Meenal Lele, THE BABY AND THE BIOME: How the Tiny World Inside Your Child Holds the Secret to Their Health
Zibby interviews Meenal Lele, a medical researcher and the founder of Lil Mixins (the #1 pediatrician-recommended allergy-prevention product), about her revolutionary new parenting book The Baby and the Biome: How The Tiny World Inside Your Child Holds the Secret to Their Health. Meenal talks about immune systems, revealing that ages 0 to 3 are the most critical and listing the best things we can do to strengthen and protect a baby’s microbiome. She also talks about the power of early allergen introduction, which is the key to ending eczema and food allergies before they even start, and is the founding principle of her company, Lil Mixins.
Transcript:
Zibby Owens: Welcome, Meenal. Thank you so much for coming on “Moms Don’t Have Time to Read Books” to discuss The Baby and the Biome: How the Tiny World Inside Your Child Holds the Secret to Their Health.
Meenal Lele: Thank you so much for having me. It’s really cool to be here.
Zibby: I showed this book to my nine-year-old daughter. She was like, “What’s the secret? What is it?” I’m here to find out.
Meenal: The secret, in a nutshell, is that your microbiome — I think of it the way two hundred years ago, basically, we didn’t know about germs. We thought that we had to explain why we were getting all these diseases. We said it must be God smiting us or something. That was the only explanation because we couldn’t see that layer of it. We’ve actually known about our microbiome for a long time because as long as we’ve been able to see the bacteria, we know it’s there. The thing that we didn’t understand is how much it actually controls our body functions. That was a big difference. Every time you hear about a new disease, everyone’s chasing after all these genetic causes. They’re like, we found this gene and that gene and this gene. The truth is that genes obviously have a role to play in everything. It, to some extent, creates your predisposition to things, your susceptibility to things, but it’s actually a smaller part of the story than the environmental influences that are around you and the way those environmental influences affect you. You are you. Why does a gust of air pollution affect you and not somebody else? is because of the way it shifts the microbes that live on you. A really simple example — we see it very, very clearly. The reason to worry about it with babies is babies, generally speaking, should be born with basically the same microbiomes. They’re in the womb. Nothing’s touching them. Nothing’s influencing them. They should come out basically about the same. Then from there, you start to see this divergence. When you follow that divergence, that’s where you really start to see the differences in rates of chronic diseases and things like this. Why this is so important and the whole crux of the book is that it’s actually — because the baby is so small, because there’s so few influences on the baby and everything’s in that early stage, that’s your best chance to nudge things back onto the right course. To have your golf balls flying onto the other ones, you want it back on your own fairway.
Zibby: Have you been watching me play golf?
Meenal: No judgement.
Zibby: Keep going.
Meenal: You can keep things moving along. For a lot of us, there’s actually this window. The easiest way for me to always think about it is, we’ve understood that these early-life influences can really set up a baby’s brain. We think about the traumas a baby could have, or a toddler or things like this. We understand how zero to three, almost eighty percent of the baby’s brain is set up. Eighty percent of your neurons are laid down. Your decisions are being made about how you think about the world, how you model it. How we care for children zero to three, for their brains, really projects their trajectory for the rest of their life. Your immune system is really, really similar. It’s a second brain. Your immune system is largely controlled by this microbiome. How we treat it in the first three years kind of decides, are you going to be a sickly person for the rest of your life, or are you going to be a relatively resilient and healthy person for the rest of your life? Of course, just like with brain, it doesn’t mean nothing matters after three. It just means that there’s so much we can do to increase the odds that our children are healthy. I’ll let you get another question, but a statistic people don’t really know —
Zibby: — Keep going. This is great. You’re giving a lecture. You didn’t know, but you’re on a lecture circuit this morning. Welcome.
Meenal: Thank you. Fifty percent of babies today — if you have a baby today — I give this example with my son, who was born in Pennsylvania Hospital — we talk about it in the book. By the time fifty percent of those babies born at Pennsylvania Hospital hit college, fifty percent of them will have a chronic immune illness. That’s how bad it’s gotten. Fifty percent of us will end up with something chronic like allergies, like food allergies, eczema, lupus, Hashimoto’s thyroiditis, ADHD, autism. These are all now understood better and better to be immune diseases. Even type 1 diabetes is an autoimmune disease, a different kind of immune disease. They’re now even calling dementia and Alzheimer’s almost type 3 diabetes. It’s all the same immune system damaging itself. We can do a lot to stop it. The best part about this is that it’s not like, if only we moved to Mars, then we could stop this. I’ll give the example of — there’s a particular probiotic. It’s called L. rhamnosus. When moms take it their third trimester, through breastfeeding, the end result — why do we take L. rhamnosus? Because we want a healthy, solid amount of Bifidobacteria, actually. The L. rhamnosus really helps the Bifidobacteria grow. We want a really healthy amount of Bifidobacteria in a baby’s gut at six months old. That cuts the risk of eczema for the rest of their life by fifty percent. That’s a single intervention.
Zibby: If I have a child with eczema, which I may or may not — let’s just throw that out there.
Meenal: You may or may not be a good golfer.
Zibby: Is it because of something I didn’t take when I was pregnant, and now I’ve doomed the child forever?
Meenal: See, that’s a real defeatist way to think about it, in my opinion.
Zibby: Thank you. I always find the defeatist, most self-punishing interpretation of everything.
Meenal: I think it’s hard not to think of it that way. Look, I have a kid who has ten different food allergies. He’s got asthma. He’s got eczema. The truth is — did choices I make inadvertently increase his risk of all of these things? Yes. Is that my fault because I didn’t even know that that was a thing? No. It can both be my fault, and I’m also not to blame. Both of those things can be true at the same time. I think the more important thing is — I’m an eternal optimist. The way I look at it is, that happened, but then I have a younger son who, because I went crazy thinking about this stuff before the younger son had these, he has nothing. Even in a span of eighteen months, we were able to change little, little things that helped another person be really, really healthy. The way I look at it is, now we have this information. We know there are little things we can do to reduce the risk of eczema, the way we care for baby’s skin, how many courses of antibiotics we choose to use. We can use early allergen introduction, which is ninety-eight percent protective against peanut allergy, for example. Really simple intervention. There are choices we can make now that we have this to reduce our child’s risk. In the seventies, parents did all sorts of crazy things that they didn’t know any better. What are we supposed to do, sitting around blaming them? That’s not helpful. I don’t think of it way. I tend to think more, hey, wow, this is cool that this is in my control. I don’t have to just sit there wondering if my child will get sick. I can do something to reduce that risk.
Zibby: Two questions. One is, what are the main couple things that a pregnant person now or somebody who’s contemplating kids or their grandkid’s about to be born, whatever, what are the main things that maybe they didn’t know was equivalent to the smoking in the seventies or something? Then once kids are set on a certain path, is there anything we can do to change it? If those fifty percent of kids at University of Pennsylvania Hospital — is that it? Can there be a course correction or not? When is it too late?
Meenal: To answer your first question, what is the most important thing? If I had to pick one most important thing in pregnancy, unfortunately, I would say it’s worrying about your diet. It’s worrying about your diet because your diet will influence the state of your gut and your vaginal microbiome, which will be a hundred percent of the input to how your baby is seeded, what’s their starter set of bacteria. I think the most important thing you can do in your pregnancy is limit the negative influences on a microbiome. Smoking, air pollution. Honestly, because eighty percent of our immune system — eighty percent of that sits in our gut. It’s the high sugar, the processed foods, everything that deteriorates our gut microbes. Smoking is a good example because in some sense, people have always known on some intuitive level, hey, it doesn’t seem great to throw tar in my lungs, but I’m not sure that that’s what’s causing lung cancer. No one has ever said, I’m a hundred percent sure pizza is a great food, and that’s just as good for me as a spinach salad. No one thinks that. We didn’t really have the causal to connection to say, why is it that pizza or some other food when it’s a huge part of our diet causes us to be so sick? Now we can actually show how the processed foods, how the high-sugar foods disturb our gut and how they lead to these things.
I think that’s the most important thing you can do in pregnancy that you have at your disposal. Then there’s a bunch more stuff we talk about in the book. The second most important question is, what can we do? I have a lot of hope for the future because you can’t solve a problem until you understand the root cause of how it happened. Now that this science exists — over the last ten, fifteen years, it shows how these microbes and things disrupt it. There are a lot of therapies in development right now that use that and try and shift it to modulate the immune system to course correct. Like everything — a little bit of emotional trauma when you’re little could take ten years of psychotherapy to undo, but we can get to that healthy place. Unfortunately, that’s sort of still the ratio we’re looking at. It’s not like you can get to twenty and then say, cool, I’ll take this six-month course of Accutane and be done with it. It doesn’t work like that for a lot of these diseases. At least, not today. Obviously, people will keep pushing for better and better treatments because we can’t have fifty percent of the world be really sick. Today, there’s no good answer. Even until you get to the treatment, why go through the twenty years, thirty years, whatever it is, of that if you don’t have to?
Zibby: Awesome. I’m going to stay optimistic with all of this. Tell me about the business you also founded based on allergies, food allergies, and all of that.
Meenal: I’m an engineer — I talk about this — by training. This is sort of my bent on the world, which is a little bit why I’m optimistic, because I’m like, everything’s solvable. We just have to get the right formulas, and we’re going to fix it. When I heard about early allergen introduction — again, that was a really visceral one because I have a son, there’s ten different foods he can’t eat, which means he can’t eat at restaurants. It’s a thing because you eat three times a day. All the science came out, unfortunately, right after my kid got sick. With the younger son, we were like, great, we’ll do this. It was just an insane amount of work. I thought, this is so stupid. Something that’s so effective — anything else in society, if you said, “Hey, this is ninety-eight percent protective against a lifelong disease that has no treatment,” we wouldn’t be like, “Good luck to you. Hope you figure out how to do it.”
That’s what the doctors decided to do. Good luck to you, parents. We have this information. We may or may not even tell you about it, but you could treat it. You have a ninety-eight percent chance of fixing it if you figure it out on your own. I thought, that’s insane. This is just a manufacturing challenge. We went and created a line of products that make it really, really simple. It concentrates all these proteins into inexpensive — especially with the price of eggs today, you can get six months’ worth of exactly the infant-safe, correctly prepared eggs, everything you need for thirty bucks. That way if a parent doesn’t have to pay a lot and it doesn’t have to take up thirty minutes of effort a day, they’re much more likely to do it. I figured we could solve those problems. That’s really where Lil Mixins has come in. We’re excited that the market response has been good. If somebody can take the work out and make it inexpensive, that’s a good thing for everybody.
Zibby: It’s for kids. What ages? When do you start? Who needs to know about this product? Where do we get it? Everything.
Meenal: Every baby who is between four and six months old, so as soon as they start solid foods, should be regularly, so roughly every week, twice a week, should be feeding two grams of peanut protein, of well-cooked egg protein, of a bunch of different nut proteins into the baby’s diet. One of the ones we make is, here’s a packet a day. You give the baby a food every single day. It just throws into whatever food or milk or whatever they’re eating. You don’t have to think about it like any other additive or any other supplement or something that you’re giving them. That’s it. You do this for six months. Then that’s it. That’s the window in which the immune system decides whether or not to have food allergies. What you’re doing is basically training tolerance. By feeding the baby these proteins in this exact window, the same way our body develops antibodies to trigger a reaction to a food, our body also develops what are called T cells that tell the body, stay cool, we like this thing.
Zibby: That’s amazing that that exists. I’m sad it didn’t exist when all my kids were really little. We also have kids with food allergies. It’s no fun. Many parents do, so we know how this goes.
Meenal: We’re on the same team. It’s all right.
Zibby: So it’s not possible that a kid is just born, they’re definitely going to — I know this sounds so stupid — that from the time they’re born, we know they’re going to have the food allergies? I know there’s the genetic disposition that they may develop it. Some might be more or less likely. You can still stop it?
Meenal: Pretty much, no. It’s annoying because so many doctors still say it’s genetic, which just makes no sense. You can’t have a genetic disorder that didn’t exist forty years ago. What happened to our genetics? We didn’t all go through Chernobyl. Something had to have crazily changed our genetics if that were true. You can have kids that are very high risk and kids that are very low risk, but it’s all about those influences. The key is that the food allergy is not modulated by something that our genetics do. It’s modulated by the adaptive part of our immune system. We have an innate part of our immune system. If you think about the stuff that’s the structure that are there from the beginning, that’s really genetic. The adaptive part of your immune system that actually learns — every new virus you get, you get new antibodies to deal with that virus. That’s your body adapting to it. It’s the adaptive part of our immune system that determines if we have food allergies or not. The adaptive part is not based on genetics. It’s adapted because it’s doing it after you’re born.
Zibby: When you did this deep dive and tried to figure out how to prevent your next son from having the allergies and you went back, what were the things that you were like, “Oh, this is why my son has allergies to ten different foods”?
Meenal: The biggest things, again, are — I talk about this in the book. When my older son was little, he had all the things they talk about. Usually, they’re like, the highest risk is a C-section birth, not breastfeeding. Those two things do increase your risk, but nothing’s ever, if this, then you definitely have allergies. I had a perfectly healthy pregnancy. I eat great. I’ve always been a bit of a health nut. Vaginal birth. Nothing was wrong. We breastfed. Everything should’ve been great. I think the biggest thing that happened, actually — there’s no way to prove this. My son started to develop cradle cap. We didn’t know at the time that it’s basically a fungus. With my younger son, when he got it, we just used some dandruff shampoo. It went away. That was it. With the older son, he scratched at it until it got infected. Then he went on this course of antibiotics. Again, I can’t prove that this is true. I don’t know that it’s true. Right from there, things just started to snowball. I think it was right at that age. Suddenly, he was on these antibiotics. The antibiotics suddenly turned into way worse eczema flares. Right after the eczema flares started developing was around six months. We started introducing solid foods but were avoiding the allergens. He started developing the food allergies. His immune system was clearly just one thing after another going more and more whack. One course of antibiotics leads to a more trigger-happy immune system — that’s not a scientific term — that then maybe causes you to have another course of antibiotics. Every time you’re doing that, you’re, unfortunately, often wiping out all the good bacteria just as well as wiping out the infections. That’s what I think happened. Like I said, that could be nonsense I made up.
Zibby: Fascinating. I’m literally going back in my head. What did I do wrong? It’s okay.
Meenal: I know. I feel like a lot of people have that reaction when they read this book. I will say that the number of emails I’ve gotten from people who have reached out and said — the thing that’s most gratifying for me is when the people, even whose kids are sick but they’re looking back and being like, I knew that there was a holistic explanation to this — doctors kept saying to me it was unpredictable. It was unknowable. It’s all random. Yet I could feel in my bones that these things were all connected. Now I see it. I feel so much more sane. I can’t change it now, but it makes it all make sense.
Zibby: There is some closure to those open questions, which I also appreciate. Thank you. You did all this research. You started your business. Then in the middle of all of it, you also wrote this book. How did that fall into everything? When did you know this was a book? Tell me about that piece of it.
Meenal: I don’t remember if I talk about this in the book itself. I have a friend who, she is a — a bunch of my friends from college went on to do PhDs. It’s a running joke that they’re all — my six girlfriends, they’re all doctors of different kinds. It’s just me with my bachelor’s degree.
Zibby: You’re a slacker. You’re just the slacker in the group.
Meenal: I’m such a slacker. I know. When I email them to hang out, I’m like, “Dear doctors…” One of them, she’s written a few books. She’s a professor of art history and stuff. She was like, “You have all this stuff in your head.” We were chatting one day. She’s like, “You have all this stuff in your head. You should just write it down into a book.” I’m such a math and science person that I was like, “What are you talking about? No.” She’s like, “Worst-case scenario, just write it down, and then you’ll have it.” Really, what happened is the pandemic happened, and I found myself suddenly with a whole lot of free time. I gave myself one month, four hours a day, and I said, just write for four hours a day for one months. See what comes out of it. Again, I’d been thinking about this stuff. I’d been researching and talking to doctors and stuff for years at this point. It just flooded out of my brain into a manuscript. I was so lucky that this lovely team of folks then decided to help me turn it into something that wasn’t quite so science-y sounding and make it into something that was readable and approachable.
Zibby: Wow. Now with it out — you had already mentioned all the emails that you’re getting. What is the most satisfying piece of this for you?
Meenal: I think it’s that. It’s the little things, like someone who emailed and said, “Forever, I couldn’t convince my husband to do anything about our daughter’s eczema. After reading this, he’s like, ‘Oh, okay, there’s a root cause.’ Now he’s willing to try.” It doesn’t mean that that modification is definitely going to be the thing that fixes it, but he’s willing to try and search for a deeper fix. Later, they said their kid had gotten a lot better. This is a child who was getting sent home from day care because they were scratching at their skin so much that it would bleed on the toys. Now this kid is okay. What else can we do in life other than try and make a few other people’s lives a little bit better?
Zibby: This is not just a few other people. Eczema and all these things, these are so pervasive and really affect your quality of life. To itch all the time, it’s the worst. Wow, really awesome. What are you going to do next?
Meenal: I have a lot of things in the pipeline that we’re working on. For me, the biggest things are expanding access to this information. Again, I come back to it from my engineer’s perspective in saying, look, we’re all party to a system. These things are never, a single thing happens. It’s always, a system shifts. In that same way, how do you fix the whole system? I think that that comes down to, there’s a lot that we can do systemically to improve childhood nutrition, access to early allergen introduction and these proteins, potentially improve — one of the things we were able to do in the last few months is put together a scientific paper around L. rhamnosus and get that published in the American Journal of Clinical Dermatology. There’s a lot of education we have to do of physicians, actually, of primary care physicians, and then creating access. We’re never going to solve — when Cheetos are cheaper than carrots, people are going to eat Cheetos and not carrots. We need to be able to find a way to incorporate the externality cost of the Cheetos. I like Cheetos, for the record. I’m not saying you can never eat Cheetos. They’re delicious, but I also like carrots.
Zibby: I could take or leave Cheetos. Externality cost brings me back to business school. I’m having flashbacks with these terms. Anyway, go ahead.
Meenal: That’s it. Sorry, I also have an undergraduate business degree. You have to incorporate that cost into it and find a way. It’s interesting. There’s a lot of lawmakers that we’ve been educating. When they see it that way, okay, but if I keep this carrot really expensive or I don’t put it into the WIC package or I don’t do X, but then I’m paying on the back end. Today, health care, I believe it’s sixteen percent of our GDP. It’s just growing massively every single year. There will be a time not too long from now where half of every dollar, if not more, will just go into treating illnesses we created by penny-wise, pound-foolish. I think that’s the bigger picture.
Zibby: Changing the world, basically.
Meenal: Very discrete ways at a time.
Zibby: I love it. Last tiny question. For the treatment of eczema, what do you recommend as a mom of an eczema — what is your go-to for anyone with eczema? Not that you’re a doctor in this area. I’m just asking anecdotally.
Meenal: Eczema’s an allergic disease. What that tells you is that a form of an allergy is causing a flare. Step one is try and calm the flare down. Use your steroids. Use your creams. Things like that. If you do not pull out the allergic trigger, you will just keep flaring. What we did, for example — I recommend this to a lot of people. Try for two weeks — it only takes two weeks. Try a really hardcore elimination diet. Anything in the person’s diet that you think could be triggering their eczema, pull it out. If two weeks later, nothing’s better, then you know it’s not food. If it did get a lot better, which is also a good-case scenario, then one at a time every three days, you just add back in a food until you figure out, what’s the foods that are triggering the eczema flares? Again, it might not be food. Same thing. Try the foods first. If that helps, great. Then you just go scorched earth on chemicals in your house, the soaps, everything. Try and get rid of all of it, again, for two weeks. If it gets better, great. One at a time, go back to that detergent. Go back to the whatever. Go back to the whatever until you figure out what the triggers are. If you don’t find the triggers, you’re never going to calm that eczema down.
Zibby: This has been so fascinating for me. I am going to dive deep into this book and find all sorts of great, helpful things and just stew in my past mistakes and what I can do in the future.
Meenal: That wasn’t the point.
Zibby: I know. I know. When you find people with anxiety, that’s what they’re going to do. It’s fine. I like doing that. It’s fine. It’s very familiar-feeling. I’m excited when I get those opportunities in discrete packages. Appreciate it. Last thing. Any advice for someone else trying to write a book?
Meenal: I think you take the advice of my friend, to sit down and do it. You just don’t know. You might get to the end and be like, this is garbage. I am a big believer in, just do it because the worst thing that happened is you spent a discrete amount of your time doing it. Then it’s done. Maybe something great happens. Maybe it doesn’t. At least try.
Zibby: Thank you so much. This has been really fun, for me at least. Thanks.
Meenal: And for me. Thank you so much for having me. I really appreciate it.
Zibby: Thanks for coming on. The Baby and the Biome, a must-give to anybody as soon as they tell you that they’re having a baby. This is the go-to gift. You have to do this. They have to read this. Done.
Meenal: Thank you. Take care.
Zibby: Bye. Take care.
Meenal: Bye.
