How cesarean section affects a baby's gut microbiota
Chronic, immune-mediated, non-communicable diseases and obesity have become more common in the Western world in recent decades. At the same time, the number of children born by cesarean section has increased worldwide. As one might expect, birth by cesarean section has been found to increase the risk of asthma, allergic disease, and obesity later in life.
Based on previous research, it is known that the microbial exposure the baby gets is different between cesarean section and vaginal birth. Whereas the microbiota of a vaginally born baby is similar to that of the mother, the microbiota of a baby born by cesarean section is closer to that of the operating room (which is not a good thing). However, it is possible to restore a healthy microbiota by swabbing the baby with the mother's vaginal fluids. This will not give the baby the exact same the microbiota provided by vaginal birth, but it does help to normalize the baby's microbiota development.
A recent study shows that different microbial contact continues after birth through breast milk. The composition of the breast milk microbiota of mothers who gave birth by cesarean section was found to be different from that of mothers who gave birth vaginally. Microbiota diversity and richness of the breast milk in mothers who had delivered via cesarean section was significantly lower compared to those who had delivered vaginally. The differences could not be explained by the antibiotic treatment given to the mother during delivery, suggesting that cesarean section itself has an independent effect on breast milk microbiota composition.
Again, previous research (see the references of the study linked in the previous paragraph) has shown a link between lower gut microbiota richness and atopic eczema, food allergies, and asthma. Furthermore, a link has been found between obesity and the gut microbiota, and the gut microbiota in infancy may predict obesity later in life. The recent study at hand also shows a link between cesarean section and asthma, allergy, and obesity, and this link seems to be mediated via microbes.
To wrap this all up, "birth by CS increases the risk of the development of NCDs and obesity later in childhood and early adulthood by depleting the child’s microbial contact during birth and breastfeeding and by exposing the newborn to antimicrobial medications during the perinatal period. The association between CS delivery and later risk of developing NCD is of particular concern in situations in which the CS is performed for non-medical reasons."
In case this topic interests you, I highly recommend reading the whole study linked in the third paragraph
5 notes
·
View notes
TRIGGER WARNING. (Talk about medical issues, blood, surgery)
It’s Wednesday night and you’re exhausted. You haven’t been sleeping great because at 35 weeks pregnant it’s hard to get comfortable. It’s 9pm, you decide to take a pregnancy approved sleep medication. You crawl into bed and get all cozy, but at 9:45 just as you’re about to fall asleep you decide it is probably best to get up and pee. You ARE pregnant after all. You don’t want to turn the bedroom light on, so you turn the flashlight on your phone on and leave it on the bed, illuminating the room around you. You quickly go to the bathroom, but after you wipe you notice blood. A LOT of blood on the toilet paper. Thinking this can’t be real, you must be seeing things, you check again. More blood. More clots. Now you can feel it and hear it just dripping out of you. You “whisper yell” for your husband because your toddler is sleeping in the next room. After calling his name 3 times he hears you and comes from the kitchen. He says “what’s wrong?”, an uneasiness in his voice. You calmly ask him to get your phone for you. [looking back, I'm not sure why this is the first thing I said or asked for]. He asks again “what’s wrong?” You again say “Please hand me my phone”. At this point he looks at you, holding the toilet paper you had used, and said “are you bleeding?” He goes to grab your phone. When he comes back 5 seconds later he hears it, questions “are you peeing right now?” To which you calmly reply a simple “No.”
He immediately springs into action. While you call the emergency on call number to speak to your OBGYN he starts packing a bag for you and calls your mom.
The OBGYN calls you back in less than a minute. He says “Tell me what’s going on.” You let him know you’re bleeding, really bleeding. Wanting more details he asks “Bright red blood? Clear/pink tinged? Can you describe it? Was it a large amount? Has it stopped? Are there clots?” You answer his questions 1 by 1, “it’s bright red blood, just coming out as I sit here, and gets worse when I stand. It hasn’t stopped since it started and there are quite a few clots from what I can see”.
He calmly tells you to go to the birthing center at the hospital for evaluation. You knew this would be his response. In October you were bleeding a much smaller amount and had a 2 night stay in the hospital because of it. At that time they said you had some bleeding because of placenta previa. Which 2-3 weeks later they said had “resolved”.
So you are sitting there, thinking what exactly you need to do because the blood is still just coming. The bleeding gets worse when you stand, so you sit back down feeling a little light headed. Eventually you decide to just grab the hand towel from the bathroom and stick that in your pants.
Your husband lets you know a neighbor is here to stay with your sleeping toddler until your mom arrives.
He drives you to the hospital.
When you get there, they take you to a triage room, tell you to put a hospital gown on & provide a urine sample. As you try to give them a urine sample you realize you caught a large clot in the cup instead. Being the person you are, you come out and apologize and ask for a different sample cup. Once the nurse sees the clot she says not to worry about the urine sample, to come get on the stretcher so they can check out baby. Your nurse puts the monitor on you to check on baby. She says “ok, baby is on the monitor. We will call your OBGYN that’s on call, but in the meantime the hospitalist OBGYN who is here will come see you. So let me just go update her and I’ll be right back”.
Being a nurse yourself you expect a little bit of a wait. Sometimes it can take a bit to get a doctor to come see a patient. So you close your eyes and concentrate on listening to your baby’s heart beat on the monitor. You’re surprised that just about 2 minutes later the door was opening. It was 3 different nurses and they said they needed to go over paper work & consents, start an IV, and draw some blood. Not even a minute later your original nurse walks in with another nurse and the OBGYN that was already in the hospital. The original nurse starts doing admission questions in the computer, the doctor stated she needs to do a pelvic exam, and the other nurse starts going over an anesthesia questionnaire with you. All of this at the same time they are starting and IV and going over routine consents & papers with you. The doctor does the pelvic exam for what felt like mere seconds and you overhear her tell a nurse “we gotta take her back.” Next a CRNA from the anesthesiology team comes in. She starts asking questions and telling the nurses to please call the lab to rush the blood work they just sent saying “I need to know her platelet level before I do a spinal. If I don’t have her labs back then we have to do general”. This wasn’t said to me, but I knew what she was saying. My husband on the other hand did not. He had been keeping it together pretty well, you’re used to this kind of thing at work, but he is not. You can tell on his face he is worried and his anxiety is staring to set in, but he’s on the other side of the room and there are still nurses and doctors talking at you and to you, so you can’t talk to him right now. You’re trying to pay attention to the nurse having you sign consents, while listening to the others in the room. You overhear “she’s still bleeding now”, “we need to get her back there now”, “you sent a tube to type & cross right?” . . .
This is when your OB walks in. He gets a brief update from the other doctor, talks to you, and answers questions from your husband. He’s the first person to actually say to you that they need to take baby out now. They start telling your husband, “we will lead you to your room and you can put your things there. Once she’s ready in the OR you can come back.” You can tell he’s really starting to freak out a bit now. Says “so she’s delivering the baby? Like tonight? Right now?” The doctor calmly explains that yes, we are gonna have a baby. Tonight, right now. He’s going to perform a c-section because that’s what is safest for both of you, because they need to stop the bleeding. They start leading him to the room to put the bags there and start rolling you to the OR. You say his name to get his attention, tell him to come back and give you a quick kiss. He does and you say “I love you. We will both be ok”.
You get back to the OR & the CRNA informs you your labs did come back already, you don’t need to go under general anesthesia. Yay!
They have you transfer from the stretcher to the OR table. Explain the process to you. While the anesthesiologist is doing your spinal he asks what you normally do while you’re not here. You tell him “well I’ve been out of work since October on bedrest, but I am a nurse”. At this point you just had to laugh bc there was an audible “ohh that makes sense” from a few nurses and the CRNA. You ask “what makes sense?” They tell you you just seem so calm for everything that’s going on.
From there everything goes so quickly. Your little man was “delivered” at 11:42pm. He’s 5 lb 6 oz which isn’t bad for someone who is 5 weeks early. He doesn’t have go to the NICU and you’re so grateful.
And that’s how my second little man came into this world.
This was all so crazy. A timeline for reference
9:45pm notice bleeding
10:30pm arrive to hospital
11:42pm baby is out of me
It was so quick, I barely had time to process it.
The doctor said I was hemorrhaging due to a placental abruption.
They sent my placenta to pathology to figure out how this happened.
Overall it was a pretty scary situation but I feel like my husband and I handled it fairly well.
5 notes
·
View notes