*2.7.2 Recommendations for clinical practice*


This chapter reviews the existing literature on vaginal seeding, a practice aimed at replicating the microbial exposure of a vaginal birth for infants born *via* cesarean section (C-section). The review focuses on the impact of vaginal seeding on the neonatal microbiome composition, immune development, and health outcomes. Several studies have explored these aspects, providing insights into the potential benefits and controversies surrounding vaginal seeding. Studies have reported varying results concerning the impact of vaginal seeding on the neonatal microbiome. Some suggest that vaginal seeding can lead to an increased abundance of beneficial bacteria, similar to those found in infants born vaginally. However, methodological differences among

*Vaginal Seeding in Term Cesarean Section Is a Mandatory Condition for Improvement… DOI: http://dx.doi.org/10.5772/intechopen.114043*

studies may contribute to inconsistencies in findings. More well-controlled studies with standardized protocols are needed to further clarify the effects of vaginal seeding on the neonatal microbiome.

Vaginal seeding has been investigated for its potential role in promoting immune maturation in newborns. Some studies indicate that it may influence immune cell populations and cytokine profiles, contributing to immune tolerance. Nevertheless, the clinical significance and long-term implications of these immune changes remain unclear and require further investigation.

Observational studies have suggested associations between vaginal seeding and reduced risks of certain health conditions such as allergies, asthma, and autoimmune disorders. However, evidence in this area is limited and based on small-scale studies or anecdotal reports. Large-scale and well-designed studies, including randomized controlled trials, are necessary to evaluate the potential benefits and long-term effects of vaginal seeding on health outcomes [56–63].

The review identifies several gaps in the current knowledge about vaginal seeding. These include the lack of standardized protocols, variations in vaginal seeding practices, small sample sizes, limited long-term follow-up studies, and insufficient diversity among study populations. Safety concerns, mechanistic understanding, and the need for broader well-controlled research are also highlighted as areas that require attention..

In conclusion, while the existing literature provides some evidence suggesting the potential benefits of vaginal seeding, it also underscores the need for further research. Standardized protocols, larger sample sizes, diverse study populations, and extended follow-up periods are essential to establish a clearer understanding of vaginal seeding's impact on the neonatal microbiome, immune development, and health outcomes. Addressing these gaps will help healthcare professionals make more informed decisions about the use of vaginal seeding and its potential role in promoting neonatal health and well-being.

#### **2.8 Recapitulation of the importance and implications of the research**

The research on vaginal seeding holds significant importance in the field of neonatal health and microbial development. Recapitulating the key findings and implications of the research sheds light on the potential impact and controversies surrounding this practice [56–63].

The neonatal microbiome plays a crucial role in immune development, metabolic processes, and overall health outcomes. Understanding how vaginal seeding influences the neonatal microbiome composition can have far-reaching implications for neonatal health and disease prevention. With an increasing number of births occurring *via* cesarean section, exploring interventions such as vaginal seeding becomes crucial to promote microbial diversity and mimic the benefits of vaginal delivery. This research addresses the potential differences in the microbiome between infants, born *via* C-section and those delivered vaginally. Investigating the impact of vaginal seeding on immune development provides insights into potential strategies to promote immune tolerance and reduce the risk of immune-related disorders in later life. Exploring associations between vaginal seeding and reduced risks of allergies, asthma, and autoimmune disorders highlights the potential long-term health benefits of this practice. However, due to limited evidence, further research is necessary to draw definitive conclusions [56–63].

The findings of this research may influence clinical practice by encouraging healthcare professionals to consider vaginal seeding as an option for infants born *via* C-section. However, due to safety concerns and the need for more robust evidence, further research and standardized protocols are necessary before widespread adoption. The research underscores the importance of educating pregnant women about the potential benefits and risks of vaginal seeding. Clear communication with expectant mothers can help them make informed decisions about their birth plan and understand the implications of various delivery methods.

Identifying gaps in the current knowledge highlights the need for future research priorities. Larger-scale studies with diverse populations, long-term follow-up, and standardized protocols will contribute to a more comprehensive understanding of vaginal seeding's effects [56–63].

### **2.9 Final remarks and closing thoughts**

In conclusion, the research on vaginal seeding represents a compelling area of investigation with potential implications for neonatal health and development. The neonatal microbiome and immune system are critical factors in shaping an infant's health and well-being and understanding how vaginal seeding influences these aspects is of utmost importance.

The conclusions drawn from the body of material already in existence indicate the potential advantages of vaginal seeding in promoting a microbiome composition that is similar to that of vaginally delivered children. Such a procedure may promote immunological development and maybe lower the risk of developing certain diseases in later life. However, it is essential to recognize that the evidence is currently limited and often inconsistent, necessitating further research with standardized protocols and larger sample sizes to validate these findings [56–63].

The research also emphasizes the importance of addressing gaps in our current knowledge. Long-term follow-up studies, inclusion of diverse populations, and standardized procedures are necessary to draw definitive conclusions about the safety and effectiveness of vaginal seeding. Moreover, ethical considerations surrounding informed consent, safety protocols, and potential risks should remain at the forefront of any research or clinical implementation [56–63].

The idea of vaginal seeding has potential, but caution must be used to prevent oversimplifying results until more conclusive data are available. The medical community should collaborate to prioritize research efforts in this field to ensure that decisions concerning vaginal seeding are evidence-based and prioritize the well-being of newborns and their mothers [55–63]. In closing, the exploration of vaginal seeding represents a fascinating avenue of research that has the potential to impact the future of neonatal care positively. By advancing our understanding of the neonatal microbiome and immune development, we can pave the way for more personalized and effective interventions. Continued investigation, collaboration, and critical evaluation will be crucial in unlocking the full potential of vaginal seeding and its implications for neonatal health and long-term outcomes. Ultimately, with evidence-based knowledge, we can strive to provide the best possible start in life for every newborn and support their journey toward a healthy and thriving future.

*Vaginal Seeding in Term Cesarean Section Is a Mandatory Condition for Improvement… DOI: http://dx.doi.org/10.5772/intechopen.114043*
