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Maternal bacteria to correct abnormal gut microbiota in babies born by C-section

  • Butler, Éadaoin M.1, 2
  • Chiavaroli, Valentina2, 3
  • Derraik, José G.B.1, 2, 4, 5
  • Grigg, Celia P.2
  • Wilson, Brooke C.2
  • Walker, Nicholas6
  • O'Sullivan, Justin M.2
  • Cutfield, Wayne S.1, 2, 5
  • 1 A Better Start – National Science Challenge
  • 2 Liggins Institute, University of Auckland, Auckland, New Zealand
  • 3 Neonatal Intensive Care Unit, Pescara Public Hospital, Pescara, Italy
  • 4 Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
  • 5 Endocrinology Department, Children's Hospital of Zhejiang University School of Medicine, Hangzhou, China
  • 6 Department of Obstetrics and Gynaecology, Auckland City Hospital, Auckland District Health Board, New Zealand.
Published Article
Ovid Technologies (Wolters Kluwer) - Lippincott Williams & Wilkins
Publication Date
Jul 24, 2020
DOI: 10.1097/MD.0000000000021315
PMID: 32791721
PMCID: PMC7387037
PubMed Central
  • Research Article
  • Study Protocol Clinical Trial


Introduction: There is evidence that caesarean section (CS) is associated with increased risk of childhood obesity, asthma, and coeliac disease. The gut microbiota of CS-born babies differs to those born vaginally, possibly due to reduced exposure to maternal vaginal bacteria during birth. Vaginal seeding is a currently unproven practice intended to reduce such differences, so that the gut microbiota of CS-born babies is similar to that of babies born vaginally. Our pilot study, which uses oral administration as a novel form of vaginal seeding, will assess the degree of maternal strain transfer and overall efficacy of the procedure for establishing normal gut microbiota development. Methods and analysis: Protocol for a single-blinded, randomized, placebo-controlled pilot study of a previously untested method of vaginal seeding (oral administration) in 30 CS-born babies. A sample of maternal vaginal bacteria is obtained prior to CS, and mixed with 5 ml sterile water to obtain a supernatant. Healthy babies are randomized at 1:1 to receive active treatment (3 ml supernatant) or placebo (3 ml sterile water). A reference group of 15 non-randomized vaginal-born babies are also being recruited. Babies’ stool samples will undergo whole metagenomic shotgun sequencing to identify potential differences in community structure between CS babies receiving active treatment compared to those receiving placebo at age 1 month (primary outcome). Secondary outcomes include differences in overall gut community between CS groups (24 hours, 3 months); similarity of CS-seeded and placebo gut profiles to vaginally-born babies (24 hours, 1 and 3 months); degree of maternal vaginal strain transfer in CS-born babies (24 hours, 1 and 3 months); anthropometry (1 and 3 months) and body composition (3 months). Ethics and dissemination: Ethics approval by the Northern A Health and Disability Ethics Committee (18/NTA/49). Results will be published in peer-reviewed journals and presented at international conferences. Registration: Australian New Zealand Clinical Trials Registry (ACTRN12618000339257).

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