In our country, about a fifth of children are born by caesarean section. An operation is performed only in cases when natural childbirth is impossible, or they are very dangerous for the mother and / or for the child. That is, a caesarean section is performed to save. Scientists have long realized that Caesarean children have features of health, development, and even the psyche. Studies of how the method of delivery affects a child are still ongoing. In this article we will talk about the microbiome of children born by caesarean section. How does it affect human health?
How is the fetus colonized by microflora after natural birth?
The health of a newborn baby and its subsequent development depend on a variety of factors. Far from not the least importance is the way in which its gastrointestinal tract will be colonized by microbes. In another way, this process can be called the formation of a microbiome.
The correct and timely formation of the digestive tract biocenosis is the key to the health of the child. The biocenosis of the skin and mucous membranes in contact with the environment also affects the health of the child. I wonder what significance the method of delivery plays in this matter?
When born naturally, the child first encounters those microbes that live in the genital tract of the mother. It is these microbes that will play a primary role in the formation of the microbiome of the intestine of a newborn baby. The composition of the microbiome of the genital tract of the mother directly depends on the microflora of her intestines.
After passing the birth canal, a baby born in a satisfactory condition is laid out on the mother’s stomach. In modern maternity hospitals, two-hour skin contact of the mother and child is practiced. At the same time, his skin and mucous membranes begin to be populated by those microbes that live on the skin of his mother. The first skin contact is very important.
What other significant events take place shortly after natural birth? The baby is first applied to the mother’s breast. It is important that the first feeding takes place in the first 30-60 minutes of life. Drops of colostrum are very valuable for the health of the newborn baby. Exceptionally breastfeeding a newborn baby favorably affects the colonization of the baby’s intestines with the “right” microbes.
What are the features of the formation of the microbiome of Caesarean children
It would seem, what’s the difference, in what way was the baby born? Is it true that the microbiome depends on how a child was born? What are the features of cesarean section?
A child born operatively does not pass through the vagina, therefore, the process of colonizing his skin and mucous membranes with the flora of the birth canal of the mother does not occur. He does not put his mother on the stomach, does not lie with her in the delivery room for 2 hours, often there is no early skin contact. The very first microbes that he encounters are the hospital flora. Diapers, tools, hands of the staff – this is what first touches the baby.
How is a baby Caesaren fed for the first time? In some hospitals (but by no means in all), the practice of putting a child to the chest directly in the operating room. Such children were lucky, because they were able to get drops of mother’s colostrum in the first minutes after birth. But not all children stick to their breasts immediately after cesarean section; it’s not always possible to pump out at least a drop of colostrum from my mother’s breast. Yes, and feeding in the operating room itself is not long in time.
Most children born by Caesarean section are fed with milk formula in 1-2 days. This also does not have the best effect on the formation of intestinal microflora.
Even the formation of the intestinal biocenosis of a newborn baby is affected by the intake of antibiotics by the mother. It is proved that after surgical labor women receive antibiotics more often than after vaginal labor.
It was found that in children born operatively, at a later date, the intestines are colonized by bifidobacteria, lactobacilli, and bacteroids. In addition, the intestines of Caesarean babies are intensely populated by opportunistic microbes, which include Staphylococcus aureus, Klebsiella, Clostridia, and Candida mushrooms. They live in the intestines of every adult and child, but their increased reproduction with a lack of representatives of the normal intestinal flora leads to an imbalance in the immune response.
Is Caesarean Allergy and Autoimmune Disease Higher?
Due to the incorrect formation of intestinal microbiocenosis, the child’s adaptation to extrauterine life is disrupted, he becomes more vulnerable to the effects of adverse environmental factors. Caesarean children have a higher predisposition to the development of purulent-septic diseases and infectious bowel diseases compared to children born naturally.
Some modern studies suggest that children born into the world by caesarean section have a higher risk of developing allergic and autoimmune diseases, with a predisposition to them being detected already in the first year of life. Researchers attribute this phenomenon to the impaired formation of biocenoses of the intestines, skin and upper respiratory tract of Caesarean babies in their first year of life.
Of course, a variety of factors play a role in the formation of allergic rhinitis, bronchial asthma, diabetes mellitus, and other serious chronic diseases, and it is unlikely that birth to be given promptly will play a key role in this, but parents should not forget about this additional risk factor nor to doctors.
It was noted that iron deficiency anemia is more often detected in Caesars, which is possibly due to dietary restrictions due to allergies, as well as due to more frequent inflammatory and infectious bowel diseases. Data were obtained regarding the fact that in Caesarean children in adolescence, metabolic disturbances and problems with overweight are more often noted.
Research is continuing on a relatively higher incidence of respiratory diseases in the first year of life in children born operatively. At the moment, there is no clear relationship between the frequency of acute respiratory viral infections in babies and their way of birth, although some studies talk about this.
What can these studies give us?
And why do we need to know all this? Can we really give up cesarean section, knowing that the method of delivery affects the formation of the microbiome of the child in different ways? Of course not. This operation is carried out in salvation, without it in the modern world just can not do.
However, it is important to understand how physiological the natural birth is. Some indications for caesarean section require a review and a more stringent approach. Not so long ago, women with a scar on the uterus of the second and subsequent children gave birth only by surgery. Now, more and more often, women give birth to a child in a natural way, despite the fact that previous births were operative. Perhaps in a few years other relative indications for the operation will be revised.
It is necessary to make every effort to reduce the risk of malformation of the intestinal microbiome: apply the baby to the breast in the operating room, be sure to breast-feed the baby on the first day after the operative birth, use supplementary milk formula only if necessary, and learn how to express mothers (for faster formation of lactation).
In the first year of life, it is necessary to carefully monitor the health of the child, try to keep breastfeeding as much as possible, and minimize other risk factors for autoimmune and allergic diseases.