Wednesday, September 16, 2009

Bugs and Guts

I've been wanting to post about birth and healthy guts for a while now. Years ago I read an article that had a profound impact on me. It was Jeff Leach's "C-sections, breastfeeding, and bugs for your baby." His piece changed the way I viewed the birth canal. Cesareans aren't just another way to give birth. Being born through an incision bypasses an extremely important step in the birth process--being colonized by the "base population" of the mother's vaginal and fecal microflora. Following birth, breastfeeding continues the transfer of healthy microflora (probiotics) from the mother to the infant. Jeff Leach explains:
Studies have shown that at one month of age, both breast-fed and formula-fed infants possess bifidobacterium but population densities in bottle-fed infants is one-tenth that of breast-fed infants. The presence of a healthy and robust population of bifidobacterium throughout the first year or two of life contributes significantly to the child’s resistance to infection and overall development of defense systems – not to mention the physical development of the intestinal system in general. Aside from the substances secreted by these specific bacteria that are known inhibit the growth of pathogenic bacteria, they also work to make the intestinal environment of the infant more acidic, creating an additional barrier against invading pathogens. In short, breast-fed babies are sick less, are less fussy, have fewer and shorter duration of bouts of diarrhea, and have more frequent – and softer – bowel movements. (source)
Cesareans can save lives, but they also put babies at increased risk for infections, allergies, asthma, intestinal problems, skin problems (such as eczema) and future health problems. When there is an absence of breastmilk, those potential problems can become exacerbated.

What are the best ways to ensure a healthy and strong population of gut microflora for your baby?

* Give birth vaginally.
* Keep baby and mother together immediately following birth (to prevent the colonization of harmful bacteria, especially when giving birth in the hospital).
* Breastfeed as soon as possible following birth and frequently thereafter.
* Consume probiotics (in foods or supplements) yourself during pregnancy and while breastfeeding.
* Avoid giving your infant antibiotics, if possible.
* Give birth in a location far-removed from harmful bacteria, if possible.

I was delighted (not long after giving birth to my son at home) to discover a study whose results indicated: "Term infants who were born vaginally at home and were breastfed exclusively seemed to have the most 'beneficial' gut microbiota (highest numbers of bifidobacteria and lowest numbers of C difficile and E coli)" (Penders, J, et al, Factors influencing the composition of the intestinal microbiota in early infancy). I wasn't surprised by those findings one bit. It has been informative and eye-opening to see how much impact the events following birth can have.

My first daughter was born vaginally in the hospital, lifted-up briefly for me to see following her birth, taken to the other side of the room to be weighed, poked, smeared, wrapped, and finally brought to me. We were talked into giving her formula during her first night because she wasn't latching well. We did establish a good latch with the help of the lactation consultants and some contraptions. We stayed in the hospital an extra day largely because of my perineal trauma (we spent two nights there). Of all my children, she was the most irritable/fussy. She was also the only one to experience troublesome eczema and diaper rash as well as frequent bouts of croup throughout infancy and childhood. She is also the only one of my children to exhibit a possible food allergy.

My second daughter was born vaginally in the hospital, placed immediately on my chest, breastfed exclusively following birth, and spent barely over 24 hours in the hospital. She experienced only minor diaper rashes, no eczema, has never developed croup, and rarely gets sick.

My son was born vaginally at home, placed immediately on my chest, spent his first hours at my chest and breast, and never entered a hospital. He developed a skin infection a week after birth, but recovered quickly (through oral and topical antibiotics, but I chugged probiotics to prevent thrush and other problems). I have consumed more probiotics while breastfeeding him than I ever have before. He has been my least fussy baby and has never needed diaper ointment nor developed eczema.

The more I learn, the more convinced I am that what happens during and after birth matters A LOT. Do you think you baby's postpartum gut microflora had an impact on his/her behavior or health short-term or long-term?

Related links:

Allergies, Asthma, and Eczema: Response to Disturbance of the Microbiota of the Newborn Gut

The potential for probiotics to prevent bacterial vaginosis and preterm labor

Improved appetite of pregnant rats and increased birth weight of newborns (following probiotic feeding)

Probiotics may aid postpartum weight loss

Probiotics during pregnancy, postpartum, breastfeeding, and their impact on immunity

Probiotics in infants for prevention of allergic disease and food hypersensitivity


Buscando la Luz said...

FYI: I made a few minor changes to this post since originally posted. :-)

Diana J. said...

I read that article too, and it really changed the way I thought about vaginal birth - there's a reason that the birth canal has bacteria and a reason why the baby passes through it!!! Thanks so much for bringing this issue up.

Sarah H said...

Interesting post!

Sweetpea said...

My son (the one born in a hospital after a "failed homebirth") has definitely struggled more which health issues. He has eczema, was a very fussy and needy baby, and had repeat ear infections for a while. But, he was born vaginally and breastfed exclusively. We didn't nurse until the morning after he was born, though. The eczema and ear infections showed up when he was about 4 months old, interestingly enough after we had decided to him some immunizations. I will never do that again.

Anne-Lis said...

Love it! The healthiest babies are the ones born vaginally, breatfed, and not vaccinated. We need to go back to our roots and live more naturally. The benefits are amazing!

Ginger Harvey said...

Now that you mention it, my second son never got diaper rashes until we stopped breastfeeding. He was a biter, even before teeth. So once those teeth came in and I couldn't get him to stop biting, I had to stop nursing. He was around 9 months when we switched him to formula and then he started getting these diaper rashes that were so bad that we'd have to rinse his tushie in the sink rather than use wipes.

With my first son, nursing didn't work out and he's always had some TERRIBLE eczema. My second doesn't have it.

Just a side note, my first was born much like your second, only the nurses kept trying to give him sugar water, gave him an IV in his head without even informing me first due to my quick labor and Strep B positive, he had a few vaxes before I learned enough to make me stop (he did have a small reaction to one, and then was suspected of being autistic for a while)... my second was born at home and was much like your third birth, never has had any vaxes, was breastfed, very different from the first.