The Microbiome Effect by Toni Harman and Alex Wakeford is must-read. It is a fascinating account of emerging research that shows how vital bacteria are for human health. Our exposure to them during labour, birth and beyond helps develop the immune system. It talks about how C-Section deliveries impact the immune system. This in turn makes them more susceptible to non-communicable diseases.
Here is my synopsis for all birth educators and expectant parents. In this blog, I want you to understand the intricacies of a vaginal birth and the vital components that help your baby thrive.
The human body is made up of of trillions of human cells and microbes (bacteria, viruses, archaea, fungi etc). These cells and microbes live on and inside us. The bacteria inside our body help it work properly and give it the ability to fight off diseases.
There are aspects of today’s way of living such as diet, antibiotics and C-sections - to name a few – that are adjusting the diversity of microbiomes in the human body. Current research suggests, this change in the way we live is giving rise to many common non-communicable diseases. They include allergies, asthma, auto-immune disorders, diabetes, obesity and more.
All the way through pregnancy, labour, birth and infancy, development happens in a particular order. When the birth process is interrupted with medical intervention, the foundational layers of the immune system are disturbed too.
Research has also shown that the microbial profile of a baby born vaginally resembles that of its mother. This profile similarity continues with each generation that is born vaginally. However, this pattern is interrupted by a C-section delivery. In these instances, the child may not match the mother’s microbial profile and it may fail to inherit critical ‘keystone’ species of bacteria to ensure good health. C-sections could be contributing to key microbe species being lost, making us more susceptible to pandemics.
Other evidence suggests a correlation in C-section babies having a higher risk of developing asthma, type one diabetes or coeliac disease, and of becoming overweight or obese. This is not to say that all babies born this way will go one to develop any of these, they are simply more susceptible. What we don’t know yet are the ongoing repercussions of this.
For a long time, antenatal educators have discussed the benefits of a vaginal birth vs a C-section birth, but for many other reasons. One of these reasons is baby's ability to breathe with more ease straight after birth. In a vaginal birth, the birth canal compresses the lungs to expel the liquid that has been in them during pregnancy. Once the baby is born, they tend to breathe more easily. This is not always the case for C-Section babies born at the same gestation.
The Microbiome Effect looks into many other vital stages that a baby encounters during a vaginal birth. It reveals how a C-Section can impact his/her long-term health.
During pregnancy a baby lives in a near sterile environment and exposure to microbiomes is minimal. In a vaginal birth, once the amniotic sac had ruptured, a baby begins to be exposed to bacteria. This is when it comes into contact with vaginal, faecal and skin microbes. These enter the baby's eyes, ears, nose, as well as being swallowed through the mouth. This prenatal exposure is one of the main seeding events for the baby's gut. Once baby is born, it will come into contact with more bacteria. These encounters help to colonise the baby's gut.
Babies born via a Caesarean section, when the amniotic sac hasn’t ruptured, won’t come into contact with the mother’s vaginal or intestinal microbes. As a result. the baby’s gut microbiome composition will be different.
Babies born via C-section are recommended to have skin-to-skin contact and breastfeeding where possible. Why? Because this is the second major influx of microbes exposed to newborns. (Babies born vaginally are also recommended to do this too).
During skin-to-skin contact, and when a baby is looking for milk, it will open its mouth and suckle or lick the mother’s skin. Breastmilk provides essential nutrients for the baby's growth and development. This includes key immune components and sugars. The sugars provide energy for the baby. But it also feeds the bacteria in the gut, quickly colonising it. It prevents other harmful bacteria from taking hold. These events provide contact with the right bacteria to continue the development of the infant immune system. It learns to recognise friendly and harmful bacteria, and know what to attack, or not.
In contrast, a baby that is fed formula milk will only receive the nutritional benefits. This milk is missing prebiotics to feed the gut microbes. It also lacks the right bacterial species and immune components that the developing baby needs. These missing components could mean health implications later in life.
So what can we do about it?
As an antenatal educator, I feel it is my duty to inform my parents of the potential health implications of babies born via a C-section. Parents need to better understand the importance of vaginal births, as a way to ensure that their baby receives the necessary exposure to bacteria, which will help colonise its gut in the right way - to ensure a fully-functioning immune system.
There will always be world in which some babies need to be born via C-section. In these cases, there are steps the caregivers can take to help the baby receive optimal seeding and feeding. They can test mothers to see if they are suitable for “swab-seeding” (this is currently under a strict protocol). Babies should be passed to mum's chest immediately after birth, even if that means assisted. If the mum is unwell, the baby can benefit from aided skin-to-skin contact. It may even seek the breast for its first feed. This allows the baby to be exposed to essential bacteria and microbes.
This article only scratches the surface and highlights the key points of the book. I strongly recommend mothers to read it and learn more about it. Ask your midwife and/or obstetrician how much they know about this subject. If they don’t know too much about this subject, politely ask them to do their research. Your baby’s life is in their hands.
The Microbiome Effect is published by Pinter and Martin. It is available on their website: http://www.pinterandmartin.com/the-microbiome-effect
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