The Influence of Birth History on Gut Flora  - "Protecting Diversity of Gut Flora" as a Model to Transcend Medical & Cultural Controversy

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birth history gut microbesWith so much controversy surrounding breastfeeding, natural birth, parenting advice, & medical practices following birth, it's time for a new lens of discussion.

A new lens requires drawing a bigger "box" around the issues to shed new light & open up areas where all sides can agree.
 
I propose the lens to be a model of gut health - that no matter one's birth history or health status, a proactive effort to support and maintain a healthy gut microbiome will serve everyone & create a safe forum to discuss questions and issues surrounding birth, parenting, or medical practices.
 
Babies born via C-section and given formula miss out on some of the diversity gained from natural birth through the probiotic-rich vaginal canal, as well as the immune, probiotic & prebiotic factors in breastmilk.
 
Babies may be introduced to complex proteins (from milk, eggs, soy, corn & tree nuts) that their young immune systems are not equipped to deal with so early. The introduction can come from solid foods, but also from the diet of a breastfeeding mother who passes immune components through her breastmilk. Often a mother needs to abstain from high-allergy potential foods like milk or soy during breastfeeding.
 
Ultimately, this is why exclusive breastfeeding is recommended for the first six months & that the timing of food introductions (not too early, not too late) is considered so carefully.
 
The effects of these immune imbalances may manifest in childhood such as colic, ear aches, dermatitis, tonsillitis, asthma, mood swings, focus difficulty, vomiting & bedwetting. Other symptoms or problems may not manifest for the first time until closer to ages 25-45 years old - the peak years when most autoimmune diseases are diagnosed.
 
You have a 25-45 year gap between the “cause” & the effect - so it’s easy for both critics & advocates to cry out & point to their tomes of evidence. When an effect is a year out, or 45 years out, it can be just as difficult to prove innocence as it is to prove cause.
 
There’s not enough public money or professional and commercial interest to pioneer 25-45 year randomized, controlled, double-blinded studies. The answers of such investigations may threaten old patents to a greater degree than they create new patents - so don’t count on them appearing any time soon. 

Perhaps instead of arguing over the details of antibiotic use, vaccinations, school lunches, & letting kids play in the dirt, get fevers & go outside without a coat - the one thing we can all agree with is that it is developmentally important to promote diverse gut microbiomes in ourselves & our children!

It is also our fundamental right to choose a birth by C-section, to choose vaccination, whether or not to breastfeed, what our kids eat, and the values we imprint on our children. 

There are also numerous medical and socioeconomic scenarios where all of these practices will make logical, financial, and medical sense based on individual circumstances.

Mother and her daughter preparing a salad in their kitchenWe will get much further in our understanding, our confidence in making decisions, & gain more public traction if we demonstrate how certain activities affect the gut microbiome & the long-term balance of the immune system.

The decision points become much less of an issue of "right vs. wrong", but of risk & tolerance.
 
There's no right or wrong - it's a matter of personal circumstance and preference.

As long as you're aware of the risk or benefit profiles in the first place & what actions are to be taken if unwanted scenarios develop. 

With decisions, you can have a perfect decision making process, and a bad result can still happen. You can also have a terrible decision-making process and a good result can occur.

You learn to become comfortable thinking in terms of probabilities - and your concern or acceptance of those probabilities can be weighted in values and emotions.
 
Instead of trying to link a practice or behavior to a single clinical entity like Autism - we'll be better served by focusing on the immune changes & patterns that lead to a range of clinical presentations that may include but are not limited to spectrum disorders.

In one child, the influences lead to allergic dermatitis, another a food allergy, in another it may be a spectrum presentation.

Focusing on the underlying patterns of these individual cases will show how they can be intricately linked further upstream to birth history as well as childhood practices driven by Western culture & medicine.

In determining mechanisms, we'll find that somewhere upstream they are linked to loss of diversity in the gut microbiome, or immune imbalances driven from dysbiosis, infection or inflammation. There are natural (& medical) strategies to mend each scenario.

Birth history is one influence - but not the sole influence on these states.
 
No matter the cause - the strategies to replenish microbiome diversity, calm inflammation, heal gut mucosa, or quell infections are the same.

It is much less controversial to say that that dysbiosis and loss of microbial diversity in the gut are linked to a number of gut & immune problems in childhood and adulthood. Certain activities or medical practices may lead to dysbiosis, loss of diversity & resulting immune imbalance. 

"I don't want to promote immune imbalance and gut dysfunction in my child" may carry more weight than focusing on a specific "black & white" diagnosis of something that may not apply to your child.

It also carries much less perceived guilt of not having the ability to breastfeed a child or delivering via C-section. If we accept that formula feeding & C-section deliveries can very well be medically necessary - then, we can also accept that these practices do disrupt optimal development of the gut flora and the immune system.
 
Finally, we can then accept that there are natural strategies to shore up any gaps & engage with them guilt-free.

The benefit of that acceptance is that it directs us into practices that help restore balance or diversity where it may have been lost or understand why "my kid needs to take probiotics & abstain from junk food" - free from self-driven, medically-driven, or society-driven guilt.
 
In short, your child may or may not have a specific clinical condition, but they can likely benefit from greater diversity in their gut & a more balanced immune system.
 
There are kids with optimal birth histories, who still need help replenishing diversity in their microbiome. There are also kids with less optimal birth histories and socioeconomic backgrounds whose immune systems are robust and healthy in thanks to some of the disadvantages they experienced.
 
While birth history may increase the need for some of these practices, the push to protect gut diversity is something that ties all of us together independent of birth history or cultural judgment.

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Dr Alex Rinehart

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