Microbiome specialist Emily Cerda walks through a pregnancy gut health test at 27 weeks, explaining two key metrics: Microbiome Seeding, which tracks how much of an infant's microbiome comes from the mother versus environment, and HMO-digesting Bifidobacterium species, which break down nutrients in breast milk. Low bifido levels can link to infant reflux and poor sleep, so she recommends prenatal bifidoprobiotic supplementation.
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Hi, my name is Emily Cerda. I'm a microbiome specialist here with Tiny Health, and today we're going to go through, uh, the gut health test of somebody who is 27 weeks pregnant. Um, I'm just going to point out some of the basics that are different, um, in a pregnancy gut health test versus those that are not. Um, so if you want the big overview of what, like, a whole walkthrough of all the gut Health Test metrics. Um, you can find that in the practitioner resources in a different video. I'm just going to quickly point out here what's different in pregnancy. So, um, here we can see on the main page it does look a little bit different. So to the right under the action plan, we can see microbiome seeding pops up, and this seeding is really interesting. Um, it's not going to be here yet, But if mom and baby both have a microbiome test done within the first 6 months, um, of birth, then we'll be able to go ahead and compare those tests and see what portion of mom's microbiome has seeded to baby and what portion is from the environment. Um, this is really interesting. I have a lot of, um, patients who are very interested in getting this information. So definitely talking to, um, any of your pregnant patients about this possibility is really important because we need that within the first 6 months from both individuals. And we can see here that there are different impacts to seeding at birth depending on different modes of birth, where they were born, all kinds of different things, location, antibiotics, interventions that may or may not have occurred. And then of course breastfeeding. So if you have somebody who tests tests baby at, say, 20 days versus somebody who tests at 4 months and is breastfeeding, that may look, that may look very different, but we can still get the seeding here, which is really, really interesting and also an impetus for your pregnant patients to kind of work on that microbiome health while pregnant because we can do that safely. So I'm gonna jump into the all— see all metrics. And at the top, In the beneficial microbes, you'll notice that, um, if you run any, any tests on babies or toddlers, they also have this HMO-digesting species metric. Um, but children and adults do not typically. So for pregnancy, we put this here because HMO-digesting species are specific types of Bifidobacterium. So we can see here we do have an optimal range for this., and this individual needs to work on that. And the Bifidobacterium are listed here. They are Infantis, Breve, Bifidum, and Longum. And those bifido, um, species are really, really good at breaking down the human milk oligosaccharides, or HMOs, that are the complex sugars found in breast milk and in some formulas. And so that is really baby's only job. In the first few months of a life is to have that milk to, to break down those complex sugars and to grow and to develop from those sugars. So you can imagine if we don't have the right, um, constituents in the microbiome for baby, then they're not breaking down those complex sugars properly. So I will see things like, um, sometimes reflux, poor sleep, just babies that are like kind of hungry all the time and, and not sleeping well. Every now and then we see that this also correlates to a low overall bifido level for babies. And so things have— disruptive microbes have moved in and there's a little inflammation or maybe atopic march starting because the immune system is learning from this microbiome in an infant. And so here we're focusing on that infant's health before that infant is even breastfeeding. So we're setting mom up so that she can give baby all the things that she needs to, and those HMO-digesting species are really, really important. So here we can see mom has enough bifido for herself. The HMO-digesting species are in the gray. We can see that actually longum is the only one that is one of those HMO digesters. So in this case, I would probably say let's do a couple months of a prenatal type, um, bifidoprobiotic so that we're getting those HMO digesters in there and making them stick. And then baby's gonna be ready to go when the birth happens. So that is one difference that you will see in the pregnancy test. Um, the other one that you'll see is under the disruptive microbes, we add Group B strep. So Group B strep, it is also in our vaginal health test for anybody who's trying to conceive or who is pregnant because we want to try to get ahead of that. And a lot of patients want to try to, try to knock it out before the birth so that they don't have to go through the antibiotics and have baby exposed to antibiotics right off the bat with GBS being positive. GBS can also be in the gut. So sometimes I'll have practitioners run a gut test. We're trying to optimize the bifidos, all of that. GBS will pop up in the gut. We can definitely do things like raw garlic and things that are very, very safe during pregnancy to try to alter this environment. But then I also recommend like, oh, maybe we should run a vaginal test to make sure that that GBS isn't also harbored. In the vaginal microbiome. So, um, GBS will show up in both places, and, um, I always recommend testing earlier than later, um, in pregnancy because then we actually have time to shift this before that pregnancy, um, before birth happens. So those are the two biggest differences, um, here in the pregnancy test. Everything else is pretty much the same. Of course, We're, um, when we walk through results together, we will talk about only interventions that are safe during pregnancy and avoiding things. Um, we even avoid things that don't have evidence of safety, which can be very, very difficult. Um, because of course we're not testing on, on, um, pregnant women in RCTs to try to figure out if things are safe. That wouldn't be ethical. Um, but we're being very cautious here. We're setting her up for if she decides to breastfeed for that to be successful for baby's health. And we're trying to really bring as much intervention as we can gently before that birth. So remember about the seeding in the first 6 months, very cool feature. And if you guys have any questions, feel free to reach out and check out the other resources in our resource library.
