“Vaginal seeding” of infants born by caesarean section

Cunningham, A. et al. BMJ 2016;352:i227

How should health professionals engage with this increasingly popular but unproved practice?

The microbiota is the community of microbes that colonises our bodies, outnumbering our own cells 10 to 1. This complex microbial community varies from one part of the body to another, and from one person to another. Characteristic differences in the microbiota are associated with various diseases. As a result interest has surged in the potential for manipulating the microbiota to promote health and treat disease.

The term “vaginal seeding” describes the use of a gauze swab to transfer maternal vaginal fluid, and hence vaginal microbiota, on to an infant born by caesarean section. The composition of the early microbiota of infants is heavily influenced by mode of delivery. In infants born by caesarean section the microbiota resembles that of maternal skin, whereas in vaginally born infants it resembles that of the maternal vagina.

These early differences in the microbiota have been suggested to determine susceptibility to an increasing number of common non-communicable diseases. In theory, vaginal seeding might restore the microbiota of infants born by caesarean section to a more “natural” state and decrease the risk of disease. The potential benefits of vaginal seeding have recently been reported in the press and, as a result, demand has increased among women attending our hospitals. Demand has outstripped both professional awareness and professional guidance on this practice.

Read the full editorial here

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