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On Zika, gut bacteria and resilience in children: Highlights from the final day of the Childx conference

26514712171_f7e76b8d5b_bStanford's Childx conference on Friday featured a lineup of presentations focused on microbes and early life, as well as on how children can thrive in a changing environment.

One highlight was a talk by Phillip Tarr, MD, of Washington University in St. Louis, who described how new research on the gut microbiome is improving our understanding of necrotizing enterocolitis, a very serious bowel disease seen in premature babies. "This disorder is about 10 times more lethal than myocardial infarction," Tarr told the audience.

For the last several years, Tarr's team has been learning how the gut, which is sterile at birth, is normally colonized with bacteria, and asking whether the makeup of the community of microbes gives clues as to which babies are at risk to develop necrotizing enterocolitis. After a herculean effort — collecting 77,000 stool samples from a group of babies over the first several weeks of life and identifying different types of bacterial DNA in each — his team has identified one group of bacteria associated with greater risk of the condition and another group of bacteria that may have protective value. He's optimistic about the future:

I think we are now at a point where we can start to use microbiome science for prediction of outcomes. We're getting beyond an era of cross-sectional comparisons.

Stanford's Desiree LaBeaud, MD, discussed the new, significant challenge posed by the  Zika virus. "This is the first time I've been able to witness the discovery of a novel teratogen," LaBeaud said. "As a mother of three, I know that pregnancy is a time of a lot of anxiety; there are so many unknowns. Right now, for a lot of women in the Americas, their pregnancies have become a terrifying state for them — keep them in your minds."

The mosquito species that transmit Zika — Aedes aegypti and Aedes albopictus — are hardy creatures whose eggs can dry out for years and still remain virulent, LaBeaud said. Mosquito-control experts around the world are now contemplating strategies to slash the number of new infections. Their task is tricky: the mosquitoes prefer to breed in man-made containers and need only a tablespoon of water to do so. In addition, they bite mostly during the day, so bed nets are a less-effective Zika prevention strategy.

LaBeaud also discussed the large and growing body of evidence linking Zika to microcephaly and brain problems in babies exposed to the virus in utero, summarized in a New England Journal of Medicine report published last week.

Christina Bethel, PhD, a professor of population, family and reproductive health at Johns Hopkins Bloomberg School of Public Health, who is shown above, discussed the wide-reaching effects of adverse childhood events on many dimensions of children's well-being. Studies of these adverse events show that children exposed to more types of trauma fare worse on all kinds of measures, and yet some kids with very traumatic lives can also be very resilient. Having an adult mentor and being able to share things that matter in life are both protective factors that help increase children's resilience, she said.

It's important to let young people know that their lives can change, Bethel said, continuing:

Instead of a sense of getting stuck, there is a transformative power in just instilling a growth mindset. Our new science of thriving concerns itself with the capacity for positive human development even in the face of adversity and frames well-being as a learned ability."

Watch for more from Childx — we'll be sharing videos and photos from the event in coming weeks.

Previously: Countdown to Childx: Talking Zika with a Stanford infectious disease expert and Countdown to Childx: Previewing the "epicenter of innovation" for expectant moms and children
Photo by Saul Bromberger

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