Babies born vaginally are expected to have an advantage over those born by Caesarean section. They pick up bacteria from the birth canal of the mother, which scientists believe helps protect against asthma, obesity, and other health problems as they age. Now, a new study offers advice that researchers may be able to provide these same benefits for babies by C-section "redo" their microscopic community shortly after birth.
Although the work is very preliminary, it is also "a very interesting and simple procedure" which opens new avenues of exploration, said Dennis Kasper, a microbiologist and immunologist at Harvard Medical School in Boston, who was not involved in the study.
mothers in labor, like the rest of us, boast of a constellation of bacteria anywhere in their body is called the microbiome. Babies born vaginally develop a microbial community that looks at first that the vagina of their mother, while babies enter the world via C-section have a similar microbial makeup to the skin of their mother. These differences, in turn, have been associated with an increased risk of asthma, allergies, obesity, and immune deficiencies, in human studies and mouse. Exactly how many mounts risk is unclear, but studies have attracted the attention of many scientists.
This is the next step "if logic" according to Maria Gloria Dominguez-Bello, a microbial ecologist at New York University School of Medicine in New York: whether the microbiome of a baby born by caesarean section could be moved immediately after birth. Dominguez-Bello was particularly eager to test it because, after 11 years working in Puerto Rico, she was alarmed by the extraordinarily high levels of C-section here, almost 50%, and in other countries of America Latin. "There's this idea that C-section is fine and there is no need to go through the work," she said, and many cesarean sections are not medically necessary.
Then Dominguez-Bello teamed up with computational biologist and expert microbiome Jose Clemente C. Icahn School of Medicine New York City's Mount Sinai to launch an unusual clinical trial. They and their colleagues recruited mothers programmed to have a caesarean section. An hour before the operation, the researchers placed a sterile gauze in the vagina of the mother, where he was left until just before surgery. At that time, the team placed in a sterile container. Within 3 minutes of great baby's entrance, whipped doctors gauze and rubbed all over the body of the newborn, starting with the lips and face
"We know this is an approximation. We can not reproduce all the factors that are involved in the work, "says Clemente, noting that his own daughter was in the birth canal" for hours. "At most, infants in this study were rub-down one minute with bacteria from their mother's vagina.
However, the treatment seems to have an effect. Repeated sampling of bacteria on the skin, in the anus and in the mouth over the next 30 days revealed a change to a typical vaginal microbiome. This was particularly true of areas on the skin and mouth. in particular, the researchers report today in Nature Medicine , there was "early enrichment" of Lactobacillus bacteria, followed within a week by 2 Bacteroides -two types of healthy bacteria that are significantly decreased in babies born by caesarean section. "If you expose a baby [the] vaginal secretions of her mother, pick up bacteria in different locations and flowers," said Dominguez-Bello.
But even the authors acknowledge some large reserves. The number of babies in this pilot study was very small: Just four received treatment gauze, while seven others born by Caesarean section did not. (There was also a comparison group of seven babies born vaginally.) Because there is a significant variation in the microbiome in C-section and vaginal birth group, a small sample size, it is particularly difficult to catch lasting changes in the microbiome. And there was less difference in the anal microbes in four babies treated than on other sites, compared with those born by Caesarean section are not treated. This suggests the intestine may have been less affected than other parts of the body by the experience of gauze, because the bacteria are ingested by the baby, as they can be during a vaginal birth. Finally and critically, there is no way of knowing if the microbiome changes will affect health on the road.
Dominguez-Bello and Clemente recruited 86 families to expand the approach, and are hoping to add many others and follow the baby for at least a year.
Although it is not known if this strategy will affect health later, and indeed, the link between C-section and health effects is still just a hypothesis -the approach so easy it's tempting to try. Indeed, one of the authors of the article, the biologist Rob Knight computing at the University of California, San Diego, he applied to his daughter when she was born by emergency Caesarean section last few years, before the start of the study. "We took things in hand," he said in a TED talk in 2014, "and made sure that she was born with germs, she would have naturally."
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