MODE OF DELIVERY AND THE EFFECT ON INTESTINAL BACTERIA
Erin Smith
Research Question
Does an infant gain the same amount of bacteria necessary for that initial micro-flora development when born vaginally vs. being born by caesarean section?
Does the type of feeding have an impact?
Outline Background Information
Case study overviews
Conclusion
Room for improvement
Probiotics ‘live micro-organisms which confer a
health benefit on the host when administered in adequate amounts’
Prebiotics
Synbiotics
Natural sources: yogurts and Kefir
ProbioticsThe brain weighs 3 Ibs and probiotics weigh 3.5 Ibs.
Bacteria Bifidobacterium- added in probioitic
supplementation B. Infantis
E. coli- diarrhea, nausea, and stomach
cramping
C. difficile- leading cause of diarrhea and colitis
Methods denaturing gradient gel electrophoresis
(DGGE) temperature gradient gel electrophoresis
(TGGE)
“molecular fingerprinting techniques”
Mode of BirthVAGINAL DELIVERY CESAREAN DELIVERY Infant comes in
contact with the vaginal and intestinal flora of the mother which starts the colonization
Infant is relying exclusively on the environmental bacteria to aid in colonization
“Cesarean Delivery May Affect the Early Biodiversity of Intestinal Bacteria,”
46 full term infants
Fecal sample on day 3
TGGE and DGGE
Conclusion- Delivery mode influenced within 3 days of life with little to no influence of the type of feeding
“Factors Influencing the Composition of the Intestinal Microbiota in Early Infancy”
1032 infants fecal samples at one month of age Participants with diverse lifestyles
Conclusion- There were also same differences except feeding method also had and impact
Bifidobacteria
E.Coli C. difficile
B fragilis- Group
Lactobacilli
Place and Mode of Deliviery
Prevalence %
Prevalence %
Prevalence %
Prevalence %
Prevalence %
Natural delivery at home
99 85 19 83 32
Natural delivery in hospital
99 88 26 85 34
Artificial delivery in a hospital
100 91 34 87 30
Cesarean section in hospital
96 91 42 63 32
“Factors Influencing the Composition of the Intestinal Microbiota in Early Infancy”
Most were breast-fed exclusively for 1 mo.
232 formula-fed exclusively 98 combination
Conclusion- Formula fed more colonized with E. coli and C. difficile.
Vaginal Delivery
Cesarean Delivery
• Bifidobacterium
• C difficile• E. Coli
“Microbiota of 6-week-old infants Across Europe: Geographic
Influence Beyond Delivery Mode, Breast-feeding, and Antibiotics”
606 infants 5 European Countries Filled out 2 questionaires Fecal samples at 6wks.
Conclusion- Cesarean had counts of Bifidobacterium and counts of C. difficile
Nutritional Impact Breast-fed babies- bifidobacteria and
significantly proportions of bacteroides, C coccoides, and Lactobacillus groups compared with formula-fed babies.
“Molecular Monitoring of Succession of Bacterial Communities in Human
Neonates” 2 healthy baby boys
Both vaginally delivered and breast-fed immediately after birth.
Baby 1- breast-fed 130 days, then infant formula was added and baby was weaned by day 200.
Baby 2- breast-fed until day 17, then infant formula was added and increased over time
Samples daily first 2 wks of life Then twice a months For 10 to 12 months
Conclusion- Breast-fed baby had more Bifidobacterium.
All Studies All conclude that mode of delivery has an
impact on bacterial development. One study suggests type of feeding has
no impact in first 3 days of life. Other 3 studies suggest that by 1 month
of age nutrition type does have an impact on development.
Room for Improvement Feces samples taken at a clinic or
location of the studies.
Ensure same infant formula is used with all infants.
These would decrease inconsistency.