Microbiome formation at birth
Until recently we have not paid too much importance to our gut. But there is now research coming out with a new paper being published every 6 hours around the world with how important the gut and the microbes are to particularly our long term health.
What is the gut to a baby – milk goes in at the top and poo comes out at the bottom. The gut is now known to be the most important part of our immune system. We are full of microbes. In fact we have approximately 1,5kg of microbes in our body. We are full of microbes – there are trillions in our intestines, different ones on our skin, in our mouth, nose etc. Each area of our body has a unique pattern of microbes. There are thousands of different species of bacteria. If we took a swab from say our computer keyboard and cultured it we would have a unique “fingerprint” of microbes. Each individual is unique. People in the same family would have similarities.
Medical conditions associated with specific patterns of gut microbes include diseases such as – asthma, allergies, cancer, autism, dental caries, depression and anxiety, diabetes, ischaemic heart disease, necrotising enterocolitis, obesity, rheumatoid arthritis, sepsis, stroke….. In fact we have 10 times as many bacterial cells as human cells. We carry 150 times as many bacterial genes as human genes. So how does a new baby acquire these essential cells and genes for a healthy being?
Through the birthing process, the new baby is colonised with first colonisers from its first environment. This means different things for different babies. A baby that is born vaginally is exposed to its mom’s vaginal microbes during labour as it is passing through the vagina. The vaginal secretions coat the baby as it is born and these good vaginal microbes enter its mouth, cover its body and are on its fingers. As it is born it passes very close to the mom’s anus where often during labour she has passed a small bit of poo. Baby comes into contact with her intestinal microbes this way. As baby is put on the mom’s chest skin to skin – baby explores his new environment of the mom using the most sensitive part of it – its mouth – licking the mom’s chest, licking the nipple and picking up the microbes from moms skin. Baby then latches on to the nipple and suckles breast milk which has microbes of its own that joins the other first colonisers lining this baby’s gut – in this case giving the baby a healthy microbiome and setting it on a healthy path for life.
For other babies – those born via caesarean – they will have different first colonisers – baby comes through a sterile environment, touched first by latex gloves, placed in a hospital towel. So this baby would be colonised by hospital organisms leading to an unhealthy microbiome at birth and setting the baby up for susceptibility to chronic diseases at birth, purely because of what baby is initially exposed to at birth!
Babies have different microbiota and totally different gut microbes because of the way they are fed – either breast milk or formula. To the extent that babies are 26% more likely to be obese if they were born by caesarean than vaginally.
So is there anything we can do about a baby that is born via caesarean – how can we maximise their exposure to a healthy microbiome? A swab can be placed into the mom’s vagina before the caesar so vaginal secretions can be placed on the baby at birth. A mom can wear a towel from home before the caesar and the good microbes from mom’s skin will coat the towel and ask for the baby to be put on this towel instead of a hospital one first. Baby can be given a good probiotic immediately at birth. These steps will certainly help create a healthier microbiome, but they won’t be as good as a baby that is born vaginally and then exclusively breastfed. Place baby skin to skin as soon as possible in theatre during the caesar.