Vaginal seeding should not be performed outside the context of an institutional review board-approved research protocol until adequate data regarding the safety and benefit of the process become available, according to recommendations from the American College of Obstetricians and Gynecologists (ACOG). The intended purpose of vaginal seeding is to transfer maternal vaginal bacteria to the newborn. As the increase in the frequency of asthma, atopic disease, and immune disorders mirrors the increase in the rate of cesarean delivery, the theory of vaginal seeding is to allow for proper colonization of the fetal gut and, therefore, reduce the subsequent risk of asthma, atopic disease, and immune disorders. Among the ACOG recommendations:
- ACOG does not recommend or encourage vaginal seeding outside of the context of an institutional review board-approved research protocol, and it is recommended that vaginal seeding otherwise not be performed until adequate data regarding the safety and benefit of the process become available.
- ACOG only supports the performance of vaginal seeding in the context of an institutional review board-approved research protocol.
- Should a patient insist on performing the procedure herself, a thorough discussion with the patient should be held acknowledging the potential risk of transferring pathogenic organisms from the woman to the neonate.
- Although findings are mixed regarding associations between breastfeeding and the development of asthma and atopic disease in childhood, exclusive breastfeeding for the first 6 months of life has multiple known benefits and remains the recommendation of ACOG for all women who do not have physical or medical conditions that prohibit breastfeeding.
Vaginal seeding. Committee Opinion No. 725. American College of Obstetricians and Gynecologists. Obstet Gynecol. 2017:130:e274–8.
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