Review: The Microbiome Effect by Toni Harman & Alex Wakeford

If you're a regular reader of my blog, you know I'm incredibly fascinated by pregnancy and birth. You'll probably also know I've had both a c-section birth and then a vaginal birth. I've had a baby that was poorly and had formula for his first few days of life, and I've had a baby that was as strong as an ox and took to breastfeeding like a champ moments after being born. And I do often wonder what difference any of this could make to the boys' future health... 

I started reading The Microbiome Effect a few weeks ago, and it has been a real eye opener to learn that, yes, the boys' different birth experiences and the differences in how they were fed during those early days could well be having a big impact on their future health. I have often read statistics on how the way a baby is born and the way a baby is fed can affect their future, but I've never understood why that is.

Authors Toni Harman and Alex Wakeford undertook extensive research when making their documentary film Microbirth, and in The Microbiome Effect they reveal how there are microscopic changes happening towards the end of pregnancy, at the point of birth and soon after birth that can have lifelong consequences. 

We all have a community of 'good' bacteria that we carry with us throughout our lives and it is the seeding of this microbiome along with things like breastfeeding and other processes, that jump starts a baby's immune system. New research has shown that this bacteria is hugely important for human health, vital in fact, and imbalances in the human microbiome is linked to many chronic non-transmittable diseases. 

The Microbiome Effect explains the microscopic events that happen towards the end of pregnancy and during the birthing process to transfer the good bacteria from the mother that the baby needs to kickstart its immune system. During pregnancy the baby is cocooned in a near-sterile environment, but once the amniotic sac is ruptured, the baby is then exposed to vaginal and intestinal (yep, from poo!) microbes whilst descending the birth canal. 

Both the vaginal and the intestinal bacteria are good bacteria and are crucial for colonising the baby's gut microbiome. I'm really simplifying it here, but the vaginal bacteria are predominantly lactobacilli which help break down the sugars in breastmilk. The intestinal bacteria will have colonies of bifidobacteria which helps break down the undigested sugars in breastmilk and also coat the lining of the intestine and inhibit the growth of pathogens. 

In a vaginal birth these two types of microbes arrive in the baby's gut first and are ready and waiting for breastmilk to arrive. Breastmilk contains all the nutrients a baby needs, as I'm sure you know. but it also contains antibodies, antigens, anti-inflammatories and additional species of bacteria. It also contains sugars that are indigestible by the baby, but digestible by the microbes; they are prebiotics, which means they are food to feed the good bacteria. This gives the bacteria the energy to multiply and populate the gut and start training the baby's immune system. 

The book explains all of this in much greater detail and also looks at other vaginal birth scenarios such as water births and babies that are born "en caul". Once you understand how all of these different bacteria get into the baby's gut and the roles that they play, it makes sense that interventions during birth such as inductions and c-sections, feeding formula instead of breastmilk, the use of antibiotics or even simply not having as much skin to skin time after birth can all affect the balance of the human microbiome. 

The Microbiome Effect looks at the consequences of all of these things and explains the effect that it can have on future generations, the link to diseases, the impact it can have on humanity, and why it is so important that we become more aware of this. How we give birth to our babies and how we then go on to feed them can often be a sensitive point; I know I still carry a lot of hurt about Little N's birth. Before reading The Microbiome Effect I did worry that I may finish the book feeling even more guilty, but I didn't. Not at all. 

The authors of the book have a daughter who was born by c-section, so they understand. They know what it's like. And while they say that the optimal way to "seed and feed" a baby's gut microbiome is through vaginal birth with breastfeeding, they know this isn't always straightforward. So they have also explored what can be done to help those who have their babies by c-section, what formula milk companies could do to help those babies that won't or can't be breastfed, and what we can do to change our lifestyles as a society. 

The Microbiome Effect is the most interesting book about pregnancy and birth that I have read to date. It is incredibly fascinating, and like the authors, I wish this was information that I'd known about before having my first baby. Who knows what his future health holds for him, and who knows what difference this could have made to it. Only time will tell. But now I do know about this research, and as they say knowledge is power. If I have another baby there is always the chance that I may need medical interventions. This time though, I am armed with information and know what I need to do to help get my baby's microbiome off to the best start possible.

The Microbiome Effect is published by Pinter & Martin and is currently on offer for £8.99. You can also find it on Amazon.

What do you think about this research? Would it affect your birth choices? Let me know your thoughts in the comments below!

I was provided with a review copy. Quite Frankly She Said is a participant in the Amazon EU Associates Programme, an affiliate advertising programme designed to provide a means for sites to earn advertising fees by advertising and linking to  


  1. I hope you don't mind me commenting - but I'm one of the co-authors of The Microbiome Effect (I wrote the book with my partner Alex).

    I think you've done a brilliant job summing up the science described in the book - and thanks for your kind words. I'm thrilled that you liked it!

    If anyone is interested, as well as the book - there's also our MICROBIRTH film available to stream/download/buy the DVD at

    Thanks again.

    1. I don't mind at all - thank you for commenting! It is really amazing, I have been raving about it to everyone x

    2. Hi Toni, Congratulations and thanks, this is an amazing and powerful book. We will offer a copy as a prize for the next birthlight newsletter. I wonder whether you would be willing to also offer the birth summit interviews as a prize with a short article. We have lots of birth education teachers round the world who work both in communities and in maternity hospitals and it's important that they know your films, books and your interviews with microbiome scientists. I do not have your email address but like this review and saw your reply. Thanks, Francoise.


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