Monday, June 28, 2010

Cesareans and baby immunity

You may have read about a new study that investigated the different types of bacteria found in the mouths of babies born by cesarean and vaginal delivery. I'm not going to write too much about it here, as I blogged about a similar subject earlier this year (infection and asthma), but also because I think there is a very useful website that summarizes the details very well without the need for me repeating them here.

"NHS Choices" begins:

"Children born by caesarean section are more likely to have allergies, such as asthma, because they pick up less “natural immunity” from their mother, The Daily Telegraph reported.

The story is based on a small laboratory study which investigated whether the mode of delivery affected the type of bacteria found on 10 newborn babies. Babies born by normal vaginal delivery were found to have types of bacteria that mainly resembled those found in their mothers’ vagina, while those delivered by caesarean had microbes normally found on the skin surface.

This study provides a useful contribution to our knowledge of the possible effects on babies of having a caesarean rather than vaginal delivery. However, on its own, the study is too small to offer any conclusions about the exposure of newborns to particular types of bacteria at birth, and has no implications for the long-term health of babies delivered by caesarian. Another drawback is that it did not look at any other possible differences between the mothers or their babies that may have contributed to the differences in types of bacteria, such as the use of antibiotics. As the researchers say, longer-term, larger studies are needed."

The only thing that I would add is this.

Even IF studies in the future turn out to be conclusive in establishing a link between cesarean delivery and infection and /or asthma - and even IF that link is established with maternal request cesareans at 39+ weeks' gestation too (i.e. not a link with ALL cesareans including babies born in emergency conditions or prematurely due to medical issues during pregnancy), as an expectant mother, I would still weigh this risk against other (albeit small) risks to babies that are associated with a planned vaginal delivery (e.g. stillbirth, asphyxia, shoulder dystocia), and I would personally, still choose to have a cesarean delivery.

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