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.