C-section using vaginal seeding may lead to severe infections in newborns

Why is there an issue with vaginal seeding?

Vaginal seeding, also known as microbirthing, is a technique that is growing in popularity among C-section mothers and involves applying vaginal fluid to the skin of a newborn baby. The technique involves the use of gauze swabs that are placed inside the vagina of the mother after the C-section birth, and these swabs are then rubbed onto the newborn’s face, mouth and body.

The thinking behind this seemingly bizarre practice is that when babies are born by C-section (caesarean section) they are not exposed to the range of healthy and beneficial bacteria that they would be when moving through their mother’s birth canal during a natural delivery. 

The effect of vaginal seeding is therefore designed to mimic the transfer of bacterial microbes that occur naturally during a vaginal birth, which, in some circles is thought to assist in boosting the baby’s defences against autoimmune diseases, asthma, and allergies, by effectively bolstering the infant’s immune system. This practice however and its benefits have not yet been scientifically proven and research into the technique is limited at best, with the safety of it now being questioned¹.

Despite this fact, a number of expectant parents have caught onto the trend and are now asking their doctors to perform vaginal seeding on their newborns after a c-section, with as many as 90 percent of Danish gynaecologists and obstetricians are being asked about the procedure.

Why is vaginal seeding making news headlines recently?

The Danish Society for Obstetrics and Gynaecology recently established a review board consisting of a group of doctors whose role it was to review the evidence and findings on vaginal seedings and produce a detailed guideline regarding the technique. Their collective commentary was then published in the British Journal of Obstetrics and Gynaecology in August 2017.

The group’s findings sparked an interest in vaginal seeding after the media began issuing warnings against the popular technique reporting that it may be harmful to C-section babies.

Why is vaginal seeding so popular?

Vaginal seeding was initially developed to mimic the transfer of microbes from a mother to her baby during the natural birthing process in babies delivered by C-section.

This is done because infants who are born by C-section have a slightly higher risk of developing conditions like obesity, and autoimmune or inflammatory diseases such as allergies and asthma². Some experts believe that C-section babies’ lack of maternal bacteria (microbes) which are naturally transferred to a baby during a vaginal birth, may be to blame for this slightly elevated risk. These experts believe that a C-section birth may affect a child’s natural development of the microbes needed to fight off infection.

Vaginal seeding is theoretically a successful practice which is also accessible and affordable, making it easy to see why a number of parents want the technique to be used on their new-borns.

While this practice is regarded as an interesting theory or hypothesis by some in the medical field, there is, however, insufficient evidence to support its efficacy as there have only been tests conducted on four different infants during an exploratory trial.

The mothers involved in this study had to be screened for any potentially harmful bacteria before their new-borns were administered a vaginal seeding.

Something that the Danish group of doctors noted when reviewing this study was that there was insufficient evidence and findings to allow one to decide which microbes should be screened for and that this lack of evidence may have skewed the results of the study.

Due to research lacking sufficient evidence in its findings, it is difficult to know for certain whether the technique is effective or even safe. It should be noted that the aforementioned study was conducted merely to explore the hypothesis of bacterial (microbial) transfer and therefore did not examine the safety of vaginal seeding.

What are the known risks associated with vaginal seeding?

The most prominently identified risk associated with vaginal seeding is that newborns may develop some severe infections². A serious infection that is commonly seen in babies who are born prematurely (preterm) during a natural birth, is known as early onset neonatal sepsis. This infection is the result of the transference of Group B Streptococcus (GBS) and E. coli bacteria from the infant’s mother during a natural vaginal birth.

The BMJ (British Medical Journal) has previously warned against the use of vaginal seeding due to the risk of infection being increased among new-borns. The risks identified are thought to be low, however, there is currently no evidence that suggests that the supposed long-term benefits of vaginal seeding outweigh the safety risks associated with potential infection.

The Danish group of doctors reviewing this practice suggest that expectant parents should be mindful of the fact that research on vaginal seeding is still in the exploratory phase and the exact risks are yet to be identified and plausibility of the suggested benefits proven. There are a number of other activities such as diet and breastfeeding that are deemed more important in helping babies to establish a healthy bacterial (microbial) population naturally.

What is the current medical conclusion on vaginal seeding?

The review group of Danish doctors strongly recommend against the use of vaginal seeding in babies born by C-section due to their increased risk of infection.

Bear in mind, that for parents who are concerned with giving their infant the best possible start to life after being born by C-section, there are a number of other established techniques that may be the best solution with fewer health concerns.

These techniques include skin-to-skin contact between a mother and her child shortly after the birth, as this aids in bonding and some experts believe that this practice also allows for microbial transfer. This type of contact also encourages the baby to begin breastfeeding at an earlier stage.

Breastfeeding is seen as another method of ensuring microbial transfer which may be vital for a baby during their first stages of life.

With this in mind, at the end of the day, it is still the mother’s choice as to the practices she wants performed on herself and new-born child. That said, experts do warn parents about vaginal seeding practices and urge them to wait until more research into this technique can be conducted as this will allow for the safety and effectiveness of the approach to be further examined and proven. Without the long-term side effects being known, this may pose a larger risk than we know regarding the health of newborns.

^References

1. ^{PubMed Health. August 2017. C-section mums warned about dangers of 'vaginal seeding'. Available:  https://www.ncbi.nlm.nih.gov/pubmedhealth/behindtheheadlines/news/2017-08-23-c-section-mums-warned-about-dangers-of-vaginal-seeding/ [Accessed 30.08.2017]}

2. ^{The BMJ. February 2016. Editorials. “Vaginal seeding” of infants born by caesarean section. Available: http://www.bmj.com/content/352/bmj.i227 [Accessed 04.09.2017]}