Establishing Early Gut Integrity in Babies – Why It Matters

Our modern society has led us down a path of distrusting the natural process of childbirth and towards an often clinical, scheduled event. I must add that in no way do I want to add to the guilt that many mothers feel when they are unable to deliver naturally or when they struggle to breastfeed.

In my own family, we experienced both extremes. While my son was born by normal vaginal delivery and breastfed for a year, my daughter was delivered by an emergency caesarean section. She was two months premature and with the cord wrapped around her neck, would never have survived a normal delivery. Her prematurity meant that her suck reflex was weak, which made breastfeeding a struggle.

When it comes to childbirth and feeding, there are times when the emergency medical situation prohibits choice and the option of a normal delivery. In other situations, however, mothers are encouraged to choose elective C-sections and the possibility of a normal delivery is discouraged.

“An uncomplicated vaginal delivery and breastfeeding are the cornerstones to a baby’s healthy gut microbiome.”

Current research shows that there is a link between gut microbiomes and chronic illnesses that begin in childhood and continue into adulthood. These illnesses range from obesity to auto-immune diseases, asthma, arthritis, immune deficiencies and certain cancers. An uncomplicated vaginal delivery and breastfeeding are the cornerstones to a baby’s healthy gut microbiome, which is a collection of tiny micro-organisms that live on and in the human body. These organisms play a vital role in immunity and metabolic health, and assemble for the first time in a baby’s gut.

How does this exchange happen and why is it so important?

The process is nothing short of a miracle and is a series of natural events that take place in the mother’s body by way of an exchange from the mother to her baby and prepares the newborn’s immune system to face the organisms found in the outside world.

• Pregnancy: Studies have shown that as the pregnancy progresses there are changes in the microbes of the mother, particularly in the last trimester. Lactobacilli and Bifidobacterium are among the most dominant organisms. Lactobacilli keeps the pH in the vagina low and helps to prevent harmful bacteria from infecting the amniotic fluid, placenta and foetus. Bifidobacterium, on the other hand, aids in better energy absorption during pregnancy and in the first few hours of life. Unless the microbes are disrupted, a mother’s body primes itself to provide the perfect environment for her baby.

• The birth: As soon as a mother’s water breaks, the baby is washed in all the mother’s vaginal microbes. The microbes coat the baby’s skin, enter the eyes, nose and, most importantly, the mouth. These precious microbes find their way to the baby’s gut, where all the vital work on the immunity and baby’s well-being begins. If a baby is born by caesarean, this very important introduction to the microbial world is missed. Literature also shows that the positive stress of normal delivery programmes the baby for a stronger immunity and genes that control weight and suppress certain tumours.

• Skin-to-skin touch: Whether a baby is born by caesarean or vaginally, skin-to-skin contact with the mother should be encouraged. Putting the baby to the breast immediately and the skin-to-skin touch allows for a transfer of microbes. Interestingly, research has shown that about 10% of a baby’s gut bacteria comes from the areolas of the breasts.

Breastfeeding

• Colostrum: A mother produces colostrum for about 72 hours after birth. This precursor to breast milk is yellowy gold in colour and quite thick, and has the primary function of boosting the immune system. Imagine your baby’s gut to be like a sieve when born. All manner of harmful organisms can get into your baby’s bloodstream from an immature gut. If your baby is fed colostrum, the holes of the sieve are closed up and the gut is sealed, preventing harmful organisms from entering your baby’s bloodstream via the gut. Without colostrum, there is a much higher rate of neonatal infections. Even if you’re unable to breastfeed immediately you can ask your midwife to collect the colostrum from your breast using a syringe and to give it to your baby. You will only produce about a teaspoon of colostrum a day, but this is enough for your baby. It is a superfood with everything that your baby needs in the first few days of life.

• Transitional milk: Up until your baby is about 14 days, your breasts will produce a mix of colostrum and breast milk. This transitional milk is packed with everything your baby needs including hormones, cells and the helpful bacteria (microbes). All of these aid with the growth of your baby and gut integrity.

• Mature milk: Breast milk contains around 600 types of microbes, as well as the sugars necessary to feed these microbes. These healthy, well-fed microbes flood the baby’s gut and make it extremely difficult for harmful microbes to exist in the gut. Around one third of the microbes found in your baby’s gut come from breast milk and bring with them all the benefits of good gut integrity such as immunity and protection from infection and chronic illnesses.

The microbes obtained from breast milk also prepare the gut for taking maximal nutrition from solid food once that is introduced. The microbes continue to stimulate the immune system and metabolic system for as long as breastfeeding continues, programming your baby’s body to be in a state of well-being where dreadful illnesses are kept at bay by the most natural process.

What happens if the natural process of childbirth and breastfeeding is interrupted?

Caesarean section:

• Speak to your obstetrician about breaking your waters first. Your baby can be introduced to the amniotic fluid by way of washing and still receive some benefit from your microbes.
• Begin breastfeeding as soon as possible.
• Speak to your paediatrician about pre- and probiotics, which can be given to your baby to help establish the gut biome.

Breastfeeding:

• If breastfeeding is interrupted, get help as soon as possible to get it going again.
• Pre- and probiotics may be given or a formula that contains these can be used.

The subject of a typical vaginal delivery can be a stressful one for an expectant mother and horror stories of what can go wrong often lead women to opt for an elective Caesar. But the fact is, vaginal deliveries are not always possible and it is important for mothers to be given a choice of how to deliver, as long as there is no risk to either her or her baby.

In addition, mothers need a huge amount of support and assistance when breastfeeding is difficult, and there are wonderful lactation specialists who will help a nursing mother – and most medical aids will pay for a consultation. Gut integrity has been identified as the cause of our children developing more chronic illnesses, so it is always worth considering natural birthing and feeding options.

This article has been specially written for BabyYumYum by our expert paediatrician, Dr Enrico Maraschin.