By Anne Estes, PhD

Did the film "Microbirth" convince you that microbes are an important part of a healthy start to life, but leave you with further questions? The follow-up book, Your Baby's Microbiome: The Critical Role of Vaginal Birth and Breastfeeding for Long Term Health, fills in the details from the movie and serves as an excellent and essential birth/first foods reference book. Written with childbirth educators in mind, Your Baby's Microbiome is a welcome and necessary addition to my bookshelf and should be to yours as well. The science is discussed accurately, understandably, and does not overreach the data and findings of the field. Considering an elective cesarean section or debating formula feeding versus breastfeeding? This book provides solid information for parents and health care providers to discuss different options.

Book overview

Your Baby's Microbiome details how and why vaginal birth and breastfeeding are important for establishing an infant's microbiome based on the current science. It emphasizes that vaginal birth is the main "seeding" event, while breastmilk continues to nurture and "feed" the microbes. The authors mention the research about microbes potentially being found in the placenta, but emphasize that most microbes are acquired during birth. I was a little disappointed that the authors, Toni Hartman and Alex Wakeford, mentioned the connection between the placental and oral microbiome since this association is a bit of a stretch (see Eisen's "Overselling the Microbiome" award for more details). Additionally, the book discusses epigenetic changes occurring during vaginal birth that may have long term health benefits. For a detailed list of what I liked and didn't like about the book, see the extensive review on my website.

Why read the book, isn't the film enough?

The numerous interviews Toni and Alex made for "Microbirth" had to be distilled into one dramatic message for the film. Toni remarked that "over 95% of the video we filmed wasn't used in Microbirth. A film paints with the broadest of brushstrokes. With a book, we wanted to unleash the fine-detailed information to the public that we learned from interviewing the scientists."

The Inspiration Behind the Scenes

Toni's passion for educating and empowering women during childbirth and first foods is similar to the fury and protectiveness of a mama bear. She tells an all too familiar story. Toni and her husband, Alex, attended antenatal classes and read extensively while expecting. They thought they were prepared and empowered for a natural birth. However, after four failed inductions, Toni's doctor recommended a cesarean section. Toni had difficulty establishing breastfeeding after her cesarean birth. Nurses suggested giving their infant formula, "For the sake of the baby". In the end, they felt unsupported. As Toni and Alex researched and filmed documentaries on doulas ("Doula! "), natural birth ("Freedom for Birth") and vaginal birth and the microbiome ("Microbirth") they have become increasingly passionate about empowering other parents during childbirth and creating an environment where vaginal childbirth and breastfeeding return to being the norm. Toni and Alex gladly serve as an important microphone to convey the quickly developing science of childbirth and first foods to all aspects of the childbirth community, from educators and practitioners to parents. To this end, Toni and Alex are releasing over three hours of their videos from the One World Birth Summit for free from Feb 20-28^th. Whether you catch the videos or not, certainly purchase a copy of "Your Baby's Microbiome", just released on February 20, 2017 for your bookshelf and to recommend you your clients. It's an excellent resource.

I had the opportunity to ask author and filmmaker Toni Hartman for some comments about her new book and the topic of the baby's microbiome.

Microbes and microbiome research - not yet mainstream

While the natural birth movement embraced the opening of the film "Microbirth" with open arms in 2014. The obstetrical community's response was mixed. Toni said that OBs are either excited or skeptical about the importance of the microbiome during infancy. While skeptics don't question the science, they are wary since this information comes post-medical training and after years or decades of clinical experience. This makes sense, after all for the last 100+ years, medicine, science, and society have considered most microbes as pathogens to be killed. Additionally, the science is still emerging. Toni believes that as the science is replicated, larger and longer term studies conducted, and best practices developed, microbiome-healthy birth and first foods practices will become widely adopted by the full spectrum of the childbirth community.

Changing Current Practices

Another key to adoption of these new ideas is having many different pieces of the puzzle getting the information out. Toni and her husband, Alex, are doing this in their way with films, One World Birth workshops, and their new book, Microbiome. Science-based blogs such as Science & Sensibility and my microbiome blog - Mostly Microbes, can speak to a wide audience of families, childbirth educators, and childbirth practitioners. High profile doctors, such as Dr. Philip Steer, the former editor of the British Journal of Obstetrics and Gynecology providing continuing education workshops offers further information on this topic. Support and implementation from government or international agencies will be essential to help craft protocols and put them in place. Finally, in these celebrity-influenced times, having celebrities talk about their decisions may also help spread the message. Even with these different pieces of the puzzle coming together, it still may take a decade before full-acceptance and implementation of microbiome-friendly birth practices is widespread. Toni sees these as a "squeezing" effect to help push microbiome-friendly birth practices into common practice. Both top down, governmental and health agency pressure and bottom-up information to parents and their childbirth support team are important components.

What information do you share about microbiome seeding, vaginal birth and the newborn? Are the families that you work with curious and asking questions about current best practices? How do you respond? What are your favorite resources to share?

Comment on the blog below by March 1st with your thoughts on this topic and be entered into a drawing to win your own copy of this just released book "Your Baby's Microbiome". Be sure to leave your email address or log in to comment.

About Anne M. Esteset Anne M. Estes, PhD is a postdoctoral fellow at the Institute for Genome Sciences in Baltimore, MD and a freelance science writer. She is interested in how microbes and their host organisms work together throughout host development. Anne blogs about the importance of microbes, especially during pregnancy, birth, first foods, and early childhood at Mostly Microbes.

Published: February 21, 2017

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