By Michelle Perro, MD

Infertility, surrogacy, changing family structures, low milk production, inhospitable and toxic environments, stress, and a myriad of other factors are impacting breastfeeding babies. From the perspective of the baby biota, moms are the microbial stewardesses, passing on the collection of microorganisms that will direct much of the baby’s biology, and in particular, their immunological future. Vaginal births and breastfeeding ensure the inheritance of moms’ microbial wisdom to be passed onto the infant.

But as we are all well aware, one-third of American babies are now born via Cesarean Section. With the changing landscape of parents and pregnancies, many babies are not receiving the best source of infant nutrition, especially with a lens on the microbiota, whether from the acquisition of microorganisms from a vaginal birth and/or nursing.

However, there is some good news to be shared! Nearly one-half of US moms are still nursing six months after birth. But according to the USDA, 80% of 3-11-month-old infants are fed some formula. The addition of infant formula to the baby’s diet introduces undesirable toxicants present in many formulas such as:

• Fluoride
• High fructose corn syrup (Never good!)
• Artificial essential fatty acids (extracted with toxic hexane)
• Perchlorate (found in rocket fuel)
• グリホサート

Sadly, this is an incomplete list.

Infant formula contains perhaps only one of the human milk oligosaccharides (HMOs - prebiotic lunch for the microbes), whereas mother’s milk may have up to 50 HMOs. Is there an amenable solution to infant formula?

Biohacking Breastmilk?

The quest to create a more breastmilk-like alternative has piqued the interest of bioengineers and the tech industry, with companies now trying to recreate “biomilks”. These are cultured from mammary cells outside the body, for example, and deriving the 2500+ components of breastmilk in the lab. Money is pouring in from venture capitalists, so clearly there are those that support and believe in this newest tech innovation in infant feeding.

The looming question is whether these engineered inventions are visionary or is this another baby biohack? Could moms and their ability to feed babies be ultimately replaced by slick bioengineering?

Infant formula scientists have been trying to eliminate the difference between breastmilk and formula for decades, so this concept is not new to consumers. Other techie foods are now flooding the market so we are now experiencing a tech-industry-driven glut in the fabricated food arena to create interest and acceptance. It is important to note that there has been an overall lack of scientific transparency by the companies creating novel foods, whether having utilized genetically engineered products or lab-grown.

The Impossible Burger (IB) is a perfect example of a Silicon Valley produced product, where they manufactured their own novel plant-based GMO burger, performed their own studies and made it nearly impossible to access their study results. The FDA eventually gave them the green light for sale to consumers as well as the responsibility of self-monitoring. Food advocacy groups have taken it upon themselves to research whether health issues are emerging from consuming the IB and are collecting their own data to be published in the future.

But the larger looming question is what are the potential health impacts of this lab-derived breastmilk analog and will unrealized adverse effects even be considered and studied?

Are breastmilk and breastfeeding to be replaced by a motherboard?

A historical review of the baby biota has revealed microbial evolution over the past 100 years. Fecal smears at that time were almost a monoculture of Bifidobacteria, the key microbe in protecting baby’s health. Presently, there is a noted decrease in babies’ poop of bifidobacteria and increases in proinflammatory microbes. A nutritional imperative is to protect the baby’s microbiota with an emphasis on bifidobacteria species.

Let’s think about the following…

• Will biomilks consider the impacts of lab-derived epithelial cell culture lines on the development of the baby’s microbiome from the introduction of their novel techniques?
• Will the cell lines utilized be tested for contamination? Remember, the Henrietta Lacks story and cell line corruption and contamination:

• Will companies perform appropriate test studies that are case-controlled and peer-reviewed not only for microbial but overall health impacts from this newest infant nutrition innovation?
• Will the public have access to their research, if conducted at all, or will it be proprietary? And will the futuristic concept of ‘what is the mother-as-nurturer’ be replaced by bioengineering?

Huxley’s Brave New World written, in 1931, of a futuristic World State of environmentally engineered hierarchies, wrote about the Central London Hatchery where children are created outside the womb and cloned. The era between WWI and WWII embraced the widespread belief in technology as a futuristic remedy for problems that were identified as disease and war.

In 2023, do we still perpetuate and bow to “better living through technology” bypassing Mother Nature via lab and tech-generated solutions?

Other tech upheavals that have replaced more traditional baby supplies include smart diapers, which have activity sensors that detect dampness via sending a signal to a smartphone or computer, alerting parents that it’s time to change the baby’s diaper. Wi-fi baby monitors allow caretakers to check on the baby from wherever they are via a wireless router and a phone or tablet with the downloaded app. And if the baby should have a fever, try the smart thermometer via a thermometer app. All very clever and necessity aside, the more important questions loom - are the health ramifications from the increased wi-fi exposed? What impact does all this wi-fi exposure have on the infant microbiome?

There is no doubt that infant breastmilk substitutes have become mainstream conversation in kitchens, medical offices, Wall Street and Silicon Valley Boardrooms. It is now recognized that infant nutrition may have life-long consequences through microbial modulation of the immune system. In the first few years of life, disruptions in the interaction between the gut microbes and the mucosal barrier may lead to gut permeability and a secondary effect on immune function with development of diseases later in life. Human milk is an innocuous medium for the infant's gut programming the immune system to respond appropriately to antigens, pathogens and commensals.

Whether creating a more “breastmilk-like” product is a “boon or bust” is open for debate. Nursing a baby is more than just delivering an equivalent product in a sterile bottle. There are human connections and signaling that occur during nursing. Skin-to-skin contact is also invaluable and provides more microbial information for the infant. Additionally, research now shows that the baby impacts moms’ milk through retrograde flow back into the nipple. This microbial exchange can give mom information to alter her milk ingredients to assist the baby’s needs. Research has also shown that the cessation of breastfeeding was identified as a major factor in determining gut microbiota maturation with shifts in signature species.

There is a clear recognition that we are a bacteria-controlled Superorganism and with their vast quantities of DNA, they play a major role in our development. Whether technological ‘improvements’ will honor the baby's microbial inheritance remains to be determined.