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Home Birth: Good for Baby’s Microbiome?

Planned home birth, where your baby is born at home often with a certified nurse midwife or a certified professional midwife attending, might be a great option for you if you’re experiencing a low risk pregnancy. And according to a 2018 study, there may be benefits for baby’s gut microbiome to being born at home. [1] Read on to learn more about the microbiome and what the research says about home births and happy guy microbes.

What is the microbiome? 

A microbiome is an community of microorganisms that live in the same place. When scientists and care providers talk about the gut microbiome, they’re referring to the community of mostly helpful bacteria that live in the intestines. These microbes receive protection living inside the intestines and help the human host develop their immune system and protect against infections. When the community of microbes becomes unbalanced with too many of certain species of bacteria and not enough of another, this state can cause problems with digestion and elimination, as well as contributing to the development of gut-related diseases and disorders.

How and when does the microbiome develop?

There’s some scientific evidence that the gut microbiome starts developing while the baby is growing inside the uterus, and then it’s thought that the microbiome takes off after exposure to microbes during birth—either in the vagina or on the skin during cesarean delivery. [2] Babies who are born surgically have been shown to have a different community of gut bacteria than those vaginally, which has led to the rise of vaginal seeding, in which fluids and bacteria from the vagina are wiped over the newborn’s face after birth. It isn’t yet clear whether or not vaginal seeding actually improves babies’ health, and more research is needed.

After birth, transmission of microbes from mother to infant happens for months. When researchers traced 25 mother-baby pairs for the first four months after birth, they found that microbes from the mother’s mouth, skin, breastmilk, and gut microbiome all play a role in helping the infant develop their own microbiome. [3]

What does home birth have to do with it? 

It’s also been shown that the environment can have an impact on the development of the microbiome. In a study published in 2018, midwife Joan Combellick and an international group of colleagues followed 10 babies born at home and 10 born in the hospital. [1] All the babies were born vaginally, meaning that they all received a similar exposure to their mothers’ microbes during birth, and none of the mothers or babies received antibiotics, which could artificially disrupt the development of the babies’ microbiomes.

The researchers collected stool samples from both the mothers and the babies and also swabbed the mothers’ vaginas on the day of birth and then on days 1, 2, 7, 14, 21, and 28. When the researchers compared the vaginal microbiomes of the two groups of birthing people, they found that those who birthed at home had more diverse microbial communities than the people birthing in the hospital. And when the babies were four weeks old, those born in the hospital had fewer beneficial microbes than the babies born at home.

As Combellick writes in a commentary published in The Conversation after the publication of the study, the results she and her team found are consistent with an earlier study that also showed that full-term babies born at home who were breastfed also had a beneficial community of microbes. [4, 5] In her commentary, Combellick emphasizes that it’s important to do more research to figure out what about the hospital means that babies end up with fewer beneficial microbes, so that hospitals can change their policies to benefit their littlest patients and their microbiomes.

  1. Combellick, Joan L et al. “Differences in the fecal microbiota of neonates born at home or in the hospital.” Scientific Reports. doi:10.1038/s41598-018-33995-7
  2. Moore, Rebecca E, and Steven D Townsend. “Temporal development of the infant gut microbiome.” Open Biology. 2019. doi:10.1098/rsob.190128
  3. Ferretti, Pamela et al. “Mother-to-Infant Microbial Transmission from Different Body Sites Shapes the Developing Infant Gut Microbiome.” Cell Host & Microbe. 2018. doi:10.1016/j.chom.2018.06.005
  4. Combellick, Joan. “Home birth may start babies off with health-promoting microbes.” The Conversation.
  5. Penders, John et al. “Factors influencing the composition of the intestinal microbiota in early infancy.” Pediatrics. 2006. doi:10.1542/peds.2005-2824
Abby Olena
Dr. Abby Olena has a PhD in Biological Sciences from Vanderbilt University. She lives with her husband and children in North Carolina, where she writes about science and parenting, produces a conversational podcast, and teaches prenatal yoga.

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