Vaginal Seeding


Vaginal seeding is the process of transferring the vaginal flora to the mouth, skin or nose of a newborn infant who are delivered by a C-section. The idea is to expose the newborn to the same vaginal flora, just like a newborn born through a normal vaginal delivery. This procedure has its own pros and cons. Continue reading to know more about vaginal seeding.


What is vaginal seeding?

The American College of Obstetricians and Gynecologists (ACOG) refer to vaginal seeding as a practice of inoculating cotton gauze or a cotton swab with vaginal fluids to transfer the vaginal flora to the mouth, nose, or skin of a newborn infant. If a C-section is done before the onset of labour or before a woman’s water breaks, the baby will not be in contact with maternal vaginal bacteria. The purpose of vaginal seeding is to transfer the maternal vaginal bacteria (microbiota) to the newborn. Vaginal seeding is also called microbirthing.

The science behind vaginal seeding

The microbes that are inherent in our body are thought to dictate the health and development of the host. Transfer of bacteria from mother to newborn happens through skin to skin contact, and through breastfeeding. Bacteria can stimulate the immune system, prevent the growth of pathogens, regulate development of the gut, and produce vitamins for the host. However in a cesarean delivery, there is an interruption of maternal to neonatal bacterial transfer during the crucial period of neonatal immune development. Hence the procedure called vaginal seeding is performed. Vaginal seeding can allow for proper colonization of the fetal gut and can reduce the risk of asthma, atopic disease like hay fever and eczema and immune disorders. Some of the other advantages of a healthy newborn get microbiome include reduced risk of inflammation, obesity, diabetes, irritable bowel syndrome and general improvement of digestive capacity.

Recommendations by the ACOG

As the procedure is not validated completely the ACOG has the following recommendations.

·         According to ACOG, vaginal seeding should be performed not outside the context of an institutional review board-approved research protocol. Till the safety and the benefit of the process become available, the procedure needs to be supervised by a review board.

·         If a patient needs the procedure to be carried out, she must be clearly informed on the risk of the procedure and must be clearly educated on the chances of neonatal infection.  The obstetrician–gynecologist should document the discussion and the pediatrician should be aware that the procedure was performed.

·         Breastfeeding is one of the best ways to promote baby’s gut health. Breastfeeding can contribute to the seeding of the infant gut.

·         There is paucity of data on “vaginal seeding” and more research will provide insights into the safety and benefits of this procedure.

 

Limitations
Since the data on vaginal seeding is limited, there are chances that
vaginal infections like group B Streptococcus (20% of pregnant women have it), herpes, chlamydia and gonorrhea, could be passed from mother to baby.  Also there is a lack of data on whether this procedure can be done in preterm infants. There are chances that it can increase the risk of sepsis (a serious blood infection) in preterm infants. The other factors that could influence the colonization of GI tract include gestational age, antibiotic exposure and mode of feeding (breastfed or formula).

 

 

 

 

 


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