Seeding the Cesarean Born Baby

5 Steps to Assist the Cesarean Born Baby's Microbiome

Baby at a cesarean birth
Photo © Vernon Wiley/Getty Images

Your body is made up of many cells. They are all over your body, not simply inside. Some of these cells are a part of you, other cells are bacteria that live in your body and on your skin. Many people have heard that bacteria live in the gut and help us digest food. Here is an example: Perhaps you have experienced a problem with your bacteria with something like a yeast infection following antibiotics.

This is where the antibiotics also disturb the good bacteria that help keep our body in check, thus causing an overgrowth of yeast.

Joshua Lederberg first described the microbiome “to signify the ecological community of commensal, symbiotic, and pathogenic microorganisms that literally share our body space and have been all but ignored as determinants of health and disease. He won a Nobel Prize for his work. First you have to understand that for a very long time we thought that the uterus was a sterile environment and that this only changed when there was an infection of the amniotic sac or uterine. Recent research, and previous animal studies, have shown us that this may not be true, though we aren't yet positive how the baby is colonized in pregnancy or if it is. If it happens, it could be via the placenta. What we do know is that as the water breaks in labor, and a huge part of the process happens as the baby passes through the vagina, the baby comes into contact with bacteria.

Once the baby is born, skin to skin contact with mom, helps the process continue. Many babies born via cesarean section miss these last two steps completely.

Research shows us that babies born by cesarean bear a correlation to increased rates of obesity, asthma, celiac disease and type 1 diabetes later in their lives.

This research suggests that it is the differences in the microbial content of the gut that plays a part in the rise in these diseases. This is just one theory about why the risk of those conditions is higher in babies delivered by cesarean. 

So how do you help infants who are born by cesarean with the lack of variety of microbes? Dr. Michelle Bennett recommends taking vaginal swabs from the mother and putting them over the body and in the mouth of the baby to help restore the delicate balance for babies who were born by cesarean. This information was also shared at a recent conference of the American Society for Microbiology by a group of other physicians.

Dr. Maria Gloria Dominguez-Bello, an associate professor in the Human Microbiome Program at the NYU School of Medicine, presented some preliminary results on that research. She has a five step process to do what is called an inoculum or “seeding” the infant.

  1. Sample the mom’s bacteria 
  2. A gauze pad is placed in the vagina of the mother for about an hour.
  1. Remove the gauze before the cesarean.
  2. Expose the newborn to the gauze. (Start with the mouth of the infant, then their face, and the rest of the body.)
  3. Sample the infant’s bacteria.

It should be noted that this is only for mothers who are HIV negative, as well as Group B strep negative.

While this is not a perfect solution, it does partially restore the bacteria from the mother to the baby in the small study that was previously done. More studies are being conducted and will continue according to Dr. Dominguez-Bello.

Because it is still being studied it is not yet common practice, but some practitioners are doing this either at the request of the parents or because of their knowledge of the study. If this is something that you would like to have done after your cesarean, be sure to talk to your doctor and include it in your cesarean birth plan. Another way to increase the bacteria naturally is to have plenty of skin to skin contact with mom after birth. Though the researchers do not believe that this is an either or proposition, but both.

Sources:

Azad, M. B., Konya, T., Maughan, H., Guttman, D. S., Field, C. J., Chari, R. S., . . .Kozyrskyj, A. L. (2013). Gut microbiota of healthy Canadian infants: profiles by mode of delivery and infant diet at 4 months. Canadian Medical Association Journal, 185(5), 385-394. doi: 10.1503/cmaj.121189

Penders, J., Thijs, C., Vink, C., Stelma, F. F., Snijders, B., Kummeling, I., Stobberingh, E. E. (2006). Factors Influencing the Composition of the Intestinal Microbiota in Early Infancy. Pediatrics, 118(2), 511-521. doi: 10.1542/peds.2005-2824

Goldberg, C. Research: Could Birth-Canal Bacteria Help C-Section Babies? http://commonhealth.wbur.org/2014/06/birth-canal-bacteria-c-section Last Accessed July 18, 2015

Hyde MJ, Modi N. The long-term effects of birth by caesarean section: the case for a randomised controlled trial. Early Hum Dev. 2012 Dec; 88(12):943-9.

Romano-Keeler, J., & Weitkamp, J.-H. (2015). Maternal influences on fetal microbial colonization and immune development. Pediatric Research, 77(0), 189–195. http://doi.org/10.1038/pr.2014.163

Song, S. J., Dominguez-Bello, M. G., & Knight, R. (2013). How delivery mode and feeding can shape the bacterial community in the infant gut. Canadian Medical Association Journal, 185(5), 373-374. doi: 10.1503/cmaj.130147

Continue Reading