Washington, DC—Due to the lack of data regarding the safety and efficacy of vaginal seeding, the American College of Obstetricians and Gynecologists (ACOG) does not encourage or recommend it outside of the context of institutional review board-approved research, according to new guidance issued today. Vaginal seeding is the practice of inoculating a cotton swab with vaginal fluids to transfer the vaginal flora to the infant.
There has been growing interest in vaginal seeding due to evidence that suggests the frequency of asthma, allergies and immune disorders in children is increasing at a rate that mirrors that of cesarean delivery. When infants are born via cesarean delivery and with intact membranes, or before the water breaks, the new Committee Opinion states there is often a lack of maternal vaginal bacteria transferred to the baby, which helps to stimulate the immune system, prevent the growth of dangerous bacteria and regulate the gut.
“Understandably, patients who may need to undergo a C-section are increasingly seeking counsel from ob-gyns on whether vaginal seeding is appropriate,” said Christopher Zahn, M.D., vice president of Practice Activities. “However, due to the lack of sufficient data, the very real risks outweigh the potential benefits. By swabbing an infant’s mouth, nose or skin with vaginal fluid after birth, the mother could potentially, and unknowingly, pass on disease-causing bacteria or viruses.”
Much of the research that exists regarding the link between cesarean delivery and incidence of allergies and autoimmune diseases has found an association with mode of delivery. However, there is still not enough evidence to prove causation due to the environmental, dietary and genetic factors that also impact the development of conditions, such as asthma. Additionally, the microbiota of infants born by C-section will cause a variation in the research findings because some may have had contact with maternal vaginal bacteria if the procedure was performed after the onset of labor or rupture of membranes.
“Breastfeeding for the first six months is the best way to overcome the lack of exposure to maternal vaginal flora at birth,” said Zahn. “The bacteria present in breast milk and on the nipple is sufficient for natural colonization or seeding of the gut. There may be some initial difference in the gut microbiota of infants based on mode of delivery but research has shown that difference disappears after about six months.”
Should a patient insist on performing the procedure herself, ACOG recommends ob-gyns have a documented discussion of the potential risks.
The American College of Obstetricians and Gynecologists (The College), a 501(c)(3) organization, is the nation’s leading group of physicians providing health care for women. As a private, voluntary, nonprofit membership organization of more than 58,000 members, The College strongly advocates for quality health care for women, maintains the highest standards of clinical practice and continuing education of its members, promotes patient education, and increases awareness among its members and the public of the changing issues facing women’s health care. The American Congress of Obstetricians and Gynecologists (ACOG), a 501(c)(6) organization, is its companion organization. www.acog.org