C-section birth is a medically essential intervention in many cases, yet it carries implications that extend far beyond the delivery room—especially for the developing infant microbiome and the mother’s recovery journey. Issue 5 of The Feed explores this multifaceted topic through expert commentary and evidence-based guidance.
The edition opens by framing the growing prevalence of Caesarean section (C-section) births globally. While life-saving in appropriate clinical contexts, elective or non-medically indicated C-sections may disrupt several biological processes crucial to early infant development. Prof. André van Niekerk highlights how bypassing the vaginal canal deprives infants of the microbial “rite of passage”—exposure to maternal vaginal and gut flora that initiates colonisation of beneficial microbes such as Bifidobacterium. This delay in colonisation has been linked to increased risks of allergies, autoimmune conditions, metabolic disorders, and neurodevelopmental issues.
Prof. Claudia Gray further explains that a newborn’s microbiome acts as a critical extension of their genome, influencing immune modulation, gut integrity, and neurological development. She emphasizes that breast milk plays a vital compensatory role, as it provides both prebiotics (e.g., HMOs) and probiotics, forming a natural source of synbiotics that help re-establish microbial balance. When exclusive breastfeeding is not possible, formulas containing synbiotics that mimic breast milk composition may offer additional support.
The edition also explores the challenges and strategies surrounding breastfeeding after C-section, a topic detailed by childbirth educator and midwife Lynne Bluff. C-sections are associated with delayed initiation of breastfeeding and lower exclusivity rates. However, skin-to-skin contact immediately after delivery, even in surgical settings, significantly improves outcomes. Techniques like the “football hold” and the promotion of biological nurturing—allowing infants to initiate feeding through their innate reflexes—can enhance comfort and reduce nipple pain, increasing breastfeeding success.
Prof. Priya Soma-Pillay contributes practical guidance on maternal recovery, including antenatal preparation, wound care, early mobilisation, and postpartum contraception. She stresses that supporting the mother’s emotional and physical wellbeing is equally important to ensuring the health of the newborn.
Together, these expert insights present a comprehensive view of how early practices—especially breastfeeding and skin-to-skin care—can help mitigate some of the unintended consequences of C-section birth. The magazine advocates for a proactive, nurturing approach to microbial, nutritional, and emotional recovery, providing healthcare professionals with the tools to guide families through this increasingly common birth journey.
