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Microbial Colonization of Newborn Skin and Gut


Easy Steps to a Safer Pregnancy - View e-book or Download PDF - FREE!
An interactive resource for moms on easy steps they can take to reduce exposure to chemical toxins during pregnancy.

Other excellent resources about avoiding toxins during pregnancy

These are easy to read and understand and are beautifully presented.


Subsections on this page:



Podcasts



Secrets of Baby Guts from Science Friday Podcast, w/Dr Chana Palmer, Program Director, Canary Foundation, San Jose, CA



Resources



NEW AND NOTABLE!!! - Honestly, I find this one hard to believe, but . . .

New Research in Babies Microbiomes - Babies May Not Be Born Sterile But With Their Own Bacteria! - Evidence is now showing that babies are born with the bacteria that colonise the mother’s digestive system in the womb. Originally the first bacterial flora to colonise an infant was thought to be obtained by the mother’s vagina or the environment the infant was born into.



The Healthy Birth: Dyad or Triad? Exploring Birth and the Microbiome [4/28/15] - Healthy Birth & the Microbiome - A hot topic of recent years is the importance of mode of birth on the baby's microbiome, the ecology of microorganisms that inhabits and has powerful effects on us for good or ill.

The infant gut microbiome: New studies on its origins and how it's knocked out of balance
[5/13/15] - Babies born via C-section had gut bacteria that showed significantly less resemblance to their mothers compared to those that were delivered vaginally.


The Healthy Birth: Dyad or Triad? Exploring Birth and the Microbiome [4/28/15] by Sharon Muza



Research: Could Birth-Canal Bacteria Help C-Section Babies? [6/25/14] - researchers have begun to experiment with . . . collecting birth-canal bacteria and wiping them onto babies after birth.



How Breast Milk Engineers a Baby’s Gut (and Gut Microbes) Feb., 2014 by Ed Yong

Right from birth, babies are colonised by legions of microbes that set up shop in their guts, skin, and more. These are vital. They help the growing human to digest its food, and to keep harmful microbes away. They are so important that newborns temporarily suppress their own immune system to give their microbial partners a chance to establish themselves.

Lisa Funkhouser and Seth Bordenstein have speculated that the lymphatic system conveys bacteria from a mother’s guts into her mammary glands, where they can be taken up by suckling infants.


The assembly of an infant gut microbiome framed against healthy human adults by Antonio González [9/25/12] -  Here we present how a new born human gut microbial community develops from resembling the delivery method (vaginal) to look like, after almost 3 years of life, the one of an adult. This trajectory is created from the data published by Koenig JE et al. 2011 framed around the data generated by the Human Microbiome Project (HMP).


In a normal, healthy birth, a baby is born sterile.  Nature intended that the baby pick up normal skin bacteria from the mother, since the mother and baby both typically will already have immunity to those germs, or they will be benign germs.  If the baby is colonized with germs from other non-family members or from non-family household items, such as sheets or blankets, problems could result.  As Michel Odent, MD, says, "The first germs on the baby's skin will rule the kingdom."


Many of the probiotics that are especially helpful to newborns have lost their usefulness to adults, so it's especially easy for them to be wiped out by a course or two of antibiotics. If this happens, the mom doesn't have them to pass along to the baby, which is how problems can arise.

A couple of weeks ago, I was looking in the refrigerated supplements section at Whole Foods, and they had two new probiotics formulas "for babies", but I assume they would be helpful to a pregnant woman to help colonize her gut with these newborn-supportive probiotics.

Does anyone have specialized knowledge about what and when would be especially helpful for a pregnant woman to take during pregnancy to support her newborn at birth?


Babies' bacteria depend on type of delivery - The way babies are delivered exposes them to different bacteria that could affect their future health, a study finds. Vaginal births appear more advantageous than C-sections [6/25/10] By Jessie Schiewe, Los Angeles Times


Microbes Colonize a Baby’s Gut with Distinction


Of microbes and men - Bacteria disappearing from our bodies may harm human health [Boston Globe, 2/25/08]



Pregnancy Changes Mom's Gut Bacteria
-  [Scientific American, 8/15/12] - Pregnant women's microbial makeup changed dramatically between the first and third trimesters.


Host Remodeling of the Gut Microbiome and Metabolic Changes during Pregnancy.
Koren O, Goodrich JK, Cullender TC, Spor A, Laitinen K, Kling Bäckhed H, Gonzalez A, Werner JJ, Angenent LT, Knight R, Bäckhed F, Isolauri E, Salminen S, Ley RE.
Cell. 2012 Aug 3;150(3):470-80.

Many of the immune and metabolic changes occurring during normal pregnancy also describe metabolic syndrome. Gut microbiota can cause symptoms of metabolic syndrome in nonpregnant hosts. Here, to explore their role in pregnancy, we characterized fecal bacteria of 91 pregnant women of varying prepregnancy BMIs and gestational diabetes status and their infants. Similarities between infant-mother microbiotas increased with children's age, and the infant microbiota was unaffected by mother's health status. Gut microbiota changed dramatically from first (T1) to third (T3) trimesters, with vast expansion of diversity between mothers, an overall increase in Proteobacteria and Actinobacteria, and reduced richness. T3 stool showed strongest signs of inflammation and energy loss; however, microbiome gene repertoires were constant between trimesters. When transferred to germ-free mice, T3 microbiota induced greater adiposity and insulin insensitivity compared to T1. Our findings indicate that host-microbial interactions that impact host metabolism can occur and may be beneficial in pregnancy.

Highlights

► The composition of the gut microbiota changes dramatically during pregnancy
► Third trimester stool is associated with greater inflammation and energy content
► Third trimester microbiota induce pregnancy-like metabolism in germ-free mice
► Gut microbiota impacts metabolism in pregnancy similarly to metabolic syndrome



Baby’s First Bacteria Depend on Birth Route - C-section newborns may harbor fewer helpful microbes than infants born vaginally [6/22/10]


Why We Develop Food Allergies - Author Per Brandtzaeg explains how oral tolerance is established in the first months of life and the factors that influence this process, including the role of breastfeeding and the advantage of vaginal delivery for inoculating babies with healthy bacteria.


Recovery of potential pathogens and interfering bacteria in the nasopharynx of otitis media-prone children and their smoking and nonsmoking parents.
Brook I, Gober AE.
Arch Otolaryngol Head Neck Surg. 2005 Jun;131(6):509-12.

CONCLUSIONS: A high recovery rate of potential pathogens and a low number of interfering organisms were observed in OMP children.


Earache-prone kids tend to carry more bacteria - [6/20/05, Reuters] - Children who suffer frequent ear infections -- otitis media -- often harbor high numbers of the bacteria that cause the infections, and a low number of organisms that inhibit growth of the disease-causing bugs, a small study indicates.

Drs. Brook and Gober conclude that otitis-media-prone children exhibit "a high recovery rate of potential pathogens and a low number of interfering organisms."  They comment that "therapeutic colonization" of the nose and throat of parents with harmless interfering organisms might be worth looking into, as way of reducing the number of disease-causing bacteria and thereby the number of ear infections in their children.



Skin Flora



See also: Bathing Baby
See also: Umbilical Cord Care


Typically, babies are sterile until they come into contact with the extrauterine world, i.e. beyond the cervix.

Sometimes babies are born with some blood or mucous in their hair or in a few spots, and some parents may choose to do some spot washing.  If there is white, creamy vernix on the baby's skin, this can be rubbed in or left to be absorbed, as it will protect the baby's skin.

The reason that hospital personnel are so eager to bathe newborns is that the baby is assumed to be a source of germs in the same way that the birth canal is a source of germs.  They are concerned that they might be exposed to some of these germs if the baby isn't thoroughly scrubbed with disinfectants shortly after birth. However, they can easily wear gloves to handle the baby, and this actually protects the baby from *their* germs.  So it's very reasonable to decline the ritual bathing of the newborn.  Hospital personnel then may put a note on your baby's bassinet to remind them to wear gloves when handling your baby; just watch them to make sure that they *change* their gloves before handling your newborn so they don't contaminate your baby with germs from other babies or the hospital environment.


Does bathing newborns remove potentially harmful pathogens from the skin?
Medves JM, O'Brien B.
Birth. 2001 Sep;28(3):161-5.

"The findings did not support the efficacy of bathing with soap and water to reduce skin colonization of bacterial pathogens"



Gut Flora



In Dec., 2010, one of my supplements sources (Metagenics) had a little note that B. infantis strain has recently been reclassified as B. lactis.  I think they may be wrong.

The best information I can find about this is a Sept., 2010, abstract.  This seems to say that B. infantis and B. longum are both subspecies of B. longum and that B. lactis is a subspecies of B. animalis.

Genomic insights into bifidobacteria.
Lee JH, O'Sullivan DJ.
Microbiol Mol Biol Rev. 2010 Sep;74(3):378-416.

Since the discovery in 1899 of bifidobacteria as numerically dominant microbes in the feces of breast-fed infants, there have been numerous studies addressing their role in modulating gut microflora as well as their other potential health benefits. Because of this, they are frequently incorporated into foods as probiotic cultures. An understanding of their full interactions with intestinal microbes and the host is needed to scientifically validate any health benefits they may afford. Recently, the genome sequences of nine strains representing four species of Bifidobacterium became available. A comparative genome analysis of these genomes reveals a likely efficient capacity to adapt to their habitats, with B. longum subsp. infantis exhibiting more genomic potential to utilize human milk oligosaccharides, consistent with its habitat in the infant gut. Conversely, B. longum subsp. longum exhibits a higher genomic potential for utilization of plant-derived complex carbohydrates and polyols, consistent with its habitat in an adult gut. An intriguing observation is the loss of much of this genome potential when strains are adapted to pure culture environments, as highlighted by the genomes of B. animalis subsp. lactis strains, which exhibit the least potential for a gut habitat and are believed to have evolved from the B. animalis species during adaptation to dairy fermentation environments.

This is confirmed by a bit from Wikipedia on the new name for b. infantis

In 2002, three previously distinct species of Bifidobacterium, B. infantis, B. longum, and B. suis, were unified into a single species named B. longum with the biotypes infantis, longum, and suis respectively.[6] This occurred as the three species had extensive DNA similarity including a 16s rRNA gene sequence similarity greater than 97%.[7] In addition, the three original species were phenotypically difficult to distinguish due to different carbohydrate fermentation patterns among strains of the same species.[1] As probiotic activity varies among strains of B. longum, there exists an interest in the exact classification of new strains, although this is made difficult by the high gene similarity between the three biotypes.[8] Currently, strain identification is done through polymerase chain reaction (PCR) on the subtly different 16s rRNA gene sequences.[8]


The effects of selected probiotic strains on the development of eczema (the PandA study).
Niers L, Martín R, Rijkers G, Sengers F, Timmerman H, van Uden N, Smidt H, Kimpen J, Hoekstra M.
Allergy. 2009 Sep;64(9):1349-58

METHODS: In a double-blind, randomized, placebo-controlled trial, a mixture of probiotic bacteria selected by in-vitro experiments (Bifidobacterium bifidum, Bifidobacterium lactis, and Lactococcus lactis; Ecologic Panda) was prenatally administered to mothers of high-risk children (i.e. positive family history of allergic disease) and to their offspring for the first 12 months of life. RESULTS: Parental-reported eczema during the first 3 months of life was significantly lower in the intervention group compared with placebo, 6/50 vs 15/52 (P = 0.035). After 3 months, the incidence of eczema was similar in both groups. Cumulative incidence of parental-reported eczema at 1 and 2 years was 23/50 (intervention) vs 31/48 (placebo) and 27 (intervention) vs 34 (placebo), respectively. The number needed to treat was 5.9 at age 3 and 12 months and 6.7 at age 2 years. The intervention group was significantly more frequently colonized with higher numbers of Lc. lactis. Furthermore, at age 3 months, in vitro production of IL-5 (146 pg/ml vs 72 pg/ml; P = 0.04) was decreased in the probiotic-group compared with the placebo-group. CONCLUSIONS: This particular combination of probiotic bacteria shows a preventive effect on the incidence of eczema in high-risk children, which seems to be sustained during the first 2 years of life. In addition to previous studies, the preventive effect appears to be established within the first 3 months of life.


Factors influencing the composition of the intestinal microbiota in early infancy.
Penders J, Thijs C, Vink C, Stelma FF, Snijders B, Kummeling I, van den Brandt PA, Stobberingh EE.
Pediatrics. 2006 Aug;118(2):511-21.

CONCLUSIONS:  . . . 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).


Here's an interesting study about the significance of the germs that colonize the baby's digestive tract:

Friendly Microbes Control Intestinal Genes, Study Finds  - "One of our findings is that microbes are able to regulate intestinal genes involved in breaking down foods into simpler units that can be absorbed," explains Gordon. "This raises the question of whether there are variations in the types of intestinal microbes between individual humans, and how such differences affect our nutritional status, our health and our predisposition to certain diseases." According to Gordon, answering this question might shed light on human diseases such as inflammatory bowel disease, irritable bowel syndrome and other disorders. Understanding the regulation of intestinal barrier functions might even reveal how some microbes affect our susceptibilities to food and other allergies.  [Hooper LV, Wong MH, Thelin A, Hansson L, Falk PG, Gordon JI. Molecular analysis of commensal host-microbial relationships in the intestine. Science, Feb. 2, 2001. ]


From The first hour following birth by Michel Odent, MD [4th September 2002]

"Perspective six. The bacteriological point of view

"At birth, a baby is germ-free. An hour later there are millions of germs covering her mucous membranes. To be born is to enter the world of microbes. The question is - which germs will be the first to colonize the baby's body? Bacteriologists know that the winners of the race will be the rulers of the territory. The germ environment of the mother is already familiar and friendly from the perspective of the newborn because mother and baby share the same antibodies (IgG). In other words, from a bacteriological point of view, the newborn human baby urgently needs to be in contact with only one person - her mother. If we add that early consumption of colostrum will help establish an ideal gut flora, there is no doubt that, from a bacteriological point of view, the hour following birth is a critical period with life long consequences. Our gut flora can be presented as an aspect of our personality that cannot be easily modified later on in life."


According to Gordon, answering this question might shed light on human diseases such as inflammatory bowel disease, irritable bowel syndrome and other disorders.


I'd like to add necrotizing enterocolitis, on an individual level, which as I understand it is when a portion of the intestines actually rots and must be surgically removed.  It is a condition which is linked to withholding breastmilk to use substitutions, and was more common when all babies went to the nursery for 24 hour periods and were fed sugar water or formula.  The babies' intestines were therefore not colonized with the beneficial bacteria within the mother's milk which helps to protect against this condition.  Of course there are other predisposing factors, "including perinatal hypotension, hypoxia, or sepsis, as well as umbilical catheters, exchange transfusions, and the feeding of cow milk and hypertonic solutions" (Williams Obstetrics, 21st ed, p 1073).  Another potential tool in breastfeeding education.  Help prevent needless gastrointestinal surgery for your newborn baby.


Hacking Your Body's Bacteria for Better Health


Infant Probiotic Formulation - L. Acidophilus, B. Bifidum and B. Infantis (250 billion cfu per gram. $165 per 100 gram; $100 per 50 gram.)
This is expensive stuff, but if your baby is having ongoing health problems, this is a good place to start.



Gut Flora and Colic



Friendly Help for Your Baby's Health - It is not only adults who benefit from these friendly bacteria. Breast-fed babies generally have a lower incidence of colic and other digestive disturbances than bottle-fed babies, and this has been attributed to friendly microorganisms in the digestive system whose growth is encouraged by mother's milk.


Natren produces a probiotic product designed specifically for infants. Life Start is made with Bifidobacterium infantis - the beneficial bacteria which is most prominent in infants.  This can be beneficial for newborn thrush, newborn diarhea or diaper rash.


Origin of digestive flora in new born babies - more than 99% of the intestinal flora of a healthy breast-fed infant should be made up of Bifidobacterium infantis  (B. infantis).  BioFlora makes a product called Infantiflora, containing B. infantis.


 Long-term consumption of infant formulas containing live probiotic bacteria: tolerance and safety.
 Saavedra JM, Abi-Hanna A, Moore N, Yolken RH.
Am J Clin Nutr. 2004 Feb;79(2):261-7.

Long-term consumption of formulas supplemented with B. lactis and S. thermophilus was well tolerated and safe and resulted in adequate growth, reduced reporting of colic or irritability, and a lower frequency of antibiotic use. [Ed. It's possible that they missed the mark on this study and should have been studying Bifidobacterium infantis  (B. infantis), the bacteria most naturally found in an infant's gut.]



Gut Flora and Asthma



Improving health with bacteria in diet - `PROBIOTICS' RESEARCH AT UCSF HOLDS PROMISE [9/20/06]
By Kendra Marr, Mercury News

Researchers at the University of California-San Francisco are seeking volunteers for a study in which newborns will be fed live bacteria in hopes it will keep them asthma-free.


Clinical Trial for Asthma and Eczema - The Impact of Perinatal Daily Supplement of a Probiotic (Lactobacillus Rhamnosus GG), Given to Mothers, on Immunological Development, Atopic Sensitisation and Allergic Disease in Their Off-Spring


Another Clinical Trial for Asthma and Eczema - Influence of Probiotics on Prevention of Atopy, Atopic Disease and Immunological Responses



Gut Flora and Eczema



See also: Laundry Issues since delicate newborn skin may react to dry cleaning fluid or even ordinary household laundry products.
See also: Eczema


In a recent study, Kukkonen and her colleagues gave a probiotic containing four strains of gut bacteria to 461 infants labeled as high risk for developing allergic disorders. After two years, the children were 25 percent less likely than those given a placebo to develop eczema, a type of allergic skin inflammation. The study was published in the January issue of Journal of Allergy and Clinical Immunology. [from Hacking Your Body's Bacteria for Better Health ]


Clinical Trial for Asthma and Eczema - The Impact of Perinatal Daily Supplement of a Probiotic (Lactobacillus Rhamnosus GG), Given to Mothers, on Immunological Development, Atopic Sensitisation and Allergic Disease in Their Off-Spring


Another Clinical Trial for Asthma and Eczema - Influence of Probiotics on Prevention of Atopy, Atopic Disease and Immunological Responses


Effects of probiotics on atopic dermatitis: a randomised controlled trial.
Weston S, Halbert A, Richmond P, Prescott SL.
Arch Dis Child. 2005 Sep;90(9):892-7.

CONCLUSION: Supplementation with probiotic L fermentum VRI-003 PCC is beneficial in improving the extent and severity of AD in young children with moderate or severe disease.


WedMD - A new study shows children of women who took supplements of Lactobacillus rhamnosus GG (Lactobacillus GG) around the time of childbirth were half as likely to develop atopic eczema by age 4 than those who did not.


Probiotics and prevention of atopic disease: 4-year follow-up of a randomised placebo-controlled trial.
Kalliomaki M, Salminen S, Poussa T, Arvilommi H, Isolauri E.
Lancet. 2003 May 31;361(9372):1869-71.

Perinatal administration of the probiotic Lactobacillus rhamnosus strain GG (ATCC 53103), reduces incidence of atopic eczema in at-risk children during the first 2 years of life (infancy). We have therefore assessed persistence of the potential to prevent atopic eczema at 4 years. Atopic disease was diagnosed on the basis of a questionnaire and a clinical examination. 14 of 53 children receiving lactobacillus had developed atopic eczema, compared with 25 of 54 receiving placebo (relative risk 0.57, 95% CI 0.33-0.97). Skin prick test reactivity was the same in both groups: ten of 50 children previously given lactobacillus compared with nine of 50 given placebo tested positive. Our results suggest that the preventive effect of lactobacillus GG on atopic eczema extends beyond infancy.



Immune System Issues



C-section boosts diarrhea, allergy risk - [10/25/04] - Archives of Disease in Childhood 2004; 89: 993-7

Could mode of delivery influence the neonatal immune response? - Cesarean section may increase the risk of diarrhea and allergy in susceptible babies, German researchers suggest.



Newborns Suppress Immune System to Let Gut Bacteria In by Ed Yong [11/7/13] - We have often talked about a newborn's immune system as immature.  It now looks as if it's actually more capable than previously thought, but that there is active suppression to allow for gut colonization.  This confirms that newborns are immunocompromised and should be protected from dangerous bacteria, such as found in hospitals.

Caesarean Birth May Raise Allergy Risk in Babies
Wed Oct 20, 2004 07:08 PM ET

LONDON (Reuters) - Being born by Caesarean section may increase a baby's risk of suffering from food allergies and diarrhea in the first year of life, German doctors said on Thursday.

"The researchers suspect that in babies born by Caesarean section the colonisation of natural bacteria in the gut which promotes health and plays an important role in the immune system response is delayed or altered by a Caesarean birth."



Cesarean Effects



Child's Cavity Risk Linked to Cesarean Delivery

Mode of Delivery and Other Maternal Factors Influence the Acquisition of Streptococcus mutans in Infants.
Li Y, Caufield PW, Dasanayake AP, Wiener HW, Vermund SH.
J Dent Res. 2005 Sep;84(9):806-11.

"[T]hose delivered by Caesarean section acquired S. mutans 11.7 mos earlier than did vaginally delivered infants (p = 0.038)."


Caesarean section and gastrointestinal symptoms, atopic dermatitis, and sensitisation during the first year of life.
Laubereau B, Filipiak-Pittroff B, von Berg A, Grubl A, Reinhardt D, Wichmann HE, Koletzko S; GINI Study Group.
Arch Dis Child. 2004 Nov;89(11):993-7.

"Caesarean delivery might be a risk factor for diarrhoea and sensitisation in infants with family history of allergy. Further research in this area seems warranted as choosing caesarean section becomes increasingly popular."


Mode of delivery and risk of allergic rhinitis and asthma.
Bager P, Melbye M, Rostgaard K, Stabell Benn C, Westergaard T.
J Allergy Clin Immunol 2003 Jan;111(1):51-6

"People who were born by cesarean section are 33% more likely to develop asthma than people who were delivered spontaneously."



Other Issues



Dental Microbial Colonization

Child's Cavity Risk Linked to Cesarean Delivery

 




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