Birth Method, Gut Bacteria and Health Outcomes

Birth Method and Health Outcomes via the Gut

 Reference: JAMA Pediatrics Jan 2016 

 When a baby is born naturally, it usually is facing downwards. That makes it easiest to flex and turn its head through the vaginal canal. Now, recalling the 20 or so babies I've delivered in my career, I do recall that most of them squeeze out a bit of stool from mom's rectum just before delivery. Pretty quickly, the babies face then emerges and the baby takes a deep breath and yells. 

We wipe the blood and stool and messy vaginal juices off their face and hand them over to mom. What just happened? Mom just did one of her more important actions. She passed on her bacterial biome to the baby to populate its intestinal tract. The vaginal bacterial are heavily weighted to lactobacillus that digest milk just fine. And the 30,000 different species in mom's intestinal biome get gifted to baby. They all get a healthy start. 

Now that we know that our colonic biome is critically linked to many health outcomes. This is a good thing. Guess what happens when you get delivered via a sterile C-section. You got it! Your gut gets a whole different start. Then, guess what good things breastfeeding does for your gut biome! You got it. Dramatically better diversity and balance of bacteria when vaginally delivered versus c-section delivered. That's what Dr. And her team discovered following 102 deliveries of which. 70 were natural vaginal deliveries and 32 Were c- sections. Then 70 women exclusively breastfed,   26 Women breastfed and supplemented with some formula and 6 exclusively bottle fed. At 6 weeks the babies had their colonic biome evaluated. And this is where it gets really interesting. 

Being delivered vaginally results in 6 bacterial families having statistically different abundance. This constituted a greater change in abundance and distribution of bacterial families than breastfeeding versus formula feeding. In that, there was difference enough.   Pure breastfeeding showed a different population of bacteria in the baby's colonic biome than formula feeding. Interestingly enough, adding some formula in made it as though you were only formula feeding, losing the benefit of breastfeeding. Cesarean delivery has been associated with an increased risk for obesity, asthma, celiac disease, and type 1 diabetes mellitus. 

That is at least 3 autoimmune illnesses that have a connection to the type of birth. Don’t you find that intriguing? It suggests that the cross-talk between the bacteria in your colon and your immune system is far more complex, and more beneficial than we have understood to date. Our colon is emphatically not just an organ dedicated to conserving water, but rather a complicated, mutually beneficial arrangement with implications we have yet to fully understand. The implication is pretty clear to me. If you are forced by circumstance to have a C-section for your baby’s delivery, you might be well served to make sure your baby gets a taste of your vaginal bacteria, and some of your stool. And then, breastfed, exclusively.   This study is in progress, and its results should be coming soon. How about a cotton swab?   We already know that kids who grow up on farms with early exposure to animal dander and poop have fewer allergies. Perhaps it’s all by the same route. More diversity. 

  www.What Will Work for me.   I’m getting a lot more casual about the dirt in my environment. I’m trying to still wash my hands and my fruit/vegetables, just to get off all the pesticides and viruses I picked up off the door nob. But the mud from my yard….may be just what I need. What I want to learn is how to interpret the variety of bacteria when I test it, and I haven’t found a good source to help me sort that out. That is still a work in progress.  

 Pop Quiz  

1. You get beneficial bacteria from your mother’s stool at the moment of birth. T or F       Answer:   True, get over it.

2. Vaginal delivery results in a very different bacterial biome from c-section delivery. T or F        Answer:   True

3. C-section babies get their bacteria from the nurses in the delivery suite, their husbands, the doctor and the nurses assistant, instead of from mom. T or F                     Answer:  True

4. Breast feeding exclusively appears to provide added benefit for colonic diversity and abundance, a benefit lost with modest formula supplementation.   T or F                    Answer:   Again True

5. In the future, it may be standard of care to swab a mother’s vagina and rectum to pass on bacteria to a baby at birth, if the baby was born by c-section.                      Answer:  May be. Makes perfect sense. And time is of the essence.