27 Sep Seeding your baby with a healthy mircrobiome
By Hettie Grove – Nursing sister, advanced midwife, internationally certified childbirth educator, internationally certified lactation consultant, SA certified perinatal educator, SA certified lactation consultant curse developer and coordinator
Every person has a genome, which nothing changes, it is a complete set of genetic material that babies inherit from their mom and dad. But babies and adults also have a microbiome, which is interchangeable and that is all the bacteria, yeast and microorganisms present in and on our bodies. The gut is the starting point of a baby’s immune system. The gastro-intestinal tract is a constant changing collection of nutrients, bacteria and pathogens. It is obvious that if good bacteria reign the harmful bacteria have a much lower chance to have an influence. Bear in mind that a disruption in balance may lead to illness. Very important is the fact that the first influences or microbes to colonise your baby’s gut will be the starting point of the trajectory of your little angel’s immune system for the rest of his life.
Your baby’s community of gut microbes is unique and the groundwork is laid during pregnancy and birth. The thought is that the baby inherits the microbiome from the mother and we need to remember that what we do is going to influence not only our children but also our grandchildren. Your body is busy transferring an entire bacterial community to that little baby that is so snug in your uterus right now.
This is an ever increasing community and is influenced through the placenta, expanded when the amniotic sac ruptures and your waters broke in labour or before, expands again as it moves through the birth canal, expands again when the baby is in skin-to-skin contact on your chest and increases further through breastfeeding. The cycle doesn’t stop there but even in the first week as you hold your baby you will seed baby with a bacterial microbiome and lay the foundation forever.
As a mother you pass your bacterial communities to your baby. Numerous studies provide us with information that a mother with a healthy microbiome has less chance of a host of conditions. Unfortunately some of the things we can’t change but we have an awesome opportunity to change some of them. The microbiome is a relatively new concept yet we already know so much that we can actually make a large difference.
A few tips for expectant mothers to be able to make this difference
- Oral health
Your placental microbiome resembles the oral microbiome. Your mouth has a multitude of bacteria and research has indicated that mothers who have problems with their mouth and teeth may have an increased chance of preterm birth. The reason is that the unhealthy bacteria in the mouth are transferred via the bloodstream to the placenta. By taking care of your teeth brushing, flossing, seeing your dentist as well as using a mouth rinse you not only decrease your chances of preterm birth but you also care for the placenta
- Watch what you are eating
We are what we eat, even more so in pregnancy. Your baby is what you eat and guess what you and only you have control over that. We used to think that the baby had a sterile gastro-intestinal tract, but more and more studies show that baby already has some gut bacteria, and they think it’s from the mother’s digestive system. Be sure you try and keep it “clean and green” without processed and unrefined foods and you may influence your baby and his gut as well
- Try and avoid antibiotics as much as you can
Always outweigh the benefit versus the risk. Viruses don’t benefit from antibiotics and yet sometimes you need to take them. Make sure if you need antibiotics you take some probiotics as well
- Stop smoking and avoid second-hand smoke
Stopping smoking improves a better microbiome and a myriad of other health reasons as well
- Ask your healthcare worker to evaluate you for bacterial vaginosis
Bacterial vaginosis is a common vaginal infection that disturbs the normal flora of the vagina resulting in an increase of bad bacteria. Symptoms are usually an increased discharge and a “fishy” smell
- Decrease stress
Stress hormones usually decrease your body’s ability to have a healthy microbiome so consider some relaxation techniques, deep breathing and take some ME time
- Avoid douching
Douching disturbs the vaginal flora and the microbiome and has been linked to low birthweight, preterm birth and infections of the sac around the baby. It also increases the risk of transmission of sexually transmitted disease and HIV
- Consider your birthplace
Homebirth may result in avoiding the hospital bacteria and a more favourable microbiome profile for your baby
- Push for a normal birth
Emerging research shows that bacteria are absolutely vital for human health, and imbalances in the human microbiome significantly contribute to chronic non-transmissible diseases, as the baby moves through the birth canal he is exposed to all sorts of bacteria, because of this the baby is colonised with all the healthy bacterial species of the vaginal microbiome.
Toni Harman wrote “Two amazing events happen during childbirth. There’s the obvious main event which is the emergence of a new human into the world. But then there’s the non-human event that is taking place simultaneously, a crucial event that is not visible to the naked eye, an event that could determine the lifelong health of the baby. This is the seeding of the baby’s microbiome.
However, with interventions like use of synthetic oxytocin (Pitocin / Syntocinon), antibiotics, C-section and formula feeding, this microbial transfer from the mother to baby is interfered with or bypassed completely.”
“Communities of vaginal microbes change during pregnancy in preparation for birth, delivering beneficial microbes to the newborn. At the time of delivery, the vagina is dominated by a pair of bacterial species, Lactobacillus and Prevotella.
In contrast, infants delivered by caesarean section typically show microbial communities associated with the skin, including Staphylococcus, Corynebacterium, and Propionibacterium.
While the full implications of these distinctions are still murky, evidence suggests they may affect an infant’s subsequent development and health, particularly in terms of susceptibility to pathogens.”
Differences in bacterial colonisation are now being blamed for why caesar babies are at increased risk for asthma and obesity. An unplanned caesar after normal labouring may help the microbiome by some of these healthy bacteria still being transmitted.
Dr Hannah Dahlen, associate professor of midwifery at the University of Western Sydney, explains: “A baby born vaginally is exposed to about 300 different bacteria as it comes down the birth canal. These bacteria set up the child’s microbiome, which is what enables their body to defend against all kinds of diseases. Obviously, when a baby is born by C-section, they aren’t exposed to these bacteria and their immune system isn’t as strong as a result. We believe this is part of the reason why children born via C-section have an increased risk of autoimmune diseases.”
- In the event of a caesar be pro-active
We call this the “icky-Factor” very new to South Africa. Some believe it will become a standard recommendation in future. Here goes: if you are going to have a caesar because this is the way you want to or need to birth your baby, consider taking a vaginal swab of your vagina or even a piece of gauze, keep it in a sterile container and after the birth rub these secretions/good bacteria on your baby’s skin, mouth and hands. Sounds a bit “icky” but when the baby moves through the birth canal that is exactly what happens. They are then coated with the secretions and bacteria so what you are now doing is mimicking that exposure. Ask your healthcare worker to help you or do it yourself if you are comfortable.
- Lots of skin to skin as soon as possible, as long as possible
Skin to skin soothes and it transfers all your healthy bacteria on the baby, some sources even state take your own towel to dry the baby after you have put him in the skin-to-skin position or cover both of you with it. Remember skin-to-skin soothes and while the baby is left in this position the nine instinctive stages proceeds and with his little hands he actually leaves little trails of amniotic fluid on your body which will help him to get to the breast easier.
- Postpone the first bath for at least 24 hours
Although this might be the latest protocol in some hospitals ask for it. The rationale for not bathing the baby is actually to establish this healthy microbiome and allow the vernix which is awesome for the baby’s skin to be absorbed. Definitely delay the bath till after the first efficient latch and breastfeeding session. This is easier if you communicate it with your birth team so that no misunderstandings happen.
- Skin to skin with the father
If the mother can’t do skin-to-skin let the father do it. Familiarity soothes and the baby knows his father’s voice and baby will not experience separation distress.
- Breastfeed your baby
Breast milk is high in all the beneficial bacteria but also contains a certain oligosaccharide to support the growth of these bacteria. It’s better to give the baby the colostrum and breast milk even if it’s just for a while although breastfeeding is dose relevant – the more you feed, the lesser the risks of artificial feeds for your baby.