Fecal transplant from mother to baby compensates microbial deficiency after CS

Nowadays, parents-to-be deal a lot with the question what the birth should look like and if a Caesarean section is an option. Every now and again there are in fact medical indications that make Caesarean section necessary, but luckily, the tendency of preferring CS to natural birth just because you can, is declining. And one of the reasons for that is the higher probability of CS babies for diseases like inflammatory bowel disease, rheumatoid arthritis, celiac disease. These illnesses are probably caused by a deficient gut microbiome of these CS children. But a newly released study be the University of Helsinki shows that fecal transplant from mother to child after birth could be the solution.

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In October 2020, the “Cell” journal released the study (1). It is based on the assumption that during labor, the baby swallows small amounts of maternal feces. Until now, one method of balancing the missing microbial impact at CS babies, was the so-called vaginal swab (2). The Helsinki study assumed that not the contact to the mother’s vaginal microbiome, but rather her gut microbiome is responsible for a healthy microbial development with the new baby.

To prove this assumption, the team checked 17 women during their pregnancy for compatibility with the study. A stool sample was taken around three weeks prior to birth and screened for pathogens, such as HI-virus, norovirus, or hepatitis, but also bacteria like Clostridium difficile, Helicobacter pylori, B-streptococcus and resistant germs. The initial 17 participants were limited to 7 suitable women whose stool was not affected by any of the above-named pathogens (a surprisingly low rate, by the way). The stool sample of the remaining mothers was then prepared and diluted and was given to the new-born babies with their first (bottled) milk. In order to prevent any illness, they were monitored very closely for two days.

The microbiome reacts to the bacteria

None of the babies showed symptoms after the gavage of the diluted fecal dose and the examinations at the age of two days, four weeks and three months showed no negative results. Fecal samples of the infants were taken at the age of two days, after that weekly, and a final sample at the age of three months. The comparative group was comprised of 27 vaginally delivered children and further 18 CS children without fecal transplant. The number of screened babies might be small, but the results are strikingly clear.

The microbes of test group and vaginally born babies differed a lot at the beginning, but got more and more similar with increasing age, starting off one week after birth. It was pretty apparent that the treated CS children adapted the microbiome of the vaginally delivered children. Previous studies show that (untreated) CS-delivered babies exhibit a higher proportion of hospital germs belonging to the genuses Enterococcus and Klebsiella (3).

Hope for better health

Experts believe C-sections to be among the key factors for a proper microbiome and therefore the health of the human for his or her entire life. Many C-sections are unnecessary from a medical point of view, so a lot could be changed for the better simply by explaining the matter to parents. At the same time, with the awareness for the importance of a healthy microbiome and the great advantage of a natural birth, parents are left at a loss when outweighing birth complications with the risk of C-sections. Evaluating the pros and cons of C-section is always reasonable, and still, the option of fecal transplant might make the choice for C-section a bit easier and be a big relief for parents.

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The treatment is not ready for use, now. Further research has to be completed, the assumptions of today have to be proven, and long-term studies have to out rule health issues. This is why the scientists around the study explicitly dissuade from trying fecal transplant on one’s own. Overdosing and poisoning of the newborns have to be prevented, by any means. But still, we can be optimistic for this method to be an option for future generation of CS babies.

Links to sources:

(1) cell.com - Maternal Fecal Microbiota Transplantation in Cesarean-Born Infants ...
(2) TheScientist.com - Restoring C-Section Babies’ Microbiota
(3) TheScientist.com - C-Sections Tied to “Stunted” Microbiota in Newborns