'Seeding' - the new birthing trend-

 

Is it beneficial to rub bacteria onto your newborn baby?

 

By Jop de Vrieze, science journalist

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Jop de Vrieze is freelance science writer and author of the book ‘Allemaal Beestjes’ [‘Critters and Crawlers’].

 Transferring bacteria

 

A new birthing trend has emerged, coming from the United States. Immediately after birth, children born via caesarian section are rubbed with bacteria from the mother’s birth canal. 

 

The technique, referred to as ‘vaginal seeding’, is based on ideas from research into the micro‑organisms in and on our bodies. This research revealed that during a vaginal birth the mother passes micro-organisms to her child, which form the initial bacterial population for the child’s gut microbiome.

 

It has been shown that the gut microbiome population of Caesarean-born children differs from that of children born vaginally. The gut microbiome of Caesarean-born children is, among others, populated with skin and hospital bacteria coming from their parents and hospital employees, instead of bacteria coming from the birth canal. 

  

In the long term the gut microbiome of people born via caesarian section is no different from that of people born vaginally. 

  

No health gain

 

In the long term the gut microbiome of people born via caesarian section is no different from that of people born vaginally. However, in the first few months this is not yet the case and in this phase in particular the gut microbiome plays a role in the development of the immune system and metabolism. Therefore, scientists suspect that this poor start of caesarian-born babies may be the cause of their 30% higher chance of developing allergies, auto-immune disorders and obesity – even though a causal relationship has not yet been proven. 

  

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Microbirth

 

Vaginal seeding has been promoted by microbiologists for a while – I wrote about it in my book Allemaal Beestjes (‘All kinds of critters’), but it became widely known thanks to the documentary Microbirth from 2014 (www.microbirth.com). The term refers to what occurs at a microscopic level during birth. The technique has been adopted by parents who would have preferred a ‘natural’ birth and hope to somehow compensate for the caesarian section. 

  

Not without risk

 

Rubbing vaginal bacteria onto your newborn baby is not without controversy, however. In February 2016, British doctors expressed their scepticism regarding the procedure in the British Medical Journal. They warned that in this way, harmful or even life-threatening pathogens may be transferred to the baby, such as herpes, chlamydia and streptococci. This type of transfer can occur during a natural birth as well, but in case of vaginal seeding it is the doctors who are responsible for the consequences. No one wants a doctor to infect their baby with a disease.  

 

In addition, it is not yet known whether rubbing the bacteria onto your baby has the same effect on the child’s gut bacteria as a ‘real’ vaginal birth. In a recent, small-scale study, investigators realized a gut microbiome through vaginal seeding which approached that of a child born via the birth canal.

 

The question is, though, whether the microbiome resulting from vaginal seeding does actually lead to relevant health gains. Moreover, if part of the vaginal microbiome is transferred by hand, the likelihood of an infection is greater than during a vaginal birth, because the pathogen faces less competition from other, neutral or beneficial microbes. In summary, too little is known about the benefits of vaginal seeding in the long term for doctors to take this risk.

     

The risks of vaginal seeding can be reduced by screening the mother’s vaginal microbiome

  

Screening

 

The risks of vaginal seeding can be reduced, however, by screening the mother’s vaginal microbiome for the most important pathogens. In the United States this is done as standard for all mothers – even if they are having a vaginal birth. In countries like the United Kingdom and the Netherlands, doctors are far more reluctant about this, because it is apparently too expensive and would result in overtreatment. Not every mother carrying streptococci contaminates her child, but many will still want to receive antibiotics.  

 

Without screening a possibly slightly lower chance of a serious but usually not life-threatening condition such as eczema or asthma must be weighed up against a very limited chance of an acute infection that may end in death.

 

For now the motto is that a vaginal birth is to be preferred, but not at all cost. In an absolute sense, the effect of a caesarian section on a person’s health is so limited that it does not warrant a risky approach to have a vaginal birth after all or to transfer bacteria. A lot of ground can be made up through healthy (breast)feeding, restraint in the use of antibiotics and possibly the use of probiotics.

  

References


Shin, Hakdong, et al. "The first microbial environment of infants born by C-section: the operating room microbes." Microbiome 3.1 (2015): 1.


Cunnington, Aubrey J., et al. "“Vaginal seeding” of infants born by caesarean section." BMJ 352 (2016): i227.
Dominguez-Bello, Maria G., et al. "Partial restoration of the microbiota of cesareanborn infants via vaginal microbial transfer." Nature medicine (2016).


Cacho, Nicole, and Josef Neu. "Manipulation of the intestinal microbiome in newborn infants." Advances in Nutrition: An International Review Journal 5.1 (2014): 114-118.

 

 

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