The impact of Caesarean section on the infant gut microbiome

Acta Paediatr. 2021 Jan;110(1):60-67. doi: 10.1111/apa.15501. Epub 2020 Aug 11.


Aim: Description of the impact of caesarean section on the infant gut microbiome, infant health and solutions to restore the dysbiosis.

Methods: We searched PubMed and Google Scholar for relevant articles. Only articles published in English were selected. Separate searches were performed for each topic. We selected 60 articles published between 1999 and 2019 by extracting subject headings and key words of interest for this topic.

Results: Caesarean section is an obstetrical procedure that is increasing in prevalence worldwide. On top of the maternal and neonatal risks that this procedure carries, it also induces a dysbiosis of the infant intestinal microbiome possibly challenging the health outcome for the infant. Antibiotics administered during Caesarean deliveries contribute to the development of the gut microbiome. Nonetheless, breastfeeding and several interventions such as vaginal seeding and supplementation with probiotics, prebiotics and synbiotics may contribute to the restoration of the dysbiosis.

Conclusion: Caesarean section is associated with the development of an imbalance of the infant gut microbiome. Long-term consequences of this imbalance are debated. Besides breastfeeding, other strategies to restore this dysbiosis need further studies before they can be recommended.

Keywords: breast feeding; caesarean section; dysbiosis; health outcome; microbiome; prebiotic; probiotic; symbiotic; vaginal seeding.

MeSH terms

  • Cesarean Section / adverse effects
  • Dysbiosis
  • Female
  • Gastrointestinal Microbiome*
  • Humans
  • Infant
  • Infant, Newborn
  • Prebiotics
  • Pregnancy
  • Probiotics*
  • Synbiotics*


  • Prebiotics