Taking Vaginal Juices and Wiping Them on Baby After Cesarean
Evelyn Marie Vukadinovich is swabbed with a gauze pad immediately afterward being born by cesarean department at Inova Women'south Infirmary in Falls Church building, Va. Mary Mathis/NPR hide caption
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Mary Mathis/NPR
Evelyn Marie Vukadinovich is swabbed with a gauze pad immediately afterwards being born past cesarean section at Inova Women's Infirmary in Falls Church, Va.
Mary Mathis/NPR
Danielle Vukadinovich is sitting up in a hospital bed at the Inova Women's Hospital in Falls Church building, Va., waiting to requite nascence.
"I feel adept, I'k excited!" says Vukadinovich, 35, of Annandale, Va., "Nervous, but good!"
Vukadinovich is getting a cesarean section today. Information technology's the second time for her — she underwent the surgical process 19 months agone when her twins were born.
This fourth dimension Danielle wants to endeavor something different, something that might sound strange. Equally shortly as her daughter is born, a doctor will wipe fluid from Danielle's birth canal or a sterile solution that serves every bit a placebo all over her baby'due south torso.
"I haven't told many people well-nigh this notwithstanding," Vukadinovich says, laughing. "I understand why people would be like, 'Oh my gosh. That'south so weird.' But I don't think it'due south yucky. Information technology'south normal. It'south natural really."
The procedure, known as "vaginal seeding," is designed to help babies develop healthy microbiomes — the collection of friendly bacteria that inhabit every person's body. Some people telephone call information technology a "bacterial baptism."
"It's a little bit like that babe's outset dunk," says Shira Levy, the microbiome inquiry manager at the Inova hospital. "That's their first religious feel. Yous know, they get the h2o and that changes their spirituality.
"In this example, they get the bacteria and that changes their microbiome," Levy says. "This is their first microbiome experience."
The procedure was developed in response to the sharp ascent in C-section births in contempo years. That increase has been accompanied by more cases of asthma, allergies, eczema, obesity, and other diseases.
The theory is that the rising in these diseases might be happening, in part, considering babies aren't getting exposed to their mother'due south microbes the way they would if they were passing naturally through the nascency culvert.
"We think that ane of the reasons that babies built-in by C-section are at increased take a chance for these diseases is considering they don't receive that starting time benign exposure to their mother's vaginal microbiome," says Suchitra Hourigan, a pediatric gastroenterologist at Inova.
One very minor study indicated that swabbing C-section babies with their female parent'due south microbes immediately after birth could make their microbiomes develop more like those of babies born vaginally.
But the appeal of vaginal seeding has outpaced testify that it is safe and effective.
Some couples have started trying vaginal seeding on their own. Vukadinovich jokes that she considered doing it herself. Afterwards all, she says, she's a nurse and her hubby is a high school biology teacher.
Danielle and Nick Vukadinovich of Annandale, Va., volunteered to accept their newborn girl be function of a study to assess the utilise of bacterial smears after C-sections. Mary Mathis/NPR hibernate caption
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Mary Mathis/NPR
Danielle and Nick Vukadinovich of Annandale, Va., volunteered to take their newborn daughter exist office of a written report to assess the use of bacterial smears after C-sections.
Mary Mathis/NPR
"I even told my mom: 'Nobody has to know. My husband would assistance me out,' " she says, laughing. "Merely I try not to take unnecessary risks."
Vukadinovich knows the procedure could be risky. Babies could be inadvertently exposed to illness-causing microbes, such equally herpes virus or streptococcus bacteria.
In fact, medical groups such as the American Higher of Obstetrics and Gynecology warn women confronting doing this. "While there are data to suggest that at that place may be some scientific plausibility to the concept, it is non without significant risks," says Neil Silverman, a clinical professor of obstetrics and gynecology at the UCLA School of Medicine, who represents ACOG. The grouping notes that mothers also transfer microbes to their newborns through skin-to-pare contact and breastfeeding.
Then Vukadinovich was thrilled when she institute out she could be part of the first study the Food and Drug Administration is assuasive to rigorously test whether the process is safe and helps improve babies' wellness.
"Who knows what's going to happen with the results? But if it does show something positive, I just think that would be great for kids and parents," she says.
Hourigan, who's helping lead the study, agrees. "Just to be able to reduce one gamble factor for obesity, particularly when in that location are such high [C-section rates] in the U.Southward., would be huge," she says.
"We call up that 1 of the reasons that babies born past C-section are at increased risk for these diseases is considering they don't receive that starting time beneficial exposure to their mother'southward vaginal microbiome," says Dr. Suchitra Hourigan at Inova Women's Hospital. Mary Maths/NPR hide caption
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Mary Maths/NPR
"Nosotros think that i of the reasons that babies born past C-section are at increased risk for these diseases is considering they don't receive that offset beneficial exposure to their female parent'due south vaginal microbiome," says Dr. Suchitra Hourigan at Inova Women'due south Hospital.
Mary Maths/NPR
In the study, one-half of the babies will become swabbed with their mother'southward microbes; half will get swabbed with a sterile solution. All of the mothers will exist advisedly screened for dangerous infections.
All of the babies will then be followed for three years to run across if they go obese or develop other health problems. A similar study is starting at the Icahn School of Medicine at Mountain Sinai in New York Urban center.
Vukadinovich agreed to let an NPR reporter and lensman observe her infant's nascence and the swabbing. It's the first time journalists have been allowed to scout a baby become through the written report.
Evelyn Marie is born
As the nurses wheel Vukadinovich into the operating room, Hourigan, Levy and Dr. Varsha Deopujari follow. Deopujari, the study'southward clinical manager, will do the actual swabbing.
Inside the OR, everyone quickly takes their places. As the surgeon starts, Hourigan explains what'southward happening. Information technology goes very fast.
"An incision is being fabricated into mom, and they are getting ready to take out the infant," Hourigan says. "They tin can meet the head. And the head is now coming out of the C-section incision. Infant's head is out."
In less than a minute after the surgery starts, the baby girl is completely out. A nurse rushes the newborn to a nearby table to clear her breathing. Later the infant is animate smoothly, Deopujari starts swabbing with a gauze pad.
Showtime, she swabs the baby'southward rima oris, cheeks and face. Afterward turning the gauze over to expose more bacteria, Deopujari wipes the infant's hands and artillery. Side by side, she wipes down her chest, goes over her abdomen, up the other arm and and then over her back.
A gauze pad that volition exist used in a study of vaginal seeding is taken from a storage container. Mary Mathis/NPR hibernate caption
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Mary Mathis/NPR
A gauze pad that volition exist used in a study of vaginal seeding is taken from a storage container.
Mary Mathis/NPR
"And the swabbing is now over," Hourigan says.
Deopujari easily the baby back to a nurse. Hourigan and her team quickly head out of the OR.
"That went perfectly," she says. "Babe came out and was crying. We waited until babe was stable, and the swabbing went but every bit planned."
Hourigan and her colleagues will swab 50 babies to make sure their procedure is safe. If information technology is, they program to expand the report to 800 babies, who would randomly receive either the bacterial swab or a placebo, throughout the Inova infirmary system.
The results could prove of import. "Nosotros need more than data and we need better data," says Silverman, of ACOG. "If it shows that in that location is a clear benefit, then this process can be re-evaluated."
The next morning, Vukadinovich, her husband, Nick, 41, and their new daughter are together in a hospital room.
"I'm good — feeling good today," she says, cradling her baby.
The couple doesn't know if their new girl, who they would later proper name Evelyn Marie, was exposed to her female parent's microbes or a sterile placebo solution. But they have their fingers crossed she was swabbed with bacteria.
"I really hope that she was," Vukadinovich says. "If there'south a decreased risk of her having any wellness issues, that would be awesome."
Her husband, Nick, agrees.
"Nosotros're not terribly religious so we won't baptize with water — holy water," Nick says. "Simply since we're scientists, we like the idea of a bacterial baptism instead of a holy baptism — considering at present she'south been initiated with bacteria, friendly bacteria, that should protect her down the road."
Source: https://www.npr.org/sections/health-shots/2018/10/30/658254175/doctors-test-bacterial-smear-after-cesarean-sections-to-bolster-babies-microbiom
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