Letters “Vaginal seeding” after caesarean section

Author's reply to Banda and Lokugamage

BMJ 2016; 352 doi: https://doi.org/10.1136/bmj.i1738 (Published 31 March 2016) Cite this as: BMJ 2016;352:i1738
  1. Aubrey J Cunnington, clinical senior lecturer in paediatric infectious diseases
  1. Section of Paediatrics, Department of Medicine, Imperial College London, London W2 1PG, UK
  1. a.cunnington{at}imperial.ac.uk

Both Banda and Lokugamage refer to a recent study showing that vaginal seeding partially restores the microbiota of caesarean born infants.1 2 3 4 I would like to assure them that we did not selectively ignore this evidence.

Our editorial was written several months ago, was accepted for publication on 8 January 2016, and we approved the proofs on 19 January 2016. The article that Banda and Lokugamage refer to was not published online until 1 February 2016. Banda suggests that we should consider this study because in principle it provides scientific support for the practice of “vaginal seeding.” It certainly provides proof of concept that transfer of bacteria at birth can alter the developing microbiota. Indeed, it would be surprising if this were not the case. However, it provides no evidence that this has any health benefit, as the authors themselves stress. Furthermore, we cannot make any generalisations about the safety of the procedure because only four caesarean born infants received seeding, and they had all undergone screening for group B streptococcus. Thus the findings of this study do not contradict any of the messages we aimed to convey in our editorial.


  • Competing interests: None declared.


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