if any disruptions would be noted,

0:09:38.806,0:09:42.664
a tailor-made product[br]to restore the microbiota

0:09:42.664,0:09:44.080
would be prescribed.

0:09:44.080,0:09:47.195
I mean, how wonderful would that be,

0:09:47.195,0:09:50.812
if the onset of any chronic diseases[br]would be extremely rare

0:09:50.812,0:09:56.519
because of this preemptive[br]health care system?

0:09:56.519,0:09:59.746
Can you imagine such a world?

0:09:59.746,0:10:04.518
Do you believe that that kind[br]of future would be possible?

0:10:05.291,0:10:07.127
I do.

0:10:07.127,0:10:10.021
I believe in that future[br]and I want to contribute

0:10:10.021,0:10:12.440
in the unfolding of that future,

0:10:12.440,0:10:18.748
a future in which each baby[br]has an equal starting point for life

0:10:18.748,0:10:20.929
to be programmed for lifelong health.

0:10:20.929,0:10:24.826
Thank you.

0:10:24.826,0:10:26.690
(Applause)