A Pioneer of Baby Gut Health Testing & a Trusted Partner for Families

Sara Eshelman
Spero Ventures
Published in
5 min readMar 5, 2024

Why we invested in Tiny Health

Tiny Health is empowering families to take a proactive approach to their health, especially in the first 1,000 days of a baby’s life, when gut development is most malleable and scientific research is strongest. They are on a mission to unlock a deeper understanding of the gut to improve health outcomes for future generations.

Children have seen a significant increase in chronic conditions, such as eczema, asthma, allergies, and digestive issues. The CDC estimates over 40% of children are impacted. One hypothesis is that our modern lifestyles and overuse of antibiotics are potentially disrupting early immune development in the gut.

The microbiome is a community of 38 trillion tiny microbes that play an essential role in immune development and lifelong health. Over the past decade, a vast body of research has shown that early gut microbiome imbalances are linked to many immune-mediated disorders and early correction may help prevent and even reverse chronic illness, particularly since 80% of our immune system lies in the gut.

The infant microbiome has 10x less diversity and is very malleable compared to the adult microbiome. Therefore, it is much easier to characterize what makes up a healthy Baby Gut Type vs. archetypes that are connected with colicky or gassy symptoms, sleep issues, eczema, constipation, and other common baby issues. Course correcting major imbalances in this critical time can reduce the child’s microbiome risk of chronic inflammatory conditions and metabolic health issues later on.

This powerful realization led us to invest in Tiny Health.

Tiny Health partners with families to offer the first-ever at-home gut microbiome test designed specifically for them. The tests use shotgun metagenomic sequencing (the gold standard in microbiome research today) to identify all microbes present in the gut — from bacteria, fungi, parasites, viruses, and archaea — and categorize them into friendly, unfriendly, variable, or unknown microbes. In addition, the tests can show important gut functions like Short Chain Fatty Acid production and Gut Inflammation markers, and can show microbial resolution down to the strain level (data no other consumer company has launched). The results were initially benchmarked against 3,000+ pediatric gut microbiomes, but the dataset has expanded by over 25,000 families in just 1.5 years, making it the largest longitudinal dataset of its kind.

Taking into account age, diet, lifestyle, and other risk factors, Tiny Health recommends specific evidence-based diet and lifestyle changes. If necessary, it also recommends supplementing with specific strains of missing microbes to improve the balance within a child’s gut. Users can also book to speak with a functionally trained microbiome specialist to better understand their results and next steps.

80% of users who re-test report improvement in their infant’s symptoms. For most families, Tiny Health provides peace of mind that they are managing early-life microbiome risk factors proactively. But for some, the results are life-changing. Tiny Health has two clinical studies underway to show that their microbiome platform can help improve health outcomes for babies and reduce the healthcare burden on families and health systems.

Right now, it’s helping families navigate the dizzying options for their children’s health. Dozens of products promise to support pediatric gut health and immune development. These range from prebiotics and probiotics to foods that claim certain health benefits. But not all supplements are created equal, and it’s hard to discern if your child even needs one. The only way to know is by testing to understand what’s missing and needs support. Tiny Health is an unbiased, science-based partner to help families navigate this landscape.

Soon, it will help families be proactive about assessing their kids’ microbiome risk for specific chronic conditions. As Tiny Health grows, so does its database on pediatric gut composition and the metadata associated with it. Families provide rich data on their birth mode, diets, lifestyles, interventions, and clinical outcomes. With this data, it has vast potential to develop unique predictive biomarkers to help families and their clinicians understand microbiome health risks and hopefully avert them. These biomarkers may one day help therapeutic companies discover and personalize microbial therapeutic recommendations. There is also potential for their testing suite to be used as a companion diagnostic to identify high-risk patients who need gut microbiome modulation before treatment to ensure a more successful treatment protocol. The possibilities are vast and promising.

Tiny Health’s starting point is the baby gut, but the market is everyone. The company already offers pregnancy gut and vaginal microbiome testing to help expectant mothers understand potential pregnancy-related conditions like gestational diabetes or preterm labor risks. They can also assess whether mothers have the beneficial microbes that may seed their newborn’s gut, and how to address potential imbalances to give their baby the best start in life. Due to consumer demand, Tiny Health now offers gut health testing for older children (ages 3–17) and adults, a practitioner PRO version, as well as a standalone vaginal health test. The company is already working with 600+ practitioners and has a program to support them.

As part of its vision, the company will expand its platform to support growing families across pediatrics, women’s health, metabolic health, and beyond. As it did with infants, Tiny Health is committed to bringing high-quality testing and rigorous scientific evidence to support patients across life stages to understand and take control of their health, seek out leading-edge providers, and solutions to minimize risk and maximize health. It’s already enabling B2B partners to bring microbiome analysis and insights to their members across a range of conditions through its Powered By Tiny platform.

Cheryl Sew Hoy founded Tiny Health after working to restore her daughter’s microbiome after a C-section delivery. Cheryl built the product she wished she had during this time. She partnered with Dr. Ruben Mars, an Assistant Professor at Mayo Clinic focused on microbiome research, as well as leading scientists like Dr. Noel Meuller, a Johns Hopkins researcher and Tiny Health scientific advisor. Ruben took a sabbatical from his academic lab to incubate Tiny’s scientific work, now led by an established team of 7 researchers and bioinformaticians. Shortly after, Cheryl met Donald Koo, who now leads growth and operations across the company.

Tiny Health is already changing lives. We’re excited to be on the journey with Cheryl and her incredible team to continue changing more lives.

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Sara Eshelman
Spero Ventures

Partner at Spero Ventures — venture capital for the things that make life worth living.