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Kids are mammals, time we started treating them like it

A child born in the United States today has a one in three chance of entering this world through a surgical incision rather than a birth canal. A recent WHO report found C-section rates in private hospitals in Latin America and Asia could top 50 percent, with rates in China nearing “epidemic proportions.” With rates rising by 53 percent between 1996 and 2007 in the U.S. alone, there has been a lot of finger pointing to causes that might explain the dramatic increase. Whether its from being to posh to push or doctors wanting to schedule deliveries between golf rounds, virtually nobody is addressing the global health ramifications of what can happen when a mammal skips the time-honored “seeding” of microbes when passed through the birth canal.

Upon natural delivery, a human fetus is passed through an ecosystem of microbes that immediately cover and begin to colonize the newborn. A baby is born with an immunological tolerance that allows for the acceptance of these microbes that will soon assist the newest member of our species in defending against a daily onslaught of challenges from the microbial-dominated biosphere it just entered. Importantly, the microbes handed from mother-to-child will play an important role in the physical and immunological development of the gut and set the tone for a more complex and stable adult microbial ecosystem to come.

However, studies of birthing method have clearly shown that a child born c-section acquires a less desirable bacterial population more similar to the mother’s skin, which is very different from the pioneering colonizers acquired during a natural birth. This disconnect with nature, possibly among all others, is unmatched in human history in its extent and its potential consequences to human health.

Our initial microbial colonizers have much to do with who we are, or about to become. According to Finnish researchers, c-section babies are at greater risk of becoming obese later in life, a finding consistent with the study of 284 infants by Harvard researchers. In both studies, researchers speculate early inoculation of microbes at the center of the problem. Further studies reveal a link between bith method and rates of asthma, And there are many more studies that suggest the same.

But how we enter this world is just the beginning of what it means to pull away from nature. Dropping breast feeding rates are adding injury to our biological insult of c-sections. While anthropologist have show us that modern humans evolved on exclusive breast milk for a year or more, and extended breast feeding for two or more years, the CDC reports that 50 percent of the children born in Louisiana today will never breast fed. And of the ones that do, only seven percent are still doing so at one year. Breast feeding matters as it contains not only a well known suite of nutrients needed by a growing baby, but indigestible oligosaccharides the newborn’s gut microbes need to flourish and defend against infection. Something not contained in the majority of the baby formula being peddled by predatory tactics in the maternity wards of every U.S. hospital.

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The average child in a developed country will receive 10-20 courses of antibiotics by their 18th birthday. While life-saving in some situations, researchers believe the over zealous use of antibiotics may be leading to an unprecedented rise in irritable bowel disease from a disruption in gut microbes that can often stay out of balance for years.

We are rearing entire generations on a medical system not well trained in the principals of evolutionary medicine, not to mention a portion of the general public is still not completely comfortable with our evolutionary past. Our modern lives are out of synch with our ancient bodies and mammalian rituals, and while our overconfident anthropocentric worldview has allowed us incredible control of the modern world, it is doing so at the expense of our microbial defenses and sacrifice of healthy years in life.

We desperately need an integrated public health approach that understands that our cradle to coffin strategy must begin with a restoration of our ancestral microbial ecology. We need to reduce c-sections, or at least empower parents with the information they need to make an informed decision. We need to improve normalization of breastfeeding in public and work spaces, making mothers more comfortable or able to provide her little mammal what it needs. And we need to think harder about the consequences of the greatest experiment ever imposed on the human-microbe population: antibiotics.

The First Lady has inspired a nation with a few vegetables grown on the South Lawn. Maybe its time a nursery was opened as well, so mothers working in the White House could tend to the microbial garden of their children. Doing so will only improve the health of any nation.

 


 

24 Comments

  1. Thank you for this phenomenal body of work that you do Jeff, I’m so glad that it’s a passion of yours! All the very best, and I’ll follow as much as I can :) .

    • Thanks Allison. It will take a village of sorts. Hopefully you can join our effort to start 10,000 DIY projects – focused on diet, health and our microbiome. Be sure and follow along and sign up for the newsletter – and please tell others. Peace.

  2. Is anyone studying inoculating c/sec babies (orally?) with beneficial bacteria? I’ve been a miwife for 18 years and it’s been stunning to see how relentlessly c/s rates have climbed, despite the very well-known (within obstetrics) risks.

    • Jenn. As far as nobody has. Both my kids were born c-section. The increasing rates are alarming. I think mothers who deliver via c-section should inoculate the baby contentiously over the first few days herself. Easily done. However, I have never seen this recommended. Do midwives talk about or recommend this?

      • I am a midwife and I recommend that women who end up with c-sections do this herself the first few days. Most moms who wanted homebirth in the first place are comfortable with this idea. Not sure ‘the mainstream’ would be unless it was medically prescribed/not seen as dirty.

        • How, exactly, do I inoculate my baby with my vaginal bacteria? I have a high-risk pregnancy, and will be having a c-section. Can anyone point me towards any links, or give me any advice?

          • really no links out there. chat with you doctor about inserting a sterile swab into your lady parts – remove after some time – and use to swab newborn immediately after c-section delivery. inserting into babies mouth, and wipe baby down with it as well. you and your partner might do this several times over the first 24-48 hours. again, chat with your doctor about this. should be doable.

      • HFP, you say it’s easy done, I’m about to have a c/s, how do I inoculate my baby safely? I can’t find any info on this!

        • hard to say – chat with your doctor about it. no DIY guide out there. but most ppl are using a sterile gauze covered in vaginal fluids – ie, wiping baby with it – and inserting in babies mouth. could also use ‘gloved’ hand as well. good luck! make sure that baby gets to play in the dirt – a lot. also get a dog and other animals and breast fed as long as u can – lots of microbes in breast milk – along with nutrients for the babies bugs.

  3. I’m excited to see this website! I can’t wait to read the results of your gut study. I’m wondering if there are studies comparing the gut microbes of vaginally-born babies whose mothers received antibiotics during labor to those whose mothers didn’t. To me, the routine use of antibiotics during labor to GBS+ mothers even when there are no other risk factors seems to be a grave mistake.

  4. Thankyou for you fantastic work.

    What the Western world is heading for [especially the big phrama driven experiment that is the USA] is that when the s— hits the fan, and a major pandemic arises, they will be the ones with weakened/undeveloped immune systems who will succumb, and perhaps become extinct, leaving space fer those who are presently living in s— in the slums and the 3rd world to inherit the earth.
    An alternative is: The experiment that is the USA will develop a new evolution of man, which will be totally dependant on highly processed, msg laden foodstuffs and cola soda pops. Perhaps an evolution that will be better suited to eating out of a paste tube on the space flight to anywhere but here, only to die out when they encounter a microorganism on another planet…

  5. Thank you for this article! I wonder about the standard practice of giving GBS+ mothers antibiotics during birth, essentially creating a sterile birth canal. Feels very wrong to me, and I wish someone would do research on this!

  6. Dr. Natasha Campbell-McBride (GAPS) and Donna Gates (BED) recommend coconut water kefir on the nipple before feedings for all babies based on the presumption that most mothers in the West have insufficiently diverse gut flora to begin with, but they only have the collective ear of a specific population who probably already have a child with high needs as a result of a wonky gut biome. There is a greater awareness of the benefits of avoiding antiseptic perineal wiping during birth among midwives than OBs, at least where I am, but I have not come across specific recommendations about oral seeding.

    For an example of how midwifery regards GBS, see http://empoweredbirth.typepad.com/empowering_birth_blog/2008/01/thoughts-on-bet.html, and note that the Cochrane Collaboration has deemed routine intrapartum antibiotics to *not* be evidence-based.

    A note on the article text: You’ve written “The average child in a developing country will receive 10-20 courses of antibiotics by their 18th birthday.” I suspect that should say developED.

  7. Hi Jeff; I very much appreciate the terrific site you have going here. If I can suggest – for those of us who are not citizens of the USA – could you maybe say “health of *any* nation” ? All the rest of us out here are struggling with these issues too (eg. Finnish researchers), and it takes the steam out of concluding statements when it morphs into fist-pumpin for America. (Yours was a mild one) We get so much of that through your media already ….

  8. I’m mummy to 3 little ones. First born 100% natural, no drugs just has and air and straight on the breast.. 2nd was 9 wks prem and emergancy c-section. 3rd was 4 wks early and also an emergency c-section. I wanted to give birth naturally again so badly. I had such a good experience first time. I feel do guilty for not being able to give either of my 2 younger kids that start. Please remember mums like me when you rub salt in our wounds with articles likr this. I fed each child until 1yr. Please appreciate the complexity that causes theses situations. If it wasn’t for c section I’d be mum to 1 not 3!

    • Hi Kim. Both my kids born c-section. So, I get it. As for rubbing salt in the wounds, I think you miss the point of why I write these posts – it’s to raise awareness. As you know, c-section is a must in many situations but not 1 out of 3 births in the US. The problem is the system. The problem is parents not being given all of the information about the ramifications. The problem is not 9 week prem babies. By allowing a great many c-sections for mums who don’t need them, we are potentially creating some long term issues down stream. Again, this has nothing to do with c-sections that are a must.

      • Well, except it does have to do with c-sections that are a must, because those babies’ microbiomes aren’t ideally seeded, either. I don’t think the bacteria take into account whether the c-section was a matter of necessity or convenience or an overabundance of caution or whatever. So whether it’s your intention or not, writing that c-sections set babies up for later health problems may understandably cause added heartache to Moms who wanted to give birth vaginally but didn’t, or more likely, weren’t “allowed to.” You make some really convincing arguments for wide-ranging societal change that would improve things, but some more specific suggestions about what individual mothers and families could do after a c-section delivery would be helpful as well.

  9. what advice would you give a mom who has a c-section kiddo? At 4 years old, we are well beyond the innoculation with vaginal secretions and breast feeding stages! Probiotics?

    • spending more time outside can’t hurt. getting dirty. embrace animals. eat more plants – diversity matters… and avoid the obvious dietary pitfalls…

  10. I’m having a scheduled c-section this winter because of an earlier myomectomy. I am very concerned about this baby’s initial microbiota and am going to inoculate a few times after birth with vaginal fluid. I’ve read several different articles about this (including the recent NY Times piece and a 2010 US News piece) that suggest both putting vaginal material in the baby’s mouth as well as onto its skin. We’ll see! I’m nervous that the nurses & my OB will think it’s very strange, even though I am giving birth in a major NYC teaching hospital.

  11. I have been looking and trying to find info on whether a baby born in an intact bag of waters also misses out on these beneficial microbes. One of mine was born with the membrane completely surrounding her, and she tends to get minor colds very frequently. However, they are never more than minor, and she is still nursing at age 3, so I know she’s got some good things going for her… but I wonder if it might be helpful to inoculate a baby with vaginal secretions when that baby is born vaginally but emerged with the membrane covering its face?

    • interesting. i’m not sure. good Q.

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