Dr. M’s SPA Newsletter Volume 15 Issue 18

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Breastmilk is Dynamic

Cellular and transcriptional diversity over the course of human lactation

This recent 2022 paper in the Proceedings of the National Academy of Sciences by Dr. Nyqiust and colleagues is a site for sore eyes.

It offers a remarkable, high-resolution portrait of how the cellular landscape of human breast milk (hBM) shifts over time. The authors capture something both scientifically rich and uniquely human: the dynamic, living composition of milk as it adapts to the changing needs of mother and child.

The abstract: “Human breast milk is a dynamic fluid that contains millions of cells, but their identities and phenotypic properties are poorly understood. We generated and analyzed single-cell RNA-sequencing (scRNA-seq) data to characterize the transcriptomes of cells from hBM across lactational time from 3 to 632 d postpartum in 15 donors. We found that the majority of cells in hBM are lactocytes, a specialized epithelial subset, and that cell-type frequencies shift over the course of lactation, yielding greater epithelial diversity at later points. Analysis of lactocytes reveals a continuum of cell states characterized by transcriptional changes in hormone-, growth factor-, and milk production-related pathways. Generalized additive models suggest that one subcluster, LC1 epithelial cells, increases as a function of time postpartum, daycare attendance, and the use of hormonal birth control. We identify several subclusters of macrophages in hBM that are enriched for tolerogenic functions, possibly playing a role in protecting the mammary gland during lactation. Our description of the cellular components of breast milk, their association with maternal–infant dyad metadata, and our quantification of alterations at the gene and pathway levels provide a detailed longitudinal picture of hBM cells across lactational time. This work paves the way for future investigations of how a potential division of cellular labor and differential hormone regulation might be leveraged therapeutically to support healthy lactation and potentially aid in milk production.” (Nyquist et. al. 2022)

And more information on breastmilk immunology and a recipe.

Dr. M

Dr. M’s Women and Children First Podcast #96 Joel Warsh, MD Vaccines – What Do We Know in 2025?

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Welcome back to Dr. M’s Women and Children First podcast where we look at the world of Women and Children’s Health through an anthropological lens with the humble understanding that we have a lot to learn.

Today, I’m joined by Dr. Joel “Dr. Gator” Warsh, a pediatrician, author, and advocate for a whole-child approach to healthcare. Dr. Warsh earned his medical degree from Thomas Jefferson Medical College and completed his pediatric residency at Children’s Hospital of Los Angeles. Along the way, he also obtained a Master’s degree in Epidemiology and Biostatistics from Queen’s University in Canada, giving him a strong foundation in both clinical care and population health. These educational pursuits make him uniquely suited for today’s conversation on vaccines.

He is the author of Between a Shot and a Hard Place. In his own words, he says: I’ve dedicated my career to helping families navigate complicated health topics with clarity. My book addresses vaccine questions in a calm, data-driven, and practical way, offering parents guidance that steers clear of extremes. Parents face unprecedented pressure to make the “right” choices, often without enough balanced information. He has been featured on major platforms sharing his message with more than 400,000 parents through social media. We discuss his passion for empowering families to make informed, individualized decisions, including in areas that have been challenging or even taboo to discuss.

Today, we’ll dive into his latest work, his perspectives on vaccines and preventative care, and how he envisions a future of pediatrics that is proactive rather than reactive. This is a conversation about rethinking the foundations of child health and it’s one you won’t want to miss.

Enjoy,

Dr. M

Dr. M’s SPA Newsletter Volume 15 Issue 17

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Inflammaging from a Population View

In a landmark study published in Nature Aging on July 7, 2025, researchers challenge a cornerstone of modern gerontology by showing that inflammaging, chronic, age-associated low-grade inflammation, is not universal across all human populations. The abstract states the following: “Inflammaging, an age-associated increase in chronic inflammation, is considered a hallmark of aging. However, there is no consensus approach to measuring inflammaging based on circulating cytokines. Here we assessed whether an inflammaging axis detected in the Italian InCHIANTI dataset comprising 19 cytokines could be generalized to a different industrialized population (Singapore Longitudinal Aging Study) or to two indigenous, nonindustrialized populations: the Tsimane from the Bolivian Amazon and the Orang Asli from Peninsular Malaysia.

We assessed cytokine axis structure similarity and whether the inflammaging axis replicating the InCHIANTI result increased with age or was associated with health outcomes. The Singapore Longitudinal Aging Study was similar to InCHIANTI except for IL-6 and IL-1RA. The Tsimane and Orang Asli showed markedly different axis structures with little to no association with age and no association with age-related diseases. Inflammaging, as measured in this manner in these cohorts, thus appears to be largely a byproduct of industrialized lifestyles, with major variation across environments and populations.” (Franck et. al. 2025)

The research team analyzed 19 cytokines in over 2,800 individuals from four diverse populations: two industrialized cohorts: Italy’s InCHIANTI and the Singapore Longitudinal Aging Study (SLAS); two non-industrialized, Indigenous groups: the Tsimane of the Bolivian Amazon and the Orang Asli of Peninsular Malaysia.

In Italy and Singapore, the industrialized regions noted classic inflammaging signatures with inflammatory markers like IL‑6, TNF-α, and CRP increased with age, and correlated strongly with age-related chronic diseases such as cardiovascular and kidney disease….. and more on inflammaging…

Dr. M

Dr. M’s SPA Newsletter Volume 15 Issue 16

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A Rooted Approach to Modern Medicine: The Vision Forward

My emerging and chronically iterating philosophy of medicine is a rising structural entity rooted between ancient healing wisdom and modern scientific insight. It is layered with root cause immunometabolomic thinking and built upon anthropological foundations. As a pediatrician, educator, and onion peeling thinker, I believe that a medical approach grounded in compassion, prevention, and the pursuit of root causes is the way forward. Medicine is not just about treating disease but about reshaping the very terrain in which illness arises. This can and must start with our women and children.

At the heart of this vision is a belief in the power of systems biology and our deep interconnectedness. The human body cannot be understood or healed through isolated parts or siloed provider experiences. We must move beyond symptom suppression and toward an understanding of the why behind disease. Why does a child struggle with allergies, ADHD, or autoimmune illness? What factors in the environment, diet, stress response, or microbial ecosystem have altered their trajectory? Why are the governmental and NGO leaders not guiding us towards a benevolent goal of whole child health? These are the questions that shape and guide our practice….and a literature review.

Dr. M

Dr. M’s Women and Children First Podcast #95 – Sanjay Bhorjaj, MD – Living Longer and Klotho

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Today’s guest is Dr. Sanjay Bhojraj, a powerful voice at the crossroads of advanced interventional cardiology and root-cause wellness. Dr. Bhojraj is board-certified in Cardiovascular Diseases and Interventional Cardiology, and one of only a small number of interventional cardiologists in the United States who is also certified in Functional Medicine through the Institute for Functional Medicine.

Dr. Bhojraj earned his medical degree from Indiana University School of Medicine, trained in internal medicine at Northwestern, and completed a cardiology fellowship at the renowned Henry Ford Health System. For over two decades, he practiced in conventional cardiology, saving lives daily with stents, angioplasties, and transcatheter valve replacements.

But along the way, something essential began to stir. He found himself asking bigger questions: Why do people arrive in the cath lab in the first place? Why are we not doing more to prevent the first or second heart event? And what role do nutrition, sleep, stress, and emotional health truly play in long-term cardiovascular outcomes?

These questions led Dr. Bhojraj to Functional Medicine, not as an alternative, but as an evolution, a model that restores agency to patients and equips the body to heal through comprehensive lifestyle optimization. He now leads the Well12 Program, a transformational experience that guides individuals in upgrading the foundational systems of their health from metabolism to mindset, so they can live not just longer, but better.

Today, Dr. Bhojraj and I explore the remarkable protein Klotho and the emerging science linking it to human longevity and health span. This is a conversation you won’t want to miss, a glimpse into what may become a defining frontier in upstream disease prevention.

Enjoy,

Dr. M

Dr. M’s SPA Newsletter Volume 15 Issue 15

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Systemic Maternal Inflammation and Neurodevelopment: The Role of IL-6 and IFN-γ in Autism Spectrum Disorder

I just returned from Estes Park, Colorado where I presented a lecture on the Growing Brain/Mind – a tour through the underpinnings of childhood neurological changes that we call Autism. The timing is perfect for this article to be written.

In an era when chronic disease in children is rising at an unprecedented pace, the search for root causes must include an honest inquiry into the conditions present during fetal development. The review article by Majerczyk and colleagues, Systemic Maternal Inflammation Promotes ASD via IL-6 and IFN-γ, brings forward a critical piece in this puzzle that I began to explore a few years ago when writing a book. It connects the dots between maternal immune dysregulation and long-term neurodevelopmental outcomes, specifically autism spectrum disorder (ASD). Through a synthesis of clinical data and animal research, the authors make a compelling case for the centrality of two inflammatory messengers, interleukin-6 (IL-6) and interferon-gamma (IFN-γ), in shaping fetal brain development during gestational stress. The key words here being GESTATIONAL STRESS, the recurring scientific theme for ASD development, not vaccines… and some literature reviews.

Dr. M

Dr. M’s Women and Children First Podcast #94 – Melinda Elliott, MD – Feeding the Infants

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Today, we explore the intersections of cutting-edge science, compassionate care, and the future of pediatric and maternal health with Dr. Melinda Elliott, MD, FAAP, a leading neonatologist and the Chief Medical Officer at Prolacta Bioscience. Dr. Elliott has dedicated her career to advancing the care of our most vulnerable patients, premature and medically fragile infants, through both clinical excellence and research-driven innovation.

Dr. Elliott earned her medical degree from West Virginia University School of Medicine. She went on to complete her residency in pediatrics and her fellowship in neonatal-perinatal medicine at the University of Florida, where she also served as chief resident and a faculty member, helping to train the next generation of pediatricians and neonatologists.

Throughout her clinical and leadership career, Dr. Elliott has been deeply involved in advancing evidence-based care in the NICU, improving nutritional strategies for preterm infants, and advocating for human milk as a therapeutic intervention in neonatal health. Her work with Prolacta Bioscience supports NICUs around the globe in providing 100% human milk–based nutrition to reduce complications such as necrotizing enterocolitis (NEC), a devastating condition that disproportionately affects preterm infants.

Please join me in welcoming Dr. Melinda Elliott, a champion for babies and a voice for innovation in neonatal medicine.

Dr. M

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