Why Some Mothers Are Practicing Bacterial 'Seeding' After C-Section (And Why You Probably Shouldn't)

My seven-year old son has just reached that lovely stage where he won't take a drink of his sister's water bottle, or finish the donut I was eating, because he's afraid that weird, foreign germs will reach his system that way. Years ago, he was obsessed with a song, found on YouTube, about bacteria: "bacteria, bacteria, everywhere you go," the song went. "You might not see them, but they're there." He didn't seem that bothered then, but he is certainly very bothered now. 

It's not difficult to see the argument in favor of teaching young children, children who are still in the stage where they love to dig in the dirt and would even put a lollipop that had already been in someone's mouth in their own, about human conception and birth. "Oh,cool," my young son would say upon hearing about his birth. Now, if I were to bring it up again, I'm sure he'd pull faces at the idea that he passed through my birth canal. He doesn't like the thought of gut bacteria either. After hearing that Actimel was supposed to feed the good bacteria in his tummy, he gave up on the idea of trying to make me buy those expensive little bottles. Because — bacteria, eeew!

Disgusting as it would sound to my seven-year old son — and really, when we truly think about it, probably to most of us — it is a fact that, while vaginally-born babies pass through the birth canal, they are exposed to a rich amount of bacteria, bacteria that will become part of that baby's microbiome. Many of these bacteria are helpful, and become part of the individual's gut environment, which is as unique as a finger print. Indeed, humans are significantly outnumbered even within our own bodies.

Several studies, such as Penders at al (2006), Azad et al (2013), and Prince et al (2014), demonstrate that the microbiome of babies born vaginally differs significantly from that of babies born by c-section. While the microbiome of babies born vaginally resembles the colonies found in the vagina, consisting primarily of  Lactobacillus, Prevotella and Sneathia, c-section babies are more likely have Staphylocci and C difficile — found on the mother's skin and in a hospital setting. Indeed, research indicates that the bacterial colonies that vaginally-birthed babies end up with is optimal. Some even go as far as to suggest that homebirth babies end up with extra-special microbiomes. 

READ Vaginal Birth After C-Section - When Is It Safe?

The bacteria a baby initially comes into contact with can do a lot to aid digestion and build a healthy immune system, if, that is, that baby is born in "the right way". What are you to do if you are a pregnant mother who needs a c-section, then? Are you just going to let your baby miss out on that wonderful bacterial cocktail? Of course not! After placentophagy (yes, eating your placenta) and water birth, natural birth advocates have come up with something new — "seeding". If that sounds creepy already, wait until you find out what it involves. 

What Is 'Seeding' After A C-section, And Is It Safe?

Place a piece of gauze soaked in sterile normal saline and folded up like a tampon into the vagina before you're about to have a cesarean section, leave it in for an hour, and have it removed right before your baby is born. Then, immediately upon birth, ask your birth attendants to smear it across your baby's face, in their mouth, and on the rest of their body. 

If this is what you imagined vaginal seeding following a c-section to be, you were absolutely correct. 

Just like my seven-year old son is weirded out by the thought of drinking from his sister's water bottle, the thought of vaginal seeding makes me feel ever-so-slightly queasy. Just like my seven-year old son still doesn't think anything of it when his sister, instead of trying to share her water bottle, accidentally forgets to cover her mouth while coughing in his direction, I don't have the same aversion towards bacterial colonization upon vaginal birth. That's natural, after all!

Is Vaginal Seeding Safe?

First off — is the normal vaginal environment through which the baby passes safe for babies during vaginal births? Not necessarily. That is why tests for HIV, other sexually transmitted diseases, and Group B Strep are carried out routinely during pregnancy. Even if these tests have been carried out, there is the possibility of a yeast infection, and also the risk of fecal contamination during the insertion and removal of the seeding cloth. Furthermore, we don't know if bacterial colonization works in the same way when attempted with a piece of gauze as it would, were it to happen naturally during the course of birth.

Indeed, the practice of vaginal seeding is based on a presentation by Dr Dominguez-Bello, a presentation rather than a peer-reviewed study. Thus, while we can't simply throw out the idea that vaginal seeding is a viable option, further research is certainly necessary to prove that this practice is beneficial, and safe. 

What Should You Do, Then?

At the moment, following the advice of your medical team seems to be the best option if you are having a c-section and would like to optimize your baby's microbiome. In practice, they will be rather unlikely to advise vaginal seeding. Instead, take into account that current research shows that the uterus, rather than being sterile, also contains samples of the maternal microbiome. In other words, your baby may get some of those good bacteria even without vaginal seeding. 

READ Doula Dani: Homebirth After C-section A Gamble

In addition, you can breastfeed, avoid giving your baby unnecessary antibiotics, practice skin-to-skin contact, and go home from the hospital as soon after birth as possible. While research hasn't yet determined the risks and benefits of vaginal seeding, your safest bet is to hold off.