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Episode 186
The Doctor's Farmacy

Baby’s Gut Instinct: Why Having a Healthy Gut is Critical to Infant Health

Open the Podcasts app and search for The Doctor’s Farmacy. If you’re viewing this site on your phone, you can just tap on the

Tap the subscribe button and new shows will be added to your library.

If you’re using a different device, our show is available on the following platforms.

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Today we’re talking about one of my favorite topics: poop. And we’re finding out that the most important time to pay attention to our poop and what it can tell us about the microbiome is in the earliest months of life.

I recently did a really interesting webinar on this topic. It’s such a critical aspect of creating lifelong health that I wanted to share it on the podcast, to make sure anyone who missed it had a chance to listen. With the huge rise in inflammatory diseases from obesity and diabetes to autoimmunity and so many more, it’s imperative we look at the gut to optimize whole body health—this is a fundamental piece of Functional Medicine that I’ve been using with my patients for decades.

To dig into the specifics of how we can start kids off with the best health possible, I sat down with Dr. Tracy Shafizadeh. She is leading the work in understanding the infant microbiome, as a nutritional scientist who helps new and expectant moms learn about creating healthy gut bugs in their babies.

While focusing on babies’ health is important for future generations, this is really a topic that impacts all of us today. Modern society has created the perfect storm for a depletion of our good gut bacteria. Overuse of antibiotics, poor diet, glyphosate, C-sections, and so many other factors are leading to an epidemic of missing microbes—especially one of the most essential ones called Bifidobacterium infantis or B. infantis, for short.

There is even a new condition related to this called Newborn Gut Deficiency (NGD). This is when there is an overwhelming shortage of good bacteria in a baby’s gut, and bad bacteria then have room to take over and cause inflammation. NGD is linked to some of the most frustrating issues parents deal with, like colic, diaper rash, fussiness, poor sleep, and eczema. And it’s estimated that 90% of babies being born in the US fall into this category, with numbers rising in other industrialized countries as well.

Dr. Tracy and I dive into what the research on B. infantis reveals about optimizing health in our tiniest humans. Babies are born with a clean slate, so to speak, when it comes to gut bacteria. We want to help B. infantis set up shop, because it might struggle to become well established for the reasons I mentioned above. Dr. Tracy has been leading the way with research on how to promote optimal levels of B. infantis and has developed the Evivo probiotic to make it easier for parents to foster this important bacteria in their babies early in life.

We also talk about why the strain of B. infantis matters, the topic of vaginal seeding, and so much more. This is a really interesting and important topic that will help our children and grandchildren thrive. I’m even excited to work on improving my own levels of B. infantis to see what kinds of benefits I notice myself!

This episode is brought to you by BiOptimizers, Primal Kitchen, and Beekeeper’s Naturals.

You can try BiOptimizers Magnesium Breakthrough for 10% off by going to  magbreakthrough.com/hyman and using the code HYMAN10. For a limited time, BiOptimizers is also giving away free bottles of their bestselling products P3OM and Masszymes with select purchases. 

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I hope you enjoyed this conversation as much as I did. Wishing you health and happiness,
Mark Hyman, MD
Mark Hyman, MD

Here are more of the details from our interview (audio):

  1. Our epidemic of chronic inflammatory diseases
    (4:32)
  2. The vital importance of having a balanced microbiome
    (8:17)
  3. How a baby receives gut microbes from its mother and how this process regularly gets disrupted
    (11:23)
  4. Why 50% of human breast milk is indigestible by the baby
    (18:11)
  5. Differences between human breast milk and baby formula
    (23:50)
  6. What is Newborn Gut Deficiency and does it affect your baby?
    (30:23)
  7. The long term consequences of having lack of B. infantis and how it can be restored
    (38:15)
  8. How does Evivo work?
    (45:40)
  9. Are probiotics good for you?
    (53:44)
  10. Vaginal seeding and the gut microbiome
    (1:03:30)

Guest

 
Mark Hyman, MD

Mark Hyman, MD is the Founder and Director of The UltraWellness Center, the Head of Strategy and Innovation of Cleveland Clinic's Center for Functional Medicine, and a 13-time New York Times Bestselling author.

If you are looking for personalized medical support, we highly recommend contacting Dr. Hyman’s UltraWellness Center in Lenox, Massachusetts today.

 
Dr. Tracy Shafizadeh

Dr. Tracy Shafizadeh is leading the work in understanding the infant microbiome, as a nutritional scientist who helps new and expectant moms learn about creating healthy gut bugs in their babies. Dr. Tracy translates her extensive scientific knowledge of breastmilk and the gut microbiome into practical terms to help parents understand how a balanced gut from infancy leads to a healthy immune system and metabolism for life. Dr. Shafizadeh received her PhD in nutritional biology from the University of California, Davis, and spends her free time “loving the guts” out of her two boys.

Transcript

Speaker 1:
Coming up on this episode of the Doctor’s Pharmacy.

Dr. Tracy Shafizadeh:
We used to think of colic as just being a rite of passage. You just got unlucky and got a colicky baby. But what we now are starting to see is colic is actually just a manifestation of dysbiosis or newborn gut deficiency in the first month or so of life.

Dr. Mark Hyman:
Hey, everybody. It’s Dr. Hyman. How are you all? I am so excited to be here with an extraordinary guest. We’re going to talk about poop, my favorite topic you know which is not just any poop, but baby poop, and why it’s so important and what we have to learn about it and how it’s revolutionizing our ideas about how to take care of our babies during the first year of life and the implications it has for their whole life and particularly the acquiring or not of autoimmune diseases, obesity, allergies, all kinds of stuff.

Dr. Mark Hyman:
So, this is going to be a very juicy conversation. We’re going to get into the details of stuff that I think is among the most important things to know today, and here’s why. The thing that’s striking to me is we’re seeing an epidemic of inflammatory diseases, I mean pandemic of inflammatory diseases, everything, heart disease, cancer, diabetes, obesity, Alzheimer’s, autism, forget about the normal inflammatory stuff like asthma, allergies, eczema, all that stuff, autoimmunity. These are all inflammatory diseases.

Dr. Mark Hyman:
And the question is why and when did they start. And we can see if we look at maps of disease incidence and prevalence that we’ve gone all the things that used to kill us, TB, pneumonia, measles, polio, all that stuff down, all the other things up. So, all the chronic inflammatory diseases that we’re seeing are devastating our population and killing far, far more people than any of those other infectious diseases did although there were some bad ones like the 1918 flu.

Dr. Mark Hyman:
But for the most part, the things we were struggling with were quite different. And I think you’re going to learn tonight or today or every time you’re watching this. You’re going to learn about why that may be the case. And the hypothesis is that our gut is at the root of all of it. And particularly what happens to our babies’ guts at birth and after, that determines what happens to the health of our population.

Dr. Mark Hyman:
So, this isn’t really just about babies even though I like babies. This isn’t just about babies. This is about a much bigger global problem of chronic inflammatory diseases, why it starts, what we can do about it, and how we can try to start to address this early on in life is really my pleasure and privilege to have an extraordinary nutritional scientist and gut expert and author to join us tonight, Dr. Tracy Shafizadeh who is really leading the work in understanding the infant gut microbiome. It’s something we didn’t even have a sense for before.

Dr. Mark Hyman:
But now, we call it the gut inject microbiome. She’s a nutritional scientist who educates new and expecting moms about gut health for babies. She’s translated extensive knowledge about breast milk and infant gut microbiome into practical tools to help parents understand how to get their babies to have a balanced gut from the first day of life that will lead to a healthy immune system and healthy metabolism.

Dr. Mark Hyman:
And I’m going to explain why metabolism is important. We’ll get into that too because I think what does metabolism and weight have to do with gut? Well, everything, it turns out. Tracy received her PhD in Nutritional Biology from the University of California Davis and has over 15 years of experience in the life science and biotech industry. In her spare time, she can be found experimenting her own kitchen and loving the guts out of her two boys. So, welcome, Tracy.

Dr. Tracy Shafizadeh:
Thank you so much for having me.

Dr. Mark Hyman:
Okay. So, the premise I just shared was that we are currently in a pandemic of not only COVID-19 but the inflammatory diseases of modern society. And the reason that we’ve ended up with the disaster of COVID that we have in America is because we’re so pre-inflamed and unhealthy.

Dr. Mark Hyman:
And we have chronic diseases like obesity, diabetes, heart disease, all these make COVID worse and make more likely to end up in the hospital and die. The question is why? And what is the root cause of all this inflammation? And it turns out that what we’re learning about is that the gut microbiome plays a huge role in every aspect of our health, not just inflammatory conditions, but everything. It’s good. If it’s good, it’s good. It helps produce vitamins. And it helps digest your food. And it helps regulate hormones and brain chemistry.

Dr. Mark Hyman:
And your immune system is wonderful except when it’s not. And the problem is that our modern society has created a perfect storm for destroying our microbiomes, ours as adults and also children and babies. And so, we have to go back to almost birth to figure out why we’re in such trouble now and how important this balance is between the gut bacteria and you. And how do we enhance and optimize that relationship in a symbiotic way that produces health?

Dr. Mark Hyman:
In functional medicine, we coined a term which now I see in the medical literature which I think is really hysterical has been taken up as now a thing. We call it dysbiosis. So, symbiosis is this wonderful mutualistic dance between the organisms that live in you and on you, and your own biology. If they’re balanced, you’re balanced and healthy. And if they’re not, you’re sick, and this is called dysbiosis.

Dr. Mark Hyman:
So, let’s go back to the beginning, Tracy, to understand the causes of our dysbiosis as a society and also then jump into. Let’s just take a big picture what are the all the factors that screw up our microbiome. And then, let’s get right back to the beginning when we’re born. What are the factors there that are needed to have a healthy microbiome? And why do so many kids not have a healthy microbiome?

Dr. Tracy Shafizadeh:
Great. I think you may have asked five questions there. So, we’ll [crosstalk 00:06:24]. When we think about the term microbiome, it’s a term that we’re hearing more and more and more. And I think most of us have a concept that we have microorganisms that live in and on our body. And what I think we’re now starting to appreciate is that our gut microbiome, this collection of microorganisms actually is we can think about it as a microbial organ. It is not just random microorganisms that happen to be in our gut. They are serving a very specific purpose in our body. And when an organ in your body is not working properly, there are major deleterious effects. And so, when we think about the gut microbiome-

Dr. Mark Hyman:
By the way, Tracy, people understand it’s the biggest organ in your body, right?

Dr. Tracy Shafizadeh:
It really is. And we know the least about it, I would say. And we’re starting to really understand that we can no longer ignore the microbiome as a key organ in our body. If we think about babies, when babies are born, they’re essentially born with a sterile gut. They have very few microorganisms in their intestine. They’re brought into this world as we like to think as a blank slate. That’s good news and bad news. The good news is we have the opportunity to set them on a path of having a healthy gut microbiome from the moment they’re born.

Dr. Tracy Shafizadeh:
The bad news is most babies don’t get put on that healthy trajectory. Most babies have a disruption in their microbiome from the day they’re born. So, maybe, I’ll just take a step back and think a day in the life of a baby as it’s being born. So, a baby is essentially thought of traveling through the vaginal canal during vaginal birth. We all can appreciate that vaginal delivery is a crazy messy process. There’s a lot of stuff happening.

Dr. Tracy Shafizadeh:
One thing that we want to happen is we want moms to be able to pass their gut microbes on to their babies. Well, what’s in mom’s gut has to get to baby somehow. But baby’s traveling through the vaginal canal. And as they exit the birth canal, their little faces emerge first. They hopefully will get exposed to mom’s gut microbes through what we call a fecal oral transfer. We can leave it at that or we can go into [crosstalk 00:08:48].

Dr. Mark Hyman:
That’s fun.

Dr. Tracy Shafizadeh:
… that. You can totally ask-

Dr. Mark Hyman:
Sounds like eating poop.

Dr. Tracy Shafizadeh:
Yeah. So, if mom has a healthy gut microbiome, then she essentially gives the gift of seeding the baby’s microbiome from the day they’re born with their first little inoculation of microorganisms in baby’s gut. And then, breast milk, human breast milk, is miraculous in that it contains everything that baby needs to grow and develop and go through the milestones of those first six months of life. It also has all of the food for the healthy bacteria that mom has passed on to baby.

Dr. Tracy Shafizadeh:
So, it has food for baby, has food for microbiome. When all goes according to plan, it’s a beautiful synergistic symbiosis as you mentioned. But if we think about it, how many different ways can we disrupt that beautiful process? So, there is a need for babies to sometimes be borne by C-section. And in fact, up to 30% of babies can be borne by C-section in this country. They bypass the opportunity to be exposed to mom’s good gut microbes. If you think about just physically, they don’t pass through the birth canal. They don’t get exposed to mom’s microbes. Well, where are their first microbes coming from?

Dr. Tracy Shafizadeh:
So, they get their first microbes that sets them up for a lifetime of either health or disease from the microorganisms that do well on the surfaces of the hospital, counter tops and surfaces or from skin or from clothes. So, their first microbes look very, very different than [crosstalk 00:10:21].

Dr. Mark Hyman:
From the nurse who was in a bunch of other rooms with other patients. Who knows what was going on, right?

Dr. Tracy Shafizadeh:
It’s a little bit of a circus for those babies who get are born by C-section. And then, if you also layer on top of that, the number of moms who are given antibiotics during labor and delivery for, say, group B strep which can also be close to 30% of moms, any good microbes that they have in their gut even if babies born vaginally may or may not be there to pass on to baby.

Dr. Tracy Shafizadeh:
So, we now after generations of moms being born by C-section themselves, being exposed to antibiotics and babies being exposed to antibiotics, generationally, we have now really, really limited that natural transfer of good gut bacteria specifically a type of bacteria that infants need called Bifidobacterium infantis. We’ve almost eliminated it in our population here in the US.

Dr. Mark Hyman:
I can imagine there’s probably maybe not a single person who’s never had an antibiotic. Maybe, there is. But I can’t imagine that there would be too many on this webinar that have not had an antibiotic which means then that all the women who are listening who’ve had antibiotics have destroyed this particular bacteria which turns out to be exquisitely sensitive to antibiotics, right? So, if you just had a cold and the doctor said, “Oh, take this amoxicillin,” you’re screwed because then you decimate the population. And it’s gone.

Dr. Mark Hyman:
So, what we’re seeing is this phenomena of missing microbes. Now, there’s a wonderful book written by, I think, Michael Blaser about missing microbes talking about this terrible phenomena of modern society that has literally decimated whole populations of really critical gut microbes that are necessary for our health like Bifidobacterium infantis.

Dr. Mark Hyman:
So, basically, women have taken antibiotics either before or during pregnancy or birth. Babies are born by C-section. So, the likelihood of your baby not having any of this particular bacteria is pretty high. I want to come back to something you said earlier about breast milk. But I just want to take a step back because what we’re seeing is that literally a genocide of our microbiome because, one, we don’t eat a very good diet to fertilize good bugs. We don’t eat fermented foods. You don’t need high fiber.

Dr. Mark Hyman:
We used to eat 150 grams a day, as 100 calories as Hunter gathers. Now, we eat about 8 grams a day. That’s what the bugs eat. They eat undigestable fiber. We have been exposed to so many environmental toxins that are often toxic in the microbiome. Pretty much, all of us have been exposed to glyphosate which is a microbiome killer in very small amounts and pretty much 70% of all crops are sprayed with glyphosate, it’s the number one agrochemical on the planet.

Dr. Mark Hyman:
And so, we’ve also taken a lot of drugs, other drugs, like antacid drugs and steroid drugs and hormone drugs and all these drugs that screw up our microbiome. So, as a society, we literally are in this pandemic of a total society of dysbiosis. And that’s what keeps me busy in my practice because I see all these patients who have messed up microbiomes. And what you’re suggesting is that in these babies that there is a way to avert this lifelong problem of inflammatory and metabolic diseases that at comes with having a messed-up microbiome.

Dr. Mark Hyman:
And then, we know that if your microbiome is bad, you’re not only at risk for allergy and autoimmunity and asthma and eczema and all that, not only at risk for irritable bowel and colitis and autoimmune disease. But you’re also at risk for obesity, and diabetes and cancer, and heart disease and Alzheimer’s and Parkinson’s disease. I mean it goes on and on and on, autism, ADD.

Dr. Mark Hyman:
And what that means is that we have to sort of understand that our gut microbiome is something we need to pay a lot of attention to. If we’ve been born and we miss the boat on the birth thing, there’s ways we can rebuild our microbiome. But it’s quite a different approach to disease than we are taking today which is very reactive.

Dr. Mark Hyman:
And so, now I want to come back to something you said about the breast milk because this is striking to me. When you think about how beautiful nature is, 15% of mother’s milk is not digestible by the baby. It’s not like the baby’s not getting any benefit from it except it feeds this indigestible carbohydrate feeds, this particular bacteria that you mentioned, Bifidobacterium infantis or B. infantis. And it loves this stuff. It’s like actually made for it. I don’t know what’s the analogy. I don’t know, can’t think of it.

Dr. Mark Hyman:
But it’s made for this particular bacteria. So, talk about a little bit about how this works, and what happens. And why formula is a problem because these sugars, these carbohydrates called oligosaccharides are not in formula.

Dr. Tracy Shafizadeh:
Yeah. So, as a nutritional scientist, I think that this part of the research and part of the story is probably what was most impactful to me when I was learning about this topic, and the research that was coming out of UC Davis and a team of researchers that were using human milk as an example of food that in its perfect form because, if you think about it, human breast milk has not been impacted by mass industrialization.

Dr. Tracy Shafizadeh:
And we haven’t really toyed with it too much. It’s actually the pressure on human milk is actually from human evolution. And really, the body is constantly dialing in human breast milk to be exactly what the baby needs to thrive and grow in the first six months of life. So, this team of researchers at UC Davis at the Foods for Health Institute said, “Well, let’s dissect and analyze every aspect of human milk, and let’s see what’s there.” And we’ll use that as a template for what babies are supposed to be consuming.

Dr. Tracy Shafizadeh:
And everything was there that you would expect. The lipids, the protein, the lactose, the water, the micronutrients, the macronutrients were there. What was really fascinating, and you touched upon it, is 15% of the nutrients in breast milk were these complex carbohydrates called human milk oligosaccharides or HMOs for short that were completely indigestible by the baby which makes absolutely no sense that human milk which is very metabolically taxing for the mom to make would have 15% of nutrients that completely were not used utilizable or indigestible by the baby until they figured out that it’s food for B. infantis in the baby’s intestine.

Dr. Tracy Shafizadeh:
So, then, you go back to kind of our day in the life of a baby. It’s a rough 24 hours. But they get through it. And the baby is born. They’re exposed to mom’s gut microbes. B. infantis, hopefully, sets up camp in baby’s intestine, and it needs food too. So, human milk starts coming in to the intestine. And it feeds the baby. And it feeds B. infantis.

Dr. Tracy Shafizadeh:
And then, all of a sudden, those 15% of nutrients and human milk are no longer locked up in these complex carbohydrates. The infantis is utilizing them for fuel and turning them into something that the baby can actually use. And that’s the short chain fatty acids called lactate and acetate and others. And those are actually signaling molecules. They’re actually a fuel for the growing colonocytes, the intestinal cells as the baby is rapidly developing. They are changing the pH of the baby’s intestine so that pathogenic or bad bacteria can’t thrive.

Dr. Tracy Shafizadeh:
They’re creating this protective environment in the infant’s gut. It’s such a beautiful story that nature has designed. And so, when baby has B. infantis in their gut, and they’re consuming HMOs preferably from breast milk, then it sets up a protective environment where pathogens can’t grow. The infantis is getting everything it needs. Baby’s getting 100% of the nutrients in breast milk. And it’s a very calm, low inflammation, protective environment in baby’s gut.

Dr. Tracy Shafizadeh:
Now, if you can imagine the opposite scenario which B. infantis is not in baby’s gut, HMOs are coming in through the diet completely locked up in and not utilizable by the baby. Instead, pathogens are growing because the pH of the colon is in their perfect zone which is hasn’t been curated by the infantis. And those HMOs are actually being excreted in large amounts in baby’s stool. So, what we see is we see babies that are missing B. infantis with five to eight to 10 watery stools per day. They’re just pumping out HMOs.

Dr. Tracy Shafizadeh:
And if you think about it, that’s what pediatricians have been telling us moms for a long time. If you have a breastfed baby, expect five to 10 watery stools per day. But I’m not sure that is actually what we’re striving for because in clinical studies that we’ve conducted, we see that when babies do have B. infantis, and they are utilizing HMOs, they stop pooping them out, dumping them out into the stool. They’re no longer in the diaper. And babies are accessing 100% of the nutrients and benefits of breast milk.

Dr. Tracy Shafizadeh:
Now, you’re asking about formula. All babies need to be fed, all babies. And if a baby is not getting breast milk, formula is the next best option. And we are big advocates of Fed is Best. However, we know from a nutritional composition perspective, there are big differences between breast milk and formula. And formula companies are working very hard to try to get formula as close to breast milk as possible. There’s a long way to go.

Dr. Mark Hyman:
A long way.

Dr. Tracy Shafizadeh:
There’s a long way to go. And the HMOs and formula although they do have them on some of the labels contains HMOs, they are not nearly at the concentration of breast milk nor are they at the composition of what’s in breast milk. So, it is a hat tip to the idea that there are HMOs in formula.

Dr. Mark Hyman:
It’s like window dressing. It’s good marketing.

Dr. Tracy Shafizadeh:
It is indeed. So, I would say that babies exposed to antibiotics, babies born by C-section and babies that are receiving formula, they’re not going to create this high B. infantis protective environment in their gut, and that is where we start to see the high levels of inflammation in the gut. And then, the longer term effects, negative health effects as baby grows.

Dr. Mark Hyman:
Absolutely because the baby’s immune system when it’s born is not developed. And the first year is critical for its development. And it develops the immune system by sampling the environment through the food is eating, and through the microbes that are in there.

Dr. Mark Hyman:
And when those microbes are off or out of balance, it’s going to drive lifelong changes that are often challenging. And as a functional medicine doctor, I see this very often. What’s the story? Baby born by C-section, given antibiotics in the first years of life. Lots of ear infections, sore throats. Maybe, then they get some eczema and diaper rash. And they get asthma. And then, they get allergies, and they get autoimmunity.

Dr. Mark Hyman:
And you see this pattern over and over, and you start to pay attention to it. So, when I take a patient’s history, I start with the mother’s health before birth. And I go all the way through to the timeline of what’s going on. The study I read that was so striking to me that just put this in bold relief was a study where they compared the microbiome and the short chain fatty acids that are produced with babies who are breastfed versus formula fed.

Dr. Mark Hyman:
Now, you mentioned a few of them. But one of the most critical short chain fats is something called butyrate. And it regulates immunity, cancer. It feeds the colon. It’s so critical. It’s anti-inflammatory. It’s used to treat colitis. I mean it’s quite an amazing molecule. And it’s produced by the bacteria, the right bacteria digesting the starch, the fiber.

Dr. Mark Hyman:
And in this study, they looked at the kinds of short-chain fatty acids that are produced depending on what you’re eating if it’s formula or breast milk. The breast milk babies all had high levels of butyrate which is what you want. The formula-fed babies had high levels of another short chain fat called propionic acid. Now, it’s a big medical word. What does it mean? It’s one of the short chain fats. But it turns out that this is very neuroactive in a bad way.

Dr. Mark Hyman:
So, they are able to induce autism in animal models by giving them propionic acid. And guess what it’s also used for? It’s a preservative used in flour. So, anybody eating wheat in this country unless you know for sure that the company is organic and this and that and doesn’t put anything in it, they put propionic acid in which leads to behavioral issues and mood issues, attention issues. And like I said in animal studies, that can induce autism. That’s terrifying to me.

Dr. Mark Hyman:
And so, I really think that we should be looking at children’s microbiomes. We should be looking at their poop. We can measure… I do this every day in my practice. I measure short-chain fatty acids. I look at the types of them. I look at the kinds of bacteria there. And it’s quite amazing to see how many people have disordered gut microbiomes.

Dr. Mark Hyman:
And we don’t even think about it. And as physicians, we basically treat the downstream problems and not the gut. What you’re talking about is going way upstream way back to day one of a baby’s life. I mean I read a study years ago where they gave the mothers a probiotic. And then, the babies, and even the mothers of probiotic help the baby actually have less asthma and eczema and allergies.

Dr. Mark Hyman:
So, let’s talk about what we’re really going to talk about tonight which is this phenomena that I hate it when we invent new diseases. But I think this is a good one. I think we came up with gastrointestinal reflux disease or GERD. It used to be called heartburn. But then, they come back with a bunch of drugs for it, and this happens all the time in medicine. I don’t think this is that story. This is a very interesting story about a condition that has been newly kind of conceived of because we’ve started looking for it. And it’s called newborn gut deficiency. So, what is newborn gut deficiency? How many kids does it affect? And why is it such a big issue?

Dr. Tracy Shafizadeh:
Okay. So, you’re right. Newborn gut deficiency is a relatively new term. It’s more of an umbrella term that describes a collection of symptoms that we can see in many newborns. A recently published study estimates that nine out of 10 babies born in the US today are going to experience newborn gut deficiency.

Dr. Mark Hyman:
90%. 90%.

Dr. Tracy Shafizadeh:
Staggering number. But yes, 90%. And not every single symptom or condition that is experienced under newborn gut deficiency is going to manifest in every single baby. But the idea is the way that we were talking about the gut microbiome even starting from day one as a microbial organ, it provides a function in the body. It provides a function in baby’s gut.

Dr. Tracy Shafizadeh:
And if that organ is not working properly, there’s going to be a deficiency in the function that it provides. So, if baby does not have B. infantis in their gut early in life, probably most critically in the first 100 days, but I would say in the first six months of life when baby is predominantly consuming a single food source, let’s hope it’s human breast milk that B. infantis and that function that the gut microbiome is providing is so critical that if babies are missing this key element and key function, that’s what we start to call the newborn gut deficiency constellation or collection. These symptoms include things like 10 watery stools per day, fussiness, gassiness, crying, sleeplessness, colic which I think we used to think of colic as just being a rite of passage.

Dr. Tracy Shafizadeh:
You just got unlucky and got a colicky baby. But what we now are starting to see is colic is actually just a manifestation of dysbiosis or newborn gut deficiency in the first month or so of life. The pathogenic bacteria are flourishing, and they’re causing inflammation of the intestine which is uncomfortable at worst. And actually, I should say that opposite. The most benign thing about inflammation in the gut is discomfort. The worst thing about inflammation in a baby’s gut is as you pointed out the first 100 days of life are when the immune system is developing, being programmed and deciding whether baby is living in a hostile environment, and they should be on full alert and allergic to everything coming at them or if they’re in a protective calm environment where they can actually eat food and not be allergic to it, or whether they can actually enjoy being outside and not reacting and having all sorts of auto-inflammatory and autoimmune diseases later in life.

Dr. Tracy Shafizadeh:
So, newborn gut deficiency widespread, the literature now is showing that it’s widespread across the US and probably other industrialized countries that experience the same levels of C-section, antibiotic use, formula feeding. What’s really interesting is the work that we’ve done with the Gates Foundation looking at populations in developing countries where they don’t have the same levels of C-section antibiotics and formula. Those babies are full of B. infantis the first six months of life. And they do not have the same skyrocketing rates of the autoimmune and auto-inflammatory disorders later in life.

Dr. Mark Hyman:
So, lack of medical care is a good thing.

Dr. Tracy Shafizadeh:
Yean. Well, [crosstalk 00:29:04].

Dr. Mark Hyman:
Because the doctor is [crosstalk 00:29:05].

Dr. Tracy Shafizadeh:
Right. Because C-section saves lives and antibiotics saves lives but we have to understand the unintended consequences of those infant.

Dr. Mark Hyman:
And that’s not even mentioning the fact that the I think 37 or 8 million pounds of antibiotics used every year that 29 million are used in animals for prevention of diseases because of overcrowding and factory farms. And that has adverse consequences on antibiotic resistance. It gets in our food. It’s a whole problem. So, you mentioned a little bit about how do you know if your kid has it, colic, fussiness, loose stools, maybe eczema, diaper rash, what else?

Dr. Tracy Shafizadeh:
No. You’ve really hit the nail on the head in terms of the visible obvious kind of acute symptoms that moms and dads will be able to see very quickly. In fact, we have a baby gut check quiz on the Evivo website that moms and pediatricians can use to kind of just estimate without doing any testing of the stool to see what the composition of the baby gut microbiome is.

Dr. Tracy Shafizadeh:
And those are things like were you or your baby born by C-section. If either of those questions the answer is yes, B. infantis is not going to just naturally pop up in baby’s gut if it wasn’t transferred from mom during labor and delivery. So, number two, does your baby have five to 10 watery stools per day? If so, they’re not utilizing those HMOs. Chances are and, of course, you’d have to look in the stool, but chances are, they’ve got tons of HMOs being excreted into their diaper. And so, it pulls water out along with it, and you’ve got loose watery stools.

Dr. Tracy Shafizadeh:
In studies where we fed B. infantis back to babies in the form of Evivo, these are breast-fed babies fed Evivo, they, within days, started having two to three wet, soft, well-formed stools per day. You wanted to talk about poop. We can talk about poop. Soft, wet, well-formed stools per day, and that happened within one or two days because as soon as B. infantis takes up residency and starts using those HMOs, you stop the dumping of HMOs into the diaper. And, therefore, the loose watery stools.

Dr. Tracy Shafizadeh:
The third question is does your baby have diaper rash? And with a long passion for biochemistry, this might be another one my favorite parts of the story. But if we talked a little bit about the pH, we talked about the fact that B. infantis consumes HMOs, creates a more acidic pH in the baby’s gut protects against pathogens, but one other benefit is that when you reduce the pH to closer to 5.0, it also is going to be reflected in the fecal pH is going to be around 5.0 and B. infantis is there and happy and proliferating, it deactivates the fecal enzymes that are in the stool that break down the skin barrier when the stool is exposed to the diaper area.

Dr. Tracy Shafizadeh:
So, if you deactivate those degradative enzymes in the stool by adjusting the pH to the natural range, diaper rash goes away. And when we polled over 1600 consumers or moms and dads out there that are using Evivo and asked them, “Did you notice a change in diaper rash,” a vast majority said, “Within a week, the diaper rash was gone.”

Dr. Mark Hyman:
That’s incredible.

Dr. Tracy Shafizadeh:
It’s incredible. It’s a biochemistry story that’s as clear as day. And I love that it’s so obvious and so acute. Now, diaper rash isn’t the worst thing in the world. So, we’re not out to solve all the diaper rash in the world. We’re out to solve what are the longer term consequences.

Dr. Mark Hyman:
Yeah. That’s it.

Dr. Tracy Shafizadeh:
[crosstalk 00:32:58] formation and the pathogenic bacteria that are inappropriately programming the baby’s immune system in the first 100 days of life.

Dr. Mark Hyman:
Essentially, if you don’t have this as a mother in your system and you don’t pass it on to your baby, the baby doesn’t have it, the baby doesn’t get the ability even to use the oligosaccharides, ends up with all these problems, it creates a pretty bad situation long term for the baby. So, instead, what’s growing there are we call them potentially pathogenic bacteria. It’s not like getting E. coli or salmonella or shigella. It’s nothing horrible. But it’s this imbalance in things like klebsiella and pseudomonas and enterococcus, all these weird bugs that can be potentially infectious that are irritating, and they’re critical to get rid of or to change the environment in there because it will program the body for life.

Dr. Mark Hyman:
So, talk about how important is to have this early in life and what the consequences of not having it are when these other bugs tend to overgrow and lead to all these secondary problems down the road, not just colic and diaper rash and fussiness and little diarrhea as a baby. Who cares? Okay. The baby’s miserable. You’re miserable for the first year. It’ll get better. That’s not the real problem. The real problem is what I started out this webinar with which is talking about this pandemic of inflammatory adult diseases that start in childhood, in infancy. So, can you talk a little bit about that? And what happens with all these bed bugs. And what do they do?

Dr. Tracy Shafizadeh:
Yes. So, one thing that is paramount to us here at the Evivo team is that we insist that science leads the way for what we do here. And where we go and what we publish and what we bring forth for people to be able to use and the products that we make. I would say that the vast majority of the probiotic industry kind of glosses over the rigorous clinical science that needs to take place in order to really be able to say we understand what’s happening in the gut microbiome. Here’s a probiotic product that’s going to actually address that problem, and here are the clinical outcomes that you can expect.

Dr. Tracy Shafizadeh:
That is the rigor that is required, I think, is lost in the majority of probiotic products that are out on the market today. Our group, our team which is as I mentioned a spinout from UC Davis and the Foods for Health Institute, we set out to say let’s let science drive the direction that we’re going to go, and let’s look systematically at what do babies look like if we don’t do anything. And we just look at a population of babies born today in the Davis California area, breast fed babies. What does it look like if we actually give B. infantis back to them, feed them Evivo every day? And what does that do not only to the amount of B. infantis in the baby’s intestine, but to the abundance of the other pathogenic bacteria that were there in the absence of B. infantis?

Dr. Tracy Shafizadeh:
So, that is what over the last five years close to 20 different clinical publications that we’ve been able to publish in peer review journals have shown that when a baby is missing B. infantis in their intestine whether that’s because of antibiotics or C-section, whatever reason, there is instead almost full composition of what you mentioned as potentially pathogenic bacteria.

Dr. Tracy Shafizadeh:
And to your point, I want to make sure that we’re clear. That doesn’t mean overt infection that means kind of a quiet but abundant composition of the infant gut microbiome that you can’t really see from the outside of pathogenic bacteria setting up shop in the baby’s gut microbiome including staph, strep, klebsiella, clostridia as you were mentioning. And they are causing inflammation in the infant gut.

Dr. Tracy Shafizadeh:
What we don’t want to do is jump on the bandwagon, the microbiome probiotic bandwagon and over-interpret or hype, overhype any data that we have so far and say, “Just spend a lot of money on probiotics, and you’ll be fine.” We will not do that as a team and as a company.

Dr. Tracy Shafizadeh:
So, what we’ve done is we’ve gone through and said, “Not only can you restore B. infantis back to the infant gut through feeding Evivo to babies, we were able to answer that definitively in one of our early publications where we showed a complete restoration of B. infantis to babies who were fed Evivo.” But then, we looked at the composition of the infant gut. And can we reduce those pathogenic bacteria? Yes, we can up to 80% reduction of those pathogenic bacteria.

Dr. Tracy Shafizadeh:
Then, if you do that, can we see a reduction in the inflammation markers of inflammation? Can we see a reduction in antibiotic resistant genes? Can we see a reduction in many other of the markers that show that a baby is either on a path toward autoimmune and autoinflammatory diseases or not? And that’s really what we are still on this journey, I would say, collectively, not just the Evivo team, but the field of microbiome science. You have to be able to follow those kids out and do the clinical studies to be able to definitively show that you get prevention or treatment of any of those diseases that you mentioned. We’re not there yet.

Dr. Tracy Shafizadeh:
But we have many very large clinical studies ongoing right now because there is enough early data. There’s enough early basic science that shows we believe that this is exactly what’s happening. We’re reducing the inflammation. We’re reducing those pathogenic bacteria by feeding Evivo. And now, we’re going to systematically go through and say what conditions can we prevent in those babies going forward?

Dr. Mark Hyman:
Well, we do know from the field in the science in general that if you lack this bacteria, you’re more likely to have allergies, type-1 diabetes, obesity. We know that you literally can transplant the poop out of a thin mouse into a fat mouse. And the fat mouse will lose weight independent of its calorie intake.

Dr. Tracy Shafizadeh:
That’s right.

Dr. Mark Hyman:
That should shock you. I wrote about that in a book I wrote a number of years ago, I think the Blood Sugar Solution. We’ve known this for a long time. This is not a new news. And yet, it just has not reached medical practice. And to me, it seems like the better part of our judgment should be to give every baby this probiotic at birth because if 90% are deficient, and yes, we can test everybody, but tit’s benign, it’s safe, there’s really no downside except the cost. And it seems like something that would pay for itself in spades in terms of the reduction in all these secondary conditions later on such as obesity-related conditions, allergies, autoimmunity, and so forth.

Dr. Mark Hyman:
It just seems like a no-brainer to me. I don’t know why we’re not talking about it. Hopefully, you guys can get the research and we can get this reimbursed by insurance. And we can actually drive the changes that need to happen because, as a doctor, the pandemic of diseases in kids, it’s just scary to me with obesity issues, the allergies, the asthma, autoimmunity, the ADD, the autism.

Dr. Mark Hyman:
I mean these are diseases of inflammation that often start in the gut. So, how do they actually work because when we think about probiotics as an adult probiotic doctor, I treat a lot of kids too, but we really understand that these probiotics don’t take up residence, that they don’t colonize, that they’re sort of like tourists. They travel through. They change the economy down there. They have an influence on what’s happening.

Dr. Mark Hyman:
But if you take some probiotic [inaudible 00:40:57] which is a good one, it doesn’t necessarily stay. So, you have to keep taking it. Tell us about how unique this particular probiotic is in its ability to colonize the infant gut which is really remarkable to me.

Dr. Tracy Shafizadeh:
It is remarkable. And I think, to your point, the majority of the research and the focus and the effort and the dollars on microbiome research has been focused on adults to date. Babies are so unique. And if you think about the life span or the life cycle, there’s only a very, very small period of time where we have a single food source because as soon as you turn four to six months, people are giving little bites of everything on the adult’s plate to the baby, and that’s great. That’s important. That’s part of this weaning process.

Dr. Tracy Shafizadeh:
And for the rest of your life, you have a varied diet with tons of different plant fibers, tons of different fiber coming from all different sources. But in that first, I’d say let’s call it four months, when you have a single food source, you have a single fiber source as well. So, as we mentioned, human breast milk, the human milk oligosaccharides, let’s think of those as the fiber in breast milk. And they are very specific to B. infantis.

Dr. Tracy Shafizadeh:
So, B. infantis is the only bacteria that’s been found to be able to digest all of the HMOs in babies… I’m sorry, in breast milk. So, I agree with you that the studies that have been published on adults and probiotics have shown that it’s very transient, that they are tourists. They may show some benefit while you’re taking them. But as soon as you stop taking them, your body kind of reverts back to its steady state where it likes to be which probably isn’t the best state of the microbiome.

Dr. Tracy Shafizadeh:
What we found in our studies is that babies who were fed B. infantis, along with Evivo, along with breast milk for 21 days, in that first month of life, if as long as they continued to consume breast milk, B. infantis remained high in their gut microbiome until almost a year.

Dr. Mark Hyman:
[crosstalk 00:43:13] for three weeks. And then, it lasts the whole year.

Dr. Tracy Shafizadeh:
It’s never been shown before in any other population to be able to feed a probiotic for a short amount of time and then be able to track it and see that it’s steady, and it colonizes. It stays steady. And we believe that’s because B. infantis as long as it’s getting the food source that it needs which is human milk, then, it’s going to continue to populate and proliferate and colonize the infant gut.

Dr. Tracy Shafizadeh:
So, what we also saw in that same study is when babies switched over to formula or cow’s milk, you could see the levels of B. infantis slowly diminishing which is exactly what we want to happen. When babies start eating plant fibers for other bacteria to come in and say, “I can do that really well. I can digest plant fibers. That’s my jam.” And so, we let them take over. But in the beginning when HMOs are present in high abundance, B. infantis must be there to be able to digest them for babies.

Dr. Mark Hyman:
Amazing. And does it work if you have formula and, for some reason, you can’t breastfeed to take it as well? And you have to supplement with HMOs?

Dr. Tracy Shafizadeh:
Okay. So, I know we started this conversation saying that there’s very stark differences between human milk and formula. And formula is part of the reason we believe that there’s been a disruption in the infant gut. But I also said with passion that you have to feed your baby. And if breast milk is not available, you have to be able to feed your baby. And so, for those babies that are consuming formula, they have to have B. infantis in their intestine as well or else we’ve lost half the population in terms of being able to bring them the benefit of B. infantis.

Dr. Tracy Shafizadeh:
So, what we did is we looked at babies who were consuming formula and the ability of B. infantis to digest formula. And it is able to utilize some of the nutrients and formula not exactly the same mechanism as it does in breast milk. But it is able to digest some of the components of a formula. I would say to any mom or dad out there who has a formula-fed baby, some B. infantis colonization in your baby’s gut is better than none.

Dr. Tracy Shafizadeh:
So, even though you’re not going to see the same benefits that we’ve published with breast-fed babies, it is important to get some levels of B. infantis and increase the amount of bifidobacterium in your baby’s gut even if you can’t reach the same abundance as if your baby was consuming breast milk. So, I would say yes to both formula and breast-fed babies.

Dr. Mark Hyman:
And is there a way to get HMOs as a supplement to give along with the probiotic?

Dr. Tracy Shafizadeh:
Maybe.

Dr. Mark Hyman:
Because as an adult, we do give prebiotic fibers, right? So, we do give that to supplement with probiotics.

Dr. Tracy Shafizadeh:
I’m going to say maybe only because even if I could give you a source for where to get them, we haven’t looked at the ability of those exogenous HMOs to recreate what we can see when baby is consuming breast milk.

Dr. Mark Hyman:
One of the things that came up for me as well was the idea that women should take it while they’re pregnant. And there’s one study that looked at it. It was Lactobacillus GG. It was a different probiotic. But it helped. So, do you see there’s a role for taking B. infantis as a mother?

Dr. Tracy Shafizadeh:
So, I’m going to answer this question not as a researcher. I’m going to answer this question as just Tracy talking to Mark. If I were pregnant, I would want to have to ensure that B. infantis was in my gut microbiome so that when I delivered my baby, it had the best chance of getting B. infantis from me.

Dr. Tracy Shafizadeh:
However we have not conducted those studies. And if you’re treated for a group B. strep with antibiotics, then, it doesn’t matter what you took during pregnancy because those antibiotics wipe it out. And if baby is born by C-section, it doesn’t matter what you have in your gut microbiome. Baby doesn’t get it from you. So, that’s the only reason why we are very focused on getting it into baby with the idea that in a future state, we would love to be able to supplement moms or feed moms Evivo and see benefits for moms as well.

Dr. Mark Hyman:
I mean I think I know the answer to this. But someone asked does it come through breast milk if the mother takes while they’re breastfeeding will go through the breast milk.

Dr. Tracy Shafizadeh:
If I could have one statement that everyone on this webinar remembers, it is breast milk provides the food for the bacteria. It doesn’t provide the bacteria. So, breast milk is going to feed B. infantis. But B. infantis is not in the breast milk. So, that is one very common misconception that can make this whole story not make sense. We are huge advocates of breastfeeding because it’s the food for baby and B. infantis. But it’s not going to provide B. infantis to your baby.

Dr. Mark Hyman:
Yeah. Someone posted a study also that sort of challenged some of these ideas which I think it doesn’t actually because it’s a different bacteria. But basically, there was a double-blind randomized placebo-controlled trial looking at Lactobacillus reuteri for infant colic and found no benefit. It was published in the British Medical Journal or BJM a number of years ago.

Dr. Mark Hyman:
My opinion about that is that it depends on the bug and why the strain is so important. So, maybe, you can just address that quickly. And then, talk about why the particular strain of probiotic is so important because there’s so many baby probiotics out there? This isn’t like that. This is different. So, can you explain that difference and why it’s not… I mean this study for example didn’t work? And why B. infantis might work?

Dr. Tracy Shafizadeh:
Yeah. I think the person who brought up that question is very astute. There are more studies published showing no benefit of probiotics than there are even close to published studies showing benefit. And I really do think that when we do ourselves a disservice by using the term probiotic because probiotic or probiotics is such a generic term. That’s like saying is food good for you or is medicine good for you? Well, I guess-

Dr. Mark Hyman:
I would say food is good for you if it’s food. But not the stuff we’re eating. It’s not food.

Dr. Tracy Shafizadeh:
But think of how [crosstalk 00:49:38] that is it’d be like well fried chicken and a coke is probably not. But if you switched it up and ate whole grains, and things that were actually food, the answer is yes. So, very different answers depending on what food you’re talking about. Probiotics, same thing. We are really doing ourselves in servicing are probiotics good or bad because depending on the bacteria and not just the bacteria, but the bacteria and the strain of the bacteria given to a certain population at a certain time in life and giving that bacteria the food it needs.

Dr. Tracy Shafizadeh:
So, it is way more complicated than I think we ever appreciated. So, I do know the paper that your audience members posted. And I do think that this gets back to basics which is we have to understand the right bacteria, the right strain of bacteria, the right time in life and what you’re trying to accomplish for that person that you’re giving the bacteria to the probiotic to and making sure the bacteria gets the food it needs.

Dr. Tracy Shafizadeh:
So, with B. infantis, I think we’ve done a good job hammering home to this audience that B. infantis is critical to the infant. I think, hopefully, they’ve taken that from this discussion. Now, the real test is, so, you go out, and you go to the store, and you want to purchase a probiotic for your baby that has B. infantis in it. Well, there’s going to be many options, and you have to know what strain of B. infantis you’re choosing. t’s too much. It really is too much. I feel for-

Dr. Mark Hyman:
So, it’s like saying a Ford works. But what kind of Ford is it? Is it Explorer? Is it an Expedition? Is it whatever?

Dr. Tracy Shafizadeh:
Exactly. So, that’s a really good analogy, the making [crosstalk 00:51:28].

Dr. Mark Hyman:
The Fords.

Dr. Tracy Shafizadeh:
I would say another analogy that helps me kind of understand the species and the strain is when you think about your family wants to adopt a dog, and you say, “Sure, you can have a dog.” And one of the kids is like, “I want a Great Dane.” And one of the kids is like, “I want a Chihuahua.” And you’re thinking, “Well, they’re both dogs. They’re very different dogs. They serve very different purposes.” So, you said yes to a dog. But did you say yes to the Great Dane or did you say yes to the Chihuahua? Those are the differences in strain. You go, and you want to choose a probiotic with B. infantis. you have to know what strain it is so that you are choosing a strain of B. infantis that’s been clinically documented to be effective in infants and to be able to provide the benefits that the publications we’ve talked about today. You can line up all the strains of B. infantis in a lab, and they all work very differently.

Dr. Tracy Shafizadeh:
Some are great at metabolizing HMOs. Some are terrible. Some grow in a baby’s gut. Some don’t do it anything at all, and they just get pooped out. So, we’re very adamant about the strain of B. infantis that has been clinically tested that we use in Evivo that we can stand behind and say we know it colonizes the infant gut. WE know it provides these benefits. And we just want both clinicians and consumers to really understand that strain. Strain does matter.

Dr. Mark Hyman:
Yeah, very important. Another few questions that have come up was, one, how long should the baby take? You mentioned 21 days. But should it be 21 days? Should it be the first year? Is it helpful to take beyond that? And, two, what if you have a baby and they’re five months old or 10 months old or 15 months old? Should they take it?

Dr. Tracy Shafizadeh:
Yup. These are really important questions. And I would say the strongest data that we have published that I can definitively say we know that we see benefits in babies was when babies were given Evivo for 21 days. I would say at the bare minimum 21 days or let’s call it one month, one month of feeding Evivo to your baby as early as possible as soon as they start consuming milk, that is baseline in my opinion.

Dr. Tracy Shafizadeh:
But what we also know is it’s now become clear immunologists are really able to see that the first 100 days of life. So, three months is this rapid growth and development of the immune system. And if we can keep pathogenic bacteria and inflammation low during that first 100 days, we believe that this really does have a huge impact on the development of the immune system, and whether or not a baby is going to have levels of inflammation that have been correlated with the disorders you and I have been talking about today.

Dr. Tracy Shafizadeh:
So, then, my answer would be three months. But as long as baby is consuming breast milk, then I think that B. infantis is appropriate to be giving, Evivo is appropriate to be giving to your baby especially if think about if mom gets mastitis, and she goes on an antibiotic. Baby is exposed to that antibiotic through breast milk. I would want to either continue Evivo through that course of treatment or start again.

Dr. Tracy Shafizadeh:
So, in general, I would say the first six months is a good guideline. But if I can get every baby to have Evivo for the first month of life, then, we would be setting a whole generation of babies up for a healthy life [crosstalk 00:54:53].

Dr. Mark Hyman:
Monumental consequences really when you think about how many babies are born here, probably 600,000 babies. And I think in America and globally, it’s a lot more obviously, and this is a real game changer when it comes to changing the future health of our population. So, what if a baby as year old is not on formula or breast milk anymore but has eczema or has issues? Would you still use it?

Dr. Tracy Shafizadeh:
So, the clinicians that we work very closely with our collaborators and our clinical partners, they have provided so much anecdotal evidence in their practice that older babies and toddlers that are given Evivo do see benefits in terms of eczema, in terms of diaper rash, in terms of number of stools per day, and the consistency of those stools per day. But I would say I have to stick to the literature that we have published which has really only been in the tiny babies.

Dr. Tracy Shafizadeh:
But anecdotally, we are hearing from moms every day on the Evivo website through the reviews that they send and clinicians that we work with that babies well beyond the six month point are seeing benefits from Evivo.

Dr. Mark Hyman:
What about young kids or even adults? If my patients have allergies or asthma autoimmunity, would it be something to think about?

Dr. Tracy Shafizadeh:
Yes. I think so. Now, most of us are not consuming high amounts of breast milk as adults. Some of us might be. But most of us aren’t. But I think that B. infantis can do a fairly good job of consuming other types of fuel or food or fibers that there is some benefit that I think adults could see.

Dr. Tracy Shafizadeh:
And in fact, if you were to poll the adults that work on the Evivo team and say what benefits they see when they take their Evivo every day, you’d get a lot of really strong anecdotal [crosstalk 00:56:44].

Dr. Mark Hyman:
I’m going to try it. I want to try it. I mean just interesting to me because this whole microbiome is a new frontier. It’s sort of like the Wild West. It’s almost the unexplored territory that we’re just at the beginning of. And I think those who’ve been practicing functional medicine have been paying attention to this for a long time.

Dr. Mark Hyman:
And yet, the depth of the science was not as much as we would have liked. And now, it’s coming up. And it’s pretty exciting to see that the things we saw clinically, the things that we know intuitively, the things that we see in our lab tests that we actually can start to really change the course of illnesses using treatment for the gut. But it would be important to speak to, and it’ll be sort of remiss of me not to speak to this phenomena of the role of diet in your microbiome because we said that it’s very hard for these probiotics we take to colonize in the gut and stay in permanently.

Dr. Mark Hyman:
But it turns out that the diet plays a huge role. And a new study came out from Stanford. I thought you’re probably aware of this study by Sonnenburg and his crew that fermented foods worked better than fiber which you think of as a probiotic, or prebiotic that the fermented foods changed the microbiome dramatically that it down regulated all these inflammatory proteins, and that we know from other diet studies that the best way to change your microbiome other than a fecal transplant is change your diet.

Dr. Mark Hyman:
And I think that’s a real important take-home for people. So, just as the baby’s diet is important for the microbiome of the baby, the human adult diet is important for its microbiome and determines the course of your health outcomes. So, I think we’re just at the beginning of this. I’m pretty excited about what you’re doing.

Dr. Mark Hyman:
One last question is from someone who wondered about this phenomena, I know this is going on in South America and other countries where they’re seeding babies who are born by C-section. So, they’re taking vaginal fluid, and they’re sticking the baby’s mouth as the baby comes out of the abdominal incision. Can you talk about that? Does it work? Is it worth it? Does it make sense?

Dr. Tracy Shafizadeh:
Yes. I can talk about that. We published a paper on this topic recently because I think intuitively for a general audience, this makes a lot of sense. Baby’s supposed to go through the vaginal canal. So, why don’t we make sure they get exposed to what’s in the vaginal canal if they’re born by C-section? That’s great if we’re trying to restore the vaginal microbiome to the baby. But the gut microbiome is not in the vaginal canal. It’s not in the birth canal. The gut microbiome is in the colon.

Dr. Mark Hyman:
So, that’s why the babies come down face first. They come up sunny side down. And it’s true. I’ve delivered 500 babies, and they just come out head first with your face right in that-

Dr. Tracy Shafizadeh:
Right there.

Dr. Mark Hyman:
There you go.

Dr. Tracy Shafizadeh:
Right there. So, I think that it’s a misconception to think that swabbing baby with vaginal fluid is going to affect their gut microbiome in a way that helps restore what the natural colonization of B. infantis. In fact, you know that’s not true. And [crosstalk 00:59:45].

Dr. Mark Hyman:
And should we swabbing rectums and then using that? It sounds a little gross.

Dr. Tracy Shafizadeh:
I’m not quite ready to go there. But I think Evivo is much more palatable.

Dr. Mark Hyman:
Sounds better to me. Sounds better to me. Now, Evivo, does it have lactose or dairy in it?

Dr. Tracy Shafizadeh:
It does. So, it does have lactose as part of the powder. So, the way that Evivo is provided, it’s in small individual sachets. If you kind of think about many of us used to use the emergency packets, and you kind of just shake down the powder, and you pour one little sachet into your drink, same idea, is that it’s a dried powder of B. infantis bacteria, the strain EVC001 which we talked about the importance of strain mixed with a small amount of lactose.

Dr. Tracy Shafizadeh:
And this lactose and B. infantis powder, you take one sachet out of the freezer each day. You keep it in the freezer because it’s a live bacteria, and you want to keep it kind of hibernating until it’s time to use it. And you pour a little bit of breast milk three to five milliliters of breast milk in a small mixing bowl which Evivo provides. But you can use whatever bowl you want. You can use water as well, whatever is easiest for you. But most moms express a small amount of breast milk. Mix the powder and either use a dropper to get that small amount of volume into baby’s mouth or their finger to put into baby’s mouth, or you can even just put it on your nipple and have baby nurse. But it does have lactose. So, probably that was the question you were-

Dr. Mark Hyman:
Yeah, because a lot of kids have dairy allergies. And I see a lot of that going on. So, how do you address that? Is there a way to get it without that or-

Dr. Tracy Shafizadeh:
Yeah. What we would say is that if a baby has a diagnosed dairy allergy, then Evivo would not be the right product for them because it does have lactose from dairy source. However, the number of children that can consume a very small amount of lactose from a dairy source is much greater than the babies who actually cannot tolerate any dairy at all. And the amount of lactose in general is so small compared to the lactose they’re getting from breast milk.

Dr. Tracy Shafizadeh:
I mean it’s a drop in the bucket that it’s a very, very small proportion of what they would be consuming in a day. But I mean for babies that have a dairy allergy, this would not be the right product for them.

Dr. Mark Hyman:
Great. Well, I just want to take a minute to thank you and to summarize a little bit because what we just learned was mind-boggling. First, we learned that we have an epidemic of missing microbes, that 90% of babies are born with newborn gut deficiency because of the overuse of antibiotics because glyphosate, because of our poor diet in mothers, and a whole host of other reasons, and that this lack predisposes them to a whole host of inflammatory conditions later on in life, allergies, eczema autoimmunity, obesity, metabolic issues, diabetes, as well as causing all these infant problems that drive parents crazy, colic and fussiness, and diarrhea and diaper rash, trivial problems. But they’re not trivial when your kid has them.

Dr. Mark Hyman:
I remember my daughters. I think she was a crier. Oh boy. She had the worst colic. I had to literally hold in my arms and rock her for hours and play Bob Marley and try to relax. But it was terrible. So, it had all those effects. But it turns out that by using the research that you’ve done in the Evivo probiotic, that you can colonize the babies when they’re fed breast milk, and that a lot of the breast milk is undigestable humans, indigestible humans and is used for this particular bacteria.

Dr. Mark Hyman:
We still have a lot more to learn. How long should you use it? Can you give it in older kids? Can you give it in adult? Do you need to give it with HMOs? There’s a whole bunch of questions I think we still are figuring out. But you guys have gotten significant funding for research from major organizations. And it’s really inspiring to see that the world is starting to think about this in a big way not just some fringe health food store probiotic, but really mainstream science looking at the microbiome in a new way and understanding that our health depends on the health of our microbiome.

Dr. Mark Hyman:
So, Tracy, I thank you so much for your work. I think Evivo is a great company. You can go to evivo.com and learn more about their work and look at the science, read it. I feel like I want to take it. I’m curious to try it actually. And I really commend you guys for doing the hard science and hard work. A lot of people in the space don’t, and this is really gratifying. So, thank you. Any last thoughts or words you want to leave with our listeners?

Dr. Tracy Shafizadeh:
If we can take anything from nature, biology, human evolution on what direction we should go in terms of what the infant gut microbiome should look like, it’s very clear that mom, baby, human milk and B. infantis are a match made in heaven. And we just want all babies to have that benefit. So, please go to evivo.com to learn more. We have all of our clinical studies there. We have a lot of resources for you, moms and dads, to go talk to your pediatrician about. It should be a conversation between the two of you.

Dr. Mark Hyman:
I mean it seems like maybe you should talk to the American Academy of Pediatrics and have this as part of their training because it’s such a critical area.

Dr. Tracy Shafizadeh:
We talked to the AAP on a regular basis. And we are so thankful that they are really starting to go in the direction of this is not pseudoscience. This is real science. And it’s important for babies.

Dr. Mark Hyman:
Good. Thank you for doing the hard work. It’s not easy. Thank you so much, Tracy.
Speaker 1:
Hi, everyone. I hope you enjoyed this week’s episode. Just a reminder that this podcast is for educational purposes only. This podcast is not a substitute for professional care by a doctor or other qualified medical professional. This podcast is provided on the understanding that it does not constitute medical or other professional advice or services. If you’re looking for help in your journey, seek out a qualified medical practitioner. If you’re looking for a functional medicine practitioner, you can visit ifm.org and search their find a practitioner database. It’s important that you have someone in your corner who’s trained, who’s a licensed healthcare practitioner, and can help you make changes especially when it comes to your health.

If you are looking for personalized medical support, we highly recommend contacting Dr. Hyman’s UltraWellness Center in Lenox, Massachusetts today.

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