The Dr. Hyman Show - Baby’s Gut Instinct: Why Having A Healthy Gut Is Critical To Infant Health with Dr. Tracy Shafizadeh

Episode Date: September 1, 2021

Baby’s Gut Instinct: Why Having A Healthy Gut Is Critical To Infant Health | This episode is brought to you by BiOptimizers, Primal Kitchen, and Beekeeper’s Naturals Today we’re talking about one of my favorite topics: poop. And we’re finding out that the most important time to pay attention to our poop and what it can tell us about the microbiome is in the earliest months of life. I recently did a really interesting webinar on this topic. It's such a critical aspect of creating lifelong health that I wanted to share it on the podcast, to make sure anyone who missed it had a chance to listen. With the huge rise in inflammatory diseases from obesity and diabetes to autoimmunity and so many more, it’s imperative we look at the gut to optimize whole body health—this is a fundamental piece of Functional Medicine that I’ve been using with my patients for decades.  To dig into the specifics of how we can start kids off with the best health possible, I sat down with Dr. Tracy Shafizadeh. She is leading the work in understanding the infant microbiome, as a nutritional scientist who helps new and expectant moms learn about creating healthy gut bugs in their babies. Dr. Tracy translates her extensive scientific knowledge of breastmilk and the gut microbiome into practical terms to help parents understand how a balanced gut from infancy leads to a healthy immune system and metabolism for life. Dr. Shafizadeh received her PhD in nutritional biology from the University of California, Davis, and spends her free time "loving the guts" out of her two boys. This episode is brought to you by BiOptimizers, Primal Kitchen, and Beekeeper’s Naturals. You can try BiOptimizers Magnesium Breakthrough for 10% off by going to magbreathrough.com/hyman and using the code HYMAN10. For a limited time, BiOptimizers is also giving away free bottles of their bestselling products P3OM and Masszymes with select purchases.  Right now, Primal Kitchen is offering my community 20% off. Just go to primalkitchen.com and use the code DRHYMAN20 at checkout. Beekeeper’s Naturals is giving my community an exclusive offer. Just go to beekeepersnaturals.com/HYMAN and enter code HYMAN to get 20% off your first order.  Here are more of the details from our interview:  Our epidemic of chronic inflammatory diseases (4:32) The vital importance of having a balanced microbiome (8:17) How a baby receives gut microbes from its mother and how this process regularly gets disrupted (11:23) Why 15% of human breast milk is indigestible by the baby (18:11) Differences between human breast milk and baby formula (23:50) What is Newborn Gut Deficiency and does it affect your baby? (30:23) The long term consequences of having lack of B. infantis and how it can be restored (38:15) How does Evivo work? (45:40) Are probiotics good for you? (53:44) Vaginal seeding and the gut microbiome (1:03:30) Learn more about Evivo at evivo.com/ and on Facebook @EvivoHealth, on Instagram @evivohealth, and on Twitter @evivohealth.

Coming up on this episode of The Doctor's Pharmacy. We used to think of colic as just being a rite of passage. You just got unlucky and got a colicky baby. But what we now are starting to see is colic is actually just a manifestation of dysbiosis or newborn gut deficiency in the first month or so of life. Hey everyone, it's Dr. Mark. I'm all about finding the easiest ways to eat well with a busy schedule. One shortcut that I've really, really found helpful for making delicious meals come together fast is having a few high-quality condiments and sauces on hand in my kitchen.

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slash Hyman and use the code Hyman10 and you'll get 10% off this really great formula. I think you're going to love it as much as I do. And now let's get back to this week's episode of The Doctor's Pharmacy. Hey everybody, it's Dr. Hyman. How are you all? I am so excited to be here with an extraordinary guest. We're going to talk about poop. My favorite topic, you know, which is not just any poop, but baby poop and why it's so important and what we have to learn about it and how it's revolutionizing our ideas about how to take care of our babies during the first year of life and the implications it has for their whole life and particularly the acquiring or not of autoimmune diseases, obesity, allergies, all kinds of stuff. So this is going to be a very juicy conversation. We're going to get into the details of stuff. So this is going to be a very juicy conversation.

We're going to get into the details of stuff that I think is among the most important things to know today. And here's why. The thing that's striking to me is we're seeing an epidemic of inflammatory diseases. I mean, pandemic of inflammatory diseases, everything, heart disease, cancer, diabetes, obesity, Alzheimer's, autism, forget about the normal inflammatory stuff like asthma, allergies, eczema, all that stuff. Autoimmunity, these are all inflammatory diseases. And the question is why? And when did they start? And we can see if we look at maps of disease incidents and prevalence, that we've gone all the things that used to kill us, TB, pneumonia, measles, polio, all that stuff down, all the other things up. So all the chronic inflammatory diseases that we're seeing are devastating our population and killing far,

far more people than any of those other infectious diseases did, although there were some bad ones like the 1918 flu. But for the most part, the things we were struggling with were quite different. And I think you're going to learn tonight or today or whatever time you're watching this, you're going to learn about why that may be the case. And the hypothesis is that our gut is at the root of all of it. And particularly what happens to our baby's guts at birth and after that determines what happens to the health of our population. So this isn't really just about babies, even though I like babies. This isn't just about babies.

This is about a much bigger global problem of chronic inflammatory diseases, why it starts, what we can do about it, and how we can try to start to address this early on in life. It is really my pleasure and privilege to have an extraordinary nutritional scientist and gut expert and author to join us tonight, Dr. Trishi Shafazada, who is really leading the work in understanding the infant gut microbiome. It's something we didn't even have a sentence for before, but now we know what we call it, the gut infant microbiome. She's a nutritional scientist who educates new and expecting moms about gut health for babies. She's translated extensive knowledge about breast milk and infant

gut microbiome into practical tools to help parents understand how to get their babies to have a balanced gut from the first day of life that will lead to a healthy immune system and healthy metabolism. And I'm going to explain why metabolism is important. We'll get into that too, because I think, well, what does metabolism and weight have to do with gut? Well, everything turns out. Tracy received her PhD in nutritional biology from the University of California, Davis, and has over 15 years of experience in life science and biotech industry.

In her spare time, she can be found experimenting her own kitchen and loving the guts out of her two boys. So welcome, Tracy. Thank you so much for having me. Okay. So the preface I just shared was that we are currently in a pandemic of not only COVID-19, but the inflammatory diseases of modern society. And the reason that we've ended up with the disaster of COVID that we have in America is because we're so pre-inflamed and unhealthy. And we have chronic diseases like obesity, diabetes, heart disease, all these make COVID worse and make it more likely to end up in the hospital and die. The question is why? And what is the root cause of all this inflammation? And it turns out that what we're learning about is that the gut microbiome

plays a huge role in every aspect of our health, not just inflammatory conditions, but everything. It's good. If it's good, it's good. It helps produce vitamins and it helps digest your food and it helps regulate hormones and brain chemistry and your immune system is wonderful, except when it's not. And the problem is that our modern society has created a perfect storm for destroying our microbiomes, ours as adults and also children's and babies. And so we have to go back to almost birth to figure out why we're in such trouble now and how important this balance is between the gut bacteria and you. And how do we enhance and optimize that relationship in a symbiotic way that produces health? In functional medicine, we coined a term, which now I see in the medical literature,

which I think is really hysterical because it's been taken up as now a thing. We call it dysbiosis. So symbiosis is this wonderful mutualistic dance between the organisms that live in you and on you and your own biology. If they're balanced, you're balanced and healthy. And if they're not, you're sick. And this is called dysbiosis. So let's go back to the beginning, Tracy, to understand the causes of our dysbiosis as a society. And also then jump into,

let's just take a big picture. What are all the factors that screw up our microbiome? And then let's get right back to the beginning when we're born. What are the factors there that are needed to have a healthy microbiome? And why do so many kids

not have a healthy microbiome? Great. I think you may have asked five questions there. So we'll you know, when we think about the term microbiome, it really, it's a term that we're hearing more and more and more. And, and I think most of us have a concept that we have microorganisms that live in and on our body. And what I think we're now starting to appreciate is that our gut microbiome, this collection of microorganisms,

actually is, we can think about it as a microbial organ. It is not just random microorganisms that happen to be in our gut. They are serving a very specific purpose in our body. And when an organ in your body is not working properly, there are major deleterious effects. And so when we think about the gut microbiome, by the way, Tracy, people understand it's the biggest organ in your body. It really is. And, and we know the least about it, I would say, and we're starting to really

understand that we can no longer ignore the microbiome as a key organ in our, in our body. If we think about babies, when babies are born, they're essentially born with a sterile gut. They have very few microorganisms in their intestine. They are, they're brought into this world as, as we like to think as a blank slate, that's good news and bad news. The good news is we have the opportunity to set them on a path of having a healthy gut microbiome from the moment they're born. The bad news is most babies don't get put on that healthy trajectory. Most babies have a disruption in their microbiome from the day they're born. So maybe I'll just take a step back and think a day in the life of a baby as it's being born. Um, so a baby is essentially thought, um, of

traveling through the vaginal canal during vaginal birth. We all can appreciate that vaginal delivery is a crazy, messy process. There's a lot of stuff happening. One thing that we want to happen is we want moms to be able to pass their gut microbes onto their babies. Well, what's in mom's gut has to get to baby somehow, but baby's traveling through the vaginal canal. And as they exit the birth canal, their little faces emerge first. They hopefully will get exposed to mom's gut microbes through what we call a fecal oral transfer. We can leave it at that or we can go into that.

You can totally ask. Sounds like eating poop. Yeah. Yeah. So that if mom has a healthy gut microbiome, then she essentially gives the gift of seeding the baby's microbiome from the day they're born with their first little inoculation of microorganisms in baby's gut. And then breast milk, human breast milk is miraculous in that it contains everything that baby needs to grow and develop and go through the milestones of those first six months

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

So they get their first microbes that sets them up for a lifetime of either health or disease from the microorganisms that do well on the surfaces of the hospital, countertops and surfaces or from skin or from clothes. So their first microbes look very, very different. From the nurse who was in a bunch of other rooms, other patients who knows what was going on, right? Kind of, it's a little bit of a circus for those babies who get, who are born by C-section. And then if you also layer on top of that, the number of moms who are given antibiotics during labor and delivery for say group B strep, which can also be close to 30% of moms, any good microbes that they have in their gut, uh, even if baby's born vaginally may or may not be, um, there to pass on to baby. So we now after generations of moms being born by C-section themselves, being exposed to antibiotics and babies being exposed to antibiotics. There are now generate

generationally. We have now really, really limited that natural transfer of good gut bacteria, specifically a type of bacteria that infants need called bifidobacterium infantis. We've almost eliminated it in our population here in the U S I can imagine there's probably maybe not a single person who's never had an antibiotic. Maybe there is, but I can't imagine that there would be too many on this webinar that have not had an antibiotic, which means then that all the women who are listening who've had antibiotics have destroyed this particular bacteria, which turns out to be exquisitely sensitive to antibiotics, right? So if you just like had a, you know, cold and the doctor said, oh, take this amoxicillin, like you're screwed because then you decimate the population and

it's gone. So what we're seeing is this, is this phenomena of missing microbes. Now there's a wonderful book written by, I think, Michael Gershon about missing microbes, talking about this terrible phenomena of modern society that has literally decimated whole populations of really critical gut microbes that are necessary for our health, like bifidobacterium infantis. So basically women have taken antibiotics either before or during pregnancy or birth they babies are born by c-section so the likelihood of your baby not having any of this particular bacteria is pretty high um i want to i want to come back to something you said earlier about breast milk but i just want to take a step back because what we're seeing is literally a genocide of our microbiome because one, we don't eat a very good diet to fertilize good bugs. We don't eat fermented

foods. You don't eat high fiber. We used to eat 150 grams a day as hunter gatherers. Now we eat about eight grams a day. That's what the bugs eat. They eat undigestible fiber. We have been exposed to so many environmental toxins that are often toxic in the microbiome. We pretty much all of us have been exposed to glyphosate, which is a microbiome killer in very small amounts. And pretty much 70% of all crops are sprayed with glyphosate. It's the number one agrochemical on the planet. And so we've also taken a lot of drugs, other drugs like antacid drugs and steroid drugs and hormone drugs and all these drugs that screw up our microbiome. So as a society, we literally were in this pandemic of a total society of dysbiosis. And that's what keeps me busy in my practice because I see all these patients

who have messed up microbiomes. And what you're suggesting is that in these babies, that there is a way to avert this lifelong problem of inflammatory and metabolic diseases that comes with having a messed up microbiome. And that we know that if your microbiome is bad, you're not only at risk for allergy and autoimmunity and asthma and eczema, all that, not only a risk for irritable bowel and colitis and autoimmune disease, but you're also at risk for obesity and diabetes and cancer and heart disease

and Alzheimer's and Parkinson's disease. I mean, it goes on and on and on. Autism, ADD. And what that means is that we have to sort of understand that our gut microbiome is something we need to pay a lot of attention to. If we've been born and we missed the boat on the birth thing, there's ways we can rebuild our microbiome. But it's quite a different approach to disease than we are taking today, which is very reactive. And so, so now I want to come back to something you said about the breast milk, because this is striking to me. When you think about how beautiful nature is, you know, 15% of mother's milk is not digestible by the baby. It's not like the baby's

not getting any benefit from it, except it feeds this, this indigestible carbohydrate feeds this particular bacteria that you mentioned, Bifidobacterium infantis or B. infantis. And it, and it, and it loves this stuff. It's like, it's like actually made for it, you know, like, like, you know, like, I don't know what, what's the analogy. I don't know. Can't think of it, but you know, like it's, it's really, it's made for this particular bacteria. So talk about, talk about a little bit about how this works and what happens and, and why formula is a problem because this, these, these sugars, these, these carbohydrates called oligosaccharides are not in formula. So, yeah.

Yeah. So as a nutritional scientist, I think that this part of the research and part of the story is probably what was most impactful to me when I was learning about this topic and the research that was coming out of UC Davis and a team of researchers that were using human milk as an example of food that in its perfect form. Because if you think about it, human breast milk has not been impacted by mass industrialization, and we haven't really toyed with it too much. It's actually the pressure on human milk is actually from human evolution. And it really, the body is constantly dialing in human breast milk to be exactly what the baby needs to thrive and grow in the first six months of life. So this team of researchers at UC Davis

at the foods for health Institute said, well, let's dissect and analyze every aspect of human milk and let's see what's there. And we'll use that as a template for what babies are supposed to be consuming. And everything was there that you would expect the lipids, the protein, the lactose, the water, the micronutrients, the macronutrients were there. What was really fascinating and you touched upon it is 15% of the nutrients in breast milk were these complex carbohydrates called human milk oligosaccharides or HMOs for short, that were completely indigestible by the baby, which makes absolutely no sense that human milk, which is very metabolically taxing for the mom to make would have 15% of nutrients that completely were not used, utilizable or indigestible

by the baby until they figured out that it's food for the infantis in the baby's intestine. So then you go back to kind of our day in the life of a baby. It's a, it's a rough 24 hours, but they, you know, they, they get through it and the baby is born. They're exposed to mom's gut microbes. B. Infantis hopefully sets up camp in baby's intestine and it needs food too. So human milk starts coming in to the intestine and it feeds the baby and it feeds B. infantis. And then all of a sudden those 15% of nutrients in human milk are no longer locked up in these complex carbohydrates. B. infantis is utilizing them for fuel and turning them into something that the baby can actually use. And that's the short chain fatty acids called lactate and acetate and others. And those are actually signaling molecules.

They're actually a fuel for the growing colonocytes, the intestinal cells, as the baby is rapidly developing, they are, they are changing the pH of the baby's intestine so that pathogenic or bad bacteria can't thrive. They're creating this protective environment in the, in the infant's gut. It's such a beautiful story that nature has designed. And so when baby has B. Infantis in their gut and they're consuming HMOs, preferably from breast milk, then it sets up a protective environment where pathogens can't grow. B. Infantis is getting everything it needs. Baby's getting 100% of the nutrients in breast milk. And it's a, it's a,

a very, um, calm, low inflammation, protective environment in baby's gut. Now, if you can imagine the opposite scenario, which B. Infantis is not in baby's gut. HMOs are coming in through the diet completely locked up and not utilizable by the baby. Instead, pathogens are growing because the pH of the colon is in their perfect zone, which is not, um, hasn't been curated by B. Infantis. And those HMOs are actually being excreted in large amounts in baby stool. So what we see is we see babies that are missing B. Infantis with eight, five to five to eight to 10 watery stools per day. Those are, they're just HMOs. And if you think about it, that's what pediatricians have been telling us moms for a long time. If you have a breastfed baby, expect five

to 10 watery stools per day. But I'm not sure that that is actually what we're striving for clinical studies that we've been, that we've conducted. We see that when babies do have B. Infantis and they are utilizing HMOs, they stop kind of pooping them out, dumping them out into the stool. They're no longer in the diaper and babies are accessing 100% of the nutrients and benefits of breast milk. Now you asked me about formula. All babies need to be fed all babies. And if you, and if a baby is not getting breast milk formula is the next best option. And we are big advocates of fed is best. However, we know from a nutritional composition perspective, there are big differences between breast milk and formula and formula

companies are working very hard to try to get formula as close to breast milk as possible. Yeah. There are, there's a long way to go. There's a long way to go. and the HMOs in formula, although they do have them on some of the labels contains HMOs, they are not nearly at the, at the concentration of breast milk, nor are they at the composition of what's in breast milk. So it is a hat tip to the idea that there are HMOs in formula. It's like window dressing. It's good marketing. It is indeed. Yeah. So I would say that babies exposed to antibiotics, babies born by C-section and babies that are receiving formula, they're not going to create this high B infantis protective environment

in their gut. And that is where we start to see the high levels of inflammation in the gut. And then the longer term effects, negative health effects as baby grows. Absolutely. Because, you know, the baby's immune system when it's born is not developed. And the first year is critical for its development. And it develops the immune system by sampling in the environment through the food it's eating and through the microbes that are in there.

And when those microbes are off or out of balance, it's going to drive lifelong changes that are often challenging. And as a functional medicine doctor, I see this very often. What's the story? Baby born by C-section, given antibiotics in the first years of life, lots of ear infections, sore throats. Maybe then they get some eczema and diaper rash, and they get asthma, and then they get allergies, and they get autoimmunity. And it just, you see this pattern over and over when you start to pay attention to it. So when I take a patient's history, I start with the mother's health before birth, and I go all the way through to the timeline of what's going on. The study I read that was so striking to me that just put this in bold relief was a study where they compared the microbiome and the short-chain fatty acids

that are produced with babies who are breast fed versus formula fed. Now, you mentioned a few of them, but one of the most critical short-chain fats is something called butyrate. And it regulates immunity, cancer, it feeds the colon. It's so critical. It's anti-inflammatory. It's used to treat colitis. I mean, it's quite an amazing molecule. And it's produced by the bacteria, the right bacteria, digesting the starch, the fiber, right? And in this study, they looked at the kinds of short-chain fatty acids that are produced depending on what you're eating, if it's formula or breast milk. The breast milk babies all had high levels of butyrate, which is what you want.

The formula fed babies had high levels of another short chain fat called propionic acid. Now it's a big medical word. What does it mean? It's one of the short chain fats, but it turns out that this is very neuroactive in a bad way. So they are able to induce autism in animal models by giving them propionic acid. And guess what it's also used for? It's a preservative used in flour. So anybody eating wheat in this country, unless you know for sure that the company is organic and this and that, and doesn't put anything in it, they put propionic acid in, which leads to behavioral issues and mood issues, attention issues. And like I said, in animal studies, it can induce autism. That's terrifying

to me. And so I really think that, you know, we should be looking at children's microbiomes. We should be looking at their poop. We can measure, I do this every day in my practice. I measure short chain fatty acids. I look at the types of them. I look at the kinds of bacteria there. And it's quite, it's quite amazing to see how many people have disordered gut microbiomes. And we don't even think about it as a physicians. We basically treat the downstream problems and not the gut. What you're talking about is going way upstream, way back to day one of a baby's life. And maybe even, I mean, I read a study years ago where they gave the mothers a probiotic and then the babies and they gave them the mothers a probiotic, help the baby actually have less asthma and eczema and allergies.

Hey, everyone. It's Dr. Martin. Now, people are always asking me to boost their immune systems, especially as fall approaches. And I like to try to help them reframe immune health to understand that it's not always about giving it a boost, but instead helping to modulate the immune system so it can do its job the right way. That means giving our bodies the right ingredients for the immune cells to work effectively and understand when they're up against a real threat.

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code for your first order. That's beekeepersnaturals. B-E-E-K-E-E-P-E-R-S naturals.com slash hymen and enter the code hymen. I think you're going to love this throat spray as much as I do. And now let's get back to this week's episode of The Doctor's Pharmacy. So let's talk about what we're really going to talk about tonight, which is this phenomena that, you know, I hate it when we invent new diseases, but I think this is a good one. I was dealing with like gastrointestinal reflux disease or GERD. It used to be called heartburn, you know, but then they come up with a bunch of drugs for it. And this happens all the time in medicine. I don't think this is that story.

This is a very interesting story about a condition that is, has been newly kind of conceived of because we've started looking for it and it's called newborn gut deficiency. So what is newborn gut deficiency? How many kids does it affect? And why is it such a big issue? Okay, so you're right. Newborn gut deficiency is a relatively new term. It's more of an umbrella term that describes a collection of symptoms that we can see in many newborns. A recently

published study estimates that nine out of 10 babies born in the U.S. today are going to experience newborn gut deficiency. That's a staggering number, but yes, 90%. And not every single symptom or condition that is experienced under newborn gut deficiency is going to manifest in every single baby. But the idea is the way that we were talking about the gut microbiome, even starting from day one as a microbial organ, it provides a function in the body. It provides a function in baby's gut. And if that organ is not working properly, there's going to be a deficiency in the function that it provides a, a, a function in baby's gut. And if that organ is not working properly,

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

You just got unlucky and got a colicky baby. But what we now are starting to see is colic is actually just a manifestation of dysbiosis or newborn gut deficiency in the first month or so of life. Yeah. Pathogenic bacteria are, are, are flourishing and they're causing inflammation of the intestine, which is uncomfortable at, at, at, at, at worst. And, and actually I should say the opposite. The, the, the, the most benign thing about inflammation in the gut is discomfort. The worst thing about inflammation

in a baby's gut is as you pointed out, the first 100 days of life are when the immune system is developing, being programmed and deciding whether baby is living in a hostile environment and they should be on full alert and allergic to everything coming at them, or if they're in a protective, calm environment where they can actually eat food and not be allergic to it, or whether they can actually enjoy being outside and not reacting and having all sorts of auto-inflammatory and autoimmune diseases later in life. So newborn gut deficiency widespread. The literature now is showing that it's widespread across the U.S. and probably other industrialized countries that experience the same levels of C-section antibiotic use formula

feeding. What's really interesting is the work that we've done with the Gates Foundation, looking at populations in developing countries where they don't have the same levels of C-section antibiotics and formula. Those babies are full of B. infantis the first six months of life, and they do not have the same skyrocketing rates of the autoimmune and auto inflammatory disorders later in life. So lack of medical care is a good thing. Well, you know, and that happens in the medical, right? We have C-sections saved lives and antibiotics saved lives, but we have to understand the unintended consequences of those. Yeah. And that's not even mentioning the fact that, you know, the, I think 37 or 8 million pounds

of antibiotics used every year, that 29 million are used in animals for prevention of diseases because of overcrowding and factory farms. And that has adverse consequences on antibiotic resistance. It gets in our food. It's a whole problem. So, and I think, so you mentioned a little bit about how do you know if your kid has it, right? Colic, fussiness, loose stools, maybe eczema, diaper rash. What else?

No, you've really hit the nail on the head in terms of the visible, obvious kind of acute symptoms that moms and dads will be able to see very quickly. In fact, we have a, a baby gut check quiz on the Avivo website that moms and pediatricians can use to kind of just estimate without doing any testing of the stool to see what, you know, what the composition of the baby gut microbiome is. And those are things like, were you or your baby born by C-section? If either of those answers, if either of those questions, the answer is yes. B. Infantis is not going to just naturally pop up in baby's gut if it wasn't transferred from mom during labor and delivery. So number two, do you, does your baby have five to 10 watery stools per day? If so, they're not utilizing those HMOs. Chances are, and of course you'd have to

look in the stool, but chances are they've got tons of HMOs being excreted into their diaper. And so it pulls water out along with it. And you've got loose watery stools in studies where we would fed B. Infantis back to babies in the form of Avivo. And these are breastfed babies fed Avivo. They, they within days started having two to three soft, well-formed stools per day. You wanted to talk about poop. We can talk about poop, soft, well-formed stools per day. And that happened within one or two days, because as soon as B. Infantis takes up residency and starts using those HMOs, you stop the dumping of HMOs into the diaper and therefore the loose watery stools. The third question is, does your baby have diaper rash? And with a long passion

for biochemistry, this might be another one of my favorite parts of the story, but if we talked a little bit about the pH, we talked about the fact that B. Infantis consumes HMOs creates a more acidic pH in the baby's gut protects against pathogens. But one other benefit is that when you reduce the pH to closer to 5.0, it also is going to be reflected in the fecal pH is going to be around 5.0 and B. infantis is there and happy and proliferating. It deactivates the fecal enzymes that are in the stool that break down the skin barrier when the stool is exposed to the diaper area. So if you deactivate those degradative enzymes in the stool by, by adjusting the pH to the natural range, diaper rash goes away. It's really amazing. And when we

polled over 1600 consumers or moms and dads out there that are using Avivo and ask them, did you notice a change in diaper rash? A vast majority said within a week, the diaper rash was gone. And it's incredible. It's a biochemistry story that's as clear as day. And I love that it's so obvious and so acute. Now, diaper rash isn't the worst thing in the world. So we're not out to solve all the diaper rash in the world. We're out to solve what are the longer term consequences of the formation and the pathogenic bacteria that are inappropriately programming the baby's immune system in the first 100 days of life. Essentially, if you don't have this as a

mother in your system and you don't pass it on to your baby, the baby doesn't have it, the baby doesn't get the ability even to use the oligosaccharides, ends up with all these problems, it creates a pretty bad situation long-term for the baby. So instead, what's growing there are, we call them potentially pathogenic bacteria. It's not like getting E. coli or salmonella or shigella, it's not these horrible, but it's this imbalance in things like klebsiella and pseudomonas and enterococcus and all these weird bugs that can be potentially infectious that are irritating. And they're critical to get rid of or to change the environment

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

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

today, our group, our team, which is, as I mentioned, uh, uh, spin out from UC Davis and the foods for health Institute, we set out to say, let's let science drive the direction that we're going to go. And let's look systematically at what do babies look like if we don't do anything. And we just look at a population of babies born today in the Davis, California area, breastfed babies. What does it look like if we actually give B. infantis back to them, feed them a vivo every day. And what does that do? Not only to the amount of B. Infantis in the baby's intestine, but to the abundance of the other pathogenic bacteria

that were there in the absence of B. Infantis. So that is what over the last five years, close to 20 different clinical publications that we've been able to publish in peer-reviewed journals have shown that when a baby is missing B. infantis in their intestine, whether that's because of antibiotics or C-section, whatever reason, there is instead an almost full composition of what you mentioned as potentially pathogenic bacteria. And to your point, I want to make sure that we're clear that doesn't mean overt infection. That means kind of a quiet, but,

but abundant composition of the infant gut microbiome that you can't really see from the outside of pathogenic bacteria, setting up shop in the baby's gut microbiome, including staph, strep, klebsiella, clostridia, as you were mentioning, and they are causing inflammation in the infant gut. What we don't want to do is jump on the bandwagon, the microbiome probiotic bandwagon and over-interpret or hype over, over- over hype any data that we have so far and say, just spend a lot of money on probiotics and you'll be fine. We will not do that as a team and as a, as a company. So what we've done is we've gone through and said, not only can you restore the infantis back to the infant gut through feeding Evivo to babies, we were able

to answer that definitively in one of our early publications where we showed a complete restoration of B. Infantis to babies who are fed Avivo. But then we looked at the composition of the infant gut and can we reduce those pathogenic bacteria? Yes, we can to up to, up to 80% reduction of those pathogenic bacteria. Then if you do that, can we see a reduction in the inflammation markers of inflammation? Can we see a reduction in antibiotic resistant genes? Can we see a reduction in many other of the, of the markers that show that a baby is either on a path toward autoimmune and auto-inflammatory diseases or not. And that's really what we are.

We are still on this journey. I would say collectively, not just the Avivo team, but the field of microbiome science, you have to be able to follow those kids out and do the clinical studies to be able to definitively show that you get prevention or treatment of any of those diseases that you mentioned. We're not there yet, but we have many very large clinical studies ongoing right now because there is enough early data. There's enough early basic science that shows we believe that this is exactly what's happening. We're reducing the inflammation.

We're reducing those pathogenic bacteria by feeding a vivo. And now we're going to systematically go through and say, what conditions can we prevent in those babies going forward? But we do know from the field and the science in general, that if you've lacked this bacteria, you're more likely to have allergies, type one diabetes, obesity. We know that you literally can transplant the poop out of a thin mouse into a fat mouse and the fat mouse will lose weight independent of its calorie intake. Like that's should shock you. I wrote about that in a book I wrote a number of years ago. I think the blood sugar solution, we've known this for a long time. Like this is not a new, new news. And, and yeah,

it just has not reached medical practice. And to me, it seems like the, you know, the better part of our judgment should be to give every baby this probiotic at birth because if 90% are deficient, I mean, yes, we can test everybody, but it's benign, it's safe. There's really no downside except the cost. And it seems like something that would pay for itself in spades in terms of the reduction in all these secondary conditions later on, such as obesity related conditions, allergies, autoimmunity, and so forth. It just seems like a no brainer to me. I don't know why we're not doing that, but hopefully you

guys can get the research and we can, you know, get this reimbursed by insurance and we can actually drive the changes that need to happen because, you know, as a doctor, the pandemic of diseases in kids, it's just, it's just scary to me, like with obesity issues, you know, as a doctor, the pandemic of diseases in kids is just scary to me, like with obesity issues, the allergies, the asthma, the autoimmunity, the ADD, the autism. I mean, these are diseases of inflammation that often start in the gut. So how do they actually work? Because, you know, when we think about probiotics as an adult probiotic doctor, I treat a lot of kids too, but we really understand that these probiotics don't

take up residence, that they don't colonize, that they're sort of like tourists. They travel through, they change the economy down there, they have an influence on what's happening. But if you take some probiotic that you get in the store, even if it's a good one, it doesn't necessarily stay. So you have to keep taking it. Tell us about how unique this particular probiotic is in its ability to colonize the infant gut, which is really remarkable to me. It is remarkable. And I think to your point, the majority of the research and the focus and the effort and the dollars on microbiome research has been focused on adults to date. Babies are so unique. And if you think about the lifespan or the life cycle, there's only a very, very small

period of time where we have a single food source, because as soon as you turn four to six months, people are giving little bites of everything on the adult's plate to the baby. And that's great. That's important. That's a, that's part of this weaning process. And for the rest of your life, you have a varied diet with tons of different plant fibers, tons of different fiber coming from all different sources. But in that first, I'd say, let's call it four months. When you have a single food source, you have a single fiber source as well. So as we mentioned that human breast milk, the human milk, a little saccharides, let's think of those as the fiber in breast milk. And they are very specific to B.

Infantis. So B. Infantis is the only bacteria that's been found to be able to digest all of the HMOs in babies and sorry, in, in breast milk. So I agree with you that the studies that have been published on adults and probiotics have shown that it's very transient, that they are, they are tourists. They usually, they may show some benefit while you're taking them. But as soon as you stop taking them,

your body kind of reverts back to its steady state where it likes to be, which probably isn't the best, um, state of the microbiome. What we found in our studies is that babies who were fed B infantis, uh, in form of a vivo along with breast milk, for 21 days in that first month of life, as long as they continued to consume breast milk, B. infantis remained high in their gut microbiome until almost a year. You just give it for three weeks, and then it lasts the whole year. It's never been shown before in any other population to be able to feed a probiotic for a short amount of time and then be able to track it and see that it's steady and call and it colonizes, it stays steady. And we believe

that's because B. infantis, as long as it's getting the food source that it needs, which is human milk, then it's going to continue to populate and, um, and proliferate and set and colonize the infant gut. So what we also saw in that same study is when babies switched over to formula or cow's milk, you could see the levels of B. Infantis, uh, slowly diminishing, which is exactly what we want to happen. We want when babies start eating plant fibers for other bacteria to come in and say, I can do that really well. I can digest plant fibers. That's my jam. And so we let them take over. But in the beginning, when HMOs are present in high abundance, the infantis must be there to be able to digest them for babies. Amazing. And does it, does it work if you have

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

them the benefit of B. infantis. So what we did is we looked at babies who were consuming formula and the ability of B. infantis to digest formula. And it is able to utilize some of the nutrients in formula, not exactly the same mechanism as it does in breast milk, but it is able to digest some of the, some of the components of a formula. I would say to any mom or dad out there who's, who has a formula fed baby, some B. infantis colonization in your baby's gut is better than none. So even though you're not going to see the same benefits that we've published with breastfed babies, it is important to get some levels of B. infantis and increase the amount of bifidobacterium in your baby's gut, even if you can't reach the same abundance as if your baby was

consuming breast milk. So I would say yes to both formula and breastfed babies. And is there a way to get HMOs as a supplement to give along with the probiotic? Maybe. Because as an adult, we do give prebiotic fibers, right? So we do give that to supplement with probiotics. I'm going to say maybe only because even if I could give you a source for where to get them, we haven't looked at the ability of those exogenous HMOs to recreate what we can see when baby is consuming breast milk. You know, one of the things that came up for me as well was the idea that women should take it while they're pregnant. And it's one study that looked at, it was lactobacillus GG, it was a

different probiotic, but it helps. So do you see there's a role for taking B. infantis as a mother? So I'm going to answer this question, not as a researcher. I'm going to answer this question as just Tracy talking to Mark. If I were pregnant, I would want to have to ensure that B. Infantis was in my gut microbiome so that when I delivered my baby, it had the best chance of getting B. Infantis from me. However, we have not, we have not conducted those studies. And if you're treated for a group B strep with antibiotics, then it doesn't matter what you took during pregnancy because those antibiotics wipe it out. And if baby is born by C-section, it doesn't matter what you have in your gut microbiome,

baby doesn't get it from you. So that's the only reason why we are very focused on getting it into baby with the idea that in a future state, we would love to be able to supplement moms or feed moms in vivo and see benefits for moms as well. I mean, I think I know the answer to this, but someone asked, does it come through breast milk? If the mother takes all their breastfeeding, when they go through the breast milk? If I could have one statement that everyone on this webinar remembers, it is breast milk provides the food for the bacteria. It doesn't provide the bacteria. So breast milk is going to feed B. infantis, but B. infantis is not in the breast milk. So that is one very common misconception that can make this whole story not make sense. We are huge advocates of breastfeeding because it's the food for baby and B. infantis, but it's not going to provide B. infantis to your baby.

Yeah. Someone posted a study also that sort of challenged some of these ideas, which I think it doesn't actually because it's a different bacteria. But basically, there was a double-blind randomized placebo controlled trial looking at lactobacillus reuteri for infant colic and found no benefit. It was published in the British medical journal or BMJ a number of years ago. I, I, my, my opinion about that is that it depends on the bug and why the strain is so important. So maybe you can just address that quickly and then talk about why the particular strain of probiotic is so important. So maybe you can just address that quickly and then talk about why the particular

strain of probiotic is so important because there's so many baby probiotics out there. This isn't like that. This is different. So can you explain that difference and why it's not, I mean, this study, for example, didn't work and why the infantis might work? Yeah, I think the person who brought up that question is very astute. There are using the term probiotic, because probiotic or probiotics is such a generic term. That's like saying, is food good for you? Or is medicine good for you? Well, I guess it would say food is good for you if it's food, but not the stuff we're eating. It's not food. But think of how generic that is. It'd be like, well, fried chicken and a Coke is probably not. But if you switched it up and ate

whole grains and things that were actually food, the answer is yes. So very different answers depending on what food you're talking about. Probiotics, same thing. We are really doing ourselves a disservice saying our probiotics good or bad, because depending on the bacteria and not just the bacteria, but the bacteria and the strain of the bacteria given to a certain population at a certain time in life. I mean, it's and giving that bacteria the food it needs. So it is way more complicated than I think we ever appreciated. So, um, I, I do know the paper that, that your, um, audience members posted. And, um, I do think that this gets back to basics, which is we have to understand the right bacteria, the right strain of bacteria, the right time in life, and what you're trying to accomplish for that person that you're giving the bacteria to the probiotic to, and making sure the bacteria gets the food it needs. So with, with B. Infantis, I think we've done a

good job, um, hammering home this to this audience that B. Infantis is critical to the infant. I think hopefully they've taken that, uh, from this discussion. Now the real test is, so you go out and you go to the store and you want to purchase a probiotic for your baby that has B. Infantis in it. Well, there's going to be many options and you have to know what strain of B. Infantis you're choosing. It's, it's really, it's, it's too much. It really is too much. I feel, I feel for the, I feel. So it's like saying, you know, it's good. It affords work, but what kind of Ford is it? Uh? Uh, you know, is it a Explorer is an expedition? Is it a, you know, whatever. So that's a really good analogy. Um, the make and model. I would say another analogy

that helps me kind of understand this, the species and the strain is when you think about, um, your, your family wants to adopt a dog and you say, sure, you can have a dog. And the kids, one of the kids is like, I want a great Dane. And one of the kids is like, I want a Chihuahua. And you're thinking, well, they're both dogs. They're very different dogs. They serve very different purposes. So you said yes to a dog, but did you say yes to the great Dane or did you say yes to the Chihuahua? Those are the differences in strain in being, you go and you, you want to choose a probiotic with B. Infantis. You have to know what strain it is so that you are choosing a strain of B. Infantis that's been clinically documented to be effective in infants and to be able to provide the benefits that the publications we've talked about today, you can line up all the

strains of B. infantis in a lab and they all work very differently. Some are great at metabolizing HMOs. Some are terrible. Some grow in a baby's gut. Some don't do anything at all and they just get pooped out. So we're very adamant about the strain of B. infantis that has been clinically tested that we use in Avivo that we can stand behind and say, we know it colonizes the infant gut. We know it provides these benefits and we just want both clinicians and consumers to really understand that strain does matter. Yeah. Very important. Another few questions that have come up was one, how long should the baby take? You mentioned 21 days, but should it be 21 days? Should it be the first year?

Is it helpful to take beyond that? And two, what if you have a baby and they're five months old or 10 months old or 15 months old, should they take it? Yep. These are really important questions. And I would say the strongest data that we have published that I can definitively say we know that we see benefits in babies was when babies were given Avivo for 21 days. I would say at the bare minimum, 21 days, or let's call it one month, one month of feeding Avivo to your baby as early as possible,

as soon as they start consuming milk, that is like baseline in my opinion. But what we also know is it's now become clear immunologists are really able to see that the first 100 days of life, so three months, is this rapid growth and development of the immune system. And if we can keep pathogenic bacteria and inflammation low during that first 100 days, we believe that this really does have a huge impact on the development of the immune system and whether or not a baby, it's going to have levels of inflammation that have been correlated with the disorders you and I've been talking about today. So that then my answer would be three months, but as long as baby is consuming breast milk, then I think that B infantis is

appropriate to be giving Avivo is appropriate to be giving to your baby. Especially if think about if mom gets mastitis and she goes on an antibiotic, baby is exposed to that, that antibiotic through breast milk. I would want to either continue Avivo through, uh, through that course of treatment or, um, or start again. So in general, I would say the first six months is a good guideline. But if I can get every baby to have Avivo for the first month of life, then we would be setting a whole generation of babies up

for a healthy life trajectory. The monumental consequences, really, when you think about how many babies are born a year, probably 600,000 babies. And I think in America and globally, it's a lot more obviously, and this is a real game changer when it comes to changing the future health of our population. So what if, what if a baby has, you know, is a year old, is not on formula or breast milk anymore, but has eczema or has issues, would you still use it? So the clinicians that we work very

closely with, our collaborators and our clinical partners, they have provided so much anecdotal evidence in their practice that older babies and toddlers that are given Avivo do see benefits in terms of eczema, in terms of diaper rash, in terms of number of stools per day and the consistency of those stools per day. But I would say I have to stick to the literature that we have published, which has really only been in the tiny babies. But anecdotally, we are hearing from moms every day on the Avivo website through the reviews that they send and clinicians that we work with that babies well beyond the six month point are seeing benefits from Avivo. What about, you know, young kids or even adults? Like if my patients have allergies or asthma or

autoimmunity, or would it be something to think about? Yes, I think so. Now, most of us are not consuming high amounts of breast milk as adults. Some of us might be, but most of us aren't. But I think that B. infantis can do a fairly good job of consuming other types of fuel or food or fibers that there is some benefit that I think adults could see. if you were to poll the adults that work on the Avivo team and say what benefits they see when they take their Avivo every day, you'd get a lot of really strong anecdotal evidence. I want to try it. I want to try it. I mean, you know, just it's interesting to me because we, you know, we're just, this whole microbiome is a new frontier. It's sort of like the wild west. It's almost the unexplored territory that we're just at the beginning of. And I think those who have been practicing functional medicine have been paying attention to this for a long time. And yet, you know, the depth of the science was not as much as we would have liked. And now it's coming up. And it's pretty exciting to see that

the things we saw clinically, the things that we know intuitively, the things that we see in our lab tests, that we actually can start to really change the course of illnesses using treatment for the gut. But, you know, it would be important to speak to, you know, and it would be sort of remiss of me not to speak to the phenomenon of the role of diet in your microbiome. Because we said that it's very hard for these probiotics we take to colonize in the gut and stay in permanently. But it turns out that diet plays a huge role. And a new study came out from Stanford, I thought you probably were in the study by Sonnenberg and his crew that, that fermented foods, um, worked better than fiber,

which we think of as a probiotic or prebiotic, that the fermented foods changed the microbiome dramatically, that it down-regulated all these inflammatory proteins. And that we know from other diet studies that the best way to change your microbiome other than a fecal transplant is change your diet. And I think that's a real important take home for people. So just as the baby's diet is important for the microbiome of the baby, the human adult diet is important for its microbiome and determines the course of your health outcomes. So I think we're just at the beginning of this. I'm pretty excited about what you're doing. One last question is from someone

who wondered about this phenomenon. I know this is going on in South America and other countries where they're seeding babies who are born by C-section. So they're taking vaginal fluid and they're sticking the baby's mouth as the baby comes out of the abdominal incision. Can you talk about that? Does it work? Is it worth it? Does it make sense? I can talk about that. We published a paper on this topic recently because I think intuitively for a general audience,

this makes a lot of sense. Baby's supposed to go through the vaginal canal. So why don't we make sure they get exposed to what's in the vaginal canal? If they're born by C-section, that's great. If we're trying to restore the vaginal microbiome to the baby, but the gut microbiome is not in the vaginal canal. It's not in the birth canal. The gut microbiome is in the colon. So that's where the babies come down face first. They come up sunny side down. And it's true.

I've delivered 500 babies and they just come out head first with their face right in that area. Right there. Right there. So I think that it's a misconception to think that swabbing baby with vaginal fluid is going to affect their gut microbiome in a way that helps restore what the natural colonization of the infant is. In fact, we know that's not true. Should we be swabbing rectums and then using that? That sounds a little gross.

I'm not quite ready to go there, but I think Avivo is much more palatable. Sounds better to me. Sounds better to me. Now, Avivo, does it have, does it have lactose or dairy in it? It does. So, so it does have lactose as part of the powder. So the way that Avivo is, is provided, it's in small individual sachets. If you kind of think about, many of us used to use the emergency packets and you kind of just shake down the powder and you pour one little sachet into your drink. Same idea is that it's a, um, dried powder of the B. Infantis

bacteria, the, uh, strain EBC zero zero one, which we talked about the importance of strain mixed with a small amount of lactose and this lactose and B. Infantis powder. You take one sachet out of the freezer each day. You keep it in the freezer because it's a live bacteria and you want to keep it kind of hibernating until it's time to use it. Um, and you pour a little bit of breast milk, three to five milliliters of breast milk in a small mixing bowl, which Avivo provides, but you can do use whatever bowl you want. You can, you can use water as well, whatever, whatever is easiest for you. But most moms express a small amount of breast milk, mix the powder and either use a dropper to get that small amount of volume into baby's mouth or their finger to put into baby's mouth. Or you can even

just put it on your nipple and have baby nurse. Yeah. But it does have lactose. So probably, um, that was the question you were. Yeah. Because, you know, a lot of kids have dairy allergies and I see a lot of that going on. So how do you address that? Is there a way to get it without that? Yeah, what we would say is that if a baby has a diagnosed dairy allergy, then Avivo would not be the right product for them because it does have lactose from dairy source. However, the, the number of children that can consume a very small amount of lactose from a dairy source is, is much greater than the babies who actually cannot tolerate any dairy at all. And the amount of lactose in general is so small compared to the lactose they're getting from breast milk. I mean, it's a, it's a drop in the bucket that it's a very, very small proportion of what they would be consuming in a day. But I mean, for babies that are, that have

a dairy allergy, this would not be the right product for them. Great. Well, I just want to take a minute to thank you. And to summarize a little bit, because what we just learned was mind boggling. First, we learned that we have an epidemic of missing microbes, that 90 percent of babies are born with newborn gut deficiency because of the overuse of antibiotics, because of glyphosate, because of our poor diet and mothers and a whole host of other reasons. And that this lack predisposes them to a whole host of inflammatory conditions later on in life, allergies, eczema, autoimmunity, obesity, metabolic issues, diabetes, as well as causing all these infant problems that drive parents crazy, colic and fussiness and diarrhea and diaper rationality, you know, trivial problems, but they're not trivial when your kid has them. I remember my daughter, I think she was a crier. Oh boy. She had the worst colic. I had to literally hold her in my arms and like rock her for hours and play Bob Marley and try to get her to relax,

but it was terrible. So it has all those effects, but it turns out that by using the research that you've done in vivo probiotic, that you can colonize the baby's gut when they're fed breast milk. And that a lot of the breast milk is undigestible to humans, indigestible to humans, and is used for this particular bacteria. We still have a lot more to learn. How long should you use it? Can you give it to older kids? Can you give it to adults? Do you need to give it with HMOs? There's a whole bunch of questions I think we still are figuring out, but you guys have gotten significant funding for research from major organizations. And it's really inspiring to see that the world is starting to think about this in a big way, not just some fringe health food store probiotic, but really mainstream science, looking at the microbiome in a big way, not just some fringe health food store probiotic,

but really mainstream science, looking at the microbiome in a new way and understanding that our health depends on the health of our microbiome. So Tracy, I thank you so much for your work. I think Abibo is a great company. You can go to abibo.com, learn more about their work and look at the science, read out about it. I feel like I want to take it. I'm curious to try it actually, you know. And, and I just, I really commend you guys for doing the hard science and the hard work with a lot of people in the space don't. And, and this is really gratifying. So thank you. Any last thoughts or words you want to leave with our listeners? If we can take anything from nature, biology, human evolution on what direction we should go in terms of what the infant gut microbiome should look like. It's very clear that mom, baby, human milk,

and B. infantis are a match made in heaven. And we just want all babies to have that benefit. So please go to avivo.com to learn more. We have all of our clinical studies there. We have a lot of resources for you moms and dads to go talk to your pediatrician about, um, this, it should be a conversation between, uh, the two of you. I mean, it seems like, you know, maybe you should talk to the American Academy of Pediatrics and have this as part of their training. We talk to the AAP on a regular basis, and we are so thankful that they are really starting to go in the direction of this is not pseudoscience. This is real science and it's important for babies.

Good. Thank you for doing the hard work. It's not easy. Thank you so much, Tracy. Hey, everybody. It's Dr. Hyman. Thanks for tuning into The Doctor's Pharmacy. I hope you're loving this podcast.

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