The potential benefits of vaginal seeding do not outweigh the risks, according to a group of doctors who reviewed the available evidence published today (23 August) in BJOG: An International Journal of Obstetrics and Gynaecology.
Vaginal seeding is the practice of exposing babies born by caesarean section to their mother’s vaginal fluids in order to expose them to bacteria that may help to build their immunity against some chronic conditions, such as asthma and allergies. This involves taking a swab of vaginal fluid and applying it to the baby’s eyes, face and skin after birth.
Recent reports indicate this is a growing trend, but the group of doctors from the Danish Society of Obstetrics and Gynecology say other factors, such as early skin-to-skin contact, breastfeeding and diet seem more important in the development of the infant’s colony of bacteria.
In a bid to review the latest available evidence, and make clinical recommendations, a group of obstetricians analysed the only existing vaginal seeding study, from which no safety conclusions can be made as only four babies were involved. They report that the study did, however, highlight the difficulty in determining healthy vaginal bacteria and the risk of passing on infections, such as HIV, Chlamydia, gonorrhoea, herpes, Group B streptococci and Escherichia coli, from the mother to the baby.
They concluded that vaginal seeding should not be recommended by healthcare professionals as the risks are still unknown. Instead, they encourage healthcare professionals to focus on advising mothers of other factors that are known to have a positive impact on the colonization of a baby’s gastrointestinal bacteria, such as early skin-to-skin contact with the mother and/or her partner, breastfeeding and diet.
Established evidence shows that early skin-to-skin contact encourages breastfeeding which promotes healthy microorganisms in the digestive tract, while a high-fat diet during pregnancy could negatively impact the early infant gut microbiota.
In the UK, around 1 in 4 babies are born via caesarean section. Only around 10% of these caesarean births are planned, for example, when the baby is in breech position (feet first) or there is a problem with the placenta. Meanwhile 15% are unplanned, for example, when the labour isn’t progressing and there is a risk to mother and/or baby. Globally, the caesarean rate is similar but it varies between countries.
Dr Tine Dalsgaard Clausen, consultant obstetrician at Nordsjaellands Hospital, Denmark and lead author of the study, said:
“It is clear that much more research is needed to understand if exposing babies born via caesarean section to vaginal bacteria soon after birth can lower their risk of developing chronic conditions later in life. Currently, there is no evidence to show that the potential long-term benefits of vaginal seeding outweigh the risks or costs associated, however, we encourage researchers to investigate vaginal seeding further and would support patients’ participating in safely controlled clinical trials”.
“We know that women and their partners are increasingly speaking to their doctors about vaginal seeding, so it’s important that healthcare professionals promote other factors that are known to improve a baby’s colony of bacteria, such as early skin-to-skin contact, breastfeeding and a healthy diet.”
Dr Patrick O’Brien, consultant obstetrician and spokesperson for the Royal College of Obstetricians and Gynaecologists (RCOG), said:
“As this review highlights, there is no robust evidence to suggest that vaginal seeding has any associated benefits, and we would therefore not recommend it until more definitive research shows that it is not harmful and can in fact improve a child’s digestive and/or immune system. It is also important to note that some vaginal bacteria can be passed on to the baby, occasionally causing illness.
“Ultimately, it is a woman’s decision, but as healthcare professionals we must advise our patients about the balance of unproven benefits and the small possible risks involved.”
Professor John Thorpe, Deputy Editor-in-chief of BJOG, said:
“Following a caesarean section, some women may experience mixed emotions, particularly if events didn’t go as planned. This research should help reassure women who’ve had a caesarean section that the practice of vaginal seeding is unnecessary and there are other ways to help give their baby the best start in life.”
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Article: Thor Haahr et al. Vaginal seeding or vaginal microbial transfer from mother to the caesarean born neonate: a comment regarding clinical management. BJOG 2017: DOI: 10.1111/1471-0528.14792
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