Improving the Infant Microbiome: New Inova Study Leads the Way

Suchitra K. Hourigan, MD, is board-certified in pediatrics and pediatric gastroenterology. She sees patients at Pediatric Specialists of Virginia, a medical collaboration between Inova and Children’s National.

Newborn babies inherit a lot from their mothers — including beneficial bacteria that can influence their health for years to come.

The human body is home to trillions of helpful microorganisms, collectively known as the microbiome. When babies are born vaginally, they receive bacteria from their mothers’ birth canals. But babies born by cesarean section (C-section) can miss out on that starter dose of beneficial microbes — and might be at increased risk of health problems as a result.

Now, Inova is leading a groundbreaking study to improve the microbiome of babies born by C-section. This first-of-its-kind research trial could lead to better health for more than 1 million babies in the United States each year.

Gut Bacteria Are Important Helpers

The first few years of life are essential for developing a healthy microbiome. The beneficial bacteria in a baby’s gut produce nutrients, fight off harmful bacteria and play a role in the development of a healthy immune system.

Yet we know the microbiomes in the guts of babies born by C-section look a lot different from those of babies born vaginally. We also know C-section delivery is associated with an increased risk of asthma, allergies, obesity and immune deficiencies. We believe those two things are connected.

Several years ago, our collaborator Maria Dominguez-Bello, PhD, a researcher at New York University, did a pilot study to test whether “vaginal seeding” can change the microbiome of a baby born by C-section. She and her colleagues wiped newborns born by C-section with vaginal secretions taken from their mothers. After the procedure, the babies’ intestinal bacteria more closely resembled those of babies born vaginally.

Inova Study Leads the Way

Now, Inova has been allowed by the FDA to proceed with a larger study to determine whether vaginal seeding leads to lasting changes in babies’ microbiomes and health outcomes. It’s the first — and so far, only — study of its kind.

To start, we plan to enroll 50 mothers who deliver their babies by C-section. We’ll randomly assign half the babies to be wiped with their mothers’ vaginal secretions. The other half will be wiped with saline solution. If there aren’t any complications, we’ll expand the study to 800 mothers.

We will follow the mothers and babies for three years, collecting stool samples to look at their microbiomes over time. We’ll also track their health to see if the procedure lowers the risk of problems such as allergies, asthma and obesity in babies born by C-section.

This is a simple procedure and we expect it to be quite safe. We test mothers for any infections that might be transmitted to the baby. But because it hasn’t been well studied yet, we don’t recommend that women try vaginal seeding on their own. Our first step is to confirm the technique is safe and effective.

Improving Medical Practice

It is so exciting to be the first site in the U.S. allowed to proceed with testing this promising new process. It’s a natural fit for us. The Inova Translational Medicine Institute engages in cutting-edge research to understand how disease develops and to personalize treatments. Our researchers and clinicians have great experience leading long-term studies of child health and chronic disease.

Unlike many new medical treatments, applying a mom’s vaginal bacteria to her baby is a simple and inexpensive procedure. If the results of this study are positive, we could dramatically change the practice of obstetrics — and potentially improve the health of millions of babies every year.

Learn more about the Inova vaginal microbiome seeding trial. For more information about our research studies, call us at 703-776-8489.