Vaginal Seeding | How Is It Done? | Can Vaginal Seeding Help | What are its Risks?

What is Vaginal Seeding?

Also known as micro birthing, vaginal seeding is a process in which vaginal fluids that contain vaginal microbes are applied to a new-born baby who has been delivered through cesarean section. The purpose of vaginal seeding is to try and recreate the natural transfer of bacteria that would coat the baby during natural or vaginal birth.1

In vaginal seeding, swabs are placed in the mother’s vagina, and they are then wiped onto the baby’s face, eyes, mouth, and skin.2 Here’s everything you need to know about vaginal seeding and whether it works or not.

Over the years, there has been a lot of research on natural versus cesarean section births. Scientists are just now starting to understand the role of the microbiome and how it affects a person’s long-term health. Various studies over the years have indicated that an unhealthy gut microbiota has a direct connection with an increase in autoimmune diseases like asthma, obesity, and even diabetes.3

Keeping this in mind, researchers are now studying the way people are born and how this may have a role to play in the development of their microbiome. For example, a baby that is born vaginally gets ample exposure to beneficial bacteria from the very start. This happens naturally when they pass through the mother’s birth canal and, on the way, pick up the bacteria from the mother.

However, babies that are born through cesarean section (C-section) do not get this exposure and thus do not have the same advantage.

Many believe that this new procedure of vaginal seeding may help level the playing field for babies born via C-section.

How Is Vaginal Seeding Done?

Vaginal seeding is performed immediately after a baby is born through C-section. It involves wiping down the newborn baby with gauze that has bacteria taken from the mother’s birthing canal.4

The basic idea behind this procedure is that it will help expose the baby to the same bacteria that they would have been exposed to had they been born vaginally. The purpose of vaginal seeding is to transfer the benefits of normal bacteria and flora taken from the mother to the baby.

Can Vaginal Seeding Help?

There is no doubt that there has been a rapidly growing interest in vaginal seeding. This is all the more so because the rates of adolescent obesity and asthma are rising exponentially in the United States. Studies have found that babies who are born via C-section are having a higher likelihood of developing obesity and asthma.5

However, according to medical experts, there is no research available that directly links these higher rates of asthma and obesity to the microbiome of people who were born through C-section. People are only speculating that there could be a connection to the microbiome.

In order for the entire medical community to make a confirmed connection, there need to be several large and long-term studies carried out. Only then can we get meaningful and confirmed outcomes to show that vaginal seeding is helping.

Nevertheless, there are a couple of small studies that are beginning to research this link and lay the groundwork for whether vaginal seeding actually helps or not.

For example, a pilot study carried out in 2016 and published in the Nature Medicine journal found that it was possible to partially restore the microbiome of C-section babies with the process of vaginal seeding.6

This study was carried out on 18 babies and their mothers. Within the first two months of birth itself, the researchers swabbed the face, mouth, and body of the babies with gauze that contained the vaginal secretions of the mother. The researching team then went back and collected samples to conclude that this exposure helped in partially restoring the bacterial communities found in newborn babies that were delivered through C-sections to mimic that of babies born vaginally.

There are several other studies that are underway on vaginal seeding.

One study being carried out at the Inova Fairfax Hospital has around 50 women participants currently, with plans to expand to over 800 women eventually.7 Another smaller study is being carried out at the Icahn School of Medicine at Mount Sinai and consists of only 120 women.8 The Icahn study was expected to be completed by the end of 2020, while the bigger Inova Fairfax Hospital study is expected to be completed in 2023.

According to the American College of Obstetricians and Gynecologists, though, the organization does not recommend or even encourage the procedure of vaginal seeding without the supervision of medical experts or without having an institutional review board-approved research protocol.9 The organization also recommends that vaginal seeding should not be performed until there is enough data available regarding the basic safety and benefit of this procedure.

What Are The Risks Of Vaginal Seeding?

One of the biggest reasons behind why the American College of Obstetricians and Gynecologists (ACOG) is reluctant and is pushing back on vaginal seeding is the high risk of infection. Infection with group B strep (BGS) is one of the biggest concerns amongst doctors worldwide when it comes to vaginal seeding because it often goes undetected, and it is estimated that nearly 20 to 30 percent of mothers have it.10

If a woman with undiagnosed GBS decides to undertake the procedure of vaginal seeding on her newborn after giving birth through C-section, there is a huge risk of passing on a severe health risk to the baby, including a high possibility of death. While there is a lot of risk of the mother carrying on an infection, but with GBS, the risks involved are slightly different.11 Early onset of neonatal sepsis, which is a serious infection that commonly affects preterm babies, can be caused if bacteria like E. coli and GBS get transferred from the mother. In fact, this can happen during vaginal birth, as well.

Nevertheless, despite the ACOG warnings, many women who are giving birth through C-sections are asking to get vaginal seeding done. While many hospitals do not encourage this procedure, but if a parent asks for it strongly, they ultimately have to give in to the demands.

So even though vaginal seeding is garnering a lot of attention today, it is not the only way in which a baby born through C-section can get a maternal microbiome.

Breastfeeding is an excellent source of giving this microbiome to your baby.

A 2017 study carried out on 107 mothers and their new babies analyzed how much of beneficial bacteria is passed on through breast milk.12 The findings concluded that over 30 percent of beneficial bacteria that are found in a baby’s gut comes directly from the mother’s breast milk. Furthermore, an additional ten percent can also come from skin contact on the mother’s breast. Skin-to-skin contact with the mother just after birth can also help facilitate a microbial transfer while encouraging early breastfeeding.

Conclusion

The advice of medical experts and doctors urge you to avoid vaginal seeding as there are various unknown risks and an increased risk of sepsis and infection. Parents who are concerned that their baby is not getting the natural microbiome from the mother in a C-section birth can opt for other, more established techniques like breastfeeding and skin-to-skin contact for boosting the transfer of microbes.

References:

  1. Cunnington, A.J., Sim, K., Deierl, A., Kroll, J.S., Brannigan, E. and Darby, J., 2016. “Vaginal seeding” of infants born by caesarean section.
  2. Haahr, T., Glavind, J., Axelsson, P., Bistrup, F.M., Bjurström, J., Andrésdóttir, G., Teilmann-Jørgensen, D., Bonde, U., Olsén, S.N., Møller, M. and Fuglsang, J., 2018. Vaginal seeding or vaginal microbial transfer from the mother to the caesarean-born neonate: a commentary regarding clinical management. BJOG: an international journal of obstetrics and gynaecology, 125(5), p.533.
  3. West, C.E., Renz, H., Jenmalm, M.C., Kozyrskyj, A.L., Allen, K.J., Vuillermin, P., Prescott, S.L., MacKay, C., Salminen, S., Wong, G. and Sinn, J., 2015. The gut microbiota and inflammatory noncommunicable diseases: associations and potentials for gut microbiota therapies. Journal of Allergy and Clinical Immunology, 135(1), pp.3-13.
  4. Simpson, K.R., 2018. Vaginal seeding of babies born via cesarean. MCN: The American Journal of Maternal/Child Nursing, 43(1), p.60.
  5. Chen, G., Chiang, W.L., Shu, B.C., Guo, Y.L., Chiou, S.T. and Chiang, T.L., 2017. Associations of caesarean delivery and the occurrence of neurodevelopmental disorders, asthma or obesity in childhood based on Taiwan birth cohort study. BMJ open, 7(9), p.e017086.
  6. Dominguez-Bello, M.G., De Jesus-Laboy, K.M., Shen, N., Cox, L.M., Amir, A., Gonzalez, A., Bokulich, N.A., Song, S.J., Hoashi, M., Rivera-Vinas, J.I. and Mendez, K., 2016.
  7. Partial restoration of the microbiota of cesarean-born infants via vaginal microbial transfer. Nature medicine, 22(3), p.250.
  8. Clinicaltrials.gov. 2021. Vaginal Microbiome Seeding And Health Outcomes In Cesarean-Delivered Neonates. – Full Text View – Clinicaltrials.Gov. [online] Available at: <https://clinicaltrials.gov/ct2/show/NCT03298334?term=vaginal+seeding> [Accessed 5 January 2021].
  9. Clinicaltrials.gov. 2021. Vaginal Microbiome Exposure And Immune Responses In C-Section Infants – Full Text View – Clinicaltrials.Gov. [online] Available at: <https://clinicaltrials.gov/ct2/show/NCT03567707?term=vaginal+seeding> [Accessed 5 January 2021].
  10. Acog.org. 2021. Vaginal Seeding. [online] Available at: <https://www.acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Vaginal-Seeding> [Accessed 5 January 2021].
  11. Smaill, F.M., 1996. Intrapartum antibiotics for group B streptococcal colonisation. Cochrane Database of Systematic Reviews, (1).
  12. Jones, D.E., Kanarek, K.S. and Lim, D.V., 1984. Group B streptococcal colonization patterns in mothers and their infants. Journal of clinical microbiology, 20(3), pp.438-440.
  13. Pannaraj, P.S., Li, F., Cerini, C., Bender, J.M., Yang, S., Rollie, A., Adisetiyo, H., Zabih, S., Lincez, P.J., Bittinger, K. and Bailey, A., 2017. Association between breast milk bacterial communities and establishment and development of the infant gut microbiome. JAMA pediatrics, 171(7), pp.647-654.

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