VAGINAL MICROBIOTA AND NEONATAL HEALTH: A COMPREHENSIVE REVIEW OF VAGINAL SEEDING FOR CESAREAN-BORN INFANTS COMPARED WITH VAGINAL DELIVERY

The neonatal period is a pivotal window for microbial colonization, immune programming, and long-term health. Delivery mode plays a crucial role in determining initial microbial exposure, with vaginally delivered infants receiving a rich inoculum of maternal vaginal and
intestinal microbiota. Cesarean section, however, disrupts this natural microbial transfer, predisposing neonates to dysbiosis and an increased risk of immune-mediated and metabolic disorders. Vaginal seeding—the intentional inoculation of cesarean-born infants with maternal vaginal fluids—has emerged as a potential intervention to bridge this microbial gap. This review synthesizes current knowledge on the role of vaginal microbiota in neonatal health, compares microbial colonization in cesarean and vaginal deliveries, outlines the rationale and procedure of vaginal seeding, evaluates evidence for its effectiveness, and addresses safety
concerns, ethical dilemmas, and alternative strategies. While vaginal seeding demonstrates partial microbial restoration, its efficacy and safety remain unproven, limiting its routine clinical use. Breastfeeding, probiotic supplementation, and emerging microbiome-based therapies may offer safer, more effective alternatives.

Keywords: Vaginal microbiota, cesarean delivery, vaginal seeding, neonatal health, probiotics, microbial colonization.