Intended for healthcare professionals


“Vaginal seeding” of infants born by caesarean section

BMJ 2016; 352 doi: (Published 23 February 2016) Cite this as: BMJ 2016;352:i227
  1. Aubrey J Cunnington, clinical senior lecturer1,
  2. Kathleen Sim, clinical research fellow1,
  3. Aniko Deierl, consultant neonatologist2,
  4. J Simon Kroll, professor of paediatrics and molecular infectious diseases1,
  5. Eimear Brannigan, consultant in infectious diseases and infection prevention and control3,
  6. Jonathan Darby, infectious diseases physician4
  1. 1Section of Paediatrics, Department of Medicine, Imperial College London W2 1PG, UK
  2. 2St Mary’s Hospital, London, UK
  3. 3Charing Cross Hospital, London, UK
  4. 4St Vincent’s Hospital, Fitzroy, VIC 3065, Australia
  1. Correspondence to: A J Cunnington a.cunnington{at}

How should health professionals engage with this increasingly popular but unproved practice?

The microbiota is the community of microbes that colonises our bodies, outnumbering our own cells 10 to 1.1 This complex microbial community varies from one part of the body to another, and from one person to another. Characteristic differences in the microbiota are associated with various diseases.2 As a result interest has surged in the potential for manipulating the microbiota to promote health and treat disease.2

The term “vaginal seeding” describes the use of a gauze swab to transfer maternal vaginal fluid, and hence vaginal microbiota, on to an infant born by caesarean section.3 4 The composition of the early microbiota of infants is heavily influenced by mode of delivery.4 In infants born by caesarean section the microbiota resembles that of maternal skin, whereas in vaginally born infants it resembles that of the maternal vagina.4 5

These early differences in the microbiota have been suggested to determine susceptibility to …

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