For Infants Born Via Cesarean Delivery, Exposure to Mother’s Fecal Matter May Help Their Health

  • Infants born via cesarean delivery may have an underdeveloped microbiome.
  • A new study found that infants exposed to their mother’s fecal matter may benefit.
  • Experts warn this was tested in a hospital, and it’s not something anyone should try at home.

Infants who arrive via cesarean delivery, commonly referred to as a C-section, typically lack helpful gut bacteria.

This can put them at a higher risk for certain conditions compared to babies born vaginally.

Researchers have been searching for ways to build this gut bacteria in other ways.

Now a new study finds that feeding them a solution of their mother’s feces and breast milk could safely introduce healthy bacteria.

Previous research has explored a vaginal microbiome transfer, known as swabbing newborns or vaginal seeding, to increase the infant’s microbiome diversity.

“Vaginally delivered infants have a more diverse microbiome than those delivered via C-section. More diverse gut microbiomes are generally associated with better health outcomes,” noted Keith A. Crandall, PhD, a researcher from George Washington University in Washington, D.C.

He’s researched fecal microbiota transplants (FMTs) to treat recurrent Clostridium difficile infections, preferred to using antibiotics.

“I have not seen FMT used before just for building microbiome diversity,” Crandall said.

In other words, FMTs aren’t a common procedure in hospitals to respond to normal bacterial imbalances found in babies born via cesarean delivery.

“Nothing was known before our study,” said Dr. Sture Andersson, an author from the Pediatric Research Center at the University of Helsinki and Helsinki University Hospital in Finland.

“We performed a proof-of-concept trial that showed efficacy,” he told Healthline.

Going for the gut

Andersson’s report, published on Oct. 1 in the journal Cell, said the procedure appears to be safe. Infants who ingested the formula had a gut microbiome similar to infants born vaginally.

As part of the study, seven women had cesarean deliveries. Their infants’ fecal microbiota (meconium) was tested. Then the babies were given FMTs as described.

Following the transplant, the babies were hospitalized to monitor for any complications. Post-birth waste was collected from the babies at 2 days, 1 week, 2 weeks, 3 weeks, and 3 months. Two days after birth, the infants also had blood work done.

The investigators utilized information from global datasets along with data from the same hospital in the past. They compared the findings to those of the seven infants.

“This was not designed as a safety study, but we found it to be effective and supporting the concept of vertical transfer from mother to baby,” said Willem de Vos, PhD, an author and researcher at the University of Helsinki and in the microbiology laboratory at Wageningen University & Research in the Netherlands.

“However, it’s very important to tell people that this is not something they should try on their own. The samples have to be tested for safety and suitability,” he told Healthline.

“We found no indications for inflammation or other negative effects,” de Vos said. “All transplanted infants had an uneventful development in the 3-month follow-up period.”

The researchers did screen the mothers’ fecal samples, but only for a few known pathogens.

“The safest way to do FMT is with fully screened donor material or a synthetic community transfer. I haven’t seen a synthetic fecal microbiotic community developed yet,” Crandall noted. “I would rather see metagenomic screening of donor material.”

More research needed

Andersson says experts don’t know whether the FMT improves the immune development of the children, and if it ultimately reduces a child’s chance of developing asthma, allergies, and autoimmune diseases.

“This type of trial is now ongoing with long-term follow-up with blood sampling,” Andersson added.

In the future, the team wants to study the immune systems of babies born via cesarean delivery who receive FMTs and compare them to those who didn’t have the transplants. They want future studies to be blind and have a control group.

The team plans to publish a detailed protocol that could be used by doctors who want to employ this strategy.

“One of main questions I still feel is outstanding is how long the FMT can increase the relative abundance of bacteroides,” said Christopher Stewart, PhD, an academic career track fellow at Newcastle University in England. Bacteroides are the type of bacteria that differ between babies born via cesarean or vaginal delivery.

Even though the team showed the microbiome of infants similar to children born via vaginal delivery, Stewart says large cohort studies have shown bacteroides were higher in infants delivered vaginally over the first year to 14 months of life.

FMT alternatives

An FMT may be helpful in certain cases, but Andersson says he can foresee a synthetic formula that could work for mothers who don’t qualify for FMT.

That would include mothers with group B strep (GBS), a bacterium harmless to adults that can have serious effects in infants. Women are tested for it before birth so doctors know if they should receive antibiotics before the baby is born.

Research have shown that specific probiotics, along with being fed breast milk, may help restore an infant’s gut microbiota after cesarean delivery.

Andersson says giving a probiotic isn’t as effective as an FMT.

“Probiotics only have a very few species of organisms and typically no strain diversity. A normal human gut microbiome has hundreds of species. So the probiotics are clearly missing a lot,” Crandall added.

Experts: Skip DIY poop transfers

Stewart and Crandall hope families don’t opt to try this on their own. The report said that doing so could transfer harmful microbes.

“You really need to screen the fecal material first. Dosage is also an issue that I wouldn’t want to try and figure out on my own,” Crandall said.


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