Why would someone think about wiping vaginal fluid on a pristine newborn? The concept arose from the awareness that a person has a unique and valuable microbiome that consists of millions of bacteria that live on the skin, mouth, digestive tract and reproductive tracts. This micoflora influences many aspects of health and helps fend off dangerous infections. The beginning of one’s microbiome starts at birth. Babies born vaginally have a different microbiome than babies born by cesarean. Vaginal birth baths the baby in the bacterial flora of the vagina, whereas babies born by cesarean are first colonized by skin bacteria when held by an adult. The bacteria that live in the vagina are different than the bacteria that live on the external skin. The exact importance of being initially colonized with vaginal versus skin bacteria is only beginning to be understood, but conceptually could carry significant long term health risk variances. It has been postulated that obesity, diabetes, food allergies and asthma could all be influenced by one’s microbiome. And thus, the concept of vaginal seeding arose.
To date there is no evidence that vaginal seeding adds an actual short- or long-term health benefit to the baby. It also remains unclear if vaginal seeding with gauze soaked in the vagina can even result in the same level of colonization that spending time transiting the vagina during birth results in. There are however clear known risks associated with it and certainly not all mothers would be candidates for it, even if benefit is proven.
In addition to potentially beneficial bacteria, the vagina can harbor dangerous bacteria such as Chlamydia, Gonorrhea and Group B Strep as well as viruses such as herpes and HPV. There is a current proof of concept study, which examines the effects of vaginal seeding on the different outcomes. The results of this study will hopefully shed light on the issue. Of note, women in the study are tested for the presence of risky bacteria and viruses prior to qualifying for vaginal seeding.
In the meantime, vaginal seeding is not ready for the mainstream. Anyone outside of a clinical trial who is considering requesting it, or doing it themselves, should be well apprised of the lack of proven benefit as well as the hazard any personal risk factors their vaginal flora might carry.
Swabbing vaginal germs on our beautiful babies as soon as they are born may sound distasteful to some, but let’s recall that fecal transplants sounded distasteful, if not simply disgusting, and yet have proven tremendously valuable for certain intestinal infections for many patients. Time and research will tell us whether vaginal seeding is a leap of logic or a revelation in terms of improving the health of babies born by cesarean.
Rosanna Gray-Swain, MD, is a member of BJC Medical Group and a part of the West End OB-GYN practice. The practice is located at 1110 Highlands Plaza, Suite 280, St. Louis, MO and can be reached at 314-286-2620. Dr. Gray-Swain is accepting new patients, so BOOK today!