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Juliekemp

To Seed or not to Seed….what does that even mean?

Vaginal seeding. I may have already lost some readers – and I’m ok with that.

 

Let me start by saying that I appreciate that we live in a world where women now rarely die in childbirth and lives have been saved by c/sections and antibiotics.  It’s a fact that in developing countries women and babies do die in childbirth as they just don’t have access to the lifesaving medicine and procedures that we do.

However (you knew that was coming) the very high caesarean rate and antibiotic overuse are leaving our children with unknown long term health effects. Any Mum who has had one can tell you that c/sections are not the “easy way out”; they come with pain, long recovery times, heightened risk of infection and a small lower abdominal pouch that a million situps will never shift (hello, the muscle has been sliced open while it’s stretched to full capacity). Another newly realized consequence of not emerging down the birth path is that bub misses out on a huge pocket of microbes from Mum.
Nature has beautifully designed this process so that when bub slides down the birth canal it is coated with important organisms secreted high in the vagina to begin colonising its own gut and skin. Early exposure to these microbes is essential for healthy immune development and metabolic programming. Babies born via c/section obviously miss out on this gift. Add to this the likelihood of antibiotics being given before surgery and it creates a microbial shitstorm (well, the opposite of a shitstorm IYKWIM).  Now, to counter all this information is new research coming out of UWA.  While the full study is in its final stages, it has some fascinating findings.  Researchers looked at the bacterial content of post-birth amniotic fluid and found plenty of beneficial bacteria present.  This suggests the baby is not grown in a sterile environment as previously thought and therefore the birth canal is not its first bacterial exposure.  I will pass on more of this information once published.

OK, so rather than bang on about the harm of a c/section – what can be done to minimise it? This is where we come to vaginal seeding. Basically, a gauze swab is inserted into the vagina about an hour before surgery to capture these organisms. Very soon after delivery the baby is swabbed by the gauze, particularly its face, lips and skin.  An albeit small study out of NYU compares the microbiome of swabbed c/section babies with vaginally birthed bubs … Read it here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5062956/

 

Are you still with me or is this too gross to read on? So, just imagine the reaction of your caregiver when you ask about this. Some more open-minded midwives may have suggested it to you already? Think your Ob might choke on his breakfast when you mention it? There are some maternity hospitals in Perth who refuse to do it. The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) websites directs to an article in the British Medical Journal. The general idea is that yes, c/sections disrupt the microbiota and increase risk of obesity, asthma, allergies and autoimmune conditions. Vaginal seeding has no evidence but real evidence is not available yet as follow up will take years.

“It might seem reasonable to perform this simple and cheap procedure, even without clear evidence of benefit, but only if we can be sure that it is safe”
– British Medical Journal, 2016

Doctors are concerned that Mum may have an infection present without any symptoms, such as Group B Strep (GBS), herpes, chlamydia, gonorrhea (which can cause infant blindness). So if you are planning on exploring swabbing, it should be done after discussion with your caregiver. If your caregiver will not even have the discussion then you should reconsider your choice – its never too late to change your mind on who helps you deliver your baby. I don’t recommend doing it alone or behind their back or in the absence of testing. You need to know what you are working with and have the support of the professionals helping you.

 

So, while vaginal swabbing is something you should research in preparation for your birth – we are not in the business of Mum Shaming, parent bashing or judging
any birthing decision you make. Don’t focus on negativity, blame or guilt. Now its time to empower yourself with knowledge to come up with a solution. This is when we come in to support each other and our childrens health – and the health of our descendants.

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OK, so you are faced with a c/section and want to give your baby the best microbiome possible. Here are some tips:

Avoid unnecessary and early caesareans
If possible, let bub chose their own birthday. When baby is removed early, their lungs, immune system and neurodevelopment can be immature and cause issues in later childhood.

Breastfeed …. as long as possible.
The gift from Mum of a dose of bacteria isn’t confined to the vagina. Breastmilk (especially colostrum) is teaming with bacteria that bub needs. Get support and do
whatever you can to get your breastmilk into bub. If suckling isn’t happening, you can finger feed or express manually or with a pump. Breastfeeding doesn’t come naturally to
most of us, it is a learned skill that often needs support and good advice. You must also keep up a great diet full of fibre and fermented foods (yoghurt, sauerkraut etc) to keep your own microbiome in peak condition – you can’t fill from an empty cup.

Skin to Skin – from the immediate family
Not a hard one to do – cuddle your newborn and expose them to your own skin microbiome; no one can resist that newborn smell. A beautiful way to keep them warm and build up their immunity bit by bit.

Probiotics
There are infant-specific formulas available which provide a lot of the strains which a newborn needs. They pass through breastmilk so best taken by Mum so her liver can break it down before delivering to bub. Not all practitioners agree of the effectiveness of these little tablets and if they can reduce disease, however they carry little risk and the potential is enormous. To enhance effectiveness, take during pregnancy and postpartum.

Don’t be a clean freak
Only a very small number of common bacteria cause us humans any harm. Obviously we should be hygienic around newborns – handwashing and avoiding touching by too many strangers. When baby is mobile, let them out into nature to roll on the grass, touch soil and play with pets. This all exposes them to a range of organisms adds to their gut resistance. While there is no “perfect gut” picture, diversity is the most important factor.

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