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Now, I know it might be easy to think

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that microbes are bad,

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especially for infants,

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but research has in fact
proven the opposite.

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And the truth might be
a little bit more complex,

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but it's actually way more interesting.

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It seems that we need microbes

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to be programmed for good health,

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but not just any microbes,

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we need the right combination.

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We succeed best
with the little microbial bodies

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we have adapted to coexist with
during evolution.

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And I guess it won't surprise you

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to learn that we start acquiring
that right combination right at birth.

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Well, at least, some of us do.

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Babies born by C-section
and babies born vaginally

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aren't the same

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when it comes to microbial start to life,

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and after birth there are
countless different early life events

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and circumstances

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that further modulate the way
the gut microbiota is developing,

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such as the medications that might be
prescribed for the infant or the mother,

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number of pets and siblings in the family,

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as well as level of hygiene at home,

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and, in this case, it's actually better

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if it's not that perfectly
clean all the time.

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And also nutrition,
both mothers and infants.

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All of these events
and circumstances play a huge role

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in the gut microbial development

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and that has a huge impact
on the lifelong health of that baby.

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And I'm not talking about
small health implications here.

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I'm talking about the big stuff.

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Microbes we acquire or do not acquire

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affect our likelihood of developing
diseases like obesity, diabetes,

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and even some cancers.

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Since many of these
early life events I just listed

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are such that we cannot affect them,

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they are inevitable,

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for example C-sections
have been invented to save lives,

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and they do that daily,

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and most medications
are prescribed for a valid reason,

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especially for infants, and so on.

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That is why we have to learn

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how to protect the health of these babies

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after the occurrence
of such early life events

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that might disrupt their gut
microbiota development.

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I work as a researcher

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and as a technical lead
of an infant health platform,

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and the question I'm trying
to find a solution to every day at work,

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and the same question
I'm aiming to answer in this talk,

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is how can we make sure

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that all babies get the same shot
at lifelong health,

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no matter how they're born
or what early life events they encounter.

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Seems like a noble cause, right?

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Great.

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So let's figure this out.

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To begin, remember how I said that we need
the right combination of microbes?

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Well, to get that combination right,

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we need to receive those microbes
that inhabit our bodies

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in a certain order.

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You can think of it
like a colonization march.

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The very early microbes
that inhabit our bodies first

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change the environment in the infant's gut

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so that the next microbes
are able to move in,

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kind of like the first invaders

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come in first and set up
the infrastructure

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for the other settlers to build upon.

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Now, if babies are born via C-section,

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that early phase of colonization
is greatly altered,

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because instead of vaginal,
fecal, and skin bacteria of the mother,

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mainly only skin bacteria
enter the infant gut.

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And that sets that colonization march
to a totally different tone,

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and simply because that's different
to what we've adapted to during evolution,

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that might cause some health disadvantages
for C-section-born babies later on.

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We can take weight development
as an example here.

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It has been already shown
in several studies

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that gut microbiota composition

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is associated to weight

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as well as the likelihood
of developing diseases

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like diabetes or cardiovascular diseases.

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But now there are some indications

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that you could already at infancy

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see from a fecal sample of a baby

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some microbes missing
from those individuals

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who will later on develop
to be obese or overweight.

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It has also been shown
that those same microbes

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might be missing from babies
who are born by C-section

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or who are predisposed to heavy loads
of antibiotics in early life.

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And to kind of close this loop,

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it has also been shown in some research

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that babies born by C-section

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or are prescribed with many,
many antibiotics early in life

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are more likely to be obese
or overweight, even by 50 percent,

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which is a lot.

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Now, I know you might
be thinking at this point

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that, oh no, I just had a C-section
or I was born via C-section

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or my child had the antibiotics.

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But I want you to not worry.

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If these microbes are missing

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or are lost for any reason,

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they can be acquired later,

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but the baby just needs
a little help with that.

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One thing that has already for some time
been known to help is breastfeeding.

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Breast milk is kind of miraculous:

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in addition to containing
nutrients for the baby,

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it seems to contain food
for the good microbes as well.

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That's great for a breastfed baby,

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but we all know that all babies
are not breastfed.

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So what could we do to ensure that also
those babies who are not breastfed

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could restore their microbiota development

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after encountering
those disruptive early life events

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that might disrupt
their gut microbiota development.

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And now we get to the actual
solution part of this talk.

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The research in this field
has been taking giant steps lately.

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First, it was understood
that if there are some microbes missing,

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they can be ingested.

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We call the good microbes,
when they are ingested, probiotics,

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and probiotics have been tested

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in several clinical trials
during the years

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also in infants with great effects

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such as reducing their risk
of eczema later in life.

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Now, a second revolution was realized

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when the eyes of researchers
were turned to breast milk.

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That was logical, as, like I mentioned,

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it was already known that breastfeeding
is able to support the healthy development

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of gut microbiota.

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There were these particles in breast milk

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that were found already in the 1930s

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called human milk oligosaccharides,

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but their function remained a mystery

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for decades and decades
after their initial discovery.

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They were really puzzling for researchers,

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as they are really abundant in human milk.

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They are actually
the third-largest group of solids,

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but they are not digestible
by humans, not even infants.

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So why would mothers synthesize
something to breast milk,

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use their resources to put something there

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that is not utilizable by the infant?

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Usually nature does not work that way.

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Right?

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So it was quite a revelation
when it was finally understood

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what's the role of these particles,

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and that it is to selectively feed
the microbes that are best for infants,

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and that way to affect the infant health.

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There are over a hundred
of different HMO structures,

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and nowadays we are able to synthesize
some of them also in the lab,

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and that enables us to package them up

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with probiotics for children and infants

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who are not able to receive them
from breast milk

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to restore their microbiota

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after encountering
disruptive early life events.

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And that is the solution.

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As a researcher, I must say at this point

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that research in this field
is still ongoing

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and a lot of work remains to be done.

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That's a favorite sentence
of us scientists.

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But we are taking steps
towards understanding better and better

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which are the key missing microbes
in various situations

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and what HMOs we should package
with which probiotics

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to help restore the microbiota of that
particular baby in that particular case.

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What I wish you to remember from this talk

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is that, yes, vaginally born
breastfed baby has the microbiota

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we have evolved to adapt to,

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but in cases where that is not possible,

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there are means to reduce
the negative health consequences.

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Lastly, I wish you to imagine
a world for a while,

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a world where there would be
such a health care system

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that when you take your baby
to a health care check,

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they would routinely monitor the gut
microbiota development of that baby,

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and if any disruptions would be noted,

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a tailor-made product
to restore the microbiota

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would be prescribed.

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I mean, how wonderful would that be,

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if the onset of any chronic diseases
would be extremely rare

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because of this preemptive
health care system?

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Can you imagine such a world?

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Do you believe that that kind
of future would be possible?

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I do.

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I believe in that future
and I want to contribute

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in the unfolding of that future,

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a future in which each baby
has an equal starting point for life

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to be programmed for lifelong health.

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Thank you.

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(Applause)