“This is important. Birth matters.”

In this last episode of Season 1, Professor Hannah Dahlen explains why modern maternity care may be disrupting some of our most ancient biological systems.

This is a powerful conversation about physiology, women-centred care, and why birth really does matter.

Key Take-Away Messages:

• The microbiome is shaped from the very beginning of life

• Birth mode, skin-to-skin, mode of infant feeding and whether a baby or not is born in hospital all affect microbial transfer

• Modern maternity care including C-section and antibiotics can interfere with these processes

Key Quotes:

• “We are altering microbiomes - and passing them to the next generation.”

• “Where you’ve got trust and respect, fear struggles to exist.”

• “I think it’s so important that we hear about the microbiome. I think it’s so important that we hear about epigenetics.”

• “I think we need to return the understanding to the basic physiology of the human body, and we need to return the respect to the incredibleness of the human body.”

Short Summary:

In this conversation, Hannah Dahlen reflects on her career in midwifery and explains why she believes modern maternity care has become overly medicalised and disconnected from human physiology.

She explores how interventions such as caesarean birth, antibiotics, hospital environments, and reduced breastfeeding may be altering the infant microbiome across generations.

At the heart of the discussion is a call to restore respect for women’s bodies, relationship-based care, and the biological systems that support lifelong health.

What You Can Do:

If you like this episode or find it useful, please share it with a colleague.

Share

Subscribe to The Microbiome Plan podcast for more discussions that question what we think we know about early-life health.

Want More?

Catch the replay of Professor Hannah Dahlen’s full presentation at The Microbiome Plan 2026 Conference. >>> ⁠⁠https://microbiomeplan.com

Part of The Microbiome Plan podcast, exploring how early-life biology and environment shape lifelong health.

Transcript

THE MICROBIOME PLAN – PODCAST

Meet The Speakers: Hannah Dahlen

Hannah Dahlen, Professor of Midwifery, Western Sydney University, in conversation with podcast host, and co-founder of The Microbiome Plan, Toni Harman

00:00:00,100 --> 00:00:35,140 [Toni Harman]

[gentle music] Welcome to this tiny podcast about one of the biggest topics in health today. Many parents write a birth plan, but how many have a microbiome plan? Modern childbirth practices can interfere with the optimal seeding of the infant microbiome, with implications for a child’s long-term health.

But what does that mean, and what can parents actually do? That’s the subject of our conference, and in this micro podcast series, I’ll catch up with some of the conference speakers to find out about their personal passions.

00:00:36,180 --> 00:00:58,000 [Toni Harman]

I’m your host, Toni Harman, and in this episode I’m joined by a very special guest, professor of midwifery Hannah Dahlen. We filmed Hannah 12 years ago for our Microbirth documentary, and it was brilliant to catch up with her about her passion for midwifery and for championing the awesomeness of women. Let’s dive in. Hannah, hello.

00:00:58,000 --> 00:00:59,640 [Hannah Dahlen]

Hello. How are you, Toni?

00:00:59,640 --> 00:01:04,400 [Toni Harman]

I am doing great. So for those who don’t know you, who are you?

00:01:04,400 --> 00:01:21,420 [Hannah Dahlen]

So I’m professor of midwifery at Western Sydney University. I’m the dean... I’m the, um, director also of, of research. So my role is sort of research, teaching, governance, all sorts of areas, and still lots of politics and trying to communicate to the public.

00:01:21,420 --> 00:01:25,340 [Toni Harman]

So what’s your passion? What’s, what’s, what kind of drives you?

00:01:25,340 --> 00:02:28,340 [Hannah Dahlen]

It’s really hard after so many years in, in, in this business. I’ve been a midwife more than 35 years, and I would say that the same passion drives me, which is women and the importance of women in the world, the importance of giving birth and raising our children and being the mothers that shepherd the future into the world. I think it’s undervalued. I think it’s under-recognized, and I think that as a world, we suffer as a result. So it’s about women. It’s about woman-centered care. It’s about cherishing and upholding our women so we see all of the capacity and capability they have rather than what we’re currently doing, which is we’re just constantly handicapping them and, and holding them back and, you know, leaving them traumatized and devastated and entering motherhood bewildered and at, at, you know, less capacity than they should have. And, and it’s a shame on us as a maternity care system.

00:02:28,340 --> 00:02:36,380 [Toni Harman]

So what would be your future of maternity care? What your vision of where it works?

00:02:36,380 --> 00:03:18,880 [Hannah Dahlen]

If I could pick one thing, and that’s a very hard thing to pick, but if I could pick one thing, it would be that every single woman has a relationship-based care model, so they have somebody in their corner going on that journey with them throughout the pregnancy, throughout the labor and birth, and throughout the postnatal period. They have an advocate, and in that relationship-based journey, what happens when you have a relationship with a woman and a woman has a relationship with a midwife, is that trust develops. And trust leads to respect. And where you’ve got trust and respect, it’s very hard for fear to exist. And I think what’s essentially missing from our maternity care systems is we-

00:03:19,980 --> 00:03:36,380 [Hannah Dahlen]

we’ve dismantled the social part, the sociology of having a baby. We’ve made it completely focused on the medicalized, you know, get this baby out of this woman’s body alive. And never before in history,

00:03:37,500 --> 00:04:32,560 [Hannah Dahlen]

never before, have we had the capacity, the knowledge, the capability to go far beyond that and allow the emerging of not only physically well women but psychologically, emotionally, culturally, and spiritually well women, and that’s where we’re failing. We’re doing pretty good on the physical to a point. I think there’s always areas we can improve on, but certainly within our, um, developed nations, within our higher income countries, we have got fewer, uh, babies and mothers dying than ever before in history. But at the same time, we’re seeing more and more women traumatized. We’re seeing more and more women with mental health issues, and we’re seeing more and more children emerging with all sorts of issues that are emanating from our very complex society. We’ve got a long way to go, but we absolutely right now in history have no excuse.

00:04:39,740 --> 00:04:44,500 [Toni Harman]

Wow. Okay. So how does the microbiome fit into that?

00:04:44,500 --> 00:07:08,168 [Hannah Dahlen]

Well, the microbiome is one of the most ancient threads through humanity, and for much of humanity, the microbiome was a very dense and prolific and multiple entity that was handed on by mother to daughter to their daughter, and on and on it went. And really only in the last couple of hundred years have we had a massive impact on that, whether that be environmental, um, the, the, the houses we live in, the smaller numbers of children and family around us, not having animals, the food, the highly processed, uh, food that we eat, um, the way that we give birth. Uh, you know, increasingly, like, you know, I’ve heard that the UK now is up to something un- unbelievable, like 43%. I left the UK when the cesarean section rate was 13%, and we were horrified, and now we’re up to 43%. And in my country we’ve just passed 40%. You know, almost 50% of women, if not more-have antibiotics at some point either in their pregnancy or during their labor. Uh, we have enormous amounts of stress and anxiety that are impacting also on our microbiome. We’re all far too clean afterwards. Uh, and breastfeeding is a constant struggle in giving that baby that really important start to life. We’re also birthing in highly, um, you know, hospitals, hospitals that have microbes that were never meant to be part of our human microbiome. And we now know from research, you know, babies born at home have a different microbiome than babies born in hospital. And babies born in hospital are incorporating the hospital microbiome within theirs. So we’re essentially just in a very short time in history have utterly altered so many of those important components that, that feed into that construction of that microbiome. And then there’s the ripples that come from that. There’s, you know, there’s mental health issues, there’s developmental issues, there’s illness, there’s immune disorders. Uh, and then we p- then we’re passing those damaged microbiomes on into the next generation. And, and on and on we go.

00:07:08,168 --> 00:07:19,088 [Toni Harman]

Okay. So what about epigenetics? So I’m gonna speak to, uh, a few years ago you were talking about epigenetics and your epic hypothesis. What’s the latest with, with, with that?

00:07:20,388 --> 00:09:49,488 [Hannah Dahlen]

Yeah, so you know, clearly I’m not an epigeneticist. I’ve always been very open about that. I’m not a microbiologist, I’m a midwife. And so what we did when we formed the epic hypothesis and the epic group was to try and get a voice out there to get other smart people doing the research. And it was at a real opportune time when people were starting to have that conversation. Um, and we really realized as we did more, we published a few more papers that it is really complex. I think epigenetics is part of the story. I think absolutely there’s a, there’s so much we still don’t know about epigenetics. I think genetics is an important part of the story. The other part is of course the microbiome. That’s incredibly important. The extended hygiene hypothesis, which isn’t just about the, the gut microbiome in your environment, but it’s about the birth, it’s about the breastfeeding, it’s about the skin to skin, it’s about the stress, it’s about all those other things. And then it’s about our food and our environments and the way we live and the contaminants in the environment. So I think my thinking has moved a lot away from we’re gonna find one answer to there are many factors here that we have to consider. And now extremely wonderful research has been done by people who are showing, uh, important aspects of this. But I also think we’re at the beginning, even though ironically Kendal published what, in 1915, the hypothesis that he, he showed that very shortly hours within birth the microbes were, even though he did all these cesareans and sterile, um, environments on rats and mice and rabbits and that, he showed the microbes appeared very, very quickly after birth. And his hypothesis was then around birth. There’s been this huge voice for, void for about 100 years and we’re now getting back to exploring that story with the technology, with the science, with the multiple professionals looking at it. So my job really was, and, and Sue Down and, and Holly Powell Kennedy and all of us that got together and put that hypothesis together was to shout out there and say, “This is important. Birth matters”. And um, really now my work is much more around, okay, well what happens in that subsequent birth and, and what happens to the children later on, and what happens to the mothers and how could this potentially tie back to the fact that we’re altering microbiomes and having an epigenetic impact.

00:09:50,568 --> 00:10:02,208 [Toni Harman]

So what can we do? So, uh, we’ve got this conference, we’ve made films, we’ve got courses. What can we do? What can we do to, to bring about change?

00:10:02,208 --> 00:11:36,028 [Hannah Dahlen]

Well, first of all, now you’re on the right side of history. I think that’s fun to know that, you know, you are on the right side of history. There’s a whole bunch of history that looks very powerful at the moment, but it’s in the death rows. So we’ve gotta keep on going. Um, as a conference I think it’s so important that we hear about the microbiome. I think it’s so important that we hear about epigenetics. I think we need to return the understanding to the basic physiology of the human body, and we need to return the respect to the incredibleness of the human body. And you know, the reason we are the dominant species on the planet is because we’ve got it right. We have got the goods to, to allow that to happen. But we’ve squandered it, we’ve disrespected it, we’ve taken advantage of it and of our planet in many ways. And now it’s time for us to use all of that brilliance to bring it back together. So I think educating all health professionals about microbiome, about epigenetics, helping women and their partners understand the importance of it, making sure that our childbirth education classes and support is about getting women to understand how incredible their bodies are and how, what are the strategies we can do to preserve and protect physiology as much as is possible. And where we have intervention and we will always need intervention, what can we do to return to balance something that we may have disturbed?

00:11:37,088 --> 00:12:11,468 [Hannah Dahlen]

So I think that’s sort of all the critical messages. Like for example, a cesarean section, you know, and I’ve had both cesareans and, and normal vaginal births, but you know, why is not every single baby and after a cesarean section going directly skin to skin with that mother and that being seen as absolute priority and then being given extra support when it comes to breastfeeding and support. That’s how we try to undo the things we sometimes have to do in order to save lives. But we currently, I think very much throw the baby out with the bath water, as the old saying says.

00:12:13,828 --> 00:12:18,908 [Toni Harman]

So you’ve, you’ve given us some take home messages. Is there anything else you want to say?

00:12:18,908 --> 00:12:40,948 [Hannah Dahlen]

I think women are incredible. I think women are unbelievable. They’re profound. They are ... without them we have no future and we have no society. And I’ll go the rest of my days fighting for the voice of women and fighting for the rights of women and fighting for a better experience so we see the true manifestation of the power of women.

00:12:42,358 --> 00:12:46,608 [Toni Harman]

Thank you so much. That was truly amazing.

00:12:46,608 --> 00:12:49,248 [Hannah Dahlen]

Thank you Toni. It was lovely to talk.

00:12:49,248 --> 00:12:52,168 [Toni Harman]

Oh, oh, oh I just, I wanna give you a hug.

00:12:56,048 --> 00:13:22,688 [Toni Harman]

I absolutely loved everything Hannah said. For me, I really connected with her desire to educate all health professionals and parents about the microbiome. And I’ll be standing right beside her shouting from the rooftops so that more women understand just how incredible their bodies are, and so that we do have more strategies to preserve and protect physiological birth when possible.

00:13:25,228 --> 00:13:32,888 [Toni Harman]

Join me again to meet another speaker to hear their passions as together we create The Microbiome Plan. Thanks for listening.

“There is a huge gap between institutional delivery and initiation of breastfeeding within one hour.”

In this episode, pediatrician Dr Rajinder Gulati explores the growing gap between modern maternity systems and the critical biological processes newborns depend on in early life.

We discuss how hospital routines and protocols, staffing pressures, unnecessary separation, lack of lactation training, and cultural beliefs may unintentionally disrupt initiation of breastfeeding within the first hour.

Take-Away Messages:

Breastfeeding is not simply about nutrition.

It is part of a wider biological system involving:

• Microbiome transfer

• Immune protection

• Temperature regulation

• Bonding and co-regulation

• Early physiological adaptation

Short Summary:

Dr Gulati reflects on more than four decades of clinical experience supporting mothers and babies, and why better systems, education, and continuity of care are urgently needed.

This is an important conversation for anyone working in:

• Maternity care

• Neonatology

• Lactation support

• Early-life health

• Hospital policy

If you work in maternity, neonatal care, or early-life health, this episode may challenge your assumptions.

Part of The Microbiome Plan podcast, exploring how early-life biology and environment shape lifelong health.

What You Can Do Today?

If you like this episode or find it useful, please share it with a colleague.

Share

Please subscribe to The Microbiome Plan podcast for more discussions that question what we think we know about early-life health.

Want More?

Catch the replay of Dr Rajinder Gulati’s presentation at The Microbiome Plan 2026 Conference >>> ⁠https://microbiomeplan.com

Episode Transcript

THE MICROBIOME PLAN – PODCAST

Meet The Speakers: Rajinder Gulati

Rajinder Gulati, Pediatrician and National Trainer for Infant and Young Child Feeding (IYCF), in conversation with podcast host, and co-founder of The Microbiome Plan, Toni Harman

00:00:00,100 --> 00:00:35,140 [Toni Harman]

[gentle music] Welcome to this tiny podcast about one of the biggest topics in health today. Many parents write a birth plan, but how many have a microbiome plan? Modern childbirth practices can interfere with the optimal seeding of the infant microbiome, with implications for a child’s long-term health. But what does that mean? And what can parents actually do?

That’s the subject of our conference, and in this micro podcast series, I’ll catch up with some of the conference speakers to find out about their personal passions.

00:00:36,380 --> 00:01:01,140 [Toni Harman]

I’m your host, Toni Harman, and in this episode, I’m joined by Dr. Rajinder Gulati, a pediatrician with over 40 years of clinical experience and a passionate advocate for breastfeeding.

From hospital practices to cultural beliefs, this conversation uncovers what might be getting in the way of breastfeeding, and what needs to change. Let’s dive in.

00:01:02,860 --> 00:01:06,000 [Toni Harman]

So Rajinder, who are you? [laughs]

00:01:06,000 --> 00:01:48,220 [Rajinder Gulati]

[laughs] That is the basic question which I have been answering for many, many years. I am a pediatrician, basically, and I started my practice way back 40 years back. And then I came into lactation maybe 20 years back, and, it really impressed me and I was so passionate about it that whenever I used to sit in my OPD and examine the patients, what actually happened there was the things which used to influence me. For example, a mother coming to me, usually with an infected child or with a problem the child is having, is just because she is not giving her feed.

00:01:49,290 --> 00:02:16,120 [Rajinder Gulati]

This, this is most of the times. Even today also, if I see 50 or 60 patients per day in a community hospital most of them, if under the six months of age, most of the females, they are not giving their own milk, those who are attending OPD. This really hurts me, and then I came to the conclusion, “No, this needs to be promoted.” And that’s where it started.

00:02:16,120 --> 00:02:18,120 [Toni Harman]

So what’s your passion?

00:02:18,120 --> 00:04:39,260 [Rajinder Gulati]

So this all that, because now I am comparatively I’m easing out my practice and more so I am promoting this lactation part. And what I say is that if you go by the norms of the WHO, as you already know that initiating within one hour and exclusively breastfeeding, and then continuing for two hours with complementary feeding after six months. If you do that, I don’t think so your child is going to lag behind physically or mentally. And you need to promote these things. It is not only for the newborn or the infant or the toddler, it is for the mothers as well, it is for the community, it is for the family. So people do not know these things. They really need to be assured, they need to be told. There are no antenatal classes as such, and which, depending on where you are stationed globally. For example, in my part of the country, we need to train not only the pregnant mother or communicate with the pregnant mother, we also need to tell the family members, the mother-in-law, the sister-in-law. Everybody in the family should know what actually is required to be done once the child is born. And then only, I think so, change will occur. But definitely as the new generation is coming up more educated, more learned, they’re listening to what we are saying. Changes are taking place. We started with about exclusive breastfeeding only about 10 or 20%, now we are coming to the 50% kind of a thing here in India. So things are improving day by day. But definitely as far as that initiation of breastfeeding is concerned, it’s really, I’m sorry to say, despite the births taking place in the hospital, still all of them are not put to breastfeed within one hour. And not all, almost 50% are not put to breastfeed. So there is a huge gap between institutional delivery and initiation of breastfeeding within one hour. So these things have to be looked after, and the reasons are many. Again, I have said the family members, the, mm, training part, the hospital practices, the institutions, and even the monetary part. These are all things matter, so this need to be looked after.

00:04:43,400 --> 00:05:02,780 [Toni Harman]

I’m just quite shocked that the, you were saying about the 50% mark. So what’s the biggest block, do you think? Is it the institutional protocols or is it the mothers don’t necessarily desire to breastfeed?

00:05:02,780 --> 00:05:10,190 [Rajinder Gulati]

Very rightly said. If you analyze it, you can basically break up into certain things. One is the family part.

00:05:11,290 --> 00:05:35,500 [Rajinder Gulati]

The family plays a very, very important role because for them, traditions and customs, they come first, then breast milk. So we need to educate them for all those things. And in some of the communities, even it is thought that colostrum is not good, there’s not enough milk during the first few days. So that is the reason they start giving something else.

00:05:36,620 --> 00:07:04,135 [Rajinder Gulati]

Then secondly sometimes we see that we do not have our trained staff. That is the training part. First is the family part, the second is the human resources part. The system is such that most of the staff nurses or the people working in the hospitals, they are not trained to handle the newborn for early initiation of breastfeeding, more so after cesarean section. Maybe after vaginal they might do it. And secondly, we do not have lactation consultants in most of the hospitals around the clock. So that is also another reason.

The third reason, the first was the family part, the second was the human resources, the third is the hospital and the institutions. Their protocol. Sometimes their protocol is when the child is delivered, take him under the warmer, dry him, and then shift to the NICU or the nursery for a day or so till he starts taking feed, digests it, and then give it to the mother.

So these protocols have to be broken down, the doctors and the institutions. And even sometimes what happens is in the government hospital, if you see, I’ve seen deliveries 25 or even 30, 35 per day occurring, and staff nurses doing the deliveries, and there are very few doctors, and they don’t have time to look after the feeding part.

00:07:05,316 --> 00:07:12,556 [Rajinder Gulati]

So again, this is a institution problems. So we have problems at every phase which we need to take care of.

00:07:12,556 --> 00:07:14,416 [Toni Harman]

So why does this matter?

00:07:15,556 --> 00:08:08,716 [Rajinder Gulati]

A very, very, very important question, then coming off to the theme of that microbiome and bonding and uh, temperature regulation in the newborn and all these things, because one very important aspect is we can tell everybody that, see, the temperature will be maintained if you do skin-to-skin contact early. The child will get feed, the hypoglycemia will be taken care of, hmm, and bonding will be there, and microbe transfer would be there. All these things. But definitely these things have to be told prior to the delivery and in the antenatal period, not once, but maybe two or three times. Even the Academy of Breastfeeding Medicine says so that it is so important, and they have changed their these norms also that antenatal education on breastfeeding should be made mandatory for all the pregnant ladies.

00:08:09,816 --> 00:10:00,116 [Rajinder Gulati]

So only this, only then this can happen. This is not only, this only, not only stops here. Even we have seen that if we initiate breastfeeding, it’s just a statistics part between you and me. People might not understand it, but definitely we, we need to tell them that if you initiate breastfeeding within one day, maybe 24 hours, the mortality is 16%. But if you do it within one hour, it is going to... Uh, sorry, I am, I’m mistaken. The mortality is 22%. But if you do it within one hour, the mortality is reduced to about 1.7%. It’s so less, and if you take it to about three days, the mortality is going to increase to six times the initial one-hour mortality. So the earlier we start breastfeeding, the better it is because we are preventing mortality. And preterms are more more prone to infections, as all of us know, and this prevents infection. It is a small little part of microbiome and all bioactive substances. It also takes care of the intestine because it contains many growth factors. So these growth factors take care of the intestines, and they stabilize the mucus membrane so that no microorganisms enter the blood. So there are many other things. I, I, I, I can talk at length about this, but uh, we have paucity of time anyway. But definitely there are all advantages, not even a single disadvantage I see in giving breast milk to the newborn.

00:10:00,116 --> 00:10:04,616 [Toni Harman]

What are you gonna be talking about at Microbiome Plan 2026?

00:10:07,476 --> 00:11:27,656 [Rajinder Gulati]

In 2026 Microbiome Plan, my is that we have to think over and above the nutrition part for the human milk. It is not only the nutrition. It is not to be given as a nutrient. It has to be, it has to be something that it is more of a bioactive and a living fluid. Is that a dynamic living? Why I’m saying dynamic, because all mothers for that specific child produces specific type of a, a milk. If it is a preterm, the milk is different. If it is term, the milk is different. If it is first few days, the milk is different. If later on, it’s different. And even during same feeding, initially the milk is different, and later on the milk is different. So it is basically a dynamic I can say, a kind of a living fluid which not only gives immunoglobulins, but even it gives the living cells of the mother. And now we have come to the conclusion that some of the stem cells also pass on, which basically take care of the tissues in the newborn wherever healing is required. So it basically it gives a holistic kind of a thing, taking care of the newborn.

00:11:27,656 --> 00:11:36,196 [Toni Harman]

What are your take home messages? What, what do you want health professionals to do or to say? How would you change their, their behavior?

00:11:41,756 --> 00:11:51,096 [Rajinder Gulati]

My take home message, if I tell you the concluding part, any mother having a problem with breastfeeding should consult a lactation consultant.

00:11:56,096 --> 00:12:20,856 [Rajinder Gulati]

She should not on her own think, “My milk is not enough. My milk is bad. My milk is sore. I cannot breastfeed. I have problem with my breast. My child does not, my newborn does not like my milk.” All these things are irrelevant. Everything is okay. When she comes to meet with a lactation consultant, only then she will realize what fault she was doing.

00:12:23,536 --> 00:12:55,456 [Rajinder Gulati]

Otherwise, all ladies, basically, if they don’t meet a lactation consultant in problem, during problem, they are going to give artificial or you can say formula milk, which is not actually required, and thereby harming the newborn’s health. So my take home message is for any problem regarding your lactation, you should definitely consult a lactation specialist. Only then take appropriate action. Do not do on your own. You are going to do more harm than good.

00:12:55,456 --> 00:13:05,276 [Toni Harman]

Brilliant. Thank you so much for the amazing kind of a mini [laughs] a, a mini version of your talk, and I look forward to seeing you at the conference.

00:13:06,756 --> 00:13:26,256 [Toni Harman]

If this episode highlights anything, it’s this: the problem isn’t a lack of evidence, it’s a gap between knowledge and practice. As Dr. Galate makes clear, early breastfeeding isn’t just about nutrition, it’s about microbiome transfer, immune protection, and even for survival.

00:13:27,656 --> 00:13:39,316 [Toni Harman]

If you found this valuable, share it with a colleague and subscribe to the Microbiome Plan Podcast for more conversations shaping the future of early health. Thanks for listening.

Why birth was never meant to happen lying down….

In this episode of The Microbiome Plan Podcast, midwife and educator Molly O’Brien reveals the “missing piece” in preparing for birth: to move your body!

Drawing on nearly three decades of clinical experience, Molly challenges restrictive birth practices, explains how movement changes pelvic dimensions, and highlights simple ways parents can better support their bodies during pregnancy and birth.

Take-Away Messages:

• Movement during labour can help optimise pelvic dimensions and support physiological birth

• Restrictive birth environments may interfere with instinctive movement during labour

• Physiological birth supports the transfer of beneficial maternal microbes to the baby

• Simple activities like walking, yoga, dancing, and using a birth ball may help prepare the body for labour

• The pelvis is dynamic and mobile, not a rigid structure

• Birth preparation should support confidence, mobility, and trust in the body, not fear and restriction

• Small changes in maternity care environments could have a significant impact on birth outcomes and early microbiome development

Short Summary:

In this episode of The Microbiome Plan Podcast, midwife and educator Molly O’Brien explores why movement during pregnancy and labour may be one of the most overlooked factors in supporting physiological birth and optimal microbiome seeding.

She explains how modern maternity environments can unintentionally restrict physiological birth, while simple, low-cost interventions, like encouraging movement and upright positions, may improve labour progression and support the infant microbiome.

This episode reframes birth as a dynamic, instinctive process that deserves better understanding and support.

What Can You Do Today?

If you like this episode or find it useful, please share it with a colleague.

Share

Subscribe to The Microbiome Plan podcast for more expert discussions reshaping how we think about health.

Want To See More?

Catch the replay Molly O’Brien’s presentation at The Microbiome Plan 2026 Conference. >>> ⁠⁠⁠https://microbiomeplan.com⁠⁠⁠

Part of The Microbiome Plan podcast, exploring how early-life biology and environment shape lifelong health.

Episode Transcript

THE MICROBIOME PLAN – PODCAST

Meet The Speakers: Molly O’Brien

Molly O’Brien, Midwife & Educator, Biomechanics For Birth, in conversation with podcast host, and co-founder of The Microbiome Plan, Toni Harman

Molly O’Brien, midwife and educator, in conversation with podcast host, and co-founder of The Microbiome Plan, Toni Harman

00:00:00,120 --> 00:01:11,650 [Toni Harman]

[gentle music] Welcome to this tiny podcast about one of the biggest topics in health today.

Many parents write a birth plan, but how many have a Microbiome Plan?

Modern childbirth practices can interfere with the optimal seeding of the infant microbiome, with implications for a child’s long-term health.

But what does that mean? And what can parents actually do?

That’s the subject of our conference, and in this micro-series, I’ll catch up with some of the conference speakers to find out about their personal passions.

I’m your host, Toni Harman and in this episode, I’m joined by Molly O’Brien, a midwife with over 28 years experience in practice.

After a difficult birth herself, Molly devised a low-cost, but effective solution to help women labour more effectively, improving their chances of having a physiological birth.

This transfers the mother’s beneficial vaginal and gut bacteria to the baby, initiating the development of a healthy infant gut microbiome.

Let’s dive in.

00:01:02,600 --> 00:01:15,240 [Toni Harman]

With me today is an amazing, a fantastic person. In fact, I want to clone her and spread her wisdom around the world. This is Molly O’Brien. Hello, Molly!

00:01:15,240 --> 00:01:19,900 [Molly O’Brien]

Hi, Toni. Hi, lovely of you to say that. [laughing]

00:00:19,900 --> 00:00:21,910 [Toni Harman]

So who are you?

00:01:21,910 --> 00:02:30,460 [Molly O’Brien]

Well, I’m a midwife. I’m a midwife who had a difficult birth, my first baby, and I wanted to know, why does that happen? Why do we have d- difficult births? And it seems like um, does- that question’s not asked very often. Um, but we are trying to solve it by not actually understanding why it happens, and so that’s where I’ve been for a long time in the last... Oh, gosh, a well, since I’ve been a midwife. So I trained in 1996. Uh, had been a nurse before that, but I trained as a midwife in 1996, and I came in with that question in my mind. And I’ve been researching it and observing women giving birth and wondering why, and, and still getting information about it because it’s just building up now. It’s hard to find. Uh, but now getting a better understanding, and I want to tell everybody about that. So it’s about labour dystocia, difficult births, what causes it, and how the baby comes through this beautiful structure, the pelvis. So that’s, that’s what I teach about.

00:02:30,460 --> 00:02:37,280 [Toni Harman]

So give me an, an example of what you teach, how you teach it.

00:02:37,280 --> 00:05:19,978 [Molly O’Brien]

Well I’m, I’m teaching... What I learned was that when you move, [laughing] it changes pelvic dimensions. Um, you can open up a little bit more space in your pelvis. It’s kind of obvious, really, but there we are in the maternity field, where we have most women lying on their backs or semi-recumbent and or, or even in lithotomy, which is the legs up. And, and that does not help necessarily, unless women particularly choose that because they feel it’s right for them. But most of the time, no, it doesn’t. So I want to debunk a lot of things, but I also want to help everybody understand better how the body works. And I mean, there’s lots of things I could, We are talking quite big stuff, actually, Toni. You know, we’re talking about shifting mindsets. Um, but, but, but this one now, when we’re talking about the pelvis, for example, we often consider it almost like it’s a rigid structure, and it isn’t. It’s an articulated piece of architecture in our bodies that babies pass through, and it’s not just bony, but we’ll look at this right now. I’ve got the pelvis here. This is the sacrum. Here it goes. It moves. And even at the front, it opens up a wee bit more here ‘cause that is- has got, flexibility there, a wee bit. So we can make changes of these of pelvic dimensions just through movement, and I think this is really crucial that we understand that better. How does that move? And, and within that pelvis, there’s also fascia. Again, this is new stuff to us.

We didn’t know about fascia a, a few decades ago, or, or at least it wasn’t commonly known, and we’re getting to understand that better. We’ve got ligaments, um uh, we’ve got muscles and fibres, and a pelvic floor that we don’t fully understand. I know I’m jumping around here, but a pelvic floor, do you know what really gets my goat a wee bit, is saying it’s a hammock. Come on, a hammock? That’s what it’s described as, and it’s not a hammock. It’s a dynamic feature within our, um our, our pelvis, and it moves, so we need to start looking at that as well. So, that’s what I talk about. I talk about how this works, and it’s mobile. It’s separate bones.

00:05:19,980 --> 00:07:01,840 [Molly O’Brien]

You know, we get this idea it’s rigid. It’s not. It moves, and if we move, it moves as well. So yeah, I just love this. I am a bit of an an- anatomy nerd, and [laughing] I think it’s wonderful, and it’s it’s our bodies, you know? We should be celebrating it. Um, I, I mean, I, I could go on a wee bit more. [laughing] I could talk about, um the fact that we consider this shape of pelvis here, which is called a gynecoid shape pelvis, it’s a specific kind of shape here. Um, how the baby traverses this pelvis and the ada- adaptations it makes through this pelvis is related to its shape, but not everybody has that shape of pelvis.

And this has come from a study or studies from almost 100 years ago, that were not correct, actually. And we need to keep- get up to date with that and actually understand that we have different shapes, and that means it’s reflected in the mechanism, how the baby travels through, and that’s reflected in the patterns of labour that we see. And we have normalised this, only this shape as being the best one, and that is is not good. It’s not good to do that. So we need to widen our sphere of understanding, and I actually... Do you know what? I don’t, I don’t need to know what shape of pelvis you’ve got necessarily. What I do need to know is, are you having difficulty?

00:07:04,087 --> 00:07:10,087 [Toni Harman]

So what can health professionals do to support any shape of pelvis?

00:07:10,087 --> 00:10:45,728 [Molly O’Brien]

Yeah. They need to make sure, because again, let’s, let’s, let’s just think about this. This is the mechanical element of birth, that we have it’s been in the domain of the, of obstetrics. So it’s pathologized, and that’s a challenge in itself. So, so what we’ve now got in our birth rooms is being ignorant of how this moves and how wonderful it is, and we are restricting women in the birth room, so they’re not moving. Women don’t move in the birth room, not unless they’re in a midwife-led unit that is specifically set up to support physiology, and that’s where I was going with this. We’ve got the mechanical element, but it does not sit alone. We are not mechanical bodies. It is a part of our... the system the process, but we have got everything else, and it’s all connected. We’ve got the, the, the hormones, the mind, and the emotions, and the physical and the mechanical element, too.

So what midwives do, and it’s our, our, our profession is grounded in this, of physiology. How do we support and optimize physiology is very much part of our remit. So when you have a midwife-led unit, it’s the birth environment set up to provide that support, and that means there’ll be a birth ball there. It means the bed will not feature in a central way. We, we do like a bed, ‘cause we need a wee lie down from time to time [chuckles] and comfort, but it’s not a central feature.

Whereas in where most women are giving birth, in hospitals, it’s the bed is the central feature, and technology, and machines, and you’re probably attached to a machine, and you are restricted, and you can’t move, which means this can’t move. So we’re causing problems. So I want everyone to understand it is your right to have movement in the birth room. It’s a human right to be able to move, and in birth, I think. [chuckles] Um, and, and, and, and, and that’s the plan A, [chuckles] is to make sure everybody understands how important that is. It’s not just a wee thing, it’s a big thing. Move. Help yourself. Listen to your own body.

You know, Toni, I do say I say this is our... The top of what we need to do is to, to, to provide an environment and then where women can move instinctively. And I say that so easily. It rolls off the tongue so easily, but yet so hard to achieve for the p- for the reasons I’ve just spoken about, the restrictions in the birth room, but also how women feel about themselves, about their own ability to give birth, and that’s been influenced by media, by a cultural belief that we can’t do that. It’s too hard. It’s too risky. Um, and, and actually, it’s not, but we need that education to remind ourselves we can do that.

00:10:48,348 --> 00:11:02,328 [Molly O’Brien]

So it’s, you know, there’s a lot of a lot of different factors. It’s kind of simple, but it’s not straightforward [chuckles] because of those elements.

00:11:02,328 --> 00:11:10,887 [Toni Harman]

How would you encourage a laboring person to move? What can they do?

00:11:10,887 --> 00:12:58,308 [Molly O’Brien]

I would encourage them to, um... [exhales] I would, I, I would start in pregnancy and, and, and let them know that move- moving feels good. Dancing. Dance and move around. Get to know your body a little bit more. I think we’re kind of disconnected, you know, from our bodies, aren’t we, Toni? We- we’re on the screens, and, and this is something we all know. You know, our, our our society has changed. We’re all on phones and screens. We have a sedentary lifestyle. But get up and move. Move your pelvis. Feel what that feels like. Sit on the ball. Move. Um, do yoga. And, and once you start moving and understanding and feeling your body, you are more likely to do that in the birth room. And a birth ball is a very, very simple tool to use. Sit on that and move your pelvis. I’m going to say right here now, and somebody- anybody who wants can, can, can, can say, can correct me, but I don’t really see an awful lot of point of bouncing up and down.

[chuckles] I don’t see any point in that at all, except for it maybe being a bit in... You know, if you like it, and it feels good. But really, if you want to be moving this beautiful structure here and keeping it mobile, so it doesn’t get stuck, because it can do, ‘cause of, of various reasons. I haven’t got time to go into that, but it can get a little sticky, and we want that to keep on moving and being able to open up for your baby to come through. Sitting on a birthing ball and moving in certain ways can enable that to happen more easily. So that’s what I’m going to be talking about, actually, in the workshop at the conference.

00:12:58,308 --> 00:13:04,608 [Toni Harman]

So what are the take-home messages you would suggest?

00:13:04,608 --> 00:14:57,568 [Molly O’Brien]

The take-home message is, straight off, um uh, is-... do things in pregnancy that are gonna keep you be mobile. Move a little bit, and it doesn’t mean you have to go to the gym or anything like that. It just means walk, get up. If you’re a- if you sit in the... If you’re an office worker, get up every half hour or 45 minutes or so, and just move around a little bit. Be aware of your posture. How are you sitting? Are you slumping? Are you tucking your tail in?

You know, ‘cause we do a bit of that, too, don’t we? So, p- be aware of your posture. Sit up a little bit on your sit bones, your bum bones, which are down here, and you can put your hands under that and feel where they are. Sit up on them, and, and, and, and be aware of how you’re holding yourself. I would, if you could, do some yoga, some stretching.

We actually have evidence that that will help you in labor, that it actually reduces the perception of pain. It reduces the length of labor. We have got a lot of good evidence that supports these activities. Um, in the NHS, actually, in the UK, we’ve actually got a poster that has been created by the chief medical officer, and it’s all evidence-based. Walk, dance, do some yoga, swim. Do the things that you enjoy, you know? It doesn’t have to be hard. You don’t have to... Don’t make a meal of it. Just, just move around. Get up and have a wee dance. Get your favorite music on, and to me, that is really important. I feel that we will- because that can shift things in your own head about moving.

00:15:57,568 --> 00:15:31,928 [Molly O’Brien]

Do you know women actually reduce their activity totally when they’re pregnant? They actually reduce it. Now, I don’t know whether that’s because they’re uncomfortable or whether they’re a wee bit afraid, and they’re not quite sure about what to do. Um, but if you move more, you will become a little bit more comfortable. So get out there and go for a walk. Every day have a little walk. Get up and dance. Every day have a dance. It’s that simple, and that’s what I would say: Move. That’s my take-home message.

00:15:32,188 --> 00:15:46,047 [Toni Harman]

I completely agree with you, ‘cause there’s so much evidence about movement and the microbiome and how it’s all connected. And it’s all really important. How can someone find out more about you?

00:15:46,048 --> 00:16:51,488 [Molly O’Brien]

Well, I have a website which I have slightly neglected, ‘cause I’ve been teaching so much, [laughing] but there’s still quite good information there, and it’s www.optimalbirth.co.uk. So I’m teaching a lot of healthcare professionals. I teach doulas, obstetricians, midwives, um birth preparation instructors, ‘cause women need to know about this information, and their partners. Um, and I’m, at the minute, tr- trying to transfer everything onto a more, an easier platform. I do sit in front of the screen. I sit h- I sit too much, [laughing] um, but, um I’m trying to avoid, um uh, move away a little bit from that and do self-directed learning and modules, and so people, everybody can understand the, what goes on in childbirth and celebrate it rather than pathologizing it and seeing it all as very risky.

00:16:51,488 --> 00:16:55,146 [Toni Harman]

Thank you so much for sharing your wisdom. You are amazing.

00:16:55,148 --> 00:16:59,068 [Molly O’Brien]

Thank you so much. [laughing]

00:16:59,068 [Toni Harman]

I love Molly’s take-away message, to encourage everyone to be a bit more mobile, but particularly in pregnancy. Whether that’s going for a walk, a swim, doing some yoga, bouncing on a birth ball, or having a dance.

As Molly says, once you start moving your body in pregnancy, you are more likely to do that in the birth room.

If you found this valuable, share it with a colleague and subscribe to The Microbiome Plan for more conversations to help shape the best possible future health.

Thanks for listening.

About This Podcast

In this episode, Professor Debby Bogaert suggests that clinicians are trained to prevent infections by doing more. However, when it comes to the early-life microbiome, doing more may sometimes mean inadvertantly doing harm.

Key Take-Aways:

• Antibiotics can be life-saving, but they may also disrupt a critical window of immune development.

• Probiotics are promising, but we still lack precision on what works, for whom.

• And simple practices like washing a baby immediately after birth may be interfering with a biological process we’re only just beginning to understand.

Short Summary:

In this episode of The Microbiome Plan Podcast, Debby Bogaert, Professor of Paediatric Infectious Diseases, University of Edinburgh, explains how early-life exposures shape the developing microbiome, and why this critical window may have implications for a child’s long-term health.

From the widespread use of antibiotics to the limits of current probiotic evidence, Professor Bogaert highlights the delicate balance between necessary medical intervention and unintended disruption.

The conversation offers some simple no-cost suggestions to help the microbial transfer of beneficial microbes from mothter to baby, like delaying the washing of newborns, and supporting immediate skin-to-skin contact.

What Can You Do Today?

If you like this episode or find it useful, please share it with a colleague.

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Want To See More?

Catch the replay Professor Debby Bogaert’s presentation at The Microbiome Plan 2026 Conference. >>> ⁠https://microbiomeplan.com⁠

Part of The Microbiome Plan podcast, exploring how early-life biology and environment shape lifelong health.

Subscribe to follow the full series on how the microbiome is shaped from birth.

Episode Transcript

THE MICROBIOME PLAN – PODCAST

Meet The Speakers: DEBBY BOGAERT

Debby Bogaert, Professor of Paediatric Infectious Diseases, University of Edinburgh, in conversation with podcast host, and co-founder of The Microbiome Plan, Toni Harman

00:00:00,100 --> 00:01:03,340 [Toni Harman]

[gentle music] Welcome to this tiny podcast about one of the biggest topics in health today. Many parents write a birth plan, but how many have a microbiome plan? Modern childbirth practices can interfere with the optimal seeding of the infant microbiome, with implications for a child’s long-term health. But what does that mean, and what can parents actually do?

That’s the subject of our conference, and in this micro podcast series, I’ll catch up with some of the conference speakers to find out about their personal passions.

I’m your host, Toni Harman, and with me today is Debbie Bogaert, professor of pediatric infectious diseases at the University of Edinburgh, and a leading expert in pediatric microbiome research.

From the limits of current probiotic evidence to the long-term consequences of disrupting microbial development, this conversation highlights what we know and what we urgently still need to understand.

Let’s dive in.

00:01:04,379 --> 00:01:07,000 [Toni Harman]

Hello, Debby.

00:01:07,000 --> 00:01:11,900 [Debby Bogaert]

Hi, Toni. It’s so nice to see you on screen, so nice to have a chat.

00:01:13,020 --> 00:01:16,580 [Toni Harman]

Thank you so much for joining me. So who are you?

00:01:16,580 --> 00:01:31,230 [Debby Bogaert]

My name is Debby Bogaert. I’m a pediatrician and a scientist working at the University of Edinburgh in Scotland, and my expertise is in respiratory infections in early life, and we try to see how we can prevent those.

00:01:31,230 --> 00:01:33,880 [Toni Harman]

So what’s your research focus?

00:01:33,880 --> 00:02:03,140 [Debby Bogaert]

Well, my research focus is on the microbiome, which may not be a surprise to you. What we try to understand is how the early life microbiome in the infant is helping to support a good immune response to infections and how actually that early microbiome might help to prevent infections. Because if we can learn from that, we can help future children preventing severe infections.

00:02:03,140 --> 00:02:05,140 [Toni Harman]

So why do you care about this?

00:02:05,140 --> 00:02:52,020 [Debby Bogaert]

Well, I care about it because I think that care came from early in my career onward. I remember that as a intern, I went to Zimbabwe to help out in pediatrics because that was my big dream, to become a pediatrician. So I got the responsibility of a pediatric ward, and I was astonished to see how many children were suffering from very, very severe infections, how little we could do about that. And at that time, I was a student that thought that medical science was so advanced, and at the same time, I realized immediately we have very little here, and I think that was the fire in me that decided this was going to be my, my future career.

00:02:52,020 --> 00:02:58,200 [Toni Harman]

So what particularly? Just the, the desire to help people, or what did you want?

00:02:58,200 --> 00:03:43,820 [Debby Bogaert]

No. I thought we in modern medicine, we focus so much on novel technologies and novel treatments in trying to help people have a better quality of life and, and, and extended lives. But then I saw these young children that from a very simple infection honestly, many of them succumbed, and I thought, we can do better. We so we, I don’t only want to become a pediatrician, I want to become an infectious diseases doctor, and I want to do science in this field because I think we need more people that focus on the simple things in life. That sounds so unfair probably, but the simple things in life that still have a major, major footprint on disease and, and mortality as well in the world.

00:03:43,820 --> 00:03:46,160 [Toni Harman]

When you say simple things, like what?

00:03:46,160 --> 00:04:34,950 [Debby Bogaert]

Well, I think we, we generally tend I, I call it, quote, quote, “simple” because people generally tend to raise their shoulders, isn’t it, if you talk about, “Oh, my child had a respiratory infection,” or, “My child...” Even if, “My child was in hospital with a respiratory infection,” people say, “Oh yeah, mine had that as well,” or, “Yes, I had the flu as well.” People talk about it as if it’s part of normal life, which is true. It is part of normal life. But on the other hand, we have still a substantial amount of especially young children that can get very severe infections. And fortunately in the Western world, mortality is not so high, but still the impact on the baby, on the families, but also the implications for long-term health, I think they’re very much underrated.

00:04:34,950 --> 00:04:37,640 [Toni Harman]

So what changes would you like to make?

00:04:37,640 --> 00:05:01,360 [Debby Bogaert]

Well, the changes I would like to make is try to really better from an ecological perspective. That’s why we study the microbiome. Try to understand what nature has designed for us to help prevent severe infections, and use that knowledge to improve or increase prevention of infections and, of course, also once you have an infection, try to treat it better.

00:05:01,360 --> 00:05:05,040 [Toni Harman]

What could be improved within, say, maternity care?

00:05:05,040 --> 00:06:00,090 [Debby Bogaert]

Well, what we have learned over recent years is that that early life microbiome, and I really, really talk about the microbiome in the first days and weeks of life, seem to be really critical to teach your own immune system what is right and wrong. And we see that that signal, those early life microbes seem to play a very big and important role, not only in the guts, but especially also in the respiratory tract. There’s also microbes there. People think always it’s about the gut, but there’s more to this than the gut, that also in the respiratory tract, your own natural flora, your own microbes really help you fight off viral infections. For example, RSV, we have learned a lot from RSV research and really show that who’s there in your nose at the time as a baby you got a viral infection, that they help you to fight off that infection.

00:06:00,090 --> 00:06:09,040 [Toni Harman]

You’re a pediatrician, though many pediatricians use quite a lot of antibiotics. How do you feel about that?

00:06:09,864 --> 00:08:14,484 [Debby Bogaert]

Well, I understand why it’s been done. It’s part of guidelines and protocols, and especially in early life. We were all raised and trained that early life is a very vulnerable period in life. We know that infections for a long time and still if you look on a global level, are an important cause of morbidity and mortality. So that we all raised to say you have to be aware of infections, and you have to act fast, and if, if you’re in any doubt, give antibiotics.

So we’re all trained. I was trained like that as well. But now, at that time, we did not consider the microbiome to be part of our body and to be an organ system that helps to fight off infections, that orchestrates our immune system and our metabolism and all these things we’ve learned now, which we only learned over the last, well, what do we talk about, 15, 20 years.
And so that was not part of the curriculum when we were trained. So I understand that that’s still part of the way people think, and people want to do no harm to start with, and they want to prevent any infection if at all there is a chance the baby has an infection. So I get that.

But what we’ve, in the meanwhile, learned is that antibiotics, especially around birth and in early life, are really harmful to that initial developing microbiome, and that that has long-lasting effects, and even more important, that that phase where we potentially do harm to this microbiome has an imprint into how our immune system responds to everything in the outside world. So I do think that antibiotic treatment should still be there as a safeguarding me- um, method to protect moms and babies in case there are infections.

But simultaneously, we need to be aware that there can be a cost of them and that we need to start weighing that in into our decision-making. We need to make that part of our conversation, and we need to make that part of even our guideline development. That’s my strong belief.

00:08:14,484 --> 00:08:16,244 [Toni Harman]

What about probiotics?

00:08:16,244 --> 00:09:14,544 [Debby Bogaert]

Well, that’s a very interesting thing because it seems to be almost the other side of the antibiotics, isn’t it? Antibiotics seem to eliminate and kill certain species, and probiotics seem to try to give them back into the ecosystem. And what we’ve learned over recent years is that actually several different healthy microbes, especially in the gut, we have potentially good probiotic products for.

So I am a strong believer that those probiotics might actually help, especially if you talk about children that for one or other reason were born by cesarean section, um received antibiotics in early life, or where mom has received already antibiotics affecting her microbiome and then the microbes she hands over to her baby. So for those groups of children that we know are more vulnerable for microbiome harm, if you may call it like that, I do think probiotics could be a good tool.

00:09:14,544 --> 00:09:17,844 [Toni Harman]

Are there caveats to that? Should every baby get a probiotic?

00:09:17,844 --> 00:11:27,123 [Debby Bogaert]

No, I don’t think so. I think a child born with a mom that had very little health issues in her pregnancy, that was born by natural delivery that did not need any antibiotics, that did not show signs of infection, I th- I still really as a pediatrician believe in the hands-off principle and allow nature to take its course because over the years, I became more and more intrigued by what nature has designed, and it’s brilliant. It’s beautiful.

But that said, there where we need interventions, there we, where we need that very likely, we induce harm to the microbiome, I do think there is a place for probiotics. But that said slightly frustrated by the fact that also as a doctor, I think we need proper evidence, medical evidence showing what probiotic, what strain in what probiotic may be suitable for what child, and that research needs to be done.

We can do that. It’s the basic science that we tend to do, clinical science. But it’s very difficult to get funders in Europe and the US to commit to funding those type of trials. There where we think we have very basically cheap products to make a huge difference in a vulnerable group of children that still have a whole life ahead of them, so might have a proper benefit of those probiotics, I think it’s the, worth the investment.

But it has been difficult to get those things funded unfortunately. And I do think we need that proper scientific evidence using randomized control trials, for example, before, as a pediatrician, I can recommend a specific product or a specific strain for a specific indication.

And that sounds maybe a little bit, yeah, very medical, but I think that’s the principles we try to, to practice on, isn’t it? It has also to do with do no harm as a start. Uh, you don’t want to give something to a baby where you’re not 100% sure it will be the proper bacteria for that child.

00:11:27,124 --> 00:11:30,304 [Toni Harman]

What are you going to be presenting on at our conference?

00:11:30,304 --> 00:12:21,904 [Debby Bogaert]

So that’s nice. What I really want to show to the audience is the intricate way that nature has designed to make sure that microbes go from mother to babies. It’s not only the gut-gut or the vagina-gut, but we will show that the microbiome of the mom, including breast milk and skin and the respiratory microbes, arrive in and on their babies and then from there on actually find their own feet and start to create their own specific microbe that seems to be suitable for that child.

And that, that process I want to highlight so people understand that it’s, it’s not only intricate and cool, but also that from that perspective, you might start to look different at our routine practices, for example.

00:12:21,904 --> 00:12:23,624 [Toni Harman]

Why do you care about that?

00:12:23,624 --> 00:13:52,976 [Debby Bogaert]

Well, because I think a lot of routine practices might have trickled in, as I said, really to do good, to try to prevent infections, for example.

And think about a washing of the baby immediately after birth. If you start to understand that by the different routes all these microbes have just arrived on that baby, and that’s a vulnerable ecosystem that still needs to find their feet, you might actually think, “Well, maybe I should leave the baby and their microbes now for a while, and, and, and allow them to start colonizing the baby and developing the baby biome,” instead of thinking, “Oh, I need to be clean and sterile, and, you know, the baby need to be washed. Otherwise, there might be a risk of infection.” That might be for certain babies but, but certainly not for the majority of them.

And also the skin-skin contact, you start to maybe understand immediately, like, oh yeah, it’s really important to get that bare baby on the bare breast of mom or dad if mom is not available. Uh, all these simple practices that you maybe just start to rethink, and from that perspective may, yeah, be empowered to say very simple things we can actually optimize and improve or stimulate and explain to parents. So yeah, that’s why I really want to talk about this aspect of our research at this meeting.

00:13:52,976 --> 00:13:54,936 [Toni Harman]

What are your take home messages?

00:13:54,936 --> 00:15:05,636 [Debby Bogaert]

Well, my take home messages the first I think is that this, this intricate seeding happening from mother to child, I think that’s the first thing I really want to show as a take home message. Also, that that’s not a one time off. It’s not only happening at birth, but also in that period to follow.

So I think that’s helpful for people to also sort of realize and understand. And I think the second thing is maybe to start thinking about our routine practices, not only the things we do, but also the things we don’t do to see how that can already improve this process of mother to child seeding of microbes.

You know, focused on protection of moms and children, including of infections, but also at the same time leaving that very important natural population process of the baby biome, um development as much as possible intact, I think. And also, what we said the take home message is, is think microbiome before starting antibiotics.

00:15:05,636 --> 00:15:12,576 [Toni Harman]

Okay, most important question. Will you join us on this mission to change the health of the next generation?

00:15:12,576 --> 00:15:22,396 [Debby Bogaert]

Well, it seems I have convinced you, Toni. So yes, of course, I would love to join you on this mission. I would very happy to, to be present. Absolutely.

00:15:22,396 --> 00:15:25,036 [Toni Harman]

Thank you so much for joining me. That was brilliant.

00:15:26,096 --> 00:15:27,756 [Debby Bogaert]

Thank you, Toni. Looking forward.

00:15:29,336 --> 00:15:38,136 [Toni Harman]

My biggest takeaway from this discussion is that scientists don’t yet have all the answers to how early life microbiome shapes long-term health.

00:15:39,296 --> 00:15:45,916 [Toni Harman]

But from the little we know so far, what happens in early life could matter more than we ever realized.

00:15:47,336 --> 00:16:00,236 [Toni Harman]

If you found this valuable, share it with a colleague and subscribe to the Microbiome Plan Podcast for more expert conversations shaping the future of health. Thanks for listening.

About This Podcast

What does it really take to breastfeed more than one baby - and why does it matter for the infant microbiome?

In this episode, I’m joined by lactation consultant and author Kathryn Stagg, a mum of four and a leading advocate for better breastfeeding support for families of twins and triplets.

Drawing on both personal experience and decades of professional work, Kathryn shares why breastfeeding multiples is absolutely possible - and why so many families are still told it isn’t.

Key Take-Aways

In this episode, we cover:

• Why breastfeeding twins and triplets is possible (and often misunderstood)

• The impact of early birth on feeding and microbiome development

• How to establish and protect milk supply, especially with preterm babies

• The importance of antenatal conversations and mindset

• What real, empathetic breastfeeding support looks like

Quick Summary:

We explore the unique challenges faced by parents of twins and triplets, from premature birth and milk production to the logistics of feeding more than one baby at a time. Kathryn also highlights the critical role of antenatal education, empathetic support, and evidence-based guidance in helping families meet, and even exceed, their feeding goals.

This conversation is a powerful reminder that true support means meeting parents where they are, and that better breastfeeding support could have lasting impacts on infant health and the microbiome.

Part of The Microbiome Plan podcast, exploring how early-life biology shapes lifelong health.

What you can do today?

If you work in maternity, neonatal care, or early-life health, this episode may challenge your assumptions.

🎧 Listen now - and then ask yourself:
If the evidence points one way, why are our systems still doing another?

If you agree, or strongly disagree, please share this with a colleague. This is a conversation worth having.

Share

Subscribe to The Microbiome Plan for more discussions about the microbiome in pregnancy birth, breastfeeding, and early-life health.

Want To See More?

You can watch the replay of Kathryn Stagg’s presentation at The Microbiome Plan Conference at https://microbiomeplan.com

Subscribe to follow the full series on how the microbiome is shaped from birth.

Episode Transcript

THE MICROBIOME PLAN – PODCAST

Meet The Speakers: Kathryn Stagg

Kathryn Stagg, IBCLC, in conversation with podcast host, and co-founder of The Microbiome Plan, Toni Harman

00:00:00,100 --> 00:00:35,120 [Toni Harman]

[gentle music] Welcome to this tiny podcast about one of the biggest topics in health today. Many parents write a birth plan, but how many have a microbiome plan? Modern childbirth practices can interfere with the optimal seeding of the infant microbiome, with implications for a child’s long-term health. But what does that mean? And what can parents actually do? That’s the subject of our conference, and in this micro podcast series, I’ll catch up with some of the conference speakers to find out about their personal passions.

00:00:36,180 --> 00:01:02,420 [Toni Harman]

I’m your host, Toni Harman, and my very special guest today is Kathryn Stagg, a mum of four boys, a lactation consultant, and author of the book Breastfeeding Twins and Triplets: A Guide for Professionals and Parents. I’m a twin myself, so for me personally, I was fascinated by what Kathryn had to say on breastfeeding multiples. So let’s dive in. Hello, Kathryn.

00:01:02,420 --> 00:01:03,400 [Kathryn Stagg]

Hi. Lovely to be here.

00:01:04,760 --> 00:01:05,700 [Toni Harman]

So who are you?

00:01:06,720 --> 00:01:17,330 [Kathryn Stagg]

So yeah, who am I? I am Kathryn Stagg. I am a mum of four boys, so I had twins 20 years ago and it was a bit of a shock [laughs].

00:01:18,420 --> 00:01:46,090 [Kathryn Stagg]

So yeah, had twins. I was very lucky in that I received some really good breastfeeding support for them and managed to breastfeed those lovely two babies at once quite often. They were doing a lot of tandem feeding. I then was completely mad and decided to have two more children, and so, but they had them one at a time. So so my middle one is now 15, and my youngest is 11. So yeah, mum of four boys. Very, very busy. so when I had this breastfeeding support

00:01:47,160 --> 00:03:12,560 [Kathryn Stagg]

You know, I managed to breastfeed. I love breastfeeding. It’s really, really good enjoyable experience most of the time. Intense when you’re trying to feed two babies at once. It’s really hard work from that point of view. And then started getting out and about n- a bit, and I realized that I had been lucky to get the support that I had, and that not everybody did, and there were many people that I came across over the first sort of year or so of being a parent who had not had the same experience as me and had not managed to reach their breastfeeding goals, and I was a bit cross about this. So I was given the chance to train as a breastfeeding peer supporter about a year or so after my babies were born. I thought this would be a lovely thing to do. I can sort of, you know, support other parents to do, do the same thing that I did and hopefully help change this a little bit. And here I am, 20 years on, or 19 and a half, and still trying to change the world [laughs] of breastfeeding. so yeah, w- we’re kind of, you know, getting somewhere a little bit I think, but it just makes me really, really angry. I always say I’m fueled by rage because it is so unfair. There is such, you know, disparity between maybe one area of the UK and another. You know, you can even live on the opposite side of a street, and you can get really good breastfeeding support on one street on one side, and on the other side there’s nothing. So it just makes me really, really cross. So that’s why I’m still here and still doing this and still trying to change the world.

00:03:12,560 --> 00:03:14,760 [Toni Harman]

And so what are your qualifications?

00:03:14,760 --> 00:05:00,700 [Kathryn Stagg]

So I am an international board-certified lactation consultant. I came up via the breastfeeding counselor route. There’s two ways of becoming a lactation consultant. Lots of people are healthcare professionals, and they have breastfeeding as part of their job, so maybe midwife, health visitor, that kind of stuff, and they then get this additional qualification and come from that side. For me, I came from the volunteer sector. So as I said, I trained as a peer supporter, volunteered locally in ... I’m in Harrow in North West London. Volunteered locally for donkey’s years. I think it was 11 years or something like that that I volunteered. Caught the bug completely. Trained as a breastfeeding counselor, which is kind of a next level up. It’s about a year or two training, that kind of thing. Started volunteering on the national breastfeeding helpline, supporting parents that way as well. Set up my Facebook group, which is called Breastfeeding Twins and Triplets UK. realized there was a massive hole in breastfeeding support for more than one baby. Just hu- there’s just ... Yeah, nobody knew what to do with us, basically. Do you know what I mean? So set that up, and then worked for the NHS for a year. They only had funding for us for a year, and then we all got, you know, sent away again because apparently they couldn’t, you know, manage to keep us employed. You’re just like, “Ah.” All that effort that we put in, and then they just go, “No, sorry. Bye.” So that was the point where I decided to take my IBCLC exam and uh ... So yeah. And then basically I run a small private practice in Harrow in North West London, and I then run my Facebook group for twins and we’ve just been ... Well, I say just. It’s now six years ago, we’ve been accepted as a UK charity, and so we offer one-to-one support to t- mums of twins and triplets around the UK and in Ireland as well funded by our charity, which is rather wonderful.

00:05:00,700 --> 00:05:02,500 [Toni Harman]

So what’s your superpower?

00:05:02,500 --> 00:05:59,740 [Kathryn Stagg]

Ooh, that’s a really good question. I, I think I’m very empathic. I’m very enthusiastic about my topics [laughs] of choice. I think, you know, it’s one of those things when you get very interested in a, in a topic, and I’m sure you are the same, Toni, with your microbiome obsessions [laughs] so ... Which is so, so related to breastfeeding, as we know. You just wanna learn all about it, and so I’ve just done ... I’m reading stuff. I’m find- yeah, I’m trying to be evidence-based. But I think the most important thing is because of coming from the breastfeeding counselor side of training, we have all those counseling skills as well, and so we try and really support the, the parents where they’re at with what situation they’re in, individualized care, and being empathic, and working with them about their feeding goals and what they want and their situation, their particular, you know, place that they are at at the moment, and how we can make this better and, you know, hopefully improve everything for them, and get them meeting their goals and sometimes exceeding them is even better.

00:05:59,740 --> 00:06:04,860 [Toni Harman]

Love it. So you’re gonna be talking at our Microbiome Plan 2026 conference. What are you gonna be talking about?

00:06:05,364 --> 00:07:11,624 [Kathryn Stagg]

I’m gonna be talking about breastfeeding twins, weirdly. That’s my like, total passion about how to get more healthcare professionals and breastfeeding supporters understanding the barriers that a parent of twins has in order to establish breastfeeding. And triplets as well. Doesn’t have to be just twins. You can breastfeed triplets as well. you know, through things like premature birth and early term birth, late preterm birth, that kind of stuff, it has a massive impact on being able to feed effectively, even just being two or three weeks earlier than full term, you know? that’s one of the biggest barriers. Um, you know, and then sort of how to support parents and making sure they understand how milk production works and, you know, all the amazing stuff that’s in human milk, you know, who just ... Yeah, I’m, I’m a massive ... I always get blown away whenever I see you talk about breastfeeding and the microbiome. It just, you know, it’s so, so cool. [laughs] So. So yeah, trying to kind of help people to be able to help families that they may encounter during their working week in whatever s- you know, place that they’re at, basically. Wherever they work and where they find them. So ...

00:07:11,624 --> 00:07:13,084 [Speaker 2]

And why is that important?

00:07:13,084 --> 00:07:56,084 [Kathryn Stagg]

Because twin parents deserve just as good breastfeeding support as any other parent does, if not more, in my opinion. But I’m probably slightly biased on that one. And because we do have slightly more difficult barriers, the main one being this early birth, and also double milk production, plus also ... Or triple if you’re, if you’re triplets. Plus also logistics of being able to care for more than one child at a time who are the same age, which is quite intense. [laughs] So it’s quite challenging. So we have these unique barriers that can make feeding, breastfeeding more difficult, you know? And so we actually need really, really good breastfeeding support in order to be able to meet these goals. But twin and triplet moms deserve it. That’s why.

00:07:56,084 --> 00:08:13,544 [Speaker 2]

No, I fully support ... I’m a twin myself, so I fully, I’m, I’m fully on board with you. Okay. So what messages ... What, what can people do? What can health professionals do to better to support multiples or preterm birth, help um, breastfeeding, and for that initiation of breastfeeding?

00:08:13,544 --> 00:08:31,164 [Kathryn Stagg]

Yeah, absolutely. So I think firstly, when we see anybody antenatally, so this is where we have to start with this because the first thing that you think, or maybe the second thing that you think when you first find out that there are more than one baby in your tummy, after swearing a lot,

00:08:32,224 --> 00:08:47,184 [Kathryn Stagg]

you then go, “Will I ever sleep again?” And then you go, “Will I be able to breastfeed?” They’re the two first questions that most people think about after swearing a lot when they first find out that [laughs] they’re expecting more than one baby. Um,

00:08:48,244 --> 00:10:29,203 [Kathryn Stagg]

and society doesn’t seem to have woken up to the fact that it is actually possible to breastfeed more than one baby. And so we need these antenatal conversations to be happening. So anybody who finds themself in the company of someone expecting twins ... What we usually find, you know, if you’re expecting one baby is everyone’s really excited and, “How lovely,” and, “Congratulations,” and blah blah blah blah. When you are expecting twins, you get a lot of, “Oh, wow. Oh my goodness. Rather you than me. I thought I’d like twins, then I only had one baby.” That’s a really good one. So you get all these insane things, you know what I mean? That, that you’re already feeling concerned about having more than one baby. Then you get all this thrown at you as well. double trouble is another one. The amount of times ... If you get pounds for every time someone said that to me, I’d be absolutely rolling in it. Um, so yeah, you know. So we actually get slightly different reaction from people than you do when you’re just, just expecting a singleton. Um, and then as soon as you mention the fact that you’re thinking about breastfeeding, everyone says, “Oh, no. You can’t do that. That’s gonna be too hard. You’re not gonna make enough milk. You’re not gonna be able to do this. You know, how on earth are you gonna manage that? That’s too difficult.” You know, blah blah blah blah blah. So straight away people are just assuming that you can’t do it. Um, and many twin and triplet families do not understand that you can. And so they, they don’t then ... They’re not in the right mindset to actually ask for support once the babies have arrived ‘cause they just assume it’s not gonna work. If you assume it’s not gonna work, you don’t try that hard. Do you know what I mean? So this is, this is the reason. So we need to just educate people that it’s possible. So what I’d like all healthcare professionals who come into contact with twins and triplets antenatally is to say, “Oh, how wonderful that you would like to breastfeed your babies. This is fantastic. Here, let me signpost you to some evidence-based information and some breastfeeding support to help you.” There you go. [laughs] That’s all it is.

00:10:29,204 --> 00:10:33,044 [Speaker 2]

Brilliant. any other take home messages that you can share?

00:10:33,044 --> 00:10:37,904 [Kathryn Stagg]

Just that it is absolutely possible to breastfeed more than one baby. It is absolutely possible.

00:10:37,904 --> 00:10:41,364 [Speaker 2]

And what about preterm babies? Are there any special challenges?

00:10:41,364 --> 00:11:27,824 [Kathryn Stagg]

So what we have to do when they are premature is we have to start by establishing milk production before the babies are able to breastfeed. So we have to express. So the milk production has to be basically established first and then the babies learn how to feed. And then they can take that milk that you’re already making, hopefully, eventually directly by breastfeeding and won’t have to have any extra milk later on. So but it’s a bit of a long process. And most babies who are premature will not be able to fully breastfeed somewhere around four to eight weeks. It’s usually either a week or two before normally for a lot, but sometimes it’s a little bit after. But it’s somewhere in that window. So in those ... Depending on how many weeks early they are, in those weeks that, that ... before they hit about 38 weeks,

00:11:28,964 --> 00:11:47,484 [Kathryn Stagg]

we have to protect milk production. We have to pump as if you are pump- You basically have to pump for the future, your future milk production, so that when the babies do start to breastfeed, they, the milk will be there for them very easily. And so that’s, that’s one of the main things that we have to explain to parents about how important it is to do that, basically.

00:11:47,484 --> 00:11:48,904 [Speaker 2]

Do you have anything you want to promote?

00:11:50,144 --> 00:11:51,224 [Kathryn Stagg]

Oh, I do.

00:11:51,224 --> 00:11:55,624 [Speaker 2]

Yay. That’s a book by Catherine, and it’s called Breastfeeding Twins-

00:11:55,624 --> 00:11:56,684 [Kathryn Stagg]

And Triplets

00:11:56,684 --> 00:11:57,014 [Speaker 2]

... and Triplets.

00:11:57,014 --> 00:13:08,828 [Kathryn Stagg]

And the little bit here says, “A guide for professionals and parents.” ‘Cause I was very keen when I wrote this book to make sure that it was for everybody because there’s not much out there-On this topic. In fact, there’s, there’s re- this is the only really current book at the moment that’s, that’s available. There was a wonderful book called Mothering Multiples, which was available when mine was my, my kids were little. However, that is currently out of print. and I don’t think it’s going to get back, but you can still find them. Do you know what I mean? So it’s a really, really good book as well, but it’s not currently in print. So I was very keen for it to be for everybody. The the publisher was, is more aiming at healthcare professionals and breastfeeding supporters. That’s what they do as a publishing company. But I was just like, you know, I think it’s really important for the parents to be able to access this as well and access information. So it’s really hopefully easy to read. There’s lots of science-y stuff, but there’s also lots of personal experiences and stories. And at the end of each chapter, I do a little kind of idiot’s guide to what I’ve just talked about. So you can even just, you know, sort of learn the basics within, you know, a couple of pages. And then if you want, get interested in it, you can go into a deeper dive into the whole chapter. So that’s basically how it works. And, yeah, so it was my brain in paper form. That’s basically what it is.

00:13:08,828 --> 00:13:13,088 [Toni Harman]

I love it. Um, most importantly, will you join us on this mission?

00:13:13,088 --> 00:13:15,648 [Kathryn Stagg]

Absolutely. I’m up for it completely.

00:13:17,088 --> 00:13:25,908 [Toni Harman]

Thanks so much, Kathryn. You’ve been amazing. Um, everybody buy her book and and we’ll see you at Microbiome Plan 2026.

00:13:27,008 --> 00:13:52,108 [Toni Harman]

My biggest takeaway from talking to Kathryn was this idea of what true support really means. It’s meeting parents where they are at, to really take into account a parent’s individual situation and the place where they’re at mentally, physically, and emotionally at that particular moment. That is true support, and that can be truly powerful.

00:13:54,148 --> 00:14:01,708 [Toni Harman]

Join me again to meet another speaker to hear their passions as together we create the Microbiome Plan.

00:14:02,928 --> 00:14:07,627 [Toni Harman]

Thanks for listening. [outro music]

Subscribe to follow the full series on how the microbiome is shaped from birth.

About This Podcast

Are probiotics being used with enough precision, or have they become the wellness world’s answer to “try this and see”?

In this episode, Dawn Whitten (Naturopath, IBCLC) tackles one of the most debated questions in microbiome health:

👉 When should we actually use probiotics?
👉 Why do they work for some people and not others?
👉 And are we asking the right questions before recommending them?

Because not all probiotics are equal. And timing, context, and clinical reasoning matter.

Key Take-Aways

• Probiotics are not one-size-fits-all

• Strain specificity matters far more than generic labels

• The “when” may be just as important as the “what”

• Clinical context, symptoms, and health goals should guide use

• Early-life, post-antibiotic, and immune-support contexts may differ significantly

• Overgeneralised probiotic recommendations can be misleading

• A microbiome-first approach requires more precision and less guesswork

Short Summary:

In this conversation, Dawn Whitten (Naturopath and lactation consultant), explores the science and clinical thinking behind probiotic use - moving beyond trends and into practical decision-making. Dawn gives the research-based lowdown on probiotics for babies and breastfeeding women, including which ones to take, when, why, what for, and crucially, when not to take them.

The discussion challenges simplistic recommendations and instead focuses on when probiotics may be appropriate, why they can be effective, and the importance of matching the right strains to the right clinical context. This episode is a timely reminder that microbiome support should be evidence-led, not assumption-led.

What Can You Do Today?

If you work in healthcare, nutrition, or microbiome research, this episode raises an important question:

🎧 Listen now and ask yourself:
Are we recommending probiotics with enough precision to truly help patients?

If this sparks questions, or challenges your current thinking, please share it with a colleague.

Share

Subscribe to The Microbiome Plan for more expert conversations at the intersection of microbiome science and clinical practice.

Part of The Microbiome Plan podcast, exploring how early-life biology shapes lifelong health.

Want To See More?

Watch the replay of Dawn Whitten’s presentation from The Microbiome Plan 2026 virtual conference (replay available now!). >>> https://microbiomeplan.com

Subscribe to follow the full series on how the microbiome is shaped from birth.

Episode Transcript

THE MICROBIOME PLAN – PODCAST

Meet The Speakers: DAWN WHITTEN

Dawn Whitten, Naturopath, Herbalist & IBCLC, in conversation with podcast host, and co-founder of The Microbiome Plan, Toni Harman

00:00:00,100 --> 00:00:59,839 [Toni Harman]

[gentle music] Welcome to this tiny podcast about one of the biggest topics in health today. Many parents write a birth plan, but how many have a microbiome plan? Modern childbirth practices can interfere with the optimal seeding of the infant microbiome, with implications for a child’s long-term health. But what does that mean, and what can parents actually do? That’s the subject of our conference, and in this micro podcast series, I’ll catch up with some of the conference speakers to find out about their personal passions.

I’m your host, Toni Harman, and my guest today is Dawn Whitten, naturopath, herbalist, lactation consultant, and someone with clinical expertise working in women’s and children’s health.

Dawn will give the lowdown on probiotics, which ones to take, when, why, what for, and crucially, when not to take them. So let’s dive in.

00:01:01,300 --> 00:01:02,040 [Toni Harman]

Hello, Dawn.

00:01:03,100 --> 00:01:04,720 [Dawn Whitten]

Hi. Nice to see you.

00:01:04,720 --> 00:01:05,980 [Toni Harman]

So who are you?

00:01:05,980 --> 00:02:41,900 [Dawn Whitten]

Well, I’m a naturopath and a lactation consultant, and I love kind of bringing, I guess, trying to lift the, the knowledge and capacity of, of naturopaths, so that’s kind of my passion. I was actually kind of born in a bubble, if you like. So I was born in this setting where I was just kind of immersed in natural birth and, you know, normal breastfeeding experiences, and it wasn’t until I had my second baby when I was just coming to the end of my naturopathy degree that I realized I was in this bubble and that other people hadn’t had the privilege that I’d had of having, having that. You know, that, that kind of passive kind of education through, through that contact, just that normal kind of contact that we would have all previously had in kind of ancient times. And the barriers that, that so many women experience with breastfeeding and the the gaps in health professional knowledge in- including naturopaths. So that’s kind of felt, I guess it’s been a, a passion of mine to try and do what I can to kind of lift things in that area. So that’s, yeah, that’s, that’s my work focus. I do a fair amount of teaching health professionals. I’ve done a fair amount of academic writing and a little bit of research, so I kind of have a critical lens, but also a very practical, pragmatic lens because I’ve been in clinical practice for twenty years and or more, and so I’ve had, yeah, a l- I’ve had a, a lot of time in that sort of clinical head space too. So I’ve kind of got the, the merge of those, if that gives you a bit of a sense of who I am.

00:02:41,900 --> 00:02:50,300 [Toni Harman]

I love this idea of you are a lactation consultant but also a naturopath. How do they work together? How do they lead into each other?

00:02:50,300 --> 00:03:48,820 [Dawn Whitten]

Started as a naturopath and, and because I was working this space, realized I needed to upskill in that area. A lot of people would perhaps come to me like they want herbs for increasing their milk supply or their concern about the infant’s microbiome and then, you know, that circles us back to supporting breastfeeding. So having those skills to be able to help coach mothers with breastfeeding is actually kind of, I guess, a fundamental core of supporting this population, I feel. So that’s been, yeah, a really nice combination. I guess I kind of have some opportunities that you may not have if you’re just out there as a lactation consultant because people come, you know, seeking an alternative, and then I get the, I get these moments with people where we might just have one of those conversations that is just that moment in time where someone’s at a crossroad. You can give them some useful information about how the breast physiology works and milk supply and just have these, these opportunities.

00:03:48,820 --> 00:03:57,560 [Toni Harman]

So how does it work in terms of what a mother eats or probiotics she takes? How does that reach her her milk?

00:03:57,560 --> 00:05:26,060 [Dawn Whitten]

Ah, fabulous question. I think there’s, there’s lots of, lots of things we don’t know, but some particular probiotic strains appear to be transferred into mother’s milk. Seems to be, you know, the characteristics of that particular bacteria that will determine whether it is transferred into mother’s milk. Um, but also probiotics seem to potentially have other effects on transmitter effects in other ways, perhaps influencing some of the immune messages that come through mum’s milk. So it’s not necessarily the bacteria coming into the milk, but some, you know, might change some of those immune messages. And it’s, you know, fascinating research coming out around prevention of eczema, for example, where they’ve found that giving probiotics to the mother while she’s breastfeeding seems to have the strongest effect for helping to prevent eczema in infants and giving probiotics directly to the infants actually had the weakest effect and maybe even diluted the effects of giving the probiotics to the mothers. So you, you’re like, “Okay, what’s happening there?” You know, “Why is that happening?” Like it’s some, you know, maybe some of it is, you know, the, the actual microbe coming through into the milk, but probably a lot of it is some of these immune messages that are, you know, kind of getting modulated through that. So I think that’s really fascinating, fascinating to try and understand, and that’s quite a large body of evidence. Like this is systematic reviews, and a number of them are continually finding this, so it’s pretty yeah, pretty interesting.

00:05:26,060 --> 00:05:39,420 [Toni Harman]

I’d never heard that before. I think, I think that’s amazing. So what, so what if you’ve got a breastfeeding mother, what would you suggest she eats or takes, and what shouldn’t she eat or take?

00:05:39,420 --> 00:06:36,628 [Dawn Whitten]

I mean, I think the, you know, having a Mediterranean style diet, lots of whole foods you know. Fruit in particular seems to be really beneficial.Very interesting for supporting the microbiome resilience of the breast. So if you’ve had, you know, some microbiome disturbances, for example, you know, you’ve had to have an- had antibiotics or had a cesarean birth the-- having that sort of lifestyle seems to really support that bounce back of the ecosystem. So that, I guess some of those are just very, you know, common recommendations, I guess, to kind of eat this kind of whole food-based diet. There are some probiotics that can have potentially an influence on supporting that breast milk microbiome bounce back after antibiotic exposure as well, and that’s a, a possibility to consider, consider that as well. But I think the main thing is just kind of the, you know, the simple things first.

00:06:36,628 --> 00:06:40,688 [Toni Harman]

What type of probiotic would support that bounce back?

00:06:40,748 --> 00:07:18,528 [Dawn Whitten]

Um, there’s some research on Lactobacillus fermented set fifty-seven sixteen, that particular strain. Um, and we think that maybe it just helps to suppress some of the microbes that might dominate in that situation when you’ve had a disturbance. It just kind of help push them down a bit so the ecosystem can, can kind of bounce back. But really, I mean, I think, you know, having like a, you know, plant food rich diet and will be, will be really supporting that as well. So I think it’s not, it’s not certainly not kind of, yeah, something that everyone needs to do.

00:07:18,528 --> 00:07:28,747 [Toni Harman]

What maybe a, a breastfeeding mother, what shouldn’t she eat? What will have the, a negative effect on her, her own microbiome and potentially her baby’s microbiome?

00:07:28,748 --> 00:08:12,048 [Dawn Whitten]

Yeah. I mean, I think there’s a lot of resilience there. So it is pretty amazing how resilient that ecosystem is. I want people to be stressed about things, but I think you know, trying not to have too many refined foods, trying not to have, you know, too many, you know, really ultra-processed foods with emulsifiers and you know, preservatives and things like that in there i- is, is good if you can. Um, what else? What else could have a harmful effect? I mean, I don’t sort of have a kind of a, a strong sense of yeah, many like foods that really have a, a negative effect on your, your breast milk ecosystem is really, I guess, around thinking about the ones that might be of benefit.

00:08:12,048 --> 00:08:20,868 [Toni Harman]

But as well as foods and probiotics, is there anything else a breastfeeding mother could do to benefit her own and her baby’s microbiome?

00:08:20,868 --> 00:09:01,268 [Dawn Whitten]

Well skin-to-skin time, you know, coming back to some of these fundamentals. Direct breastfeeding, like, you know, there’s a lot of, I guess, shift towards expressing an indirect breastfeeding in this kind of modern context that seems to be, you know, a, a much more common thing. So yeah, we know that or we-- it appears that more direct breastfeeding is really beneficial both for the breast microbiome and also you know, you might just see more favorable microbes being transmitted to the infant. Obviously, having any breast milk’s, you know, what we want. But, you know, when that can be that more direct breastfeeding seems to, yeah, certainly be of value in that way.

00:09:01,268 --> 00:09:08,268 [Toni Harman]

Does it matter how often a mum breastfeeds or expresses? Does that have any influence?

00:09:08,268 --> 00:11:08,828 [Dawn Whitten]

On the microbiome I-not sure about that, but I think that I guess it’s certainly important for maintaining good supply. And I guess I guess a point that I think is important for us to, you know, consider is just how important it is to support and protect breastfeeding and protect breastfeeding success so that, you know, breastfeeding often enough to maintain a good supply is im-important. You know, re- breastfeeding in response to your infant’s cues. Sometimes a younger baby might need reminding. I like to think of breast milk as kinda the ultimate gardener of the infant’s ecosystem. Yes, ‘cause it’s like seeding. It’s got this array of microbes coming. You know, some of them, you know, seem to be from gastrointestinal origin. So like some that you might find in, normally find in stool, we actually find in mom’s breast milk microbiome. So we’ve got the seeding, and then we’ve got the weeding ‘cause there’s all those incredible kind of anti-- like selective antimicrobial components. And then we’ve got the feeding ‘cause it’s got, of course, an abundant supply of, you know, a diverse array of different prebiotic components. So it’s, it’s really the ultimate gardener for the infant gut. And so if we think about anything that we could, you know, add in like, you know, a probiotic or, I don’t know, just any kind of small intervention is, is really just a tweak when you look at that amazing... You know, it’s kinda like a galaxy going on there. You know, like there’s so much happening there that our efforts to really, you know, remove the barriers I think I think that’s the most important place for our efforts to be. Um, ‘cause we can sometimes get... I mean, I use, I prescribe probiotics a lot. I think there’s some, you know, ones that can be really useful, but I feel very cautious about us con-- like using too much of our energy focus on that rather than making sure that, you know, that family has good breastfeeding support. So that’s like the core, the, the cornerstone of, of, of supporting them.

00:11:08,828 --> 00:11:16,498 [Toni Harman]

Are there any negative sides to using probiotics for breastfeeding mothers or for infants?

00:11:16,498 --> 00:12:13,428 [Dawn Whitten]

So when we’re thinking about, you know, whether we give a probiotic directly to an exclusively breastfed infant, which is a different population to an infant that’s not breastfed or perhaps, you know, a, a preterm infant where the evidence might be a bit different, although I still, you know, firmly feel that prioritizing making sure that infant has access to human milk is, you know, the most important intervention that we can take care of. Um, but if we’ve got an exclusively breastfed infant should we give them a probiotic? You know, and I mean, certainly our experience if you walk into any store is, you know, suggested that we should because there are so many baby, you know, baby probiotic products. It’s almost like you need your pram and yourYour, your car seat and you need a baby probiotic. But I guess what I worry about is throwing in that probiotic can potentially, you know... I guess we just don’t, we just don’t know enough about, you know, the possible harm that could do.

00:12:20,608 --> 00:14:36,068 [Dawn Whitten]

And we have, you know, this appreciation that there’s so much we don’t know and, and we wanna lead with first do no harm. We throw this probiotic into the picture. Is it gonna influence the evolution of that infant’s ecosystem? You know, the assembly of it. We don’t know whether it, you know, it takes all the food, or if it shares food, or if it takes the place of an important family origin strain that’s, you know, more, more benefit and more likely persist in that infant. So I guess those are some of the questions I have about, you know, value of that particular probiotic. But then we also have to remember, of course, probiotic products are not just the probiotic. They also have the fillers, you know, and excipients in there. So when we give those to an infant, we’re exposing al- that infant also to those elements and also the possibility of a bacterial contaminant, like a contamination with a potentially pathogenic bacteria and there are examples of this because manufacturers, you know, the settings are not perfect. It’s not, you can’t you know, perfectly prevent this from happening. And even kind of well-respected brands, this, the, there are examples of this and it’s, you know, a tragedy. So, you know, we need to be cognizant of these possibilities and weighing up the risk-benefit, I think, and, and appreciating, okay, we’ve got mum’s own milk here, which is, you know, this guarder of the infant gut with, you know, beneficial microbes and the prebiotic components and the selective suppressants. So do we really need to add something in here? [laughs] We give something, you know, maybe we feel like, you know, that, that family is just desperate to take a probiotic or, or, you know, there’s a, a clinical reason where we think we might giving a, give a probiotic. I like to consider doing that through the mum instead and I think if we can think of that principle of treating through the mother, we can kind of avoid giving a message that, you know, that, that, you know, what her body can offer to her exclusively breastfed infant is not enough, and we can work instead, you know, through the mum and, and kind of avoid getting that family in the habit of also giving things directly to the infant ‘cause I think this can be kind of a bit of a gateway to giving them more things and just kind of keep things more simple.

00:14:36,068 --> 00:14:37,988 [Toni Harman]

What are you gonna be talking about at the conference?

00:14:39,288 --> 00:16:11,988 [Dawn Whitten]

So my topic is looking at probiotics and breastfeeding women, which product, which probiotic, when, why, and why not. And I guess what I really wanna do is like kinda sort through some of the evidence and really kind of, I guess, consider you know, what might determine our decision-making maybe question some of the, the popular uh, ideas out there about when to use probiotics in particular. Um, well, you know, there’s certain commonly promoted uses of probiotics, which I think could do with a little bit of a critique. For example, using probiotics in mastitis is an area that I feel is something we, we need to ask some questions about that and when the, when’s the appropriate time for that. And then I guess, you know, talk about some of the things I mentioned before around you know, the way that probiotics can potentially have benefits when, when mothers take them. We could have some other ways that probiotics might work through mum’s milk transmitting immune messages or you know, having favorable effects, such as helping to prevent condition, common conditions like atopic eczema, which is, you know, often like a, you know, part of that atopic march. So if we can get in early and, you know, have some interventions that might reduce the risk of that turning up, then that’s a, that’s a nice thing to have in our toolbox. Yeah, so that’s kind of the, I guess the gist of it. I’m hoping to make it quite clinically relevant for people. Um, yeah.

00:16:11,988 --> 00:16:14,768 [Toni Harman]

Just sounds fantastic. Any take home messages?

00:16:14,768 --> 00:17:11,628 [Dawn Whitten]

Take home messages. One is strain specificity matters, so people that are into probiotics often use the example of dogs. You know, we can have a chihuahua and a German shepherd. They’re the same species, but they’re very different beasts, and so the same with probiotics. We can have, you know, a Lactobacillus rhamnosus, which is a species, but within that species we’ll have, you know, a range of different strains. For example, Lactobacillus rhamnosus GG, huge body of research on it. We can’t expect another Lactobacillus rhamnosus to do the same thing, and this is important for us to have this discernment I think when we’re, you know, families are investing in these products to kind of be aware of the importance of strain specificity. That’s one take home message. Um, that maternal administration of probiotics may confer benefits to the infant and also potentially to the mother, so it can be a nice way to work in this chapter. And also just to be aware of

00:17:12,648 --> 00:17:27,548 [Dawn Whitten]

I guess the misleading nature of marketing in this field is pretty loose in what’s allowed in terms of labels and therapeutic claims, and so being able to scrutinize this I think is, is really important.

00:17:27,548 --> 00:17:33,108 [Toni Harman]

How can people reach you? What-- Do you have a program? How what do you want to promote?

00:17:33,108 --> 00:18:00,628 [Dawn Whitten]

Oh, thank you. Well, I’m currently teaching the a, a natural early life course, which is kind of an upskill in naturopathic and functional support for working with, during the early life chapter, mothers and infants. Um, so that’s actually we’re taking intakes in, in late April. Um, so that’s kind of my main work. You can find us, me at the Microbiome Restoration Center there.

00:18:00,628 --> 00:18:06,128 [Toni Harman]

Thank you. Thank you for sharing your knowledge. I, I found that fascinating.

00:18:06,128 --> 00:18:08,808 [Dawn Whitten]

Oh, thank you, Toni. It’s, yeah, it’s a privilege. Thank you.

00:18:09,908 --> 00:18:25,708 [Toni Harman]

Before talking to Dawn, I’d never really considered what else goes into probiotics, like fillers and the possibility of bacterial contaminants, and right now it does seem to be a bit of a Wild West in terms of marketing claims.

00:18:26,928 --> 00:18:29,988 [Toni Harman]

So my take home message, do your research.

00:18:32,568 --> 00:18:40,148 [Toni Harman]

Join me again to meet another speaker to hear their passions as together we create The Microbiome Plan.

00:18:41,368 --> 00:18:42,268 [Toni Harman]

Thanks for listening.

00:18:43,788 --> 00:18:45,468 [Toni Harman]

[outro music]

Subscribe to follow the full series on how the microbiome is shaped from birth.

Did you know.... the microbiome helps determine how pregnancies develop and whether they remain healthy?

In this episode, Midwfery Lecturer Dr Michelle Irving explains why now is the time for midwives, and other maternity care workers, to become fully informed about this important new knowledge about how human physiology works in tandem with the microbiome.

This knowledge could be used to inform innovations in clinical practice and enable maternity care to protect and promote the health of the maternal and infant microbiomes.

Could this be the key that unlocks better long-term health outcomes, for mothers and their babies?

Key Takeaways

• The microbiome plays a central role in training and regulating the immune system

• A large proportion of immune activity is located in and around the gut

• Early-life microbial exposure is critical for proper immune development

• Disruption to the microbiome may contribute to chronic inflammation and immune-related disease

• The immune system is constantly interacting with diet, microbes, and environment as a dynamic ecosystem

• Many modern exposures (diet, antibiotics, lifestyle) may unintentionally alter immune function via the microbiome

• Supporting the microbiome may be a key lever for preventative health, not just treatment

Short Summary:

In this episode, Midwifery Lecturer, Michelle Irving, reframes the immune system as something deeply interconnected with the microbiome. Rather than acting alone, the immune system is continuously trained and modulated by microbial signals - especially in early life. This challenges a core assumption in medicine: that immunity can be understood in isolation. If the microbiome is foundational to immune function, then many current approaches to health and disease may be missing a critical piece of the puzzle. This is key information for all midwives, and perinatal health professionals to understand.

What you can do today?

If you work in maternity, neonatal care, or early-life health, this episode may challenge your assumptions.

🎧 Listen now - and then ask yourself:
If the evidence points one way, why are our systems still doing another?

If you agree, or strongly disagree, please share this with a colleague. This is a conversation worth having.

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Part of The Microbiome Plan podcast, exploring how early-life biology and environment shape lifelong health.

Want To See More?

You can watch the replay of Michelle Irvings’s presentation at The Microbiome Plan Conference at https://microbiomeplan.com

For more, watch Dr Michelle Irving's presentation from The Microbiome Plan 2026 virtual conference (replay available now!).

>>> https://microbiomeplan.com

Subscribe to follow the full series on how the microbiome is shaped from birth.

Episode Transcript

THE MICROBIOME PLAN – PODCAST

Meet The Speakers: MICHELLE IRVING

Michelle Irving, Lecturer in Midwifery and Midwife, in conversation with podcast host, and co-founder of The Microbiome Plan, Toni Harman

00:00:00,120 --> 00:01:00,880 [Toni Harman]

[gentle music] Welcome to this tiny podcast about one of the biggest topics in health today. Many parents write a birth plan, but how many have a microbiome plan? Modern childbirth practices can interfere with the optimal seeding of the infant microbiome, with implications for a child’s long-term health. But what does that mean? And what can parents actually do?

That’s the subject of our conference, and in this micro podcast series, I’ll catch up with some of the conference speakers to find out about their personal passions.

I’m your host, Toni Harman, and with me today is someone I’ve been working with for a few years, but I’ve never actually met in person, Dr. Michelle Irving, lecturer in midwifery at Bournemouth University.

I caught up with Michelle to learn what midwives and other health professionals can do now to support the optimal seeding and feeding of the infant microbiome.

So let’s get to it. Hello, Michelle.

00:01:00,880 --> 00:01:01,780 [Michelle Irving]

Hello.

00:01:01,780 --> 00:01:03,540 [Toni Harman]

[laughs] So who are you?

00:01:04,680 --> 00:01:44,940 [Michelle Irving]

Who am I? So, as you say Michelle. I’m currently a lecturer at Bournemouth University. My background has been to be a home birth midwife for almost 20 years, so supporting lots of women in their, in their choice to, to have a home birth. And then in the last 12, 13 years I’ve, I’ve been going down the academic path. I did my PhD, all about continuity of care and the benefits that brings to women. And yeah, so now I’m training student midwives to become the best midwives they can be.

00:01:44,940 --> 00:01:49,820 [Toni Harman]

You’ve got an interest in the microbiome. Where, how, where did this interest come from?

00:01:49,820 --> 00:03:01,940 [Michelle Irving]

Well, the, the, the interest initially came from Macbeth, so seeing the film and just having that kind of awakening. It’s like, ah, there’s all this going on that we don’t have any professional knowledge of. So in the last, I guess it’s about, ooh, seven years or more I’ve done quite a deep dive into the literature, the research around sometimes just around the microbiome generally and, and what that means for the human body, and then that application of that knowledge to, to pregnancy. You know, how it is so incredibly relevant to, to women and to midwives caring for women. So yeah, I’ve really, really understood that the microbiome is underpinning our health, it’s underpinning how our bodies work and how our immune system works and how we stay healthy or, or how we become unhealthy. You know, the knowledge is out there, and, and we need to, to bring it to the practitioners so they, they understand too.

00:03:01,940 --> 00:03:06,829 [Toni Harman]

In your opinion, do midwives and student midwives, do they know about the microbiome?

00:03:06,829 --> 00:04:09,880 [Michelle Irving]

Not generally. So I’ve talked to quite a lot of midwives, and there, there’s a sort of a, a vague understanding that, you know, maybe the, the microbiome is about gut health and, you know, maybe about digestion, but very little insights into how basically the microbiome impacts the functioning of all our body systems, how our immune system works, how our hormonal system works. And, you know, that is so relevant to, to pregnancy.

So you know, whether women can get pregnant is impacted by the health of the microbiome. So are they producing the hormones that enable them to ovulate and then enable them to, you know, to have a pregnancy that is successful? Whether that pregnancy continues successfully is so related to our hormones, which are so related to our microbiome.

00:04:09,880 --> 00:04:18,780 [Toni Harman]

So give us a, a rundown from conception to pregnancy to birth to breastfeeding, and how does it all work?

00:04:18,780 --> 00:10:31,230 [Michelle Irving]

Yeah, so our, our microbiome is working at, you know, multiple levels. It is working on, as I say, how, how our hormones are released. It is working with the immune system to determine, you know, are we responding appropriately to what’s happening around us in our bodies, so leading to immune responses that are appropriate.

So for some people they have inflammation, and we know now that inflammation is pretty much the starting point for disease, you know, for our physiology not, not working as it’s designed to. So on that basis, it, you know, the microbiome is, is implicated in all aspects of health and all aspects of ill health. In order to get pregnant, we need to be releasing the hormones that, you know, help us ovulate, help the, help the pregnancy or the conception to occur.

There is a microbiome within the uterus, so yeah, the microbiome is going to affect whether that, whether that conception can actually be implanted into the uterus and can become a developing embryo and fetus. The microbiome determines how the pregnancy continues. You know, we now know that having an unbalanced or a dysbiotic microbiome is implicated in whether women develop pre-eclampsia whether they have a preterm birth. So really important, significant, you know, either diseases or conditions. That’s, you know, are going to impact the health of the mother, impact the health of the baby. So we know those are affected by the microbiome.

Going into labor, you know, we need to think about if this is the point when, from the evolutionary point of view, this is, this is how the mom’s microbiome is transferred to the baby. Vaginal birth being the main event that, that transfers that, that, that microbiome. You know, what happens during, during labor and birth is really important, and it’s something that, as midwives, we need to be considering.

You know, when the baby is born, how we help manage that is gonna have an impact on the sort of the ongoing process of transferring the microbiome to the baby. So the baby’s been exposed during, during vaginal birth to all the, the normal microbes that are in the mother’s vagina, but that continues when the baby’s held against the mom’s skin.

That then has implications for breastfeeding, and that’s, again, the ongoing process of continuing to transfer microbes to the baby, and then helping the baby establish that colony of, of microbes, yeah, on them and in them. There’s lots of opportunities during that whole pregnancy continuum where midwives can be giving information to, to moms and, and, and, and parents generally about, you know, what are the things that support a healthy microbiome? You know, what, what can parents do, you know, during pregnancy, for example, to optimize?

Because I think probably, probably most of us, yeah, we have room for improvement [laughs] in our microbiomes. Once people are aware that that is, you know, that is largely down to them, you know, there’s a lot as individuals we can do. You know, we don’t need we don’t need drugs. We don’t, you know, we don’t need an intervention. You know, the microbiome, because it’s how we evolved, it’s very much embedded in kind of normal human behavior. Um, so it is related to what we eat. It’s health is gonna be related to how we move our bodies, the stress levels. You know, the microbiome does not like high levels of stress you know, chronic stress.

So, you know, once you’re aware of that, then you can think, “Okay, maybe there are strategies I can, I can put in place that can lower my stress, which is then going to reduce that burden on the, in, on the microbiome that it’s constantly being exposed to stress hormones.”

Sleep. Sleep’s really important. You know, the, the microbiome needs us to sleep so that it can rest. You know, the microbiome has its own circadian rhythm, so, you know, it’s, it has periods when it needs to not be doing anything so that it can function as well as it can do. So again, once we know that these, you know, these lifestyle behaviors are totally in our control, you know, maybe we hi- we had no idea that, that we could affect our health in such kind of natural ways.

So by us understanding that as, you know, as midwives and as, you know, people who work with women who are pregnant, you know, we can pass that knowledge, and, you know, women can make changes, you know, and they can make fairly, fairly simple changes.

You know, the beauty about, I think about the diet is, you know, one of the things you can do as a starting point is you can introduce more plant foods into your diet. You’re not transforming your diet. You’re not getting rid of this group of foods.

You can enhance just by eating more plant foods. You know, so that, that’s a really great starting point, I think. Us helping women to understand those principles that can be applied, leading to, in all likelihood, a more healthy microbiome, which is then gonna lead to our bodies being able to function, you know, more normally, more, more physiologically.

00:10:31,230 --> 00:10:44,520 [Toni Harman]

Thank you for that that [laughs] kind of a overview of the, the micro biome. Okay, so if you’ve got midwives or student midwives listening, what are sort of things, what practical things can they do or not do around birth?

00:10:44,520 --> 00:11:15,0 [Michelle Irving]

There are things we can do that are gonna optimize kind of physiological processes. You know, we’ve known for a long time that activity, you know, women being active during their labor is going to make it more likely that they have a physiological birth. So, you know, we can talk to women about that in pregnancy.

00:11:15,001 --> 00:16:08,870 [Michelle Irving]

‘Cause I think for a lot of women, the image of birth is it takes place on the bed, and more often than not, it takes place with a woman being sort of semi-reclined on a bed. And in that moment in birth, you know, if you start trying to introduce that idea to a woman, that’s gonna be too much. It’s already in her head what birth looks like.

So we need to talk to women during pregnancy and then during the birth, then we need to do things that support her desire to be active. Because the point of that is that, you know, when babies are born vaginally, then that evolutionary process happens. You know, with a healthy, fit, and well mom, and a healthy, fit, and well baby, then what we want to do is optimize, you know, the things that help labor. And a lot of it, the labor, labor and birth, you know, they very much function from the, from the parasympathetic nervous system activation.

So you’re having, having this awareness of what is going to make a mother who’s in labor feel calm and relaxed and confident. So again, that starts in the antenatal period where women understand, you know, through discussions with their midwife, okay, you know, what are the things that help that activation?

They’re often simple things.

So that sense of privacy, creating an environment for a woman that feels like a safe space. That is so important, and that, for an awful lot of women, that’s gonna help them release oxytocin. It’s gonna help them release the hormones that support labor so beta endorphin is gonna give her pain relief support, you know, as, as her oxytocin rises. So simple things like that.

And we, we know, you know, the evidence tells us the more homely a birth setting is, the more likely it is that the woman can get into that activation, and then her labor can keep progressing under its own steam. As I say, you’re encouraging women to be active to be upright, to be moving around. And having strategies, might be massage. Um, you know, massage is relaxing, so that helps oxytocin flow. That therefore helps pain-relieving hormones flow.

So you know, thinking of... They’re simple things. They’re, they’re probably things that midwives have always done, but maybe in more recent times has, has sort of come off the menu a little bit. You know, things like what can women... you know, what snacks can women have, you know, during, during their labor and birth?

And I, and I, you know, I fully appreciate that there are some cultures you know, some birthing cultures in the world where, you know, women aren’t encouraged to eat or drink. But if you work in an environment where, where that is acceptable, then that is only gonna help.

You know, if a woman is, is, is nourished and is, is hydrated, that is only gonna help the process. And then during the birth itself, as the baby is, is emerging, can we encourage women to, to be involved in scooping their babies up when they’ve, when they’ve been born so that, you know, it’s their hands that come onto the baby with their normal, healthy bacteria?

So the baby’s being exposed to its familial line of bacteria and other microbes. And, you know, I think it’s common, you know, common practice that, you know, we talk about skin-to-skin for an hour, but sometimes it doesn’t happen for an hour, and, and we need to really encourage. But actually, an hour was just a figure picked out of the air, and we need it to be longer.

Again, sort of preserving that safe time, that safe space where mom and baby and partners just have some time to, to make that transition from pregnancy through to birth, and you can be parents. Being born, you know, reducing that stress so that, you know, everybody is calm. ‘Cause again, that’s gonna be good for the microbiome.

You know, a calm baby, a calm mom, you know, their microbiomes, you know, are not then flooded with stress hormones. A calm baby is going to want to breastfeed. A calm mom is gonna be able to breastfeed. It kind of comes back to that, again, the parasympathetic activation because it, it underpins so much of how our bodies work normally.

00:16:09,880 --> 00:16:23,300 [Michelle Irving]

So, you know, enabling the moms, once the baby’s born, just to have that period where we’re not doing anything else. We’re just letting it settle and letting, you know, normal physiology reign.

00:16:23,300 --> 00:16:27,280 [Toni Harman]

I love that. What would be your take-home messages?

00:16:27,280 --> 00:17:49,000 [Michelle Irving]

Yeah, we, we need to be giving information from the, from the start of pregnancy all the way through, you know, that period, through the, through the whole continuum. We need to be putting supportive measures in place. We need midwifery appointments, yeah, so antenatal appointments where there’s time to talk there’s time to give information, but there’s time to, to check understanding. There’s, there’s time to support what a woman’s thinking is and exploration of, of, of, of her options. So, yeah, you know, we’re just talking about these... you know, as I said, the diet, the, you know, the exercise, the relaxation and sleep. You know, we’re helping women at every appointment to optimize these things. You know, we are talking to her about what it is that optimizes physiology in, in labor. So again, women are understanding what they need to do and what’s gonna help them and what might hinder them. And I think, you know, once the baby is born, it’s really acknowledging that the baby needs exposure to predominantly the mom’s microbes, and, you know, the mom’s body.

00:17:50,040 --> 00:19:15,760 [Michelle Irving]

You know, the mom’s body, I think we recognize now, you know, that is the baby’s safe environment. Um, so even if we don’t talk about the microbiome, we know it’s the safe environment because it helps the baby stabilize and transition to having been born. But as part of that, you know, because that’s how we evolved, in doing that, you are supporting the microbiome. So the less disruption at that point is really, really key. And then I think bringing a-I w-, I’m gonna say bringing a bigger focus to supporting breastfeeding for women that want to breastfeed is making that time, yeah, the priority of that time, the, so those first few hours after birth, the priority is keeping mum and baby together which is gonna s- support and promote the breastfeeding, and then giving time. Time is so important with breastfeeding. Often that’s kind of all it needs. It needs time and a, and a skilled, knowledgeable person. We don’t need, you know, we don’t need equipment. We just need that time, and it’s respect for that time that, that will then just sort of launch a mum and baby into a successful journey. But it’s not a 10-minute job.

00:19:16,820 --> 00:19:41,820 [Michelle Irving]

Sometimes it could be a two-hour job. But, you know, if that, if that leads to a mum and baby long-term breastfeeding as per their wishes, then, you know, we’ve saved healthcare systems an enormous amount of money, we have promoted mum and baby’s long-term health. So there are huge gains, and what it needs predominantly is time.

00:19:42,880 --> 00:19:46,600 [Toni Harman]

Well, thank you for your time today. That was brilliant. Loved it.

00:19:46,600 --> 00:19:48,480 [Michelle Irving]

You’re very welcome. It’s an absolute pleasure.

00:19:50,100 --> 00:20:31,020 [Toni Harman]

My biggest takeaway from talking to Michelle were her practical suggestions to optimize the physiology of labor and birth, then when the baby’s born, for midwives and other health professionals to fully support prolonged, uninterrupted skin-to-skin contact, and to spend a lengthy amount of time supporting breastfeeding. As Michelle said, we’re not talking a quick 10 minutes, but maybe a good two hours for every mother who wants to breastfeed. What do you think? [gentle music]

Join me again to meet another speaker to hear their passions as together we create The Microbiome Plan.

00:20:32,180 --> 00:20:33,420 [Toni Harman]

Thanks for listening.

Subscribe to follow the full series on how the microbiome is shaped from birth.

About This Podcast

What if your microbiome isn’t just shaped by biology, but by your postcode, environment, and lived experience?

In this conversation, Dr Ariangela Kozik challenges a growing assumption in microbiome science:

👉 That we can understand health without understanding context.

In this episode, Assistant Professor Ariangela Kozik from the University of Michigan explains why the microbiome is not just something inside us, but something that connects us to our environment in real time.

In this episode, we explore how early-life microbial exposure helps shape the immune system, why modern environments may be limiting that process, and what simple changes, like spending more time outside and letting your kids roll in the mud, can mean for long-term health.

From asthma and immune development to the question of how clean is too clean, this conversation offers a new way of thinking about our relationship with the microbial world.

Key Take-Aways

• The microbiome is dynamic, constantly shaped by diet, environment, and exposures

• Early life factors (birth mode, feeding, environment) have long-term effects on microbial development

• There is no “one-size-fits-all” microbiome—individual variation is the rule, not the exception

• Health outcomes may reflect not just biology, but social and environmental inequalities

• Focusing only on the gut misses the bigger picture—microbiomes exist across the lungs, skin, and beyond

• The idea of a universal probiotic or simple fix is likely overly simplistic

• Future medicine may require integrating microbiome science with real-world human diversity

Short Summary:

In this episode, Dr Ariangela Kozik expands the microbiome conversation beyond the gut, and beyond biology alone. She highlights how our microbial ecosystems are shaped not just by what we eat, but by where we live, the environments we’re exposed to, and the broader social context around us. The implication is significant: if microbiome science ignores human diversity, it risks missing the bigger picture of health and disease.

Part of The Microbiome Plan podcast, exploring how early-life biology and environment shape lifelong health.

What Can You Do Today?

If you work in healthcare, research, or public health, this episode raises a challenging question:

🎧 Listen now, and consider:
Are we oversimplifying the microbiome by ignoring the environments people actually live in?

If this resonates, or you disagree, please share it with a colleague.

Share

Please subscribe to The Microbiome Plan for more expert insights exploring the future of health.

Want To See More?

To watch the replay of Dr Ariangela Kozik's presentation at The Microbiome Plan 2026 virtual conference. >>> https://microbiomeplan.com

Subscribe to follow the full series on how the microbiome is shaped from birth.

Episode Transcript

THE MICROBIOME PLAN – PODCAST

Meet The Speakers: ARIANGELA KOZIK

Ariangela Kozik, Assistant Professor in Microbiology at the University of Michigan, in conversation with podcast host, and co-founder of The Microbiome Plan, Toni Harman

00:00:00,120 --> 00:01:11,650 [Toni Harman]

[gentle music] Welcome to this tiny podcast about one of the biggest topics in health today. Many parents write a birth plan, but how many have a microbiome plan? Modern childbirth practices can interfere with the optimal seeding of the infant microbiome, with implications for a child’s long-term health. But what does that mean? And what can parents actually do? That’s the subject of our conference, and in this micro podcast series, I’ll catch up with some of the conference speakers to find out about their personal passions.

I’m your host, Toni Harman, and with me today is an incredible speaker, Ariangela Cosic. Ariangela is a microbiologist, computational biologist, science communicator, assistant professor at the University of Michigan, and also the co-founder and vice president of the Black Microbiologists Association. I caught up with Ariangela to talk about the importance of the microbiome for our health and learned how clean we should be in our own homes. So let’s get to it. With me today, I’m very, very excited we have Ari Cosic. Hello.

00:01:11,650 --> 00:01:12,220 [Ariangela Kozik]

Hi.

00:01:12,220 --> 00:01:13,660 [Toni Harman]

So who are you?

00:01:13,660 --> 00:01:29,460 [Ariangela Kozik]

I am a, a researcher. I am an assistant professor at the University of Michigan in Ann Arbor. Um, I work in the Department of Molecular, Cellular, and Developmental Biology, but also in Internal Medicine and Pulmonary and Critical Care.

00:01:29,460 --> 00:01:34,080 [Toni Harman]

So how did you get into the microbiome? What’s your story to get to where you are now?

00:01:34,080 --> 00:02:26,260 [Ariangela Kozik]

I first, you know, heard about the microbiome when I was in undergrad in college, and it was right around the time that the Human Microbiome Project was getting, you know, kicking off, and there was all this, you know, buzz about all of these, you know, organisms that live inside of us and on us that are, you know, not pathogens, but it seemed like they’re really important for our health. And I was really interested in microbiology before then but finding out that there was, you know, this whole other universe of microbes that was really important for us was really exciting to me. And I intended to study neuropsychology, but after finding out about the microbiome, completely changed, [chuckles] changed course and decided to, you know, stick with microbiology and haven’t looked back since then.

00:02:26,260 --> 00:02:28,440 [Toni Harman]

So what’s your area of study?

00:02:28,440 --> 00:03:05,520 [Ariangela Kozik]

So right now, I study the airway microbiome. I’m specifically interested in the organisms that, you know, come through and live in our airways and how that interacts with our immune system and what the consequences of that are especially when it comes to chronic airway diseases. So I’m particularly interested in asthma and, uh, chronic obstructive pulmonary disease. So these diseases where there’s a lot of chronic inflammation we have, you know, treatments that sometimes help the symptoms, but we don’t have cures for these diseases and they, you know, they have a pretty significant impact on quality of life.

00:03:05,520 --> 00:03:09,920 [Toni Harman]

What’s the connection between asthma and the early life microbiome?

00:03:09,920 --> 00:05:01,000 [Ariangela Kozik]

We know from, you know, work that people are doing in the, uh, microbiome and early life space that the microbiome seems to play a really important role in helping development for us. So it seems like there is a really important component of priming or education that’s provided by the microbiome to the immune system that helps our, our immune systems tell the difference between, you know, what’s a threat and what’s not a threat. And so we also know from, you know, studies of different populations and different environments that it also, uh, appears that, you know, your environmental surroundings is also important for the development of the microbiome and for this priming to happen.

And so looking at differences between, you know, urban and densely populated areas versus more rural or, you know, pastoral areas and having, like, what those exposures look like what does that mean for your microbiome? And I study bacteria mostly, but it’s important for people to know that, you know, your microbiome consists of bacteria, but also viruses and also fungi. And, you know, the interactions and communication between all these different components of our microbiome is really important, and so I think it’s really important that we keep, you know, investing and studying in this particular area because I like to think of the microbiome as, you know, an interface that kind of is this bridge that connects our, like, inner world with our outer worlds.

And really understanding, you know, what the communication is between these two spheres I think will kind of help us, you know, have a better understanding of how our different body systems work, and then also how important the world around us is and how we can, you know, make, you know, significant impact to make that more accessible for everyone.

00:05:01,000 --> 00:05:06,500 [Toni Harman]

So what can we do? So for those who live in the city, and I live in a flat in the city, what can I do?

00:05:06,500 --> 00:07:14,448 [Ariangela Kozik]

I think it’s really important, or I think the, the evidence at this, at this stage suggests that, you know, being outside is, is a good thing. And so I know that, you know, coming off of a pandemic where, you know, people were back in their homes, we’re all kind of, you know, ha- to have our own little protected, you know, havens of airspace which, you know, was a good and necessary thing at, at the time.

I think it’s also important though to be thinking about going outside and, you know, being in nature. I think there are things that we potentially can’t see, like, you know, maybe it’s, you know, plant matter or contact with animals or livestock or things that parts of our outside natural world that have always been part of the human experience.

We haven’t been able to separate, that from us so cleanly before. And so, you know, now it could be that you can go several days without having to go outside [chuckles] and still you have what you need. We used to have to go out for water every day. Um, now we can just bring the water inside and then not have to go outside. So it’s a very oversimplified example, but, you know, just thinking about, like, that connection between our natural ecosystem a- and how we live our lives now what are ways that we can kind of you know, have more of that exposure on a regular basis?

And are our children, you know, going outside, running around, you know, playing in the mud, you know, playing in the dirt, like those things. You know, as a parent myself, that was something, as a parent who also is a microbiome scientist, that was something that I was very muchYou know, a little bit different.

Like, it’s often you have a little kid, they’re running around, they go outside to get dirty, and every- your, your initial reaction is like, “Oh my God,” just like, “Stop playing in the dirt.” Like, “Stop playing in mud.” And I was very much like, “No, go, go do that. Do more of that.” Um, and then we’ll, you know, take a bath when we come inside.

So, you know, trying to encourage more of that exploration, being outside, go be exposed to those, you know, components of our ecosystem that we have kind of slowly and maybe unintentionally removed from our, you know, living experience just because of the way society has developed.

00:07:14,448 --> 00:07:18,728 [Speaker 2]

I love that. So what else do you do in your house?

00:07:18,728 --> 00:08:56,287 [Ariangela Kozik]

So I also, especially, you know, since the pandemic and having, you know, a life that has been kind of, you know, affected by asthma myself, I’m very conscious of, you know, air quality. And so sometimes, you know, here where I am, we’ve had, you know, a lot of wildfires. Mostly, I think, from the Canadian wildfires that kind of like come down. Some days we have, like, really bad air, really poor air quality. And so being more aware of, like, when those are having, you know, filtration systems, like, in your, in our house to try to, like, keep out the smoke.

But also when that’s not a concern, you know, have a window open so that you, you know, can have some of that contact from the outside. You know, if it’s, you know, a rainy morning and you have that, you know, smell of like, you know, the wet earth and the trees and whatever, trying to like bring some of that, like, in, uh, making sure that, you know, we’re going on walks.

There’s some evidence that, you know, having pets is actually a good thing because you are-- that’s another, you know, layer of exposures that we, you know, as humans have typically had for, you know, thousands of years. So we have pets and, [laughs] you know, I consider that as a, a value add to our home, you know, ecosystem. So thinking about the-- what those exposures are, trying to, you know, bring the outside inside and, and bridge that, I really try to be intentional about that in our home so that we have not just a inside environment that is separated from, you know, nature.

00:08:56,288 --> 00:09:03,508 [Speaker 2]

What about soaps and hand sanitizers and disinfectants? I mean, do you use antibacterial sprays?

00:09:03,508 --> 00:11:08,068 [Ariangela Kozik]

I try to avoid antibacterial sprays that are, that are not necessary, so because I, I’ve noticed, like, a lot of products now will have, like, oh, it’s like everything is antibacterial, or they’ll have dish brushes, like, for washing dishes that have some sort of antibiotic, like, into the plastic or something like that. So I typically try not to use those kinds of things because I’m also, you know, very aware of, you know, antimicrobial resistance and, like, trying to not be constantly exposed to, you know, these other, you know, antibiotic substances that are not necessary.

If I need to disinfect something, I will use bleach you know, bleach solutions and, and clean things that way. I will use disinfectant wipes, like, especially if someone’s ill or there’s, like, an active, you know, exposure that we’re trying to manage. But I also really try to be mindful about, you know, where those other sources of, you know, antibiotic exposures may be coming from, because I do know that they are, you know, putting them in products, and we don’t really know what the antimicrobial is that is included.

And for, you know, hand sanitizers, that’s typically, you know, seventy percent ethanol alcohol, which is... I use-- we use that in the lab to c- to clean things, and so, like, my-- for hand sanitizer, like, that’s usually what we use is the ones that have, you know, the high enough alcohol level to sanitize. But also, you know, knowing what, what strategy to use for whatever it is that you’re, you’re trying to get rid of is important.

So, you know, for example, if you have kids, I’m sure you know what norovirus is or [laughs] like the stomach bug. Um, those viruses are super hardy, and they don’t care about the alcohol. So, you know, hand sanitizer will not work for noro. You have to use bleach. And so just trying to be aware of, like, what we’re using and, like, what the microbiology is behind what we’re using. And so that’s very much part of the practice, you know, that I have in my house.

00:11:08,068 --> 00:11:18,508 [Speaker 2]

I’ve never really heard about this. So do you use bleach over antibacterial spray? So if you had raw chicken in your kitchen, what would you use?

00:11:18,508 --> 00:12:00,028 [Ariangela Kozik]

Raw chicken, I will use soap and water depending on the length of time that it was in contact with whatever. And so if you really want to, you know, kill everything, I will use a bleach solution, but then you have to, you know, rinse it with w- potable water after, ‘cause you can’t just... I mean, bleach will dry, and it’ll leave, like, residue and everything like that. But I mean, soap and water is a tried and true for a reason [laughs], you know? But I won’t use a, like an antibacterial spray. I prefer just doing soap and water and then bleach and then rinsing.

00:12:00,028 --> 00:12:06,228 [Speaker 2]

Okay. If you drop something on the floor, do you pick it up and eat it within five seconds?

00:12:06,228 --> 00:12:10,598 [Ariangela Kozik]

In my house where there’s dog hair? No. [laughs]

00:12:11,848 --> 00:12:26,668 [Ariangela Kozik]

No. I have-- I sometimes... You know, kids are quick. It has happened before where he will get to it before I can but I typically do not eat things off the floor, no.

00:12:27,828 --> 00:12:28,008 [Ariangela Kozik]

Yeah.

00:12:28,008 --> 00:12:30,668 [Speaker 2]

Okay. Any, any take home messages you want to share?

00:12:32,008 --> 00:12:34,448 [Ariangela Kozik]

Uh, take home messages. I think that...

00:12:37,948 --> 00:14:40,494 [Ariangela Kozik]

I think microbiome science is just really cool because it’s one of those things that are, you know, immediately relevant to everybody’s lives, you know, whether or not you recognize it or not. Like we are all, I mean, this might be kind of, seem kind of gross to some, but like, you know, humans, we are coated in microbes. We’re constantly like shedding them. You know, our microbial clouds are constantly coming into contact with the microbial clouds of other people.

And so it’s sometimes I wish, you know, we could have special, you know, vision glasses or something so you can actually like see how much of the microbial world is like impacted. Like we’re always, you know, touching, interacting with, you know, all the time. And so I think just having, trying to be more aware of that or having a, a level of microbial awareness I think will be, will be good. Um, not only just for us to better understand the relationship between, you know, like the way our body works. Like, you know, we can’t digest our food if we don’t have a microbiome. Like that’s one of the important things that they, they do for us.

So just being more aware of what the microbial communities are that are around us, why they’re important, what they’re doing. Um, and then also just trying to, you know, encourage that connection or the, the connecting of thought between, you know, us and our environment, the environment we make for ourselves, but also the environment we’re making for other people through the broader, you know, societal things that are going on.

Like who has access to clean water, clean air? Like are we, you know, trying to build a society that is conducive to having healthy microbial relationships, and is that something that everyone has access to? And if not, like can we intervene to try to, to fix that? It’s one, one of the, I guess, broader, you know, big picture questions that I, I think is really important for people to think about. But it starts with having this, you know, awareness of the fact that we’re living in a microbial world, and it’s incredibly important to all aspects of our health and environment.

00:14:40,494 --> 00:14:42,824 [Toni Harman]

Thank you so much for sharing your wisdom.

00:14:42,824 --> 00:14:43,224 [Ariangela Kozik]

Thank you.

00:14:44,264 --> 00:15:20,624 [Toni Harman]

Talking to Ariangela, it made me realize how we need to rethink our interactions with our microbial environment from positive impacts like going outside, getting a dog, or letting your kids roll in the mud, and then the potential negative impacts from overuse of antibacterial products and overuse of antibiotics.

My take home message, I just love Ariangela’s description of each of us having a microbial cloud. Something to think about when you meet someone, your clouds of microbes intermingling above and around you.

00:15:21,984 --> 00:15:29,564 [Toni Harman]

Join me again to meet another speaker to hear their passions as together we create the microbiome plan.

00:15:30,924 --> 00:15:31,744 [Toni Harman]

Thanks for listening.

Subscribe to follow the full series on how the microbiome is shaped from birth.

About This Podcast

What if modern medicine has been treating the wrong patient all along?

Not the human alone, but the human without their microbiome.

In this episode, Professor Rodney Dietert argues that this fundamental blind spot may be driving the explosion of chronic disease, and that early life is where everything goes right… or wrong.

For the immune system doesn’t arrive fully formed. It learns.

Emeritus Professor Rodney Dietert, Immunotoxicology, Cornell University, examines the role of the early-life microbiome in immune system development, and how disruptions during critical windows may contribute to long-term health outcomes.

Key Take-Aways

• We are not just human, we are a “superorganism” made up largely of microbes

• Medicine has historically treated patients as a single species, ignoring the microbiome

• This disconnect may contribute to rising chronic diseases and multimorbidity

• Early life is a critical window where the microbiome “completes” the infant

• Disruptions in this period can shape lifelong immune and metabolic outcomes

• Many common exposures (drugs, environment, diet) may damage the microbiome unintentionally

• A “microbiome-first” approach could fundamentally change prevention, treatment, and public health

Short Summary

In this conversation, Rodney Dietert introduces the concept of Microbiome First Medicine, this is a radical shift in how we understand health. He argues that by ignoring the microbiome, modern healthcare may have unintentionally contributed to the rise in chronic disease.

From infancy through adulthood, the microbiome acts as a central regulator of immunity, metabolism, and even treatment outcomes. The implication is uncomfortable but important: many current medical practices may need rethinking from the ground up.

What You Can Do Today

If you work in healthcare, research, or public health, this episode challenges a core assumption:

🎧 Listen now—and ask yourself:
Are we still practising “human-first” medicine in a microbiome-driven world?

If this challenges your thinking, or you disagree, please share it with a colleague.
This is a conversation the profession needs to have.

Share

Please subscribe to The Microbiome Plan’S Substack for more expert discussions reshaping how we think about health.

Part of The Microbiome Plan podcast, exploring how early-life biology and environment shape lifelong health.

Want To See More?

Catch the replay of Professor Rodney Dietert's presentation at The Microbiome Plan 2026 Conference.>>> https://microbiomeplan.com

Subscribe to follow the full series on how the microbiome is shaped from birth.

Episode Transcript

THE MICROBIOME PLAN – PODCAST

Meet The Speakers: RODNEY DIETERT

Rodney Dietert, Emeritus Professor, Immunotoxicology, Cornell University, in conversation with podcast host, and co-founder of The Microbiome Plan, Toni Harman

00:00:00,120 --> 00:01:10,940 [Toni Harman]

[background music] Welcome to this tiny podcast about one of the biggest topics in health today. Many parents write a birth plan, but how many have a microbiome plan? Modern childbirth practices can interfere with the optimal seeding of the infant microbiome, with implications for a child’s long-term health. But what does that mean? And what can parents actually do? That’s the subject of our conference.

And in this micro podcast series, I’ll catch up with some of the conference speakers to find out about their personal passions.

I’m your host, Toni Harman, and my guest today is Rodney Dietert, Emeritus Professor of Immunotoxicology from Cornell University. Rodney has a very special place in my heart because he was one of the original people we filmed for our documentary, Microbirth.

His hypothesis on the true nature of childbirth changed our lives. But the manner he formulated it is an extraordinary story, so let’s dive in.

With me today is Professor Rodney Dietert. Hello.

00:01:10,940 --> 00:01:12,400 [Rodney Dietert]

Hello, Toni.

00:01:12,400 --> 00:01:15,280 [Toni Harman]

Lovely to see you. So who are you?

00:01:15,280 --> 00:01:51,080 [Rodney Dietert]

Well, I’m Professor of Immunotoxicology Emeritus, Professor Emeritus, Cornell University, and otherwise I’m enjoying life living in the middle of a forest in East Texas. So that’s, that’s who I am. But I write, I lecture, I publish, and despite my not being on the campus at the moment I am still extremely active in promoting our better health for the whole human, including the microbiome, and I’m excited to try to disseminate information to all who are interested.

00:01:51,080 --> 00:01:58,140 [Toni Harman]

So can you tell me, like, briefly your route to [chuckles] discovering the microbiome to where you are now?

00:01:58,140 --> 00:08:24,528 [Rodney Dietert]

Absolutely. It’s a thrill. So I actually got my doctoral degree in immunogenetics. I was studying the relationship between embryonic and early life development with the blood system, the immune system, and leukemia. And so what’s, what’s similar? What’s different? This was back in the seventies, and that was my PhD thesis, and then I was hired into Cornell as a, a vertebrate immunogeneticist, but it turned out in those days it was fruit flies and tetrahymena and small things that were part of the genetic work there. And I got funding to work in environmental sciences, environmental health and safety, and toxicology for the immune system.

So really most of my time at Cornell evolved and pushed into how to, how the immune system develops in early life, why it’s so critical, and all the things that help protect it and all the things that damage it the toxicity and how to measure it, how to evaluate those things.

And so that really was the career. It led me into doing research about things we call critical windows of early development for the immune system, the periods of their most vulnerable, where you can either have wonderful development or it can be damaged through environmental exposures.

So and it really enabled me to have a vision of chronic diseases, including cancer, of environmental risk factors of how to do safety and how we should do safety, and the developing immune system as the main target in one of the e-early life things, so critical.

And then I got stuck on a problem, and that was what would the, the question to do a paper on what the best thing you could measure in the newborn would be to best predict whether the newborn’s life would be filled with health or filled with disease. Even though things happen as you live your life, what could you measure? And that was the challenge I had to do this paper that got published in the journal Entropy in twenty twelve.

And I was stuck. I thought I knew the answer. It was within the developing immune system, but not exactly. So I went to bed that night, and I had a dream. I don’t really remember all the details of the dream, but I remember the idea, and the idea was called the completed self. And with my wife, Janice, we wrote a paper, the “The Completed Self Hypothesis Relative to the Immune System.”

And basically, the answer was what you could measure the, is the extent to which the newborn has been seeded and fed in terms of the microbiome. The newborn is only complete when the, the ancestral microbiome, microbiome donated by mom largely, but dad as well, skin-to-skin contact feeding is done. And that was the answer, and we wrote a paper, and it changed my whole career.

Thanks largely, by the way, to Microbirth and to you guys, so appreciate that. So that was how I got into the microbiome, and it just exploded into more papers and lectures and a book, and I moved from mainly being focused on the developing immune system to the integration of the microbiome and the immune system. And of course, we now know the, the microbiome affects all physiological systems in a big way.

So that started me on the route. And by the way, if you think it’s unusual to have gut instinct ideas or dreams or waking up in the middle of the night, I happened to go to an autism conference early on about twenty thirteen, and I’m sitting next to a, a microbiome scientist who’s lecturing on the program just before or right after me.

We’re adjacent. We’re sitting adjacent, and we ask each other, “How did you come to work on the microbiome?” And the answer in both cases, “Well, I had a dream.” Well, I had a dream, and that was Dr. Derek MacFabe. He’s quite renowned uh, neurologist, MD Western Ontario University in an autism center there. And he had a dream that involved his switching to work on the microbiome, and then I had a dream that propelled me into the microbiome. And I thought, “Well, he wrote a paper.” He actually published a paper about his dream that included his dream. I thought, “I should do that.”I shouldn’t be a WUTZ. I should go and write a paper there.

And that paper won actually the Best Paper of the Year award from the Birth Defects Society, or as it was called then. And, um, so who would have thought? Coincidence [laughs] or not? So we both actually had dream-inspired inspirations or ideas that propelled us to work on the microbiome. And I hope to translate what I learned in the integration and systems biology of immune system and the microbiome, and the new way to view humans.

And the new way is we are ninety-nine point nine percent microbial in terms of genes. We are a slight, slight majority, but a majority microbial in terms of cells. We live on Earth. Earth, the predominant life form on Earth are the microbes. It’s a microbial planet. We are the pinnacle or apex collector, distributor, houser, and co-partner with microbes. And the complete baby is one that’s has experienced seeding of the microbiome and feeding of the microbiome. The initial bolus is so critical.

So we need to ensure that as you go through life, as you interact with healthcare providers as you, you take recommendations from regulatory groups, from public health, they must put the microbiome first and foremost, because you are, by several measures, mainly microbial. And that will be what I’ll be talking about, by the way, is when you realize what a whole human being is, which is multi-species and a marvelous re-reflection of life on Earth at the top, that we need to manage our health, our longevity, our wellness through life by paying attention from the get-go about microbes. They are not our enemy. We are the microbes, in fact.

So that’s uh, sorry, a bit long-winded, but that’s my, my path. It was completely unexpected, and yet it was simply going with the flow that got me here.

00:08:24,528 --> 00:08:33,888 [Speaker 2]

So your talk at our Microbiome Plan twenty twenty-six conference is gonna be an update of your completed self hypothesis.

00:08:33,888 --> 00:10:02,828 [Rodney Dietert]

That’s exactly correct. And so that was something, again, written published in twenty twelve, over a decade ago. And I’m going to now try to put it in today’s perspective. And I think we’ve learned a lot over that time. I mean, there’s been terrific microbiome research by so many distinguished people, so many brilliant scientists doing really quality work and contribution. And what it’s done to me is to reveal things about the microbes we never knew, things about how they co-communicate with all of our systems in our body, how they have such a tremendous impact. And think about the microbiome. Again, it’s seeded. It’s, it’s through the gut, right? From our mouth to our anus, which is an open tube. It’s open to the environment. So our microbes are actually intimately connected with environmental microbes. So when you stick your hand in soil there’s good reason to understand that there’s microbial flow, there’s information flow, there’s communication through the internet of microbes. And that is one of the ways that we really can benefit is by not being fearful of that which is within us and outside, but of, of using that to our better health and, and understanding how to manage the microbiome, establish the infant microbiome, manage it, and then fiercely defend against things that would damage it.

00:10:02,828 --> 00:10:06,188 [Speaker 2]

Okay, so how is this gonna change the world?

00:10:06,188 --> 00:13:42,192 [Rodney Dietert]

Well, it’s gonna change the world ‘cause we’ll view ourselves differently, and I think more respectfully. Uh, if you hate microbes, then you’re kinda self-hating. And, and there’s no reason to do that. So really, we’re gonna view, view ourselves in a, in a, in a better light, I think. And we’re gonna understand how we can live a more integrated, longer life in wellness as we start to, to understand better microbes and how these interactions occur, and use that to, to our benefit, to our, again, across life. Uh, people don’t really understand that much [chuckles], you know, about bacteria. It’s kind of been siloed or pigeonholed into areas.

Bacteria are remarkable. They’re sen-sentient beings. Did you know that bacteria have intergenerational memory? So when mom donates her bacteria to the baby, those bacteria know where they come from. When mom and dad have skin-to-skin contact, those bacteria know their prior generations of bacteria. They know where they came from. They actually have-- You can demonstrate memory in bacteria. Uh, they are quantum shapeshifters. They can hold multiple states simultaneously.

They’re studied by physicists because they are the preeminent form doing that. And you’ll, you’ll hear physicists refer to purple bacteria, green bacteria, and their antennae, which are incredible energy converters, and again, can hold these multiple states. So y-you need to understand that, that these microbes are doing things you never, you never dreamed of, and they’re part of you.

So guess what? You can do things you never dreamed of yourself. And I’m going to go there in this talk. I’m going to go there both about the practicality of birth, the importance of microbirth, the importance of seeding, feeding, but also as the child develops, as you go to adulthood, managing the microbiome and defending it, protecting it.

And that means we cannot accept healthcare, medicine, regulatory agency decisions, and public health institutional proclamations that ignore the microbiome. Those days are gone. We have to insist that we’re gonna pay attention to our own body, to ourselves, we understand our own body, and medicine had better do it as well.

So one of the things that I’m proudest of was introducing the microbiome into the Cornell Veterinary College curriculum. I did that in the second year in the basic science integrated case-based learning courses, and what we found is that students actually change the students’ learning, infectious diseases, and how to protect, and antibiotics, and things like that, and nutrition to some extent, not enough, but to some. They began to view things differently. They looked at their protocols. They said, “Do we really wanna go and use another antibiotic, or is there a way to, to better integrate how we protect understanding the microbiome of our pets, understanding the microbiome of our food producing animals, understanding wildlife microbiomes?”

So it actually, once you introduce it into the medical curriculum, it changes how people think about it, just as it changes how parents think about it. It changed how I think about it. We have to insist we’re gonna learn about it, we’re gonna apply it, and doctors, healthcare providers, regulatory agencies, and public health institutions had better do the same.

00:13:42,192 --> 00:13:54,492 [Toni Harman]

What one thing would you want healthcare providers, so doctors, midwives, um, nurses, lactation professionals, what one thing would you want them to do or say?

00:13:54,492 --> 00:15:33,692 [Rodney Dietert]

Well, to begin with Ellie Silbergeld and I published a paper in 2015. She’s a Johns Hopkins University immunotoxicologist and re- regulatory scientist and public health [laughs] expert. And we published a paper saying if you’ve done safety testing, if you ... for environmental health, for example, and you haven’t started with the microbiome, which is again, is on our skin, it’s in our airways, it’s in our gut. Microbes are exposed before your mammalian cells, human cells are exposed. They’re the first exposed. You must understand how chemicals, drugs, and food, and food additives are handled by the microbes, and what things damage the microbiome. And if that testing hasn’t been done, you don’t know whether it’s safe or not. And they better not be recommending it unless it’s safe.

Again, from my director of toxicology perspective, nothing else is really acceptable. It’s either been tested properly or they don’t know. And they shouldn’t be saying anything if they don’t know. So that’s the first ... the starting point actually goes to protection.

You guys are working hard to educate people. We’re all trying to help parents and empower parents and to-be parents about healthy babies, healthy life, including the microbiome. And we must expect the same, and we must expect that things that we now know are damaging the microbiome that haven’t been addressed, haven’t even been removed from our exposure, that the change. So that’ll be one of my messages is it’s no longer acceptable to simply ignore the microbiome.

00:15:33,692 --> 00:15:37,892 [Toni Harman]

How can people contact you, and tell me about your books.

00:15:37,892 --> 00:16:24,132 [Rodney Dietert]

Okay. The best contact, and please do, I love to get [laughs] contacted, is through my email. My email is my three initials, R-R-D, Rodney R. Dietert, rrd1@cornell, C-O-R-N-E-L-L., and it’s E-D-U for education or educational, edu, rrd1@cornell.edu, and the one designates that, yes, I had been there that early, that long, pre-internet, pre-email, the whole works [laughs]. And I survived and thrived, [laughs] actually, through that. So please do. I, I welcome inquiries, I welcome questions, I welcome ideas. I’m happy to be, thrilled to be contacted. That’s the best route.

00:16:24,132 --> 00:16:25,492 [Toni Harman]

And what about your books?

00:16:25,492 --> 00:17:43,892 [Rodney Dietert]

My books, yes. Well, 2010 with my wife Janice, we published Strategies for Protecting Your Child’s Immune System, and that is from World Scientific, is the publishing house. And that is a book that de- starts out with risk. How do you, how ... When do we accept risk? Do we understand risk? And really understanding, again, risk benefit. And then goes through the immune system and goes through why early life is so critical. All the changes that are happening that need to change for the immune system to be, have integrity and be balanced. And that was actually before my dream about the microbiome. So the only apology is it’s not appropriately included as it should’ve been, but we corrected that later. So there is a book in also 2012, 2013 called Science Sifting. If you’re interested in creative problem solving that’s again a, a, a book that we used, and I used it in teaching a course at Cornell. And then finally, 2016, the real microbiome book, The Human Superorganism from Dutton, Penguin Random House. And all of these books you can find on Amazon, but then you can get them there or you can order them through your favorite route for books. So please do check. Again Strategies for Protecting Your Immune System, Science Sifting, and The Human Superorganism.

00:17:43,892 --> 00:17:50,952 [Toni Harman]

Most importantly, will you accept this mission to join us to change the health of the gen- next generation?

00:17:50,952 --> 00:18:23,332 [Rodney Dietert]

Absolutely, Toni. You guys were critical in my act- the idea being launched in the first place, people seeing the complete itself idea. You, it was largely through your, your Microbirth efforts and, and what came after that. And join you, I feel like I’ve been along the way in part, small steps along the way. I’m not leaving. I’m ready to keep diving in and to try and help any way I can to promote our better health and our understanding of what human beings really are.

00:18:23,332 --> 00:18:26,642 [Toni Harman]

Well, welcome aboard, and thank you. [laughs] Thanks ever so much.

00:18:26,642 --> 00:18:29,172 [Rodney Dietert]

Thank you, Toni. Cheers to everyone.

00:18:30,212 --> 00:18:59,832 [Toni Harman]

What struck me from my catch-up with Rodney was this idea of a chain of maternal heritage, that beneficial microbes are passed down through the generations from grandmother to mother to daughter and so on.

And yet, somehow modern maternity practices are interrupting this chain with long-term repercussions for our children’s health. Join me again to meet another speaker to hear their passions as together we create the Microbiome Plan.

00:19:00,912 --> 00:19:08,792 [Toni Harman]

For it’s not just a story about birth, it’s a plan for life. Thanks for listening. [outro music]

Subscribe to follow the full series on how the microbiome is shaped from birth.

About This Podcast

In this episode, Neuroscientist Dr Nils Bergman makes a bold claim: separating mothers and babies, even briefly, is not just unnecessary, but potentially harmful.

If that’s true, it raises an uncomfortable question:

👉 Are we prioritising systems and convenience over biology?

Drawing on decades of research and global policy developments, this conversation reframes skin-to-skin contact as a biological necessity, not an optional intervention.

We explore the neuroscience of early bonding, the physiological transition from womb to world, and why separation may interfere with critical developmental processes.

Some key take-aways:

• Skin-to-skin contact isn’t a bonus—it’s the biological default

• Routine separation may actively disrupt newborn stability and regulation

• The first hours after birth are a critical window for microbiome seeding

• Breastfeeding success is tightly linked to early, uninterrupted contact

• Many standard hospital practices persist despite contradictory evidence

• “Safe” and “normal” are not always the same thing in modern care

• Rethinking early-life care could have lifelong health implications

Short Summary:

This conversation challenges the status quo. Dr Nils Bergman argues that early separation of mother and baby, still all too common in many healthcare settings, may conflict with fundamental human biology. Drawing on decades of research, he reframes skin-to-skin contact as a critical intervention for physiological stability, breastfeeding, and microbiome development. The implication is clear: some routine practices may need urgent re-evaluation.

Part of The Microbiome Plan podcast, exploring how early-life biology and environment shape lifelong health.

What you can do today?

If you work in maternity, neonatal care, or early-life health, this episode may challenge your assumptions.

🎧 Listen now - and then ask yourself:
If the evidence points one way, why are our systems still doing another?

If you agree, or strongly disagree, please share this with a colleague. This is a conversation worth having.

Share

Subscribe to The Microbiome Plan for more discussions that question what we think we know about early-life health.

Want To See More?

Catch the replay of Dr Nils Bergman's presentation from The Microbiome Plan 2026 Conference.

>>> ⁠https://microbiomeplan.com ⁠

Subscribe to follow the full series on how the microbiome is shaped from birth.

Episode Transcript

THE MICROBIOME PLAN – PODCAST

Meet The Speakers: NILS BERGMAN

Nils Bergman, Neuroscientist and Public Health Physician, in conversation with podcast host, and co-founder of The Microbiome Plan, Toni Harman

00:00:00,100 --> 00:00:54,660 [Toni Harman]

[gentle music] Welcome to this tiny podcast about one of the biggest topics in health today. Many parents write a birth plan, but how many have a microbiome plan?

Modern childbirth practices can interfere with the optimal seeding of the infant microbiome, with implications for a child’s long-term health. But what does that mean? And what can parents actually do?

That’s the subject of our conference. And in this micro podcast series, I’ll catch up with some of the conference speakers to find out about their personal passions.

I’m your host, Toni Harman, and with me today is a very special guest, Dr. Nils Bergman, specialist in perinatal neuroscience and one of the founders of the Kangaroo Mother Care movement. His personal passion is promoting skin-to-skin contact between mothers and newborns.

00:00:55,730 --> 00:00:56,800 [Toni Harman]

So let’s get to it.

00:00:57,860 --> 00:00:59,020 [Toni Harman]

Hello, Nils.

00:00:59,020 --> 00:01:00,340 [Nils Bergman]

Hello, Toni. Thank you.

00:01:00,340 --> 00:01:01,800 [Toni Harman]

So who are you?

00:01:01,800 --> 00:01:28,160 [Nils Bergman]

Uh, I am right now a grandfather primarily, but, uh, I have been working with the Kangaroo Mother Care, broad term, skin-to-skin contact, and that’s been my passion, working for the last, uh, 35 years. Uh, and now recently, uh, recently, five years ago, the immediate Kangaroo Mother Care study was published and the World Health Organization has made global policies out of it.

00:01:28,160 --> 00:01:30,080 [Toni Harman]

Are those policies being implemented?

00:01:31,220 --> 00:01:49,000 [Nils Bergman]

So this is the reason why I’m not only a grandfather. I’d hoped that I could only be a grandfather, but no, they’re not being implemented. So the policy is immediate skin-to-skin contact on all small and sick babies. That’s pretty blanket.

00:01:50,020 --> 00:02:13,960 [Nils Bergman]

And to continuous skin-to-skin contact, uh, that I translate zero separation. Uh, your listeners have probably heard zero separation from me and others before. A-a-and before it was a song, uh, but now it’s a policy from the World Health Organization. And as you point out, nothing much is happening.

00:02:15,220 --> 00:02:20,920 [Nils Bergman]

So I’m kind of feeling I’ve got to pick up the journey again.

00:02:20,920 --> 00:02:25,850 [Toni Harman]

Okay, so for those who don’t know, what exactly is skin-to-skin?

00:02:25,850 --> 00:02:44,540 [Nils Bergman]

At birth, baby is born and continues life on mother’s chest. Skin-to-skin contact can be with another family member, but it’s skin-to-skin contact, and it’s the continuity of biology.

00:02:45,600 --> 00:03:08,200 [Nils Bergman]

The baby’s brain, its DNA, its persona, its essence depends on being in the right place. Skin-to-skin contact is not a kind of care. It’s a place. It’s quite surprising actually because there’s an intervention. Yeah, but it’s not an intervention. It’s a place.

00:03:09,500 --> 00:03:27,680 [Nils Bergman]

It’s the right place. Now you can bring interventions and you can bring everything else, but it’s the place. This is the key that unlocks wellbeing and the capacity for that baby, no matter how small, no matter how sick, to thrive.

00:03:27,680 --> 00:03:34,560 [Toni Harman]

So in your opinion, how long should a baby be placed skin-to-skin on the mother’s chest?

00:03:35,860 --> 00:03:49,180 [Nils Bergman]

Policy says start immediately and then do it continuously. Continuously, uh, for a 28-week baby can mean, uh, 24 hours a day for 24 days.

00:03:50,480 --> 00:04:03,840 [Nils Bergman]

Uh, [chuckles] obviously anything in between there. So that’s not reasonable just for a mother. That’s why we want the family also to do this. The World Health Organization says family should be admitted to the NICU.

00:04:05,180 --> 00:04:11,920 [Nils Bergman]

So NICU, how long was your question? Only your baby will tell you.

00:04:13,500 --> 00:04:31,380 [Nils Bergman]

And when you’re finished with skin-to-skin contact, then you carry on with zero separation, which means carry care and co-sleeping. And co-sleeping is not the hot potato it used to be. Uh, it’s accepted as safe if you’re a breastfeeding person.

00:04:31,380 --> 00:04:37,310 [Toni Harman]

How long does it take for a, a mother’s brain and a baby’s brain to be wired?

00:04:37,310 --> 00:04:46,620 [Nils Bergman]

That wiring they’re born with. Baby’s brain is wired by mother’s smell in a one-hour clock.

00:04:48,320 --> 00:05:17,400 [Nils Bergman]

A baby smells that same smell from the mother’s areolar gland, and so the continuity is that at birth they will make eye-to-eye contact. Skin-to-skin contact makes eye-to-eye contact. So the beginning of the wiring is in the first minutes of life. It’s wiring a circuit that couldn’t wire before because it needed eye and face and emotion.

00:05:18,720 --> 00:05:22,880 [Nils Bergman]

It begins at birth. It’s consolidated in the hours that follow.

00:05:24,860 --> 00:05:36,140 [Nils Bergman]

Mother needs 20 hours of continuous non-separation skin-to-skin contact with her baby for her brain to be wired on her baby.

00:05:37,180 --> 00:05:49,160 [Nils Bergman]

There’s a lot of circuits involved in the mother brain, many and all of them need to be synchronized. It takes a whole day of zero separation.

00:05:49,160 --> 00:05:52,840 [Toni Harman]

What about the baby’s brain? How long does it take for the baby’s brain?

00:05:52,840 --> 00:05:57,800 [Nils Bergman]

The synchronicity is mother’s synchronicity. It’s two.

00:05:59,100 --> 00:06:17,596 [Nils Bergman]

[laughs] Uh, so the baby’s brain, uh, is good when it’s born. It’s made for this. It’s the sponge that receives this.The baby either has transition to extrauterine life to accomplish. This is not the same as the emotional connection.

00:06:18,636 --> 00:07:00,816 [Nils Bergman]

But it’s built on exactly the same oxytocin and dopamine, uh, that makes the baby transition from living in water to living in air. That takes six hours, and so that’s a very particular critical time, and it’s not quite the same as the mother’s brain. The mother has already done the transition to extrauterine life. She, she knows how to breathe air. Uh, so she’s focused on the emotional. The baby’s gotta do both, and it does both. A-and so I don’t give you a time for the baby. Twenty hours, mother brain. The mother brain is the emotional synchrony. The baby’s emotionally synchronizing with mother. So you can’t separate them when you answer this question.

00:07:00,816 --> 00:07:06,976 [Toni Harman]

So what do you want all health professionals, all maternity health professionals to know or to do?

00:07:08,436 --> 00:07:17,676 [Nils Bergman]

Let’s start by looking up, reading, downloading, buying the World Health Organization global position paper on Kangaroo Mother Care.

00:07:18,856 --> 00:07:37,816 [Nils Bergman]

Document like that comes with an implementation strategy that tells you how. A-and it says, “This is contrary to previous advice and common clinical practice.” So now, yeah, it’s written for that reason.

00:07:39,136 --> 00:08:08,056 [Nils Bergman]

And so that would be a first step. And then immediate, it needs to keep mother and baby together. So this is step one. All midwives, bring the neonatal bed equipment and everything to the labor ward and the operating room permanently. Then it doesn’t matter on the mother’s condition or the baby’s condition, but you can care for them in the right place.

00:08:11,516 --> 00:08:26,096 [Nils Bergman]

And now, when you’re finished caring for them in the labor ward, you have to care for them in the NICU, and therefore put a mother bed, a hospital bed, the hospital bed that the mother needs because she just gave birth by cesarean section, put that in the NICU.

00:08:27,376 --> 00:08:57,576 [Nils Bergman]

Now, here’s my suggestion. Just put one mother bed in the NICU and see what happens in it. Put one piece of neonatal equipment, uh, in the obstetric ward and see how it works. What happens next? Uh, yeah, well, uh, begin just with one NICU bed in the obstetric ward and one mother bed in the NICU, and you do have space. Take something else out.

00:08:57,576 --> 00:09:00,936 [Toni Harman]

Is this being done anywhere right now?

00:09:02,356 --> 00:09:23,896 [Nils Bergman]

Yes. Little pieces and steps here and there, but no. Probably, to scale, not. Not. I will want to address when I speak to in a few weeks’ time.

00:09:23,896 --> 00:09:28,376 [Toni Harman]

Okay, so that was step one. What are other things that people can do?

00:09:28,376 --> 00:10:24,936 [Nils Bergman]

There’s a great deal more that, follows. So the World Health Organization has put in place. They put out implementation strategy support documents. Uh, and, uh, just in November has been published, uh, Kangaroo Mother Care: A Clinical Practice Guide that now details very specifically, uh, the manual part, uh, the, the guideline pieces, uh, the techniques, lots of po- photos referring to videos. So, so it’s not starting in limbo. There is very practical support. So the second thing would be to get that clinical practice guide, uh, go through it, and then start thinking, uh, this i-is actually the policy. What can it look like here?

00:10:27,396 --> 00:10:33,276 [Nils Bergman]

Practice guide implementation strategy documents recognize that, circumstances differ.

00:10:34,476 --> 00:11:04,976 [Nils Bergman]

But it makes no excuse for being a very high income country with the best technology possible. Makes no excuse for being zero technology. It-- This is global policy based on experience from all contexts, low income and high income. And what I’ve then presented is an underlying scientific explanation, uh, that I call nurture science. So this nurture science actually is a scientific rationale.

00:11:06,556 --> 00:11:18,696 [Nils Bergman]

And what it says is that when you fail to do this, you’re doing harm. You’re doing harm when you fail to do good.

00:11:20,256 --> 00:11:26,176 [Toni Harman]

In your opinion, what, what can parents, what can parents do? What do you want them to know?

00:11:26,176 --> 00:11:33,296 [Nils Bergman]

So parents should insist on the human rights of their child.

00:11:34,316 --> 00:12:06,016 [Nils Bergman]

There’s a convention for the rights of the child signed by almost every country in the world, a boring one, that says the child’s best interests are paramount. That child is also an infant at birth, and there are documents around this. So the child’s best interests are paramount. The mother also has a human right to her child.

00:12:07,416 --> 00:12:43,486 [Nils Bergman]

So the fact that I, I’m, I’m putting this, uh, uh, to answer your question, is it fair to ask parents, uh, to pick up, uh, the activism-Yes. They, they, they should do this. They are the ones that are actually gonna carry this. Parents. We have in Europe the, uh, in fact, there’s now a global federation for the care of newborn infants, uh, EF- GFC&I, parent organization. In the UK you have Bliss, you have organizations that are actually taking an activist stand.

00:12:44,746 --> 00:12:51,806 [Nils Bergman]

Now, those mothers can’t do that as individuals, but they can do so with support.

00:12:52,926 --> 00:13:09,106 [Nils Bergman]

And so, yes, doctors are stuck in a system that they’ve created that has created expectations in mothers that they are now supporting, but mothers can come with them and say, “I don’t have that expectation anymore. I have this expectation.

00:13:10,146 --> 00:13:24,106 [Nils Bergman]

I expect to have my baby. I expect zero separation. I want skin-to-skin contact. I want to be able to hold my baby, to feed my baby, and love my baby always.”

00:13:24,106 --> 00:13:25,266 [Toni Harman]

Why do you care about this?

00:13:27,526 --> 00:13:48,466 [Nils Bergman]

I’m a human being. I’m, carry this. I care about this partly in the sense that I’ve been through experiences in my life where, where this is my, my passion, my calling. I started as a missionary and I was sent, then I was called away from that to this.

00:13:48,466 --> 00:13:51,686 [Toni Harman]

Any last takeaway messages? Anything you want to say?

00:13:53,526 --> 00:14:00,726 [Nils Bergman]

Thank you for having this and it really this works.

00:14:00,726 --> 00:14:51,506 [Toni Harman]

Thank you so much. [gentle music] Talking to Nils, it really struck me that continuous non-separation skin-to-skin contact for up to 20 hours is something so beneficial to both mother and baby, and it doesn’t cost anything, so surely it should happen everywhere in every hospital. But somehow modern hospital protocols can often get in the way.

But maybe if we want to change things, it’s as simple as what Nils suggests, for mothers to say to their care team, “I have this expectation. I expect to have my baby. I expect zero separation. I want skin-to-skin contact. I want to be able to hold my baby, to feed my baby, and to love my baby always.”

00:14:53,826 --> 00:15:08,205 [Toni Harman]

Join me again to meet another speaker to hear their passions as together we create The Microbiome Plan. Thanks for listening. [outro music]

Find out more at THE MICROBIOME PLAN Virtual Conference.

https://microbiomeplan.com

Subscribe to follow the full series on how the microbiome is shaped from birth.