Pregnancy and child

'Vaginal seeding' may put newborns at risk of infection

"'Vaginal seeding' of babies born by C-section could pose infection risk," The Guardian reports. 

The practice of exposing babies born by caesarean section to their mother's vaginal fluid in an effort to boost their immunity may actually lead to an infection, experts say.

Vaginal seeding involves rubbing vaginal fluid on the baby with the intention of exposing it to the "healthy" bacteria it would be exposed to in a vaginal birth.

However, there is no evidence the practice is effective, and it runs the risk of babies developing serious infections from potentially harmful bacteria or viruses mothers may be unaware they are carrying.

The most effective and safe way you can improve your baby's immunity is through breastfeeding.

Where did the story come from?

Doctors from Imperial College London, St Mary's Hospital and Charing Cross Hospital in the UK, and St Vincent's Hospital in Australia, have written an opinion piece because they are concerned about the growing number of women requesting vaginal seeding.

This practice first hit the news in the US in 2015, and has become increasingly popular and requested in many other countries.

The opinion piece was published in the peer-reviewed BMJ. The authors reported having no competing interests and no specific funding.

The UK media reported on the editorial accurately and responsibly, including several quotes from the lead authors. They highlight concerns the practice is occurring without adequate professional awareness or guidelines. 

What is vaginal seeding?

Vaginal seeding is a practice used for babies born by caesarean section that aims to mimic the exposure to bacteria that would have occurred during a normal vaginal delivery.

It involves inserting a rolled-up sterile gauze into the vagina and leaving it for up to an hour, then placing it in a container until the baby is born by caesarean section.

The gauze is then wiped over the baby's mouth, face and body. Some websites report the eyes are also wiped. 

Why is it done?

The editorial reports epidemiological studies have found associations between being born by caesarean section and a "modest" increased risk of obesityasthma and autoimmune diseases. 

Other observational studies have shown associations between these conditions and changes in the different varieties of micro-organisms, such as bacteria normally present on and in the body.

These and other animal studies suggest exposure to these bacteria may play a role in developing a healthy immune system and reducing the risk of certain non-infectious diseases, but this has not been proven.

Despite the lack of studies proving cause and effect, many women in Australia and the UK are reportedly requesting the procedure after reading about it in the news. 

What is the risk?

The editorial highlights the risk to the newborn of transmitting serious infections the mother may not be aware she has, as they often cause no noticeable symptoms.

These include:

  • herpes simplex virus (HSV), which can cause genital herpes in adults – HSV in newborns is rare, but can cause severe illness throughout the body
  • group B streptococcus – 20-30% of pregnant women are estimated to be carriers, usually with no symptoms, and this bacteria is the most common cause of serious blood infection (sepsis) in newborn babies
  • chlamydia and gonorrhoea – both can cause eye infection (conjunctivitis) in a newborn, which often requires treatment with intravenous antibiotics to prevent permanent damage  

What did the authors recommend?

The authors have advised staff at their respective hospitals not to perform the procedure because there is no evidence of any benefits, so they believe that, "The small risk of harm cannot be justified". 

They recommend that if women wish to do it themselves, their wishes should be respected, but they should be "fully informed about the theoretical risks". 

They also advise that if a baby becomes unwell with an infection, staff should ask if vaginal seeding had been performed, and parents should be advised to mention it as this could change the management plan.  

Do they give any other advice?

The authors report breastfeeding and limiting exposure to antibiotics are both recommended ways to help a child have the wide variety of normal bacteria needed to build a strong immune system.

NHS Attribution