What Is Vaginal Seeding?

Introduction

Vaginal seeding is an increasingly popular and controversial practice, also known as microbirthing or microbial seeding. It involves exposing a newborn baby, typically delivered via cesarean section (C-section), to the birthing parent's vaginal fluids, such as vaginal secretions or a swab from the parent's vagina.^1,2 This is done to transfer beneficial bacteria from the mother's birth canal to the infant's skin, mouth, and sometimes even the digestive system. The goal is to help establish a more diverse and potentially healthier microbiome in the infant, similar to that of babies born vaginally. The safety of vaginal seeding depends on various factors, including the parent's health, the presence of potential pathogens (organisms that cause disease), and the specific circumstances of the procedure.² Parents who are considering vaginal seeding should discuss with their healthcare providers to understand the potential risks and benefits to make informed decisions about their newborn's health. It's crucial to prioritise safety and consult with medical experts to ensure the well-being of both the mother and the baby.

The vaginal microbiome

The vaginal microbiome is a complex and dynamic microecosystem that changes throughout a person's life.^1,2 It refers to the community of microorganisms living in a habitat, in this case the vagina. The microorganisms in the microbiome are called the microbiota. Lactobacillus is an antimicrobial bacterium, which means that it can protect against some diseases like a natural antibiotic. It has great importance in a healthy vaginal microbiome.³ Bacterial species in the vaginal microbiome also have an important role in regulating the gestation time and delivery outcomes in assigned females at birth (AFAB) of reproductive age. The presence of the Lactobacillus crispatus species in the vaginal environment lowers the risk of preterm birth.³ The mother's microbiome changes throughout pregnancy and is connected to the newborn's microbiota.⁴ 

Definition of vaginal seeding

The concept of "vaginal seeding" refers to the use of a gauze swab to transfer the mother's vaginal fluid, and hence vaginal microbiota, to a cesarean-birth child. The manner of delivery has a significant impact on the makeup of a newborn’s early microbiome. The microbiota of babies delivered by cesarean section mimics that of the parent's skin, whereas that of vaginally-born infants is like that of the maternal vagina.¹ Appropriate newborn gut microbiota formation aids early immunological development. It may help minimise the risk of some health disorders later in life, such as obesity and asthma.²

Arguments for vaginal seeding

Some may argue that vaginal seeding can have a positive impact on the infant's microbiome. Exposing the newborn to the parent's vaginal fluids during birth mimics the natural process of microbial colonisation, which might help establish a diverse and robust microbiome. Research has suggested that a balanced microbiome can play a crucial role in the development of the infant's immune system, aiding in the prevention of conditions such as allergies and autoimmune diseases.⁵

Vaginal seeding may reduce the risk of specific health issues in newborns. By introducing maternal bacteria, the infant's gut microbiota may be more balanced, potentially offering protection against conditions like asthma, eczema, and obesity. While scientific evidence supporting these claims is limited and inconclusive, the possibility of mitigating certain health risks is an appealing prospect for parents who opt for vaginal seeding.⁵

For some parents, vaginal seeding can have emotional and psychological significance. It allows them to feel more connected to the birthing process, even when a cesarean section is necessary, and can help reduce feelings of detachment or disappointment. This emotional connection to the birth experience can be a crucial aspect of the bonding process between parent and child, contributing to maternal well-being and postpartum mental health.⁵

Arguments against vaginal seeding

Vaginal seeding has sparked significant controversy and interest within the medical and parenting communities in recent years.  

This procedure has not been widely adopted by the medical community due to concerns about potential risks, primarily the transmission of harmful pathogens, such as group B Streptococcus or herpes, to the newborn. The practice is not supported by robust scientific evidence, and health authorities, like the College of Obstetricians and Gynecologists, have issued statements cautioning against it. Vaginal seeding raises complex ethical, legal, and medical questions, as it lies at the intersection of parental autonomy, informed consent, and best medical practices.⁴

The controversy surrounding vaginal seeding illustrates the broader ongoing debate about the human microbiome's role in health and disease, as well as the desire of some parents to seek alternatives to standard medical practices. While researchers continue to explore the potential benefits of this procedure, it remains a contentious topic, and individuals considering it should consult with healthcare professionals to make informed decisions about their newborn's health.

Alternatives to vaginal seeding

Several alternatives to vaginal seeding can support a newborn's microbiome and overall health. Breastfeeding provides beneficial bacteria and vital nutrients, while skin-to-skin contact fosters emotional bonding and microbiome development. Probiotic supplements, when approved by a healthcare provider, can be beneficial.^2,3 Delayed cord clamping encourages the transfer of essential stem cells. Maintaining the parent's health during pregnancy through diet, exercise, and judicious antibiotic use can positively influence the infant's microbiota. Additionally, when possible, opting for a vaginal birth over a cesarean section helps ensure natural microbial exposure. These alternatives offer options for parents to make informed choices in promoting their child's well-being.³

Conclusion

Vaginal Seeding is a controversial and complex practice with both proponents and sceptics. It has stirred significant interest due to the potential benefits it might offer in terms of enhancing the infant's microbiome and reducing the risk of certain health issues. Establishing a connection between the newborn and the parents's microbiota, especially when a cesarean section is involved, is appealing to many parents.

However, the safety and efficacy of vaginal seeding remain uncertain. The risk of transmitting harmful pathogens from the parent to the infant is a considerable concern, and the lack of standardised protocols and scientific research complicates the decision-making process. Healthcare professionals often advise against vaginal seeding due to these concerns, advocating instead for rigorous infection control measures and breastfeeding as more established methods to support a healthy microbiome.

Ultimately, the decision to pursue vaginal seeding should be made carefully and in consultation with medical experts. The practice raises ethical, legal, and medical questions that need to be addressed in the context of parental autonomy and informed consent. As research in this field continues, parents need to prioritise the safety and well-being of their children and consider the best available medical guidance while making informed choices regarding vaginal seeding.