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Vaginal seeding – a good idea?

It’s been known for some time that babies that are delivered by Caesarian section are more prone to asthma, allergies and other immune conditions – and it may be that this is due to the way the babies acquire their microbes (their microbiome). Babies born by vaginal delivery acquire their first microbes in the birth canal – which tends to mean Lactobacillus – whereas babies delivered by C-section acquire their microbes from a variety of sources. So it has been suggested that it may be beneficial to expose newborns delivered by Caesarean to vaginal microbes – so-called “vaginal seeding”. But is this really a good idea? Recent press coverage, (e.g. from the Guardian and the BBC) based on an article [1]⁠ and a commentary [2]⁠ in BJOG, suggests that it could be risky. Indeed it’s obvious that there is a potential for unintended consequences – such as exposing the newborn to pathogenic bacteria and viruses.

Of course we need to know the risks – but also the potential benefits. As with any medical intervention, it’s the balance of these two that determines the decision to go ahead or not. What’s really clear from this discussion is that we still don’t know how great the benefits are, and that there are other ways of seeding the infant microbiome such as breastfeeding, where the risks are probably much lower.

So while the narrative behind vaginal seeding is a compelling one – a simple intervention to help newborns acquire a “natural” microbiome with wide health benefits – the truth is that, as so often, much more research is needed before we can be sure.

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  1. Haahr T, Glavind J, Axelsson P, Bistrup Fischer M, Bjurström J, Andrésdóttir G, et al. Vaginal seeding or vaginal microbial transfer from the mother to the cesarean born neonate: a commentary regarding clinical management. BJOG An Int. J. Obstet. Gynaecol. 2017; 38:42–9.
  2. Eschenbach D. Vaginal seeding: more questions than answers. BJOG An Int. J. Obstet. Gynaecol. 2017; 14815.