Science/medical folks: ? Re gut bacteria

[summer]

So I keep reading about gut bacteria and how necessary it is and how having c-sections deprives babies of it.

So (asks the person who had 2 c-sections and was unable to breastfeed one) isn't bacteria fairly easy to grow? Why can't you just take a pill or something? Where do you think the science of this will go?

[ringstrue]

I just googled a bit and skimmed, but the only significant "helpful" thing they have found is for newborns- but that's just for starting to nurse. While the bacteria hangs out for a while, it's a pretty big stretch to say it would have any effect on toddlers and older kids.

Yeah you can take probiotics- even eating yogurt had some good bacteria in it and older babies can have that. Unless your kid has an actual illness that could be helped by a certain good bacteria idk that I'd worry about it.

[oliverboliverbutt]

I think that it's not so simple because there are so many different bacteria in there and we don't know which do what yet.

I know I've read about fecal transplants helping adults with various issues (I'll have to google to find what I'm talking about, but if I do now I'll never actually post anything). That's kind of like taking a pill, right?

[Deleted]

As far as birth goes, the gut plays an important role in the development of the immune system. It's the center of about 60-70% of the immune system. A baby's immune system is developing in the first months of life and the bacteria from the vagina during birth and breastfeeding play a crucial role in its development. You can't make that up later.

Also, the bacteria in the vagina that the baby is exposed to during birth cannot be replicated later in probiotic pills. If the baby misses it, it cannot make it back up in other ways. That's why some people suggest that you swab your vagina if you do have a c/s and as gross as it sounds, wipe the baby down with the swab so they can come in contact with that bacteria. Also, make sure not to bathe the baby for the first day of life and without soap for the first month so that the bacteria present on your skin during breastfeeding has a chance to do its magic.

Another thing to consider is that a single dose of antibiotics can permanently alter gut flora. Some species of bacteria can repopulate quickly, but many fail to recover even after six months of high probiotic use - even longer without probiotic therapy.

As someone living with Crohn's Disease, I find this topic fascinating. I've had fecal tests done and I am deficient in many species of gut flora, probably from years of antibiotic overuse/misuse as a teen. I'm now trying to undo the damage through therapeutic probiotic doses and a diet high in prebiotic and probiotic foods. It's going to take years for that to happen, if ever. I'm eager to see where new research will take us with this. I would definitely consider a fecal transplant if I knew that it would heal me of my Crohn's.

I should add that because Crohn's is hereditary, I am very careful about my kids and their gut flora. Studies have shown that babies born vaginally at home and breastfed have the most diverse gut flora -http://pediatrics.aappublications.org/content/118/2/511.long This is one of the reasons I have homebirths and breastfeed into toddlerhood.

[FloFTW]

There was just a piece on NPR about this a few weeks ago. They are just now beginning to understand exactly what bacteria is good and bad for what circumstance which means relatively soon (years rather than decades) we can probably develop pills. It sounds very promising for Crohn's especially.

[aurora]

Apr 14, 2014 19:28:37 GMT -5 lurkingaw said:

...

I should add that because Crohn's is hereditary, I am very careful about my kids and their gut flora. Studies have shown that babies born vaginally at home and breastfed have the most diverse gut flora -http://pediatrics.aappublications.org/content/118/2/511.long This is one of the reasons I have homebirths and breastfeed into toddlerhood.

I only just skimmed the beginning of the link you posted, but I don't really understand why birth location would matter in terms of the gut flora.  Of course I see the difference between c-section and vaginal birth, but is the argument against hospital birth more because of the treatments after birth rather than the birth itself?

[ttt]

Probably stupid question about probiotics - doesn't the bacteria get killed by your stomach acid?

[summer]

So our probiotic formula won't really help? My poor kids. We need to live on a farm or something.

[rugbywife]

I first encountered all this information when I took a nutrition course and we had a naturopath as a guest speaker. He more or less said what PP have said...vaginal births and breastfeeding expose babies to bacteria that c-sections and formula don't have. He said that he believes that his horrible eczema during childhood was as a result of the changes in his gut flora as a result of his being a c-sected formula
fed baby.

I wanted baby G on me right away, with a delayed cord clamp (like a minute, not like an hour) but because of meconium in my fluids she was one of the ones whisked away.

[ringstrue]

Apr 15, 2014 1:05:19 GMT -5 summer said:

So our probiotic formula won't really help? My poor kids. We need to live on a farm or something.

Go visit some baby chicks for Easter! ( but still wash their hands after)

But seriously- are your kids sick? Don't look for things to worry about!!

[auntie]

Apr 14, 2014 19:05:20 GMT -5 oliverboliverbutt said:

I think that it's not so simple because there are so many different bacteria in there and we don't know which do what yet.

I know I've read about fecal transplants helping adults with various issues (I'll have to google to find what I'm talking about, but if I do now I'll never actually post anything). That's kind of like taking a pill, right?

My niece was working on a fecal transplant study for tx of C.diff a while back. 

At the time it was nothing like taking a pill. The turd, I mean transplanted material, was inserted using a nasogastric tube.

[Deleted]

Apr 14, 2014 22:57:35 GMT -5 aurora said:

Apr 14, 2014 19:28:37 GMT -5 lurkingaw said:

...

I should add that because Crohn's is hereditary, I am very careful about my kids and their gut flora. Studies have shown that babies born vaginally at home and breastfed have the most diverse gut flora -http://pediatrics.aappublications.org/content/118/2/511.long This is one of the reasons I have homebirths and breastfeed into toddlerhood.

I only just skimmed the beginning of the link you posted, but I don't really understand why birth location would matter in terms of the gut flora.  Of course I see the difference between c-section and vaginal birth, but is the argument against hospital birth more because of the treatments after birth rather than the birth itself?

The theory is that babies born at home spend more time during the first few days of life in an "unsterile" environment.  They are surrounded by the bacteria of their family members.  My babies born at home spent the first two days of life lying in my (probably dirty by hospital standards) bed being snuggled by me, my husband, and my other kids.  They were wrapped in blankets and wore clothes that were washed in our home and have our bacteria on them instead of the hospital stuff.  I was lying around topless half of that time with the baby on top of me.  Research is showing there is a critical window in the first days of life where the process of "seeding" the gut flora happens.  Hospitals are more sterile.

And that leaves out the obvious differences in the actual birth process.  A vaginal birth at home is very different than a vaginal birth in the hospital (at least in my experience).  My homebirth babies spent the first hour of life on my chest and nursed within minutes of birth.  No one wiped anything off of them for a few hours, I'm sure (and my midwives actually encouraged me to keep the cheesy stuff on top of their heads, under their little caps, for days to soak in).  There were no routine antibiotics or antibiotic ointments.  No routine clearing of the nasal passages with those bulb syringes. 

The one thing that I wonder about is how waterbirth plays into this.  My two homebirth babies were born in water and research shows that waterbirths decrease the risk of passing bad bacteria (like GBS) to babies, so I wonder if it can also decrease how much of the good bacteria is passed during birth.  I think it would be interested to see a study done on that!

[summer]

Apr 15, 2014 6:43:13 GMT -5 ringstrue said:

Apr 15, 2014 1:05:19 GMT -5 summer said:

So our probiotic formula won't really help? My poor kids. We need to live on a farm or something.

Go visit some baby chicks for Easter! ( but still wash their hands after)

But seriously- are your kids sick? Don't look for things to worry about!!

Have we met?   You know this is what I do!

[aurora]

Apr 14, 2014 23:29:54 GMT -5 mr+ms said:

Apr 14, 2014 22:57:35 GMT -5 aurora said:

I only just skimmed the beginning of the link you posted, but I don't really understand why birth location would matter in terms of the gut flora.  Of course I see the difference between c-section and vaginal birth, but is the argument against hospital birth more because of the treatments after birth rather than the birth itself?

I've thought about this and it's the one thing that I think home birth has going for it. What sorts of microbes do we encounter in a hospital vs. home. And what happens in a hospital birth? You hold your baby for 15 seconds and then it's in the hands of healthcare workers, wiping it down, antibiotic in its eyes.

For a normal birth I'm thinking it's better to minimize the immediate scrub-down and have the baby be skin-to-skin with the mother for a while and feed. I didn't know this about NYS until recently but supposedly you can't refuse the eye antibiotic even if you have tested negative for STDs. I think it's about time we quit this sloppy, unwarranted use of antibiotics.

That's really interesting.  I don't have children and I didn't know that the baby gets antibiotics immediately after birth no matter what the parents want.

[rugbywife]

Apr 15, 2014 8:22:53 GMT -5 aurora said:

Apr 14, 2014 23:29:54 GMT -5 mr+ms said:

I've thought about this and it's the one thing that I think home birth has going for it. What sorts of microbes do we encounter in a hospital vs. home. And what happens in a hospital birth? You hold your baby for 15 seconds and then it's in the hands of healthcare workers, wiping it down, antibiotic in its eyes.

For a normal birth I'm thinking it's better to minimize the immediate scrub-down and have the baby be skin-to-skin with the mother for a while and feed. I didn't know this about NYS until recently but supposedly you can't refuse the eye antibiotic even if you have tested negative for STDs. I think it's about time we quit this sloppy, unwarranted use of antibiotics.

That's really interesting.  I don't have children and I didn't know that the baby gets antibiotics immediately after birth no matter what the parents want.

Mine only got antibiotic eye ointment. I don't even know what it is for - baby has a blocked duct anyways. I got it for GBS.

[aurora]

Apr 15, 2014 7:10:39 GMT -5 lurkingaw said:

Apr 14, 2014 22:57:35 GMT -5 aurora said:

I only just skimmed the beginning of the link you posted, but I don't really understand why birth location would matter in terms of the gut flora.  Of course I see the difference between c-section and vaginal birth, but is the argument against hospital birth more because of the treatments after birth rather than the birth itself?

The theory is that babies born at home spend more time during the first few days of life in an "unsterile" environment.  They are surrounded by the bacteria of their family members.  My babies born at home spent the first two days of life lying in my (probably dirty by hospital standards) bed being snuggled by me, my husband, and my other kids.  They were wrapped in blankets and wore clothes that were washed in our home and have our bacteria on them instead of the hospital stuff.  I was lying around topless half of that time with the baby on top of me.  Research is showing there is a critical window in the first days of life where the process of "seeding" the gut flora happens.  Hospitals are more sterile.

And that leaves out the obvious differences in the actual birth process.  A vaginal birth at home is very different than a vaginal birth in the hospital (at least in my experience).  My homebirth babies spent the first hour of life on my chest and nursed within minutes of birth.  No one wiped anything off of them for a few hours, I'm sure (and my midwives actually encouraged me to keep the cheesy stuff on top of their heads, under their little caps, for days to soak in).  There were no routine antibiotics or antibiotic ointments.  No routine clearing of the nasal passages with those bulb syringes. 

The one thing that I wonder about is how waterbirth plays into this.  My two homebirth babies were born in water and research shows that waterbirths decrease the risk of passing bad bacteria (like GBS) to babies, so I wonder if it can also decrease how much of the good bacteria is passed during birth.  I think it would be interested to see a study done on that!

OK, so it is the procedures that happen immediately after birth and over the next few days that make the difference, then.  That's really interesting and it certainly makes sense that what we do to babies as newborns can impact them pretty significantly.  Thanks for coming back to answer my question!

I feel like a broken record saying this on this board but I really do think it's fascinating just how much about health and nutrition (including gut bacteria) we don't understand and how much these things can impact our lives.

[Velar Fricative]

Apr 14, 2014 23:29:54 GMT -5 mr+ms said:

Apr 14, 2014 22:57:35 GMT -5 aurora said:

I only just skimmed the beginning of the link you posted, but I don't really understand why birth location would matter in terms of the gut flora.  Of course I see the difference between c-section and vaginal birth, but is the argument against hospital birth more because of the treatments after birth rather than the birth itself?

I've thought about this and it's the one thing that I think home birth has going for it. What sorts of microbes do we encounter in a hospital vs. home. And what happens in a hospital birth? You hold your baby for 15 seconds and then it's in the hands of healthcare workers, wiping it down, antibiotic in its eyes.

For a normal birth I'm thinking it's better to minimize the immediate scrub-down and have the baby be skin-to-skin with the mother for a while and feed. I didn't know this about NYS until recently but supposedly you can't refuse the eye antibiotic even if you have tested negative for STDs. I think it's about time we quit this sloppy, unwarranted use of antibiotics.

I thought NYS only required the Vitamin K shot. I read nothing about not being able to refuse the eye ointment.

[looseseal]

Apr 14, 2014 23:29:54 GMT -5 mr+ms said:

Apr 14, 2014 22:57:35 GMT -5 aurora said:

I didn't know this about NYS until recently but supposedly you can't refuse the eye antibiotic even if you have tested negative for STDs.

This is true in Iowa, as well.

However, hospital procedures had changed in the three years from the birth of my first to the birth of my second, because now they delay cleaning the baby for an hour after typical vaginal births, in order to encourage skin to skin and breastfeeding.

[bluestreet]

For the folks who are like "huh?", here's an overview on microbial gut health, immune systems, c-sections, and fecal transplants that I posted way back:

mobile.nytimes.com/2012/06/19/science/studies-of-human-microbiome-yield-new-insights.html?pagewanted=all

[debatethis]

Apr 14, 2014 23:29:54 GMT -5 mr+ms said:

Apr 14, 2014 22:57:35 GMT -5 aurora said:

I only just skimmed the beginning of the link you posted, but I don't really understand why birth location would matter in terms of the gut flora.  Of course I see the difference between c-section and vaginal birth, but is the argument against hospital birth more because of the treatments after birth rather than the birth itself?

I've thought about this and it's the one thing that I think home birth has going for it. What sorts of microbes do we encounter in a hospital vs. home. And what happens in a hospital birth? You hold your baby for 15 seconds and then it's in the hands of healthcare workers, wiping it down, antibiotic in its eyes.

For a normal birth I'm thinking it's better to minimize the immediate scrub-down and have the baby be skin-to-skin with the mother for a while and feed. I didn't know this about NYS until recently but supposedly you can't refuse the eye antibiotic even if you have tested negative for STDs. I think it's about time we quit this sloppy, unwarranted use of antibiotics.

There are a LOT of other bacteria beyond STDs (staph and e coli, for example) that are prevented by routine erythromycin administration to newborns, many of which can cause blindness. There's nothing "unwarranted" or "sloppy" about erythromicin use, especially if you deliver in a hospital. 

[Deleted]

Apr 16, 2014 7:49:39 GMT -5 @domerjen said:

I had 2 home births, but I feel the need to defend hospital births. Even in the least baby friendly hospitals, you can have a "non traditional" birth with enough will power or a professional to help you with your requests, assuming you don't have complications. Is it harder? Yes, but certainly not impossible.

They can't "make" you do anything you don't want, including vitamin k and eye goop. But you need to be clear with your attendants. And there are the cps horror stories, but I'd hazard a guess that the types hanging on CEP during a work day aren't the kinds of people triggering these flags, right or wrong.

I wasn't bashing hospital births.  The point here is that the environments are so different at home versus the hospital in terms of sterility.  No amount of clearing decisions with your attendants will change the fact.

I had a wonderful natural birth in the hospital with #2, where they left me alone during labor and let me do what I wanted.  But, there were certain things that I couldn't change, like them wanting to take my baby very shortly after birth to assess him.  And it's during that time when you're busy delivering the placenta that they make many of the decisions about these things we're talking about (eye goop and vitamin k), so if you haven't made it clear with your attendants prior to the birth, you often lose your chance to do it later.  It's one of those things where you can't have a homebirth in a hospital, so you have to be willing to compromise on certain things to follow their protocol.

Also, at my hospital the vitamin K is non-negotiable.  It's hospital policy that you have to give it if you give birth there.  You can opt out of the eye goop (with a whole lot of resistance), but not the vitamin K.  Also, I had a friend try to opt out of the routine antibiotics for GBS and the doctor coerced her into them by saying that if she did opt out it was hospital policy that her baby would have to be monitored in the nursery for 24 hours after the birth - essentially scaring her into doing it or else she would have to be away from her baby for an entire day after the birth.  He was probably full of BS, but it's hard for a mother in the throes of labor to discern the difference between truth and BS, so they often just give in, as was the case with my friend.

[carowen]

Half of me finds this all very fascinating, and half of me hates reading about it because I was GBS+ both births and had antibiotics both times which means all that good bacteria was likely killed. So I wander down the irrational path of how did that irreparably negatively impact my kids. It's insane because I can't very well go back in time anyway.

lurkingaw - it was my understanding that if I declined/wasn't able to get antibiotics before LO was born baby would get an automatic 48hrs in hospital for observation before we could go home. Not away from me though, so maybe there was misunderstanding there? Lord knows a laboring woman isn't exactly in a good place to discuss things so it's a shame they didn't go over that prior to the L&D. FWIW, we opted for the antibiotics since it dramatically reduces the risk for LO getting serious illness from GBS but I seriously considered declining and sometimes wish I had although there's obviously no way to know if my LOs hadn't gotten the doses they may have fallen seriously ill.

Like so many things, there's a tradeoff and both options have pros/cons.

[downtoearth]

Apr 14, 2014 19:58:58 GMT -5 FloFTW said:

There was just a piece on NPR about this a few weeks ago. They are just now beginning to understand exactly what bacteria is good and bad for what circumstance which means relatively soon (years rather than decades) we can probably develop pills. It sounds very promising for Crohn's especially.

I was going to say I heard something on NPR about this just a little while ago. 


Anecdotally,  I had my third baby at home, through my vagina (of course), with lots of baby/mom early skin time, not many baths, and breast fed until he was about 14-15 months old. 

Unluckily, he is my only gut-bacteria mess.  He has had toddler's diarrhea for over 6 months now.  He did have antibiotics when he was around 6-8 months for a bunch of ear and sinus things, but not very many times - maybe twice.  Anyway, it was months before he developed this and we've now tested for everything (Crohns, celiac, dairy allergies, giardia, stool problems, etc.) - it's none of those.  So now it's high doses of probiotics (the lactobacillus or lacto-acidophilus ones) and waiting to see if his guts can adapt.  Honestly, I haven't even tried cloth diapers with him in the last half a year b/c he is a gross pooper.

So that's all a long story to tell you that, I keep reading up on gut bacteria and trying to find a solution that his GI and ped haven't suggested and haven't really found much yet. It does seem like a newer science and they are just starting to realize that it's not just bacteria, but viruses, other bacteriophages, fungi, and other organisms that help make digestion work and/or can trigger or spread disease. 

www.sciencedaily.com/releases/2014/03/140310090919.htm


Heck, I can encourage bacteria to grow in dirt and eat environmental contaminants, but I can't seem to fix my own kids gut issues!

[downtoearth]

Apr 16, 2014 10:11:59 GMT -5 mr+ms said:

I wish there was a better way of assessing who will truly benefit from antibiotics for GBS. In light of learning about how important the birth process and breastfeeding are to an infant's initial gut colonization I suspect that the current guidelines lean towards over-treatment and the risks may not be worth it for a portion of those treated.

GBS infection is mainly an issue when there is a prolonged period of time spent with ruptured membranes. I guess there is more opportunity for the baby to be exposed to the bacteria and it can enter its mouth, nose, etc. while those passages are relatively clear of other microbes. I would imagine an infection could take hold more easily in that case.

I had antibiotics at birth plus a course right before and in the middle of pregnancy. This was really unusual for me and I think this may have contributed to problems DD had subsequently... milk protein intolerance, eczema, food allergies and even I ended up with random hives and environmental allergies for the first time.

For possible kid #2 I'm not sure what else to do besides get my own gut health in order so maybe the GBS won't be an issue. Apparently its overgrowth is a sign of poor gut health to begin with. Even though DD never had a drop of formula, BF for 3.5 yrs, had pets around and we're not clean freaks by any stretch... just what was I passing along to her. Microbe fail.

I was GBS+ for first two kids one round of antibiotics for first labor, but second labor we went in too late and never got them.  Neither had eye goop/antibiotics or issues after birth we left the hospital and birth center within 24 hours, so I guess CO was pretty lax in that stuff.  That being said, I tested negative for baby #3 - I totally attribute that to lots of good priobiotics for the last 3 months of my pregnancy - I hadn't taken those with #1 and #2, just yogurt. Who knows though, bodies ebb and flow with GBS and you can actually test positive one day and negative the next, from what I understand.