The gut microbiome is complex and plays a major role in the development and regulation of the immune system. Maternal health, and the state of the maternal gut microbiome, before and during pregnancy is an important determinant for the development of newborn microbiome. As the maternal microbiome is transferred to the infant, there is the potential that maternal microbiome deficiencies will also be transferred to the child. An infant’s gut microbiome is influenced by many factors that are associated with modern birth practices (SC-delivery and antibiotics). These modern practices have greatly contributed to infant survival, but also have increased the risk of developing inflammatory and gut diseases. Therefore, manipulating the development of the gut microbiome could help in countering the risk of developing inflammatory and gut diseases.

Microbiome manipulation is a process to guide microbiome development through number of methods. Among these methods are probiotic supplementation, vaginal seeding, Faecal Microbiota Transplantation and phage therapy. 

• Probiotic supplementation: Probiotic has been identified to reduce the mortality and the incidence of NEC (necrotizing enterocolitis) and sepsis in low-birth-weight infants.
• Vaginal seeding: It’s the exposure of CS-delivered infants to vaginal fluid and subsequently to vaginal microbiome. This method is still the subject of debate due to limited data and safety concerns.
• Faecal Microbiota Transplantation (FMT): It’s the “transfer of faecal microbiota from healthy donor into recipients”. Recent study demonstrated that the gut microbiota of CS-born infants can be restored postnatally by maternal FMT. However, an in-depth clinical and microbiological screening is required before FMT can be done.
• Phage therapy: “It’s the method of manipulating bacteria using bacteria-infecting viruses called bacteriophages”. Bacteriophages influence the microbiome through the introduction of genetic element into the microbiome. This method is still in the early exploratory stage and not sufficiently backed by research to be used as a therapy for humans.