Evaluating New Research on Cesarean C-section & Microbiome

Having a c-section is often a matter of emergency. And so, once mother and baby are out of the operating room, the last thing you want to hear is that a c-section permanently impacts your baby's wellbeing.

For some time now, the health community has been discussing the lack of diversity in the microbiome of infants born by cesarean section.

If a baby is delivered naturally, its intestinal microbiota is already colonised by bacteria and microorganisms. Whereas if a baby is born via c-section, they are said to have gut dysbiosis, which might permanently harm microbiome development.

Interestingly, new research has been published in the journal Cell Host & Microbe that helps us understand more about this process.

Previously, it was believed that babies born via c-section would have an impaired immune system later in life. But the latest research paints a different picture.

One of a more steady developmental trajectory for gut ecosystem development. Rather than the microbiota being permanently impacted by a c-section, there’s a gradual maturation of the gut ecosystem.

The good news is that once the baby reaches five years of age, their gut microbiota has largely normalised.

Bacteria and microbes in the gut are continually evolving, growing and changing. The new research sheds light on a more understandable unfolding of the internal terrain.

As we learn more about the microbiome, we’re dispelling myths. Such as the suggestion that c-section babies are always more likely to develop allergies or obesity.

We now know that a c-section alters the internal microbiome of the baby because they don’t gather the microbes from their mother the same way that they would during a natural birth.

In a UK study of 596 babies born in hospital, researchers compared fecal samples from c-section and vaginal birth.

Finding that initially 80 percent of c-section babies had hospital acquired bacteria, compared with 50 percent of vaginally born babies. 

Similarly to the study I mentioned above, the differences largely disappeared by 9 months. The researchers warn that “We don’t know the long-term consequences of these findings.”

What we do know is that it’s not simply the vaginal birth process that populates the gut microbiota.

By taking samples from both mothers and babies, the researchers were surprised to find that the microbes seemed to be coming from the mother’s gut rather than from the vagina during delivery. 

Related: The Most Beneficial Bacteria

Since we’ve all become fascinated by the microbiome, many bizarre practices have become popular, such as fecal microbiota transplants (FMTs) and vaginal seeding. 

The idea is that you can take a microbiome from another person and implant it in the anus or the mouth. FMT has been found to cure people suffering with bacterium Clostridium difficile (C. diff). 

Vaginal seeding has gained popularity because of the information that has been released regarding the stunted microbiome of a c-section baby. 

The idea is that the baby should have received its first dose of microbes as it passed through the birth canal. Vaginal seeding is when a swab is taken from the mother’s vagina before a c-section.

The swab is then wiped over the baby’s mouth or face. This practice is intended to help populate the baby’s gut with healthy microbes.

New research has discovered the faecal samples of both mothers and babies were similar, even in c-sections; rendering the bizarre practice of vaginal seeding more or less pointless. 

Related: Microbiome Health: The Right Environment, The Right Microbial Strains

Some studies have concluded that birth by cesarean section could impair a baby’s immune system.

The microbes in your gut impact how well your immune system functions, therefore gut dysbiosis due to c-section makes sense – kind of.

Although the gut microbiome of a baby born via c-section differs from a baby born naturally, this difference doesn’t last for long. 

It’s hard to pinpoint the exact cause and effect of a weakened immune system, but some studies have suggested that babies born via c-section have weaker immune systems.

“It could be that the immune system of these children is set on a different path early on,” suggests Paul Wilmes, Associate Professor of Systems Ecology at the Luxembourg Centre for Systems Biomedicine (LCSB) of the University of Luxembourg.

“We now want to further investigate this link mechanistically and find ways by which we might replace the lacking maternal bacterial strains in caesarean-born babies, e.g. by administering probiotics.”

Related: Shining a Light on the Immune System Microbe Connection

Although the microbiome of a c-section baby differs from those who had a natural birth, it has been found to balance out naturally by the age of 5.

Additionally, breastfeeding helps propagate the beneficial gut bacteria populations.

The question remains – do C-section babies need probiotics? As with most things in life, it’s an individual choice.

The gut microbiome is unique for everyone, and the rate that the microbes populate can vary depending on environment, genome, gender and multiple other factors. 

It’s thought that babies are born with a sterile gut, only to be populated by breast milk, food and their surrounding environment.

If you feel that your baby needs probiotics, the good news is that research has shown that even premature babies can tolerate probiotics.

Alongside breastfeeding, probiotics can populate the gut with health-promoting bacteria.

There are four main strains of probiotics; Lactobacillus, Bifdobacterium, Streptococcus, and Saccharomyces boulardii.

However, research is limited in the effects of each specific strain on children and infants. 

Related: Probiotics for Women Benefits: Hormone Balance, Menopause, UTIs

As with many scientific findings, we’re continually learning more about the microbiome and how it’s impacted during childbirth.

What we know for sure is that the microbiome of babies born via c-section is not as well developed as those born naturally. We also know that many strains of bacteria are transmitted via the gut of the mother, suggesting that we might not be born so sterile after all.

The good news is that even if a baby is born via c-section, the latest scientific evidence is showing that their microbiome will develop overtime, aligning with their peers who were born naturally. 

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