What Parents Should Know About C-Section And Children Health

Caesarean section may have potential health impact on the immune system compared to a child born naturally. Here’s how mode of delivery affects the immune system of a child and how we can boost our child's immunity.

How Does Mode of Delivery Affect a Child's Immunity?

The immune system of a caesarean child or a child born by caesarean section (C-section) may be slightly different because when children are born naturally, they pass through the mother's vaginal canal, which naturally gives them exposure to good bacteria that help train their immune system.

C-section children, on the other hand, don't go through this process, so the child lacks good bacteria in the gut where majority of immune cells are located.

But don’t worry too much, gut microbiota can be restored, and immune system can be strengthened so that they grow up healthy. 

Breastfeeding, is a superhero for a child’s immune system!

Breast milk contains very valuable antibodies to protect children from infections and help them build strong body defences.

1. Giving Birth Naturally

Children born naturally, it turns out, get most of their early bacteria from their mothers! 

[1] In a recent study of 281 healthy newborns in Thailand, scientists compared stool samples from naturally born vs C-section infants. They found that natural delivery was associated with higher diversity of gut bacteria overall; with Bifidobacterium being a dominant genus in both groups.

These results support the idea that naturally born infants get beneficial bacteria early on — an important part of healthy gut microbiome development.

2. C-section Delivery

Recent studies [6] have shown that children born via caesarean section (C-section) have a different gut microbiome. 

C-section children tend to have fewer good bacteria in their gut, especially at a young age.

Natural born children are exposed to a variety of good bacteria found in the mother's birth canal, especially bacteria from the genera Bifidobacterium. These bacteria play an important role in the formation of a healthy gut microbiome profile 

However, children born by Caesarean section (C-section) are more exposed to bacteria from the mother's skin and the operating room environment, which means they tend to have a lower diversity of gut bacteria.

This limited microbiota diversity can take up to five years to recover similar to naturally born children. 

This condition is known as gut dysbiosis, which is an imbalance in the composition of intestinal bacteria, which is often associated with immature immune system development.

Gut dysbiosis is a disturbance or imbalance in the bacterial community in the gut. This dysbiosis can lead to a reduction in beneficial bacteria such as Bifidobacterium, and an increase in harmful or unwanted bacteria.

This condition not only affects the child’s digestive system, but it can also weaken the immune system because over 70% of the human immune cells are located in the gut.

The Effect of Gut Dysbiosis on the Infant's Immune System

1. Slow-developing immune system: Without early exposure to good bacteria, C-section children may be at risk of developing an immature immune system.

2. Higher risk of infection: Children may be more susceptible to bacterial or viral infections due to insufficiently weak immunity.

3. Prone to allergies and eczema: Gut dysbiosis is associated with an increased risk of food allergies, eczema and asthma early in life.

4. Long-term health disorders: Dysbiosis in early life has the potential to be linked to inflammatory bowel disease, obesity, and metabolic disorders in adulthood.

So, if you're wondering, "Are children born via C-section more at risk with a weakened immune system?" In general, the answer is yes.

Children born via C-section are potentially at greater risk of facing health problems later in life.

For example, studies show that children born via caesarean section are 20% more likely to develop asthma or hay fever [2,3], 23% more likely to develop type 1 diabetes as a child [4,5], and 22–30% more likely to be obese as an adult [6,7]. 

Who would have thought, right? However, all of this gives us reason to pay more attention to the development of the child’s microbiome, especially for mothers who give birth via caesarean section.

How to Boost Your Child's Immune System After a C-Section

Here are some important steps that can be taken to support your child's immune system after caesarean delivery:

1. Breastfeeding is the best

You've probably heard about antibodies in breast milk, but what exactly do they do? Think of them as a protective force that extends your child's passive immunity and helps them fight off infections.

This feeds the good bacteria in the gut and fends off harmful microorganisms, thus supporting the development of a healthy immune system.

2. Follow the Child Immunisation Schedule

Follow the recommended immunisation schedule to ensure your child is protected against serious diseases such as measles and whooping cough. The first shot is usually given at 8 weeks of age, and each dose acts as a boost to the immune system to respond and build long-term protection.

3. Synbiotics support gut health

Antibiotics are often given before a caesarean section (C-section) to prevent infection. However, their use can disrupt the balance of the child’s gut microbiome, either through direct transfer from the mother or when antibiotics are given to the child after birth. 

To help restore the balance of good bacteria in the gut, you can talk to your healthcare professional about the benefits of synbiotics – a combination of probiotics and prebiotics – which have been shown to support child’s gut and immune health.

Probiotics help restore good bacteria in the gut, especially in children born by C-section and at risk of gut dysbiosis. Prebiotics support the body's defence system by increasing the number of bifidobacteria and lowering the pH of the gut, thus helping to reduce the risk of infection. This combination has been shown to support the development of children's digestive and immune systems. 

Sources:

1. Sricharoenchai, T., Hadee, P., Leelakanok, N., & Ketsuwan, W. (2024). Comparison of gut microbiomes between neonates born by cesarean section and vaginal delivery: Prospective observational study. JMIR Pediatrics and Parenting, 7, e55940. https://doi.org/10.2196/55940
2. Xu, Y., Zhang, C., He, Y., Yan, W., & Liu, Z. (2009).
   Cesarean section and risk of asthma in children: A meta-analysis.
   The Journal of Asthma, 46(6), 606–613. https://doi.org/10.1080/02770900902918267
3. Liu, W., Wang, Z., Wang, L., Chen, S., Zhao, H., Sun, Y., & Zhao, Y. (2024).
   Cesarean section and risk of allergic diseases in children: A systematic review and meta-analysis.
   The Journal of Allergy and Clinical Immunology: In Practice.
   https://doi.org/10.1016/j.jaip.2023.12.035
4. Cardwell, C. R., Stene, L. C., Joner, G., Cinek, O., Svensson, J., Goldacre, M. J., ... & Patterson, C. C. (2008).
   Birth by caesarean section and childhood type 1 diabetes risk: A meta-analysis of observational studies.
   Diabetologia, 51 (5), 726–735. https://doi.org/10.1007/s00125-008-0941-z
5. Smithers, L. G., Wills, K. E., & Ruggiero, L. (2023).
   Association between mode of delivery and childhood health outcomes: A systematic review and meta-analysis.
   BMC Medicine, 21, Article 231. https://doi.org/10.1186/s12916-023-03030-2
6. Darmasseelane, K., Hyde, M. J., Santhakumaran, S., Gale, C., & Modi, N. (2014).
   Mode of delivery and offspring body mass index, overweight and obesity in adult life: A systematic review and meta-analysis. PLOS ONE, 9(2), e87896.
   https://doi.org/10.1371/journal.pone.0087896
7. Quecke, B., Cullati, S., Graf, Y., Epure, A. M., Santschi, V., & Chiolero, A., et al. (2022).
   Cesarean section and obesity in young adult offspring: An updated systematic review and meta-analysis.
   Obesity Reviews, 23(2), e13368. https://doi.org/10.1111/obr.13368
8. Reznik et al. (2024)
   Reznik, R., Carter, K., Akinyemi, M., Shin, H., Ramirez, M., Korich, A., & Taneja, V. (2024).
   Differences in the gut microbiome by delivery mode in a racially and ethnically diverse birth cohort from an under-resourced population. BMC Pediatrics, 24(1), 148.
   https://doi.org/10.1186/s12887-024-04908-7

As featured on The Asian Parent