Exposing Cesarean babies to beneficial bacteria from their mother’s birthing canal may improve their microbiome and future health.
Scientists are just beginning to understand how your microbiome develops and what that means for your long-term health. Numerous studies have suggested that an unhealthy gut is tied to the rise in autoimmune diseases such as diabetes, asthma, or obesity.
Researchers now are starting to look at the way people are born, and how that experience may play in the development of their microbiome.
For a baby born vaginally, the exposure to beneficial bacteria is from the get-go. This happens when they pass through the birth canal and pick up flora from their mother.
But, babies born via cesarean section (C-section) don’t have that same advantage.
Now, a new procedure that may level the playing field is starting to get some attention in the medical profession.
It’s called vaginal seeding.
The process involves wiping down a baby — who is born via C-section — with gauze that has bacteria from the mother’s birthing canal. The hope is that it will expose the baby to the same bacteria as if they were born vaginally, according to Mary Lou Kopas, chief of midwifery at University of Washington’s Medicine Northwest Hospital Midwives Clinic.
“The point of vaginal seeding is to give the benefits of normal bacteria and flora,” she told Healthline.
The interest in vaginal seeding comes at a time when rates of adolescent asthma and obesity continue to increase in the United States. Studies have shown that babies born via C-section have higher rates of asthma and obesity.
But according to Dr. Matthew Hoffman of the Christiana Care Health System in Delaware, there isn’t research that directly links those increased rates to the microbiome of people born via C-section. Right now, that link is only hypothesis.
“People have speculated that it’s related to the microbiome,” he said.
In order for the medical profession to make that connection, Hoffman, and the other experts Healthline spoke to, say large, long-term studies that show meaningful outcomes would need to be conducted.
A few small studies are starting to lay the groundwork.
A 2016 pilot study published in the journal Nature Medicine did show that the microbiome of C-section babies could be partially restored via vaginal seeding.
The study involved 18 babies and their mothers. Within the first two months of birth, researchers swabbed the mouth, face, and body of the infants with gauze that was exposed to the vaginal secretions of the mother.
Researchers then went back and took samples and concluded that the exposure partially restored the “bacterial communities of newborns delivered by C-section… to resemble that of vaginally delivered babies.”
Two other studies on vaginal seeding are also underway.
One study out of Inova Fairfax Hospital involves 50 women and will expand to some 800 women if all goes well. Another, out of Icahn School of Medicine at Mount Sinai, is smaller with just 120 women. The studies are expected to be complete by 2023 and 2020, respectfully.
Last year the American College of Obstetricians and Gynecologists issued a statement that it “does not recommend or encourage vaginal seeding outside of the context of an institutional review board-approved research protocol.”
The organization also “recommends that the practice not be performed until adequate data regarding the safety and benefit of the process become available.”
One of the biggest reasons for ACOG’s pushback on vaginal seeding is the fear of infection, according to Hoffman. He noted that, in particular, Group B Strep (GBS) is of great concern because it goes undetected.
“About 20 to 30 percent of mothers have it,” he said.
Julie Lamppa, a certified nurse midwife at the Mayo Clinic added that if a woman with undetected GBS decides to vaginally seed her newborn after giving birth via C-section, she may run the risk of giving her baby a serious health risk, including the possibility of death.
“There is risk that the mom is carrying an infection,” she said, “but Group B Strep is different.”
Still, despite the ACOG statement, some women who give birth via C-section are asking for vaginal seeding. Hoffman said his hospital doesn’t encourage the practice but if a parent feels strongly about it, the staff doesn’t stand in their way.
“We respect the parent’s choice,” he said.
Kopas said her hospital takes a similar approach.
“Our official statement is we don’t encourage it,” she said, “but my take is it’s your baby and your body.”
Even though vaginal seeding is getting a lot of attention, Dr. Grace Aldrovandi of UCLA told Healthline it’s not the only way for a baby born via C-section to obtain maternal flora.
Breastfeeding is another excellent source.
Aldrovandi conducted a 12-month study last year on 107 mother and infant pairs that looked at how much beneficial bacteria comes from breast milk.
Her findings concluded that upwards of 30 percent of beneficial bacteria found in a baby’s gut comes directly from mother’s milk. What’s more, an additional 10 percent comes from skin on the mother’s breast.
“Breastfeeding is pretty tremendous,” she said. “That’s why we say breast is best.”