Birth Practices & the Microbiome Online Course(s) & Continuing Education
Access the latest clinical skills and research for Birth Practices & the Microbiome for PREGNANCY, LABOUR & CHILDBIRTH professional training. These Birth Practices & the Microbiome online courses provide practice-changing skills and valuable perspectives from leading global experts. This Birth Practices & the Microbiome education has been accredited for a variety of CEUs / CERPs and can be accessed on-demand, at your own pace.


Mary Regan has a strong clinical background in perinatal nursing, with specific training and expertise in bio informatics. She trained as a certified nurse midwife in the United Kingdom and spent over 19 years working as a perinatal nurse specialist where she gained considerable expertise in pregnancy related health issues. She has been the PI on many State-funded grants and has received NIH funding for a grant focused on women’s decision making about birth (R21 HD059074-01A1) and the vaginal microbiota in preterm birth (R01NR014826-02). The findings from the R21 have been presented internationally and multiple publications have disseminated the findings. The R01 is in its final year and to date over 200 women have been recruited from the birthing population in Baltimore and followed for six month through pregnancy and to the post part period. Dr. Regan works as an Associate Professor in the School of Nursing at the University of Maryland. She serves on the board of Improving Birth.
Emerging research about the role of the gastro intestinal microbiota (GI) and host physiology provides mechanistic understanding that elucidates the relationship between diet and preterm birth (PTB). This presentation evaluates the current evidence about those relationships ( diet, the vaginal and GI microbiota and PTB). The studies that taken together suggest that diet modulates changes in the composition, stability and diversity of the vaginal and GI microbiota, resulting in microbial states that increase the likelihood of PTB. Understanding the critical role that diet, the vaginal and GI microbiota plays in PTB is essential for developing clinical interventions that leverage the capacity of the microbiota to optimize health outcomes.


Dr. Gregory began her career as a registered nurse more than 20 years ago and has dedicated her clinical and research work to improving health outcomes for preterm infants and their families. Her research is focused on gut health and disease, nutrition and the microbiome of preterm infants. She currently serves as the senior nurse scientist for Pediatric Newborn Medicine and Nursing at Brigham & Women’s Hospital, as well as the director of Newborn Care Improvement and Analytics. Those roles involve conducting research and developing new knowledge for practice, as well as finding ways to apply this knowledge to the development of improved clinical interventions for hospitalized infants. Dr. Gregory is an Assistant Professor of Pediatrics at Harvard Medical School and Editor of the Journal of Perinatal and Neonatal Nursing.
The human microbiome has emerged as a critical factor in human health. Many of the differences in the microbiome are attributed to early life events, making study of the microbiome during infancy and childhood a public health priority. In this presentation, a current state of the science on the factors influencing the establishment of the microbiome during infancy and early childhood will be presented, with a specific focus on infants who are born preterm.


I am interested in the prevention of obesity, type 2 diabetes, and cardiovascular disease from the perspectives of life course, nutritional and microbiome epidemiology. I believe that primordial prevention of lifestyle and environmental risk factors, particularly in high-risk and nutritionally transitioning populations, provides the greatest opportunity to curb the epidemics of metabolic and cardiovascular diseases. As such, my research aims to identify early-life, modifiable antecedents of cardiometabolic disease in diverse populations locally and globally. Most recently my research has focused on understanding the determinants of gut microbiota and how they can be leveraged to prevent metabolic diseases. My research effort is partitioned among the Department of Epidemiology at Johns Hopkins School of Public Health; the Welch Center for Prevention, Epidemiology and Clinical Research; and the Johns Hopkins Food, Body and Mind Institute.
Humans acquire a rich microbial ecosystem from their mothers during natural labor. Deterministic of this microbial acquisition are myriad factors, including maternal health, use of antibiotics, and diet/lifestyle during pregnancy, and, perhaps most strongly, delivery mode. In addition to shaping newborn microbial acquisition, these perinatal factors, in particular delivery mode, are associated with the future risk for the offspring in developing modern metabolic diseases such as obesity. As such, seeding the newborn with the “right” microbes at birth holds the potential for primordial disease prevention and health promotion throughout the life course. This talk will motivate the importance of mother-to-newborn transmission of microbiota for prevention of metabolic diseases, highlight recent original research, and put forward a research agenda in this arena.

Perinatal exposures, breastfeeding and the gut microbiome: Implications for lifelong health

Dr. Meghan Azad is an Assistant Professor of Pediatrics and Child Health at the University of Manitoba. She holds a PhD in Biochemistry and Medical Genetics, and completed postdoctoral training in Epidemiology and Pediatrics. Her research program is focused on the role of maternal and infant nutrition in the development and prevention of childhood obesity and allergic disease. Dr. Azad co-leads the Manitoba site of the Canadian Healthy Infant Longitudinal Development (CHILD) Study (www.canadianchildstudy.ca), a national pregnancy cohort following 3500 children to understand how early life experiences shape lifelong health. She also co-leads the Population Health Pillar for DEVOTION (the Manitoba Developmental Origins of Chronic Disease Network – www.devotionnetwork.com). Dr. Azad serves on the Executive Council for the International Society for Research in Human Milk and Lactation, and the Breastfeeding Committee of Canada.
Cesarean delivery, perinatal antibiotics, and formula feeding are associated with increased risks of asthma and obesity later in childhood. These effects appear to be partially mediated by disruption of the gut microbiome – a complex microbial community that is established at birth and develops rapidly during infancy, influencing host immunity and metabolism throughout the lifespan. Breast milk drives “normal” gut microbiome development by providing a natural source of probiotic microbes and prebiotic oligosaccharides. These associations and mechanisms are being studied in The Canadian Healthy Infant Longitudinal Development (CHILD) pregnancy cohort of 3500 infants followed from pre-birth through early childhood. Ongoing research in the CHILD cohort and recent evidence from other studies will be discussed.


Raised with her Penobscot culture and Native American spiritual practices, Dr. Jus Crea realized the healing powers of nature at a young age. Rich with ancestral knowledge of healing, medicine, and midwifery, Dr. Jus Crea received a Doctorate in Naturopathic Medicine from the University of Bridgeport and a BS in Ethnobotany and Holistic Health from UMass, Amherst. She has also been trained as an auricular acupuncture detox specialist at Lincoln Hospital, WTS therapy for restorative healing as well as Indigenous Midwifery with Mewinzha Ondaadiziike Wiigaming. She is also a Certified Indigenous Breastfeeding Counselor. Dr. Jus Crea has lectured extensively on herbal medicine, ethnobotany, midwifery, naturopathic medicine, environmental medicine, and cultural history and traditions of Wabanaki people. She was previously an adjunct professor of Nutrition at Springfield College and Pathology at STCC as well as a primary care physician in Brattleboro VT. Dr. Jus Crea has been practicing Naturopathic Family Medicine at The Integrative Health Group in Springfield MA since 2005.
Topic: The Importance of Gut Flora in Perinatal Nutrition - [View Abstract]
Optimal gut flora balance is an important part of perinatal nutrition. Our gut microbiome plays a critical role in the prevention of many illnesses and chronic disease. Gut flora can be impacted from genetic and environmental factors including poor diets, antibiotics, cesarean sections, formula feeding, and stress. It is important to optimize gut flora as part of perinatal nutrition for the optimal health of the newborn. Optimal gut flora balance is necessary for balanced immune function, digestive health, preventing chronic metabolic disorders, and mental health. Promoting optimal gut flora in maternal nutrition can aid the health of the newborn baby.


Tom Johnston is unique as a midwife and lactation consultant and the father of eight breastfed children. Recently retired after 27 years in the US Army, he is now an Assistant Professor of Nursing at Methodist University where he teaches, among other things, Maternal-Child Nursing and Nutrition. You may have heard him at a number of conferences at the national level, to include the Association of Woman’s Health and Neonatal Nurses (AWHONN), the International Lactation Consultant’s Association (ILCA), or perhaps at dozens of other conferences across the country. In his written work he routinely addresses fatherhood and the role of the father in the breastfeeding relationship and has authored a chapter on the role of the father in breastfeeding for “Breastfeeding in Combat Boots: A survival guide to breastfeeding in the military”.
Topic: Human Milk Synthesis: Just When You Thought You Knew - [View Abstract]
Topic: New Insights Into the Maternal Child Microbiome - [View Abstract]
Topic: Promoting Provider Self-Efficacy in Breastfeeding Support - [View Abstract]
Topic: Still Swimming Upstream: Breastfeeding in a Formula Feeding World - [View Abstract]
Topic: The Making of Human Milk: A Clinical Update - [View Abstract]
Topic: The Maternal-Child Microbiome or: The “Oro-boobular axis” - [View Abstract]
Topic: The Maternal-Child Microbiome or: The “Oro-boobular axis” - [View Abstract]
Topic: The Perinatal Microbiome - [View Abstract]
Topic: Using Evidence to Develop Clinical Lactation Skills - [View Abstract]
There is much to learn about the perinatal microbiome, What is it? What can it do? What do we do about it? How do our practices in the birth arena affect the long term health of women and their children? This presentation will scratch the surface of this exciting new area of research.

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Rodney Dietert is Professor of Immunotoxicology at Cornell University, Ithaca, NY, USA and author of the 2016 book: The Human Superorganism: How the Microbiome Is Revolutionizing the Pursuit of a Healthy Life from Dutton Penguin Random House. Rodney is in his 40th year Cornell University faculty. He received his Ph.D. in immunogenetics from the University of Texas at Austin in 1977. Rodney has more than 300 publications, including 200 papers and book chapters, with most concerning environmental risk factors, developmental immunotoxicity, and programming of later-life, non-communicable diseases.
Recently, he has focused on the importance of the microbiome in health and safety. Among his prior authored and edited books are: Strategies for Protecting Your Child's Immune System (World Scientific Publishing, 2010), Immunotoxicity Testing (Springer, 2010), Immunotoxicity, Immune Dysfunction, and Chronic Disease (Springer, 2012) and Science Sifting: Tools for Innovation in Science and Technology (World Scientific, 2013). Rodney previously directed Cornell's Graduate Program in Immunology, the Program on Breast Cancer and Environmental Risk Factors and the Institute for Comparative and Environmental Toxicology and served as a Senior Fellow in the Cornell Center for the Environment. Outside Cornell, he was President of the Immunotoxicology Specialty Section (SOT) and Editor of Springer’s toxicology book series, Molecular and Integrative Toxicology. Recently, Rodney appeared in the 2014 award-winning documentary film on the microbiome titled, Microbirth. In 2015, he received the James G Wilson Award from The Teratology Society for the Best Paper of Year (2014) with a peer-reviewed publication on the microbiome.
Humans are now recognized as being majority microbial based both on numbers of cells and numbers of genes. We are estimated to be approximately 57% microbial in cells and more than 99% genetically microbial. Taken a as whole, the bacteria, archaea, protozoa, viruses, and fungi that live on and in our body are called our microbiome. Most of the baby’s microbiome is seeded at or near birth and during early infant feeding making the perinatal period a critical time for human self-completion. Because of their location on and in our body and their capacity for metabolism, cell signaling and epigenetic regulation of the body’s physiological systems, our microbial co-partners can exert a major effect on human development, physiological function (e.g., neurological, immune, endocrine, respiratory, gastrointestinal) and risk of both noncommunicable and infectious diseases. The lecture will detail why management of the perinatal microbiome is critical for health risk reduction.

“Thanks, Mom: Influences on Baby’s Microbiome Composition During the Precious Perinatal Period”

Anne M. Estes, MS, PhD is an Assistant Professor at the Department of Biological Sciences in Towson University. Her research focuses on how microbes and their animal hosts work together throughout host development. With the birth of her first daughter and the sequenced genome of Bifidobacterium longum subsp. infantis in 2008, Anne became interested in the human microbiome and evidence-based parenting. She founded her blog Mostly Microbes
The perinatal period, the weeks prior to and after birth, are a critical time for establishing an infant’s bacterial microbiome. Which bacteria and the order that these microbes colonize the infant’s body sites influences long-term microbiome community composition and perhaps human health. There are three key factors for microbiome colonization: 1) what microbes does mom have, 2) what practices at birth allow microbes to transfer to her infant, and 3) which microbes will be maintained. How pregnancy, diet, lifestyle habits, medical practices, and environment influence these factors of microbiome colonization is discussed.