Vaginal Seeding for planned caesarean

[iaMHannah91]

Hi,

I wondered if anyone has done vaginal seeding, what their experiences were and what their hospital's view on it was?

Also keen to hear thoughts of people who chose not to, and what influenced that decision, whether personal preference or medical advice?

I'm pretty sure the hospital won't carry it out for me (although I intend to ask at my pre-op appointment), but I'm trying to decide whether it is worth doing myself or not.

I found a post from Imperial College, stating why they advise against it, but it doesn't seem very well justified.

www.imperial.ac.uk/news/171053/increased-demand-vaginal-seeding-from-parents/
www.imperial.nhs.uk/about-us/blog/caution-is-key-when-it-comes-to-vaginal-seeding

See attached image for my interpretive summary :)

Sorry I have no idea what on Earth this is but I wanted to comment so the thread appears more easily for me. Is this just the doctors way of trying to lower the numbers of patients who opt for a caesarean?? I have never heard of it.

I’ve heard of this. It’s where they take a swab from your vagina, and wipe it around the newborns nose and mouth isn’t it?

I've read a bit about this. I think there have been vaginal seeding pilot projects but you need to screen carefully for pathogens that could be within the maternal gut, can you imagine the lawsuits if you intentionally gave a baby seeding that caused them to have a severe infection and they died?

It's not currently feasible to screen in that way. The benefits of vaginal vs CS birth are on a population rather than individual scale (hard to prove direct benefit). So plenty of risk, not much provable benefit.

I think it's probably better to focus on other things that support the microbiome - breastfeeding, skin to skin, good maternal diet, good weaning practices, avoiding antibiotics where possible.

This is really interesting Op, I had a c section with my DD and she had horrendous colic, my DS however had a Vbac and was a settled baby. Anecdotally only, all babies I know that have been born by C-section have been colicky with gut problems leading to excessive screaming, there must be something in it!

The idea is that each person's gut has a unique community of bacteria. They play a key role in determining health. Too many of the wrong kind of bacteria can lead to inflammation, infections etc.

Vaginal birth means the baby will ingest some matter from the mother which in the process of birth will likely contain some faecal bacteria. These 'colonise' the gut and establish the first community of bacteria. If a baby is born by CS, they aren't exposed to bacteria from the vagina and could be colonised by other bacteria around the hospital, which are less likely to be beneficial.

Some people have wondered if you can simply swab some vaginal fluid and get it in the baby somehow to achieve the same first colonisation effect.

I find it fascinating, researchers have also been exploring whether faecal transplant could help people with other bowel issues - literally taking poop from one person and giving it to another person so the microbiome changes. www.hopkinsmedicine.org/health/treatment-tests-and-therapies/fecal-transplant

I have a C section baby who needed a lot of antibiotics who has terrible food allergies so I'm very interested in this, if not possible I'd get good quality and varied probiotics and give from birth, breastfeed, skin to skin, don't antibac your house to death.
Easy to say to avoid antibiotics but I wouldn't have a living child without them so remember to keep things in perspective.

Two kids and two grandchildren born by CS. A couple planned, a couple emergency. Absolutely no issues with colic and no gut issues. Never even heard of it as a thing.

I suggested this to my midwives and they passed themselves laughing, then when they saw I was serious kindly informed me the operating theatre is a sterile environment so there was no way.
If you're really keen you could consider stabbing your seen so to speak around your nipples so that baby gets some when they try to latch for first time. Your boobs won't get wiped before surgery. Only partly joking 😉

Swabbing not stabbing nipples. Unfortunate autocorrect.

Same here, 3 CS and absolutely zero health problems apart from the 2 that were stabbed before they were born and needed stitches

😥that’s awful. Poor little things, and poor you, too.

@Ihavekids haha swabbing my nipples certainly sounds preferable to stabbing!

I am expecting them to laugh at me too...

That's why I said where possible... antibiotics are definitely life savers in many situations.

But sometimes there are alternatives eg my CS wound went a bit gunky, I washed with salt water a couple of times a day and it healed up. A gung ho doctor could have prescribed antibiotics just in case, which would have been transferred to DD in my milk.

Researchers are also looking at ways of using targeted treatments so eg if a baby develops c-difficile infection, you could use restricted scope antiobiotics that target those problematic bacteria but leave the other, healthier ones. Current antibiotics tend to wipe out everything. That would depend on having enough time to test before administering treatment so not suitable in all situations.

This is interesting. I have had both:

Vaginal delivery child - multiple allergies, ezcema, asthma with hospital admissions etc.
ELCS child - none of the above

Also I have read that by adulthood there is no difference between the gut microbiome of VB and CS born children.

I think it's really interesting. I had a c-section and a baby with silent reflux (grew out of at 2yrs) and a milk allergy (grown out of at 3) and if we are ever lucky enough to have a second child then it's something I plan to look into. She spent her life as a baby screaming her lungs out and could never be laid flat. It's a horrible thing for them to go through if it is at all avoidable.

Wow! I wasn't expecting so many replies so quickly. But it is great to hear! I'm just chilling out on my maternity leave and should probably not be googling things haha. But hey ho.

@Squamata - You're totally right! Because it hasn't been proven, there is no way that the medical team could justify it. But I'm not sure that should be a reason not to consider it personally. I don't see it as having "plenty of risk" though, as it isn't something that would be even considered if I was having a vaginal birth, as no screening occurs. So if it was very likely, pregnant women would be screened for all kinds of infections, not just a select few.

But you are very right that there are lots of other ways to boost my baby's microbiomes. It just seems very confusing how lack of exposure to microbiomes is stated as a risk of c-section, but on the flip side, the medical professionals also say it's not safe to expose the baby. So you're kind of in a catch-22.

I'm inclined to agree with @Vallmo47, that the stated risk is to warn people / put people off a maternal request C/S, but they don't want you trying to find ways to overcome the risks, because they don't really know if there is a causal relationship or not.

@QuiltedHippo - really good point about keeping things in perspective re the antibiotics. Sorry to hear your little one was so unwell!

Really interesting to hear the different personal experiences of @SandysMam, @Yesthatismychildsigh and @ZeroFuchsGiven. Perhaps it all depends on the child and not on the mode of birth at all. It is a minefield trying to work out what is best!

@ZeroFuchsGiven - Sorry your little ones got hurt! Out of interest were the two who got cuts, born via emergency or planned section? It is a risk either way, but I presumed more likely when they are in a rush?

Overall these things have an impact on a population level, not an individual level - so 1,000,000 babies born by CS, a slightly higher proportion have allergies etc compared to 1,000,000 born vaginally. (I don't know the exact difference but that's the gist.) It does not mean if your baby is born by CS the child is bound to be less healthy than another given child born vaginally, because health has very many factors.

BTW the microbiome is the total community of bacteria, so you only have one gut microbiome per person, it's microbiota if you're talking about individual bacterial strains. You can trace the development of a child through how the microbiota changes eg once you introduce solids, the community completely changes as microbiota capable of digesting plants, meat etc grow in response to the different food coming in.

What's also really interesting is how breastmilk interacts with the microbiome, it has components in it that cannot be digested by the baby but are there solely to feed the beneficial bacteria in the gut. So boobs make germ food as well as stuff to feed the baby! Not to make you feel bad if you're not bf, it's another thing that works on a population level!

My ds1 was a VB, was horrendously colicky, always ill etc. DS2 was a CS birth, the most contented baby and never ill.

I’d want to make pretty sure I didn’t carry Group B strep before any swabbing occurred!

My child got a nasty eye infection from vaginal birth so I probably wouldn’t, no. 😔

@iaMHannah91 They were all planned sections, my first my ds was cut on his back just above his bum, he is 26 now and still has the scar, then no probs with my second then my third ds was cut on the top of his head, luckily it was not his face!

Apparently this is extremely rare, just happened to me twice

They are both fine and love the story of them being stabbed before they were born.

@Squamata Thank you so much for that! I wouldn’t have a clue how to Google this but I find it incredibly interesting.
I hate when people laugh at you when you’re trying to do right by your baby 😡 - I am still inclined to believe they’re trying to lower CS numbers but I am off to do my research now thank you!

@Vallmo47 if you search for breastmilk composition, breastmilk microbiota, mode of birth microbiome etc - should give you some interesting search results!

It's a bit old now but Mary Roach has a really good book called Gulp that covers everything to do with the digestive system, that's what first got me interested. It's not just birth-related. She does really interesting, readable science books that dig out the interesting bits from research papers :)

I doubt there's a concerted effort to reduce CS by refusing to do swabbing - the health service isn't sophisticated enough for that!

Probably it's a practice that insurers wouldn't cover because of a lack of evidence, benefits not proven but risks are evident.

I guess it might also take up time in theatre when they're often pushed to get through all the CS as it is.

Both my children were born by c section and have both been very chilled babies.