美国国家公共电台 NPR Doctors Test Bacterial Smear After Cesarean Sections To Bolster Babies' Microbiomes

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STEVE INSKEEP, HOST:

Some new parents have started giving their newborns what's being called a bacterial¹ baptism. The idea is to try to help their babies develop healthy microbiomes, the collection of friendly bacteria that inhabit everyone's bodies. NPR health correspondent Rob Stein brings us this exclusive story about the birth of one of the first babies helping² scientists test this procedure.

(SOUNDBITE OF HOSPITAL MACHINE BEEPING)

ROB STEIN, BYLINE³: It's early in the morning at the Inova Women's Hospital in Falls Church, Va. Danielle Vukadinovich is waiting to give birth to a baby girl.

DANIELLE VUKADINOVICH: Hi. Danielle. Nice to meet you.

STEIN: Nice to meet you, too.

Danielle is having a caesarean section.

How you doing?

D. VUKADINOVICH: I feel good (laughter).

STEIN: Yeah?

D. VUKADINOVICH: Yeah. Excited, nervous, (laughter), but good.

STEIN: Danielle has agreed to try something that might sound a little, well, yucky - let a doctor wipe bacteria from Danielle's birth canal all over her baby's body as soon as she's born.

D. VUKADINOVICH: (Laughter). Yes. So I will tell you I haven't told many people about this (laughter) yet. And I understand why people would be like, oh, my gosh, that's so weird⁴. But I'm OK with it. I don't think it's yucky. It's normal. It's, like, real - it's natural, really.

STEIN: Some people call it a bacterial baptism. Shira Levy⁵ is the microbiome research manager at the hospital.

SHIRA LEVY: It's a little bit like that baby's first dunk. That's their first religious experience. This is their first microbiome experience. You know, they get the water, and that changes their spirituality. In this case, they get the bacteria, and that changes their microbiome. (Laughter).

STEIN: The microbiome is the millions of friendly microbes that live in our bodies. Danielle's a nurse. She knows C-sections have skyrocketed. She also knows lots of diseases, like asthma⁶, allergies⁷, obesity⁸, have spiked¹⁰, maybe partly because babies aren't getting their mom's microbes during their birth.

D. VUKADINOVICH: When a baby is born through the vaginal canal and they get that first introduction of bacteria, it starts their immune system. The C-section's a very sterile¹¹ procedure. You know, they're not getting that first kick in their immune system. And it just made sense that it's a possibility that, you know, this spike⁹ in C-sections is linked to possible health issues with our kids.

STEIN: Danielle heard about other moms trying bacterial baptisms on their own. So she thought, I am a nurse. My husband teaches high school biology.

D. VUKADINOVICH: I even told my mom, maybe I can do this (laughter) myself. Nobody has to know. My husband would help me out. But it's - you know, again, I try not to take unnecessary risks.

STEIN: Danielle knows it could be dangerous. Babies could catch nasty infections by mistake. So she was thrilled when she found out she could be part of a study, the first study the Food and Drug Administration is allowing to test whether this is safe and helps babies.

D. VUKADINOVICH: I mean, who knows what's going to happen with the results? But if it does show something positive, I just think that would be great for kids and parents.

STEIN: Dr. Suchi Hourigan is with us. She's leading the study. Half the babies will get their mom's microbes. Half will get a placebo¹². All the moms will be carefully screened to make sure the microbes are safe.

SUCHI HOURIGAN: This could be huge. Just to be able to reduce one risk factor for obesity, especially when there are such high C-sections in the USA, would be huge.

UNIDENTIFIED NURSE #1: So can't wait to meet your little one.

STEIN: Just then nurse pops in and ushers¹³ us out so they can remove the gauze pad that's been inside Danielle collecting the friendly bacteria doctor will use to swab her baby. The doctors and nurses call it vaginal seeding.

UNIDENTIFIED NURSE #1: Yeah. Very excited. I did the first seeding.

D. VUKADINOVICH: You did?

UNIDENTIFIED NURSE #1: It's really cool.

STEIN: And now it's time for the C-section. As they wheel Danielle into the operating room, I follow along with Dr. Hourigan.

UNIDENTIFIED NURSE #1: Don't touch anything blue 'cause it's sterile.

UNIDENTIFIED NURSE #2: Are we ready to start?

STEIN: Everyone quickly takes their places, and the surgeon gets to work. Dr. Hourigan explains what's happening.

HOURIGAN: An incision¹⁴ is being made into Mom, and they are getting ready to take out the baby. They can see the head, and the head is now coming out of the C-section incision. Baby's head is out.

UNIDENTIFIED NURSE #3: Time, 8:38.

UNIDENTIFIED NURSE #4: Hello, little girl.

STEIN: It happens just that quick. The nurses rush the baby over to a table to clear her breathing.

UNIDENTIFIED NURSE #1: Oh, my goodness. You're beautiful. Rub you a little more.

STEIN: Once she's nice and pink, Dr. Varsha Deopujari gets to work with the gauze swab for the study.

HOURIGAN: Varsha is wiping the swab over baby's mouth, cheeks and face. She is going to turn the swab over to get more exposure to bacteria. And then she is now wiping the baby's hands and arms.

STEIN: She swabs down her chest, over her abdomen¹⁵ and up the other arm.

HOURIGAN: And then finally, baby's back is being wiped now. And the swabbing is now over.

STEIN: They hand the baby back to the nurse.

UNIDENTIFIED NURSE #1: She did beautifully with that.

STEIN: Dr. Hourigan and her team quickly head out of the operating room.

HOURIGAN: That went perfectly¹⁶. Baby came out and was crying. We waited till baby was stable, and the swabbing went just as planned. Beautiful baby girl.

STEIN: The next morning, I stop by to check in on Danielle, her husband, Nick, and their new daughter. Hi. How you doing?

D. VUKADINOVICH: I'm good. Feeling good today.

STEIN: What a sweetie.

D. VUKADINOVICH: Yeah. She is. She's sweet.

STEIN: Danielle and Nick are still trying to decide on a name, and they don't actually know if their new daughter got Danielle's microbes or a sterile solution, but they have their fingers crossed she was swabbed with the microbes.

D. VUKADINOVICH: I really hope that she was and that, you know, she won't have any health issues. I think if there's a decreased chance of her having health issues, that would be awesome¹⁷.

STEIN: Her husband, Nick, agrees.

NICK VUKADINOVICH: We're not terribly religious so we won't baptize with water, holy water. But we like the idea of a bacterial baptism instead of a holy baptism 'cause now she's been initiated¹⁸ with the bacteria, friendly bacteria, and that should protect her down the road.

D. VUKADINOVICH: I like that. It's nice.

STEIN: Dr. Hourigan will do this with 50 babies to make sure it's safe and then hopefully expand the study to 800 newborns who will be followed for three years to see if bacterial baptisms really do help them live better lives. And if you're wondering, Danielle and her husband, Nick, finally settled on a name, Evelyn Marie (ph).

Rob Stein, NPR News, Falls Church, Va.