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The microbiota of babies born by c-section can be optimised by breastfeeding

By Dr Cian Hill, Prof Catherine Stanton and Prof. Anthony Ryan

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APC scientists have found that breast feeding is particularly important for babies born by Caesarean section, and especially those born early (<35 weeks), as it helps to develop a more “normal” gut microbiota (bacterial community).

The population of gut bacteria develops over the first 2-3 years of a baby’s life and is known to play a key role in human health. At birth, the population of bacteria found on babies resembles that of the mother’s vagina if born vaginally, or that of skin, if born by C-section.

In this in-depth study, scientists at the APC Microbiome Institute led by Prof Catherine Stanton at Teagasc and Prof Anthony Ryan at University College Cork and Cork University Maternity Hospital, compared development of the gut microbiota of 199 infants from 1 to 24 weeks of age. The infants in the study were initially breast-fed following vaginal or Caesarean section delivery and included both full-term and pre-term (<35 weeks gestation) births.

Babies born vaginally at full-term were found to have a relatively stable microbiota throughout the first 24 weeks with “good” bacteria such as Bifidobacteria predominating. Bifidobacteria are known to break down the complex sugars called Human Milk Oligosaccharides (HMOs) in breast milk and so infants with more Bifidobacteria are thought to extract more nutrition from milk digestion, thus helping them to thrive.

Dr Cian Hill, lead author on the paper, noted that “full-term babies born by C-section who were breast-fed for at least 4 weeks were found to have a similar gut bacteria composition to vaginally born babies by 8 weeks of age.  At 24 weeks all infants, whether preterm or full-term and born vaginally or by C-section, had similar gut microbiota compositions.” “This study clearly shows that mode of delivery and gestational age at birth are the strong influencers of early gut microbiota populations following birth” said Prof Catherine Stanton, leader of the research at Teagasc. “We have shown that infants that were naturally delivered through the birth canal have a much more established and mature microbiota at just one week of age, which remains relatively stable over the first 6 months, compared to infants born by C-section whose initial microbiota is very different to naturally delivered babies.”

“These results highlight the importance of breastfeeding particularly for infants born by Caesarean section” added Prof Anthony Ryan. “The long-term implications of an altered gut microbiota composition in the first weeks of life, as a result of C-section and preterm delivery, are currently unknown. But this study shows that breast feeding these babies helps to move the microbiota composition towards that of full-term, vaginally delivered babies.”

This research was funded by the Department of Agriculture, Food and Marine, the Health Research Board and Science Foundation Ireland and is published in the journal Microbiome.

Cian J. Hill, Denise B. Lynch, Kiera Murphy, Marynka Ulaszewska, Ian B. Jeffery, Carol Anne O’Shea, Claire Watkins, Gene Dempsey, Fulvio Mattivi, Kieran Tuohy, Paul Ross, C. Anthony Ryan, Paul W. O’Toole and Catherine Stanton. Evolution of get microbiota composition from birth to 24 weeks in the INFANTMET Cohort.  Microbiome. http://microbiomejournal.biomedcentral.com/articles/10.1186/s40168-016-0213-y  http://dx.doi.org/ 10. 1186/s40168-016-0213-y

Photo (left to right): Dr Cian Hill, Prof Catherine Stanton, Prof Paul O’Toole and Prof Anthony Ryan, APC Microbiome Institute