FAQs

The science behind Tiny Health

The human microbiome refers to the genetic material and products made by the vast numbers of microorganisms - bacteria, yeast, viruses, and archaea - that live with each other and with us. The gut microbiome is sometimes referred to as an “organ” that affects multiple systems throughout the body.

To give a little perspective, you have about one bacterial cell for every human cell. If you ignore red blood cells, this means that you have ten bacterial cells for every one human cell.

Even more impressive: There’s an estimated 3.3 million bacterial genes in your gut, which is 150 times more than the human genome.

But what does that have to do with our health?

Some bacteria produce vitamins and train your immune system. Other bacteria, like Bifidobacterium, help your baby digest specialized sugars in breastmilk called HMOs (human milk oligosaccharides).

From immune education and neurodevelopment to nutrient breakdown, maintaining energy levels, and more, bacteria - and their genes - are critical to our health.

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This one’s on you, mom.

While there are similarities in microbiome composition between family members, a baby gets the majority of their microbiome from the mother. This is called vertical transmission. Or in early life, seeding. Both vertical transmission and seeding describe the microbial transfer that takes place at birth and through later interactions with mom.

Factors that influences a baby’s microbiome include:

  • A mother’s diet during pregnancy
  • Antibiotic use and medication
  • How a baby is born, vaginal or C-section
  • Gestational age at birth
  • How long a baby is breastfed
  • When and what solids are first introduced
  • What environment a baby is exposed to

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As a baby grows, their gut microbiome matures and their immune system gets a little more skilled at identifying friend versus foe.

Ideally, a baby’s gut starts off dominated by Bifidobacterium, which protects the baby’s gut from being colonized by unfriendly bacteria. The first major leap we see is when a baby starts solids and weans from breastmilk. At this point, microbial diversity suddenly shoots up, which is what we want to see as the gut matures.

Parents have the greatest potential to impact a baby’s gut health during pregnancy and the baby’s first 12 months. As a toddler, there are gradual shifts towards a more diverse and adult-like microbiome that stabilizes between 3 and 5 years old.

Factors that affect baby gut health include vaginal birth or C-section, breastfeeding or formula feeding, the use of antibiotics and medications, exposures in the home and environment, time of weaning, and nutrition.

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Dysbiosis in a baby means something similar as in an adult. Essentially it’s an imbalance of the microbial communities that live in the gut.

However, unlike the adult gut, the baby gut is developing and flexible to changes in the environment. For better or worse. This window of development - a baby’s first 1,000 days - is the period during which chronic diseases can take root.

This means that off-kilter immune development, metabolic issues, and inflammation linked to dysbiosis can translate into obesity, allergies, asthma, and autoimmune disease later on in adulthood.

In early life, dysbiosis can look like low levels of certain beneficial bacteria. In your baby, this may manifest as colic, sleep issues, eczema, food allergies, or tummy troubles.

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Microbiome health as a field is relatively new compared to conventional medicine in general. However, human microbiome research has grown over the past 10 years and rose exponentially in the past five years. This has to do with sequencing technology becoming more affordable. There are now more researchers looking closely at how the microbiome is related to health and disease.

When it comes to the baby microbiome and associations with health or disease, some very clear patterns have emerged. We pull data and reference high-quality research that is reproducible and gives consistent results. This way, you can be confident in the information that we share.

Tiny Health has created something that was only possible in a clinical research setting a year ago. We’ve made comprehensive microbiome testing more accessible and affordable to parents.

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The wellness microbiome test

Diagnostic testing aims to provide clinical insights into disease risks or conditions and require FDA approval. Tiny Health tests, on the other hand, are currently exclusively intended to be used for wellness purposes.

Our reports are for informational and educational purposes. The tests we offer are not intended to prevent, diagnose, or treat disease or to substitute for a physician’s consultation.

Please visit our Help Center for any question we may not have answered here.

Unlike other commercial microbiome services, Tiny Health currently offers the first direct-to-consumer microbiome test with analytic services tailored for infants.

Our recommendations are also specific to the health needs of expectant and pregnant women and young infants.

Additionally, our shotgun metagenomics sequencing offers more comprehensive, in-depth microbiome data compared to that obtained with amplicon-based options.

Please visit our Help Center for any question we may not have answered here.

Our business model doesn't involve selling data for profit and everything you share with us is strictly confidential. Our full privacy policy can be found here.

Please visit our Help Center for any question we may not have answered here.

C-section delivery is typically associated with specific gut microbiome shifts in the infant. Breastfeeding may help correct gut microbial imbalances caused by C-section birth.

By testing mom and baby, we can give advice on how best to shift the baby's microbiome to a more ideal state.

Please visit our Help Center for any question we may not have answered here.

Baby gut health testing

During the first 1,000 days of a baby’s life, a type of programming takes place. This programming helps to determine a child’s lifelong health and has been directly linked to a wide range of metabolic and immune mediated disorders that fit under the umbrella of chronic disease, sometimes referred to as noncommunicable disease or noninfectious disease. And because of something called epigenetics, programming can even be carried from one generation to the next.

No pressure or anything.

During a baby’s first 1000 days, you have the opportunity to make a big impact in everyday ways, like simple lifestyle or diet shifts.

As a baby grows, their gut matures and their immune system gets a little more skilled at identifying friend versus foe. Gut maturity is marked by diversity. After birth, the first major leap we see is when a baby begins eating solid food.

Parents have the biggest impact on a baby’s gut health during pregnancy and a baby’s first 12 months. As a toddler, there are gradual shifts towards a more diverse and adult-like microbiome that stabilizes between 3 and 5 years old.

Factors that affect baby gut health include vaginal birth or C-section, breastfeeding or formula feeding, and the use of antibiotics.

Please visit our Help Center for any question we may not have answered here.

During the first year, a baby’s microbiome sees the most dramatic shifts and this path sets the trajectory for childhood and adulthood. What’s more, certain strains are more or less dominant at different points in time. It’s believed that this helps to support immune development.

The best way to track a baby’s gut health is with a series of tests.

For this reason, we encourage parents to sample as soon as possible, from age 0 to 3 years old and beyond. We currently have reference ranges for: 7-days, 30-days, 60-days, 90-days, 6-months, 12-months, 18-months, and 24-months.

But testing can happen at any time and is ideally customized to each baby’s needs.

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In short, it’s never too late to test. The sooner you have a baseline sample, the better.

Keep in mind that the gut is still developing until the age of 3 - 5 years old. Up until this point, you have an opportunity to check in on your little one’s gut health and make changes, if needed.

For older children, testing can reveal a lot about their gut health. Including levels of hidden gut inflammation, levels of bacteria that make anti-inflammatory short-chain fatty acids, microbiome diversity, and biomarkers for immune health and fiber digestion.  

Even if your child’s gut has reached adult-maturity, there’s still an opportunity to influence their dietary, supplement needs, and lifestyle choices.

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Candida is the most likely suspect for fungal infections. You may notice a stubborn diaper rash after antibiotic use because these yeast bloom in the gut and then may cause an infection on the skin. Diapers tend to be a great environment for Candida to grow since they are damp and warm.

But once Candida is on the skin, these yeast become less dependent on gut health. This means that while your baby’s gut may no longer have an antibiotic signature or Candida, a diaper rash can still persist.

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Terminology 101

Taxonomy refers to the naming system used to describe all living organisms. Organisms are classified according to different levels: domain, kingdom, phylum, class, order, family, genus, species, and strain. You can think of these taxonomic descriptions as Russian nesting dolls where domain is the largest and strain is the smallest.

Microbial names usually include genus and species information, such as Bifidobacterium (genus name) infantis (species name) or Candida albicans, which may be abbreviated as B. infantis or C. albicans, respectively.

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Anti- is a prefix meaning “opposed” or “against.” Biotic relates to living things.

True to their name, antibiotics have a knack for working against living things (microbes) in your body. Depending on the antibiotic, this means all bacterial life, including the beneficial microbes that we want to keep around.

Antibiotics have revolutionized medicine and made many formerly catastrophic diseases easily manageable. But the flip of this is that they also kill bacteria that are beneficial to us. Short term side effects, such as diarrhea and vaginal yeast infections, are also common after antibiotics.

Destroying large groups of bacteria indiscriminately gives opportunistic microbes a chance to grow. For this reason, we want to pay special attention to antibiotic use in your baby’s first 1,000 days.

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According to the International Scientific Association for Probiotics and Prebiotics (ISAPP), probiotics are “live microorganisms that, when administered in adequate amounts, confer a health benefit on the host.”

There’s a good chance you’ve encountered probiotics before, as they’re commonly sold as dietary supplements. However, not all probiotics are created equal.

The strains in most formulas consist of lactic acid bacteria and bifidobacteria which are not necessarily adapted to live in the gut. And that’s where the power of some probiotics teeters out. It may often be better to stimulate the friendly bacteria that are already living in the gut.

It’s worth understanding how to protect and nourish the microbes that support everyday health. And that’s what we at Tiny Health are all about.

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Prebiotics selectively feed specific gut microbes and are defined as“nondigestible food ingredients that beneficially affect the host.”

Prebiotics include human milk oligosaccharides (HMOs) in breastmilk, fibers in plant foods, and polyphenols in fruit. Many of these can also be taken as supplements.

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Postbiotics are the metabolites that microbes make to help us out, such as vitamins, secondary bile acids, and short-chain fatty acids such as butyrate. Some of these compounds can be taken as supplements or are being developed into medications.

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Are you tempted to lump fermented foods and probiotics in the same good-for-you bucket? We get it. They’re kind of the same, but not.

Here’s why: While fermented foods contain living microbes (just like your probiotic) no one really knows the strains of microbes living in your fermented food unless they do an analysis.

And when it comes to fermented foods, we also don’t know where the benefits are coming from. Is it the microbes? The microbial metabolites? The enhanced nutrition of the food? Chances are, the benefits of fermented food extend beyond it’s microbial residents. Which helps to explain how fermented foods are distinctly different from the specific strains found in a probiotic.

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The technology

When it comes to sequencing, think of it as a picture. When you send us your sample, we analyze it and you get a snapshot of where you're at.

Now, think about the picture itself. Depending on its quality, you might have a boxy, pixelated image that makes it tough to zoom in. Or maybe your picture is high resolution, with crisp edges and a whole lot of detail.

In a broad sense, the tools we use for sequencing are similar. One method, the one we at Tiny Health use, gives us a high resolution snapshot. The other methods, not so much.

Let’s break this down:

1. PCR / qPCR: These test whether specific known microbes are present and can be very sensitive.

2. 16S rRNA amplicon profiling: This tells us which high-level groups of bacteria and archaea are present but - because the image is little unclear - it can be tough to tell the difference between similar species.

3. Shotgun metagenomics: This gives us the highest resolution picture, helping us to not only identify the microbes present in your microbiome down to the species and strain level, but even discover new bacterial genes that have yet to be identified or named.

The ultra sharp image we get with shotgun metagenomics allows us to look at some viruses, yeast, and other microbes that make up the living ecosystem of your microbiome. And while currently less explored than bacteria, these other microbes also interact with bacteria and your baby’s immune system, affecting its development.

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Yes, we process submitted samples through a CLIA-certified laboratory to provide our microbiome sequencing services.

CLIA-certified laboratories are required to meet strict quality standards and ensure the accuracy and reliability of your results.

Please visit our Help Center for any question we may not have answered here.

The wellness microbiome test

Diagnostic testing aims to provide clinical insights into disease risks or conditions and require FDA approval. Tiny Health tests, on the other hand, are currently exclusively intended to be used for wellness purposes.

Our reports are for informational and educational purposes. The tests we offer are not intended to prevent, diagnose, or treat disease or to substitute for a physician’s consultation.

Please visit our Help Center for any question we may not have answered here.

Unlike other commercial microbiome services, Tiny Health currently offers the first direct-to-consumer microbiome test with analytic services tailored for infants.

Our recommendations are also specific to the health needs of expectant and pregnant women and young infants. Additionally, our shotgun metagenomics sequencing offers more comprehensive, in-depth microbiome data compared to that obtained with amplicon-based options (see The Technology section of FAQs).

Please visit our Help Center for any question we may not have answered here.

Lactose intolerance refers to trouble digesting the milk sugar, lactose.

This is different from cow milk protein allergy, which involves an immune response. Cow milk protein allergy is somewhat common in babies whereas lactose intolerance is very rare in children under the age of 5 years old.

There are two types of lactose intolerance:

1. Primary lactose intolerance: This is rare in babies and all about genetics. In this case, the body cannot make enough of the enzyme, lactase. This is the enzyme that helps break down and digest the lactose milk sugars.

Primary lactose intolerance is not caused by gut microbes. But symptoms may improve with helpful bacteria like Streptococcus thermophilus.

2. Secondary lactose intolerance: This is all about damage to the gut lining. Lactose digestion takes place in the small intestine and when the lining of the small intestine is damaged, we see secondary lactose intolerance. Which makes it hard to digest lactose. Usually this happens in adults after a long period of gut inflammation.

Secondary lactose intolerance can be caused by gut microbes if these microbes are making the gut inflamed. Repairing an injured gut and clearing inflammation can help support the digestion of lactose.

If your child is having issues with dairy it is important to talk to their healthcare provider to help understand the cause. In older children, lactose intolerance is often diagnosed by dairy elimination and/or a hydrogen breath test.

Here at Tiny Health we can provide you with helpful information like, “Does the gut have lots of signs of inflammation? How can I help to reduce inflammation?” and “Do I have beneficial S. thermophilus in my gut?”

There is no gut microbiome test that can detect lactose intolerance.

At Tiny Health we can help you understand your gut health and how it may contribute to symptoms of lactose intolerance.

Please visit our Help Center for any question we may not have answered here.

While microbiome testing does not test for food allergies, we can show associations between your baby’s gut microbiome and their symptoms of eczema or allergies. Or the potential risk of these conditions developing.

How do we do this? We use something called biomarkers.

Microbial biomarkers are bacteria associated with a higher or lower likelihood of developing a particular condition. But not everyone with biomarkers will have that condition. And everyone with a condition may not have the biomarkers.

Microbial biomarkers are developed from research. The Tiny Health Bioinformatics Pipeline uses a custom built database of over 120K complete microbial genomes. We sift through the research surrounding the microbiome and use this information to develop a  list of bacteria that we feel are important to track in early life.

Beyond the gut, there are a lot of other factors that also contribute to these conditions. Like genetics, lifestyle, and environmental exposures.

How can Tiny Health help?

If your child already has eczema or food allergies, it is likely that their gut could use some support! This is where Tiny Health would love to help provide insight.

If your child does not have any symptoms, let’s check in on the gut and see how we can help keep things on track.

Unfortunately, it’s not possible to detect specific allergies or sensitivities through any gut microbiome test.

Please visit our Help Center for any question we may not have answered here.