By Adem Lewis / in , , , , , , , , , , , , , , , , , , , , , , , , , , /

ED YONG: The following program
is rated as SGM for science, genitalia, and microbes. Viewer discretion is advised. [MUSIC PLAYING] ED YONG: Your first birthday
may have looked something like this, not that
you remember any of it. That was the day you
received you favorite rattle. You loved that thing. Oh, look, your first
stuffed animal. You may think that these were
your first birthday presents, but actually, they weren’t. Your first presents were
given to you much earlier on the very day you were born. It wasn’t your name, it wasn’t
the love of an adoring family. It was microbes. You were born slathered
in your mother’s micobes. They were everywhere,
all over you. MARIA GLORIA
DOMINGUEZ-BELLO: They’re in every mucosa, the mouth,
the skin, the gut, the nose. These are microbial communities,
and they are our first birthday present. That’s Maria Gloria
Dominguez-Bello. I’m an associate professor
at NYU School of Medicine, and I work on babies. Babies and
bacteria, which might sound like an awful
combination; but Gloria believes that those first
microbes from mom are really important
for the development of a strong immune system. The bacteria that they
baby encounters during labor before being born, those
are the pioneer bacteria. So here’s how that first
birthday present works. The vagina, microbes
number in their millions in here Oh, look there’s you,
barreling ahead head first. If you were born vaginally,
you were given a serious bath in mom’s microbes. GLORIA: It’s like an earthquake
to have a baby, the squeezing, the work. ED: Microbes are going into your
eyes, your nose, your mouth, with each swallow, new microbes
going right into your gut. By this time your
umbilical cord is cut, that microbial
bath is seeping into every one of your orifices. These microbes are the
founders of the rich community of organisms that live
on and in the body, what we call the microbiome. When an infant is born, it still
has a lot of developing to do. Its environment and its diet
help to shape its process. But so do its microbes. We’re starting to
discover that microbes play a really important role
in those critical early months, and they help to shape
the immune system so it functions properly
throughout the rest of our lives. So what happens if we miss
that first microbial bath, that first birthday present? What happens if we’re
born by a C-section? In cesarean section,
or C-section, the fetus is removed through
an incision in the mother’s abdomen and uterus. This method has been practiced
for thousands of years. Today, nearly a third
of babies in the US are born through C-sections. It’s often used when
the fetus is sideways, or if it’s in distress, if
the mother is experiencing medical complications, or if
the fetus is just too darn big. The C-section can also be used
for the sake of convenience. Unfortunately for
moms, labor takes hours. Those hours of labor,
the baby already gets exposed to our flora
from the vaginal canal. That doesn’t happen
in C-section. ED: So with a C-section, the
vaginal microbes are missing, and environmental
microbes take their place. So the question is, does
that matter for babies? The effect on
microbes is proven. ED: So babies born
through C-sections definitely have
different microbes than those born vaginally? GLORIA: Exactly. What is now proving is
the effect, the effect on health of the baby. When babies are not
exposed to the natural, primordial, microbial– I call it yogurt. When babies are not exposed
to this primordial soup of microbes, we think
there are consequences, such as increased
risk of obesity, or increase the risk of
asthma, type one diabetes, celiac disease. There’s some evidence that
babies born through C-sections have a higher risk of allergies
and other health conditions. So Gloria is
studying those babies to better understand the
potential consequences of bypassing the birth
canal and being deprived of that first microbial bath. So how do you do that? You can’t just go back
in time and deliver the baby in a different way. GLORIA: We cannot restore labor,
but can we restore the microbes that happened naturally? So Gloria designed
an experiment to answer that question. GLORIA: We had a
pilot study in which the 18 first babies,
seven born vaginally, seven born by C-section
with no exposure, and four born by
C-section and exposed to the maternal vaginal fluids. Wait, how do you do that? How do you expose a C-section
baby to mom’s vaginal fluids? To do that, we have used
a swab that we fold like a tampon, place it in
the vaginal canal before the C-section. When the baby is
born, first thing is to clean, swab this
baby with a gauze. OK, I’ve got this. So gauze, we take the
gauze, and we fold it up, fluids from mom, baby, and
we swab the baby, swab, swab, swab, swab, swab,
swab, swab, swab, and tada, one baby completely
covered in mom’s microbes. And how soon after it’s
born do you do that? GLORIA: As soon as possible,
within the first two minutes. So question, when
you were trying to get parents involved
in this, were they like, you want to do
what with my baby? Exactly. The first time was like,
what’s the rationale? Why would you give
microbes to a baby? But then once you
explain, it’s reasonable. It’s a natural exposure. What we want to understand
is will the babies that are born by C-section and
are exposed to their mother’s vaginal fluids be colonized
by the vaginal bacteria as if they were born vaginally? So what happened in the end? What were the results? We follow those babies for the
first month and compare them. And what we found is that
the babies born by C-section with exposure to
the vaginal gauze, you see vaginal microbes as if
the baby was born vaginally. Huh, so the swabbing was
enough to give the babies their microbial birthright? Yes. So this sounds
very simple, but I’m guessing you’re going to tell
us that you shouldn’t do this at home. You should not do it yourself
alone without the knowledge, because infections
could be transmitted. So what’s next? Are you going to do a bigger
study beyond just the 18 babies? GLORIA: We did it. We continued it to 84. And we are now analyzing
massive, massive, data. It’s over 10,000 samples that
we are analyzing right now the results. But here’s the thing, other
large studies have found that if you look at children later
on in life who were born either vaginally or through C-sections,
you don’t see any differences in their microbiomes anymore. They start to look
the same after awhile. So the question is,
would normalizing the microbes to
mimic a vaginal birth at this early point in life
reduce the risk of disease later on? That is what Gloria
wants to find out. That’s correct. We know that we are
restoring the microbes. But what we don’t know
is are we protecting them from the increased risks
that they had because they were born by C-section? That, we don’t know. And that takes a long
study, big, and long study. What should people take
away from this research? GLORIA: The point is,
C-sections save lives. We know that. So what is important to
consider is that it’s not free. There is a price to pay. But through your work, you’re
hoping to minimize that price. I think in principle,
we can restore nature through replacing the microbes. So that however you
come into this world, you’ve got the best possible
chance for a healthy start. That’s correct. Thank you, Gloria, for helping
us to see the process of birth in a whole new light. You’re welcome. And now, if you’ll
excuse me, it’s nap time. We aren’t the only ones who
give bacterial birthday presents to our kids. Check out our video
about the bee wolf, an insect that
does much the same, but in a very surprising way. I’ll link to the
video below, and don’t forget to subscribe to
our channel for new videos every Monday.

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