Professor Valerie Verhasselt

Professor Valerie Verhasselt
Director, Larsson-Rosenquist Foundation Centre for Immunology and Breastfeeding (LRF CIBF), The University of Western Australia

You’re investigating breastfeeding and breastmilk as preventive interventions against allergies, infections and metabolic diseases: What is your holy grail? 

My holy grail is ambitious, it is having happy children, with happy mothers, happy dads, in a happy society. I'm aware that's a big, big objective. But that is the driving force behind what I tend to achieve. 

I focus especially on topics where there is either scarce knowledge about breastfeeding and protection from disease or there is knowledge about breastmilk not being protective at the population level. For instance, for allergic disease, there is no consensus and no strong evidence that breastfeeding is protecting from allergy. The core of my research has been to try to find out what the mother could do, and should not do, to have milk that is adapted to our modern world where allergy is highly prevalent. What recommendation should we give to mothers so that they increase the chance of their breastmilk to protect from allergy? 

That is one way of getting a happy mother, a happy child and a happy family because allergy is a huge cause of stress for families. You rarely die from allergy, but it's a very high daily burden and a high economic cost. For allergies, there is a lot to be done. 

Didn’t you recently publish data showing breastfeeding is preventative for allergies?

What I've been doing for 15 years is exploring the potential of breastmilk to protect from allergy. Breastmilk contains compounds that are certainly protective from allergies. 

We aim to provide recommendations for breastfeeding mothers. For instance, our pioneering research has shown that by eating eggs, which can result in egg allergen in the breastmilk, mothers can contribute to decreasing the risk of egg allergy for their child. 

This is very simple, but this has major outcomes. 

Fifteen years ago, we were still in the avoidance period. Mothers avoided eating eggs, peanuts, all the allergens while breastfeeding. This work has been pioneering – the idea that there are maternal interventions as simple as, eat your usual diet, maybe even a bit more of an allergen, to change your milk composition and make the baby ready for later exposure.

You focus on health outcomes relevant to children in low-resource settings. Have your learnings led to new investigations?

Regarding infection, I do not do research on prevention of diarrhea or respiratory infection by breastfeeding – this is all known. Again, I go where there is poor evidence such as for instance, malaria and worm infections. These are killing diseases or severely debilitating in a lower- and middle-income country. They completely compromise the development of the children. Then of course the society is suffering in addition to the child suffering. Surprisingly, malaria is endemic in parts of Africa and Asia and helminths infection affects 1/4 of the planet, yet there is almost nothing, very, very few studies on the protection of these diseases by breastfeeding. 

The research of the LRF CIBF explores a potential game changer in the field of vaccination – research providing evidence that breastfeeding may be a natural, and very efficient, way to vaccinate children and protect them from malaria. We also aim to promote colostrum feeding. Our research is investigating whether it could be key for preventing worm infections, which is important given that colostrum feeding is suboptimal among 50% of newborns on the planet.

These newborns are not receiving the full dose of colostrum because of late initiation of breastfeeding, because formula supplementation or prelacteal feeding due to cultural belief. We know that these practices increase the risk of neonatal mortality. 

That is very well established, so I don't work on that. I work on what the long-term consequences are, and our data suggest that missing colostrum at birth may make the child more susceptible to worm infections as well as to chronic undernutrition. With all of that, we hope to bring a little piece of the puzzle towards happy families and society.

How does your work look from the implementational perspective? 

My research is far from giving guidelines. I'm doing preclinical basic research that I translate in birth cohorts. The goal of my research is to build knowledge and give people that knowledge, as strong and as excellent as possible, so people trust it and test it in a human study, a randomized control trial – that will be leading to implementation. 

Also, just by bringing attention to breastfeeding, I think I'm helping in implementation. I'm trying to spread knowledge about colostrum, about breastfeeding in general, bringing that beyond only nutrition to a high level of science so that experts consider this knowledge as something important to take into account and then go to implementation. That is also how I contribute to implementation.

The LRF CIBF started with the world’s first chair in human lactology, then a novel concept. Being endowed for the long term, you don’t need to chase grants or rush to complete projects in artificial timeframes. How does this financial freedom influence the way you work, or enable you to innovate your research? 

Before getting this fantastic position, I was working in France leading a team, and I was paid by the governmental funding source Inserm (National Institute of Health and Medical Research). I had and I still have a tenured position there, so I had the luxury to have my salary covered for whole my life, this is already exceptional. OK, it's good to have a salary for me, but then I need money to work, for performing the experiments. And there came the issue. Indeed, getting funding by governments on breastfeeding is extraordinarily difficult, certainly in terms of basic research. Now that I have funding from the Foundation that is extremely generous, it gives me peace of mind. Importantly, it allows me to do build research with long term vision.

I think we need to have the possibility to ask simple questions with simple answers that are relevant for the clinic and for the children and their mothers. When I showed that allergen in breastmilk is promoting prevention of allergy, this was a very simple experiment, and this was published in Nature Medicine. It has contributed to lead to changes in the child nutrition guideline; it has changed a lot of the thinking processes about preventing allergy.

I think that today I could not do that kind of research without the Foundation. I have tried and tried since I've been in Australia to get government grants, and I don't succeed because they don't see the point of doing research on breastmilk, which is “free”, which is available. To conclude, it's about giving freedom and giving me the possibility to do research that is relevant for the mother and the child and the society. Today, unfortunately, funders are not always aware of what is important for mothers, children and the society. 

I would quote Tobias Kollmann who works at the Perth Children’s Hospital, he’s a professor in pediatrics who spent five years here in Perth. He told me what he gained in Perth was knowledge about breastfeeding I brought him, and that would change the rest of his career. Now all of his program research will be on breastfeeding. This is a wonderful outcome because Tobias Kollmann is conducting a lot of clinical trials in Africa and now colostrum and breastfeeding will be the key focus. I'm happy about that.

What is it like being part of the Global Human Milk Research Consortium with the other LRF research centers?

We are at the beginning and beginnings are exciting. We are building knowledge together and establishing collaboration. I'm impressed by the level of expertise from all the chairs. We all have very different expertise.

I'm grateful to the Foundation to promote multidisciplinary research, and to promote the economic, the endocrinology, the biochemistry, and the neurodevelopment topics. It's not easy to do multidisciplinary research, but the foundation puts lots of effort into facilitating that. Now we have a very good human connection, which is the basis for scientific connection.

Is there anything that you wish to add? 

I want to thank the generosity of the Foundation, and the trust, I think this is amazing. The generous support of the foundation contributes largely to having a happy researcher working for a happy child in a happy world.