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Microbirthing: a good or a bad idea?

Microbirthing: a good or a bad idea?

Recently, a discussion has flared up in the medical community on microbirthing, the practice in which maternal vaginal fluid is transferred on to an infant born by caesarean section. A recent report in Nature Medicine hesitantly concluded that this might be effective in restoring the microbiota of infants, but a group of British doctors warn for the potential dangers in BMJ

Children that are born by caesarean section are more prone to several immune related conditions than children that are born vaginally. It is thought that this is a consequence of their different microbiota: that of vaginally born children resembles the microbiota of the mother’s vagina and the microbiota of children born by caesarean section resembles that of the mother’s skin. Microbirthing, also known as vaginal seeding, aims to restore the microbiota of children born by cesearean section by wiping them with maternal vaginal fluids shortly after birth. 

A group of American researchers recently published the results of their pilot study on vaginal seeding in Nature Medicine. They observed that the microbiota of babies that had been subject to vaginal seeding more strongly resembled the maternal vaginal microbiota, compared to the microbiota of babies that had not been wiped with vaginal fluids. They conclude that vaginal microbial transfer can partially restore the microbiota of babies born by caesarean section, but that the long-term health consequences remain unclear. Currently a bigger study on vaginal seeding is being carried out. 

In an editorial in BMJ, a group of British doctors warn for vaginal seeding. They argue that the beneficial effects on the health of the baby have not been proven yet, but there are some worries about the safety of this practise. They are concerned about transferring vaginal commensals and pathogens, like group B streptococcus, herpes simplex virus, Chlamydia trachomatis, and Neisseria gonorrhoeae, on to the newborn. The mother may carry these pathogens asymptomatically. Therefore, they have advised the staff at their hospitals not to perform microbirthing and advise parents to mention the performance of vaginal seeding themselves when their baby becomes unwell. Finally, they point out other ways to improve a child’s microbiota, like breastfeeding and limiting unnecessary use of antibiotics. 

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