Baby's gut flora - CS vs vaginal birth

[Dildals]

I have the option of an ELCS but I am still thinking about whether I should go the vaginal route.

The ELCS is not because of medical reasons but because of a very bad traumatic birth last time.

I think I have a good overview of the pros and cons of both options but the one that I still find hard to get a good view on is the effect the mode of delivery has on baby's gut flora and whether perhaps I am worrying about nothing.

If the baby makes its way through the birth canal it will be picking all sorts of bacteria from me, whereas if he's born by CS he will pick up bacteria mainly from the hospital. There is some evidence, or so I understand, that a rise in certain diseases, such as allergies, asthma and autism, are potentially linked to being born by CS.

Am I depriving my child by the best start in life by choosing a CS, or am I making the safer choice, in the sense that there is less chance of him passing away in labour.

(I gave birth vaginally last time and let's just say that that didn't work out too well for the baby)

I know my judgement is skewed because of past experience, but it's hard to un-skew that IYKWIM.

Thoughts? Does anyone know what the (scientific) deal is with this gut flora thing?

m.huffpost.com/uk/entry/4947959

Do you mean this? Seeding the baby's microbiome? Some women have arranged for a vaginal swab to ve taken which they then rub on the baby to try and help with this after a c-section.

More info here:midwifethinking.com/2014/01/15/the-human-microbiome-considerations-for-pregnancy-birth-and-early-mothering/

Yes, I was reading the midwife thinking article the other day. But a lot of it is still unsupported by proper scientific research.

I was going to put the vaginal swab thing on my birth plan. Not sure whether this is an accepted thing nowadays, or whether they'll look at me whether I am crazy.

So if I follow all of those guidelines (BF, use own linen in hospital, lots of skin to skin) does that then eliminate the difference / reduce it significantly?

Basically I am trying to find someone to say to me to not feel guilty about having a CS :-)

You know what? It'll be fine without the flora, vaginal swabs, breastfeeding etc

Your baby won't know any difference.

If it helps, have had three CS - the first was an EMCS as my daughter had meningitis - she had 12 hourly IV ABX for 14 days, and many bottles of SMA before I established BF. And she us a strapping 10 year old. The other two are perfectly healthy too.

Of course this is all anecdotal - but really don't put too much pressure on yourself, worrying about gut flora etc.

Don't feel guilty about having a c-section!!! Please don't. The research is still being done. There are things you can do which you have listed to help as well. I think its quote likely that the obstetrician will not ve on board but you can take a swab and do it yourself if you like. If you are fearful and stressed about a vaginal birth the likelihood of it going smoothly are reduced and I do know lots of woman for whom a second, planned caesarean is a very healing experience.

Do not feel guilty about having a c section!! Do not do not do not x

Also - the midwives happy to help with skin to skin following CS. It's lovely in recovery with your baby all snuggled on your chest.

Good luck

Please don't feel guilty about doing what's best for you.
As this is your second child I'm sure your pfb will be popping fingers & all sorts into baby's mouth ruining the flora.

If you want and need a cesarean for emotional and mental health reasons ,go for it. Plenty of babies born this way, and grow up to be perfectly healthy . Will you breastfeed ? If so that will help

Unfortunately I think you're right about vaginal births and gut bacteria.

I was at the treating autism conf this year when it was spoken about at length.

If you have any family history of autism or DC with SEN I would be really in 2 minds about what was best.

(I had a c section. And a DS with autism)

But if I didn't have a family link to anything like that I think I wouldn't worry.

OP, I'm sorry to hear about your first birth.

I'm due to give birth by c section, and have been concerned about this too (enthusiastic user of probiotics for all digestive ills!). I have thought about trying to expose the baby to my vaginal bacteria, but feel uncomfortable doing so. One of my concerns is what if I have group B strep? Microbes from the mother can be both beneficial and harmful.

I am planning to do skin to skin and breastfeeding (fingers crossed that works out!). Plus also I will investigate baby probiotics, and may take some myself while breastfeeding. Ultimately, even with a vaginal birth you can't guarantee the baby will get the optimum microbes. Plus if the baby needs antibiotics that will wipe out the good guys anyway.

I would say don't feel guilty. There is still much work to be done on the science with this. And there are many ways to colonise the baby's digestive tract with beneficial bacteria later.

Your gut bacteria is set in stone quite early. Not at birth - but I think around 3 years.

Basically after that you can't change your gut bacteria colony. If you have probiotics etc, they'll help the day you have them, but they won't change the colony inside your gut.

In fact your stools are as unique as fingerprints, and could (in theory!) be used to identify you from 3 till death!

However, up to the age of something (I think 3 years) your gut colony is developing and can be changed. And is meant to be changed. Both by the birth and by putting everything into their mouth :)

So make sure you don't keep everything too clean once your baby's home. Your baby does need a good diverse healthy gut bacteria colony.

Am I depriving my child by the best start in life by choosing a CS, or am I making the safer choice, in the sense that there is less chance of him passing away in labour.

Surely in this case, the best start in life is the delivery method where they are least likely to pass away in labour?

Both my DC were born by cs, one emcs, one crash. Both are extremely well in body and mind.

I have to say this whole area never crossed my mind when I was deciding. There are many more scientifically-proven risks and benefits for both VbAC and ELCS than an unproven area such as this seems to be . I suggest you use those as your basis for choice plus your emotional wellbeing, but if you get to do the swab thing and it makes you happier, then go ahead (though I might worry about the strep b thing).

Yes, I was reading the midwife thinking article the other day. But a lot of it is still unsupported by proper scientific research.

To say the least, OP! Unfortunately, because there are a lot of people who were already anti-section who have jumped on this with great gusto, it can be hard to cut through the crap online. The deal is that we know babies born vaginally and babies born by section have quite different gut flora. Research seems pretty incontrovertible there. We do not know whether it makes any difference to overall health and, if so, whether those born vaginally are in a more advantageous position.

Obviously, this puts the woman who is considering ELCS for MH reasons in a difficult position, because you're dealing with something that may or may not be a risk. I guess it's going to come down to whether you're more worried by a VB or by uncertainty about whether ELCS will be detrimental because of the effect on the gut flora. Only you can decide that.

There are test for Group B strep, although I know it can show up negative at, let's say 37 wks, and positive at 40.

brilliant Yes, that's what I understood about probiotics as well.

There's no history of autism or SEN in the family. My DD is at higher risk of developmental delays because of her entry in to the world but as of now it all seems fine. This one is a boy though, and they're at higher risk of autism.

I know that anecdotally it's hard to see the difference between a CS baby and a vaginal baby.

I was born at home, vaginally, and I have quite bad allergies. Then I am sure there are a host of CS babies out there that don't have any issues.

Just to be clear, even in case of a non-planned CS, the baby is partly exposed to your bacteria, after the waters are broken. So that category is slightly different again to the ELCS route.

Thanks for all your answers & support for not feeling guilty about a CS. I think I'll do the GBS testing and go for the swab. Then at least I feel like I have done the most I can. I wouldn't be able to forgive myself if something happened in labour and he didn't make it. Coming out alive is more important.

I am also planning on expressing (so I can share the love with DH) but also planning on giving my DD some of my milk. She was breastfed for about 11 months, but if there's some spare surely that can't be a bad thing.

If you want a section have one. I wanted one for dc3 after a ventouse with dc1 then a distressing forceps delivery and 3rd degree tear with dc2, consultant eventually said I could, but I had lots of sessions with a senior midwife who was trying to reassure me and I really wanted a natural birth despite my anxiety about it. Guess what? Ended up in a c section as I got myself in such a state during labour with the anxiety! If I have a 4th it will deffo be ac section, yes I'd like a perfect vaginal birth but I don't think I'm ever going to get it and a section really isn't so bad. Both have pros and cons

If you have no immediate family with autism I wouldn't obsess over this. I really wouldn't - even though I firmly believe it's hugely important.

Antibiotics destroy gut bacteria. So if you can avoid them do.

PM me if you want to discuss this offline......

This has been a worrying read as I have group b strep and will need to take ABs during labour next week and never knew the gut flora link.

Flutterby - I have tested positive for group b strep twice, twice had antibiotics in labour and both my boys had 48 hours of antibiotics after birth. None of us had any problems or adverse effects.

Boys don't have that much of higher risk of autism. The issue with boys v girls is that autism is massively underdiagnosed in girls.

I had a CS and the midwife was very clear about the importance of skin to skin and how she would support that, which she did, brilliantly.

IMO 'the best start in life' is the one that is safest for both of you, physically and mentally. You'd have no need to feel guilty about a CS, at all.

Causation v Correlation.

They don't yet know what is doing it exactly. Some hospital might have slightly different protocols for a CS than others which are worse than others. It might not be simply a CS but HOW they do the CS. It is possible that babies that need to born via C-Section for a medical reason have some sort of genetic predisposal for certain things which is why they need the CS in the first place. This includes if the CS is for breech babies because we don't really know why some babies end up in the breech position.

At present I don't think you can really get too worried about this, as the research is so early and doesn't really draw proper conclusions.

Not forgetting that there are a host of other contributing factors that may cause those problems. Everything from the use of cleaning products around the house to medicines for other illnesses to pets.

No one is going to suggest you should stop using cleaning products or get rid of the family pet, or not take medicines if you or your child need them. So why feel guilty about doing the best thing for your health - which includes mental health - if that means having a CS?

Thank you Pottering

Flutterby I had antibiotics during labour and still wish I'd taken probiotics after as still wonder whether it unbalanced something; both Dd and I ended up with food intolerances (I'd not had any until that point and no history in the family) .
I'd obviously take the antibiotics again but wish I had taken Symprove after in case helped.(and I'd stick to that one ir similar as read an article once that many others don't reach the intestine in any useful way.)

Interestingly with DS I took part in medical research as they were seeing if any link to early antibiotics etc and allergies and they took samples of my colostrum & milk but I never saw the results!
He didn't have antibiotics during his labour as no one was around to administer them. I'd taken probiotics before his arrival and he was never sick like DD or allergic and has always been as strong as an ox but who knows!
wishing you a safe and wonderful new arrival

I had an appt with my consultant yesterday and she pretty much said (in different words) what redtoothbrush said.