Does your birth — vaginal or C section — decide how you respond to vaccines?

How you were born decides the kind of immunity you acquire and the quantity of protective antibodies you can produce after being vaccinated. A research by the University of Edinburgh as well as Spaarne Hospital and Utrecht University Medical Centre in the Netherlands has shown that babies born vaginally had double the level of protective antibodies after they were administered childhood vaccines. And that’s because vaginal birth puts the new baby in touch with the good bacteria in its mother’s birth canal which colonise it as well. A C-section baby doesn’t get this initial protection and, therefore, may need more probiotics or extra vaccines.

The results, which were published in the journal Nature Communications, showed how these beneficial bacteria were doubling the levels of antibodies in response to the pneumococcal and meningococcal vaccines. Other vaccines, including flu and BCG for tuberculosis, have already been shown to be influenced by the microbiome.

Assessing the study, Dr Gunjan Gupta Govil, founder and chairman, Gunjan IVF World Group, says, “Various international studies have been carried out on the same subject before and have come to similar conclusions. There are composite factors to be considered like the effects of microbiomes during vaginal delivery, breast feeding, gestational nourishment and other environmental factors. During natural delivery, the newborn is exposed to various gut bacteria through the birth canal. This bacteria release short chain fatty acids which help in the development of B-Cells, known for producing antibodies. That’s why the birth method plays a key role in determining/altering the vaccine’s power later on,” she explains.

However, she also argues that C-section is an urgent requirement and shouldn’t be seen in a negative light. “A C-section is resorted to for eliminating risk factors in both the mother and child. There still isn’t sufficient data to confirm the theory that children born through C-section and those born through the vaginal route have different impacts of vaccines in their immune system. While the studies conducted have a smaller cohort, further studies with larger group size may efficiently conclude the correlation. Besides, the study does not include breast-feeding, which is yet another important factor as giving colostrum (mother’s first milk) to the new born boosts the immune system. And should this be proven worldwide, then the C-section baby can be given probiotics,” she adds.

“The theory is quite new but it is still uncertain if similar associations can be made while dealing with infants from different countries and regions because many factors influence the composition of a baby’s immune system,” Dr Govil says.

Dr (Major) Indu Gaur, Consultant, Obstetrics and Gynaecology, Fortis Escorts, Faridabad, argues for data on long-term impact. “Recent epidemiological studies provide evidence that elective C-sec is associated with aberrant short-term immune responses in the newborn infant, with a greater risk of them developing immune diseases such as asthma, allergies, type 1 diabetes and Celiac disease. However, it is still unknown whether C-sec causes a long-term effect on the immune system of the offspring that contributes to compromised immune health. A greater emphasis should be placed on the discussion among both professionals and child-bearing women on potential consequences of C-sec on the health of the offspring. It is also important to notice that both the mother undergoing C-Sec and her infant are more likely to be treated with antibiotics. These antibiotics can perturb the intestinal microflora rather than the birth process itself.”

The researchers tracked the gut microbiomes of 120 babies from their first poo (or the meconium) until they were a year-old to arrive at their conclusion. All the babies in the study were healthy, had reached full term and so the findings were not affected by other diseases or premature birth. Of course, considering that this concern has been around for a long time, there has been a growing trend of “vaginal seeding” in which C-section babies are smeared with vaginal fluids from the mother. A recent study even tried a faecal transplant to pass on the mother’s gut bacteria to the child. But till there is a multi-factor study on a larger cohort, there is no reason to press the panic button.

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