Is Vaginal Seeding Safe?

Vaginal seeding is a relatively new practice and involves swabbing the mother’s vagina prior to C-section (caesarean) and transferring the swab to the new-born baby’s mouth, eyes and skin right after birth, in an attempt to stimulate a microbiome rich in mother’s vaginal microbes.

Despite the kind of attention this practice is gathering, researchers could not find sufficient evidence to prove that vaginal seeding has any long-term health effects on babies born via C-section.

Conflicting Opinions and Arguments

Dr. Maria Gloria Dominguez-Bello from New York University and her research team performed the vaginal seeding technique on 4 babies born via C-section. The results were compared with 7 babies born naturally or vaginally and 7 babies born through C-section but not subjected to seeding. It was found that the microbial environment of the skin, mouth and gut of gauze-seeded babies more closely resembled that of the babies born vaginally, compared to the C-section babies who were not seeded. These results have been published in the journal Nature.

While Dominguez-Bello’s paper reports only microbial differences studied during the first month of the baby’s life, she is confident that the effects are long term. A follow up study has been planned by the research team to study the effects of seeding on the microbiome in nearly 75 children after one year of birth. However, it will need a lot more time and effort to analyze the effects of seeding on health, as that would require a long-term study extending for up to 5 years to determine any change in the frequency of infections, asthma or allergies in seeded babies compared to non-seeded ones. Dominguez-Bello also warns that mothers need to be thoroughly screened for infections before performing this seeding technique.

Meanwhile, an article published in the British Medical Journal raised concerns about the seeding technique. Experts felt that by being swabbed with the mother’s vaginal microbes, the baby could be at risk of contracting infections such as Group B Strep from the mother. The article further says that this risk should be avoided as there is no proven scientific evidence for any benefits of this procedure.

Michel Odent, renowned obstetrician, challenges the assumption that babies are naturally programmed for inheriting mother’s vaginal microbiota. According to him, in the absence of medical intervention, babies more often are born with the sac intact and with no exposure to the mother’s vaginal bacteria. This point raises a number of important questions.

Many researchers argue that babies born via C-section have a low risk of exposure to potentially harmful microbes present in the birth canal and vaginal seeding may just help transfer these pathogenic bacteria and viruses to the baby, putting the baby at risk of a fatal infection. Currently, screening of mothers for these harmful microbes is not performed routinely. Hence they conclude that this seeding practice could cause more harm than good, if any, to babies born via C-section.

Nature also reports that the health effects of vaginal seeding are not clear. According to Alexander Khoruts from the University of Minnesota, it will be a difficult task to determine the health effects of seeding in later life, as the interpretations could be complicated by systematic differences between mothers who have undergone C-section and those who delivered naturally.

Implications for Healthcare Professionals

Many health care clinics and hospitals are undecided about whether this procedure should be encouraged or not. Doctors and midwives in many hospitals are advised against performing vaginal seeding, as the benefits of this technique are not proven yet and it may cause serious infections. Although it is a simple procedure and can be performed by the parents themselves, they are advised to discuss the potential risks and benefits of this procedure with their physician before making a decision. Many healthcare professionals feel that the focus of parents should rather be on scientifically proven practices such as breastfeeding to alter the microbiota of the baby.

Summary

The technique of vaginal seeding is still in its infancy and there are no conclusive answers regarding how safe it is yet. The need of the hour is a major research study that involves follow up of seeded and non-seeded infants for a considerable period of time to determine health outcomes. Unfortunately, it will be a long way off before we know if vaginal seeding is safe for the babies and if it offers any health benefits.

References

• http://www.nature.com/news/scientists-swab-c-section-babies-with-mothers-microbes-1.19275
• http://press.psprings.co.uk/bmj/february/vaginalseeding.pdf
• http://www.telegraph.co.uk/women/health/vaginal-seeding-could-this-new-birth-trend-be-putting-babies-at/
• http://www.theguardian.com/society/2016/feb/24/vaginal-seeding-babies-born-c-section-infection-risk