The process of vaginal seeding is becoming a significant feature in some delivery rooms. The procedure currently involves incubating a piece of gauze in the mothers vagina prior to her c-section birth. Immediately after birth the baby’s mouth, face and body are swabbed with the gauze in order to replicate the initial bacterial exposure experienced through vaginal delivery.

Why is this procedure gaining attention?

Research shows that cesarean section delivery is associated with an increased risk of atopic diseases such as eczema and asthma in children. C-section deliveries are also associated with greater risk of type 1 diabetes and obesity. One dominant theory suggests that because babies delivered via cesarean do not travel through the birth canal, they miss out on initial exposure to their mothers vaginal and gastrointestinal bacteria. This reduced exposure to microbes could have an altering effect on immune cell development in these infants, namely T1 and T2 helper cells, resulting in greater risk of atopy.

One comparison, comparing the gut flora in babies born via caesarean to those born vaginally, found a marked difference in the diversity of colonising bacteria, with gut flora disturbance in caesarean babies being apparent up until 6 months of age. A more recent study found that differences were still of note at 7 years of age, with these children more likely to present with some form of atopy.

This is where the idea of vaginal seeding comes in. In the few studies that have been conducted to date, a high similarity has been found between the micro-biome of vaginally delivered babies and those that experienced vaginal seeding at birth.

There is concern surrounding the safety of the procedure, as it carries with it risk of transferring harmful bacteria from Mum to baby, such as group B streptococcus. With correct screening in place, however, this risk can be reduced.

Longer term studies are still needed to prove the efficacy of vaginal seeding in reducing the risk of atopic disease development in cesarean section babies. However, initial studies are promising, proving it is possible to alter the micro-biome of infants in the earliest stage of life.

Casey Morgan-kellow
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