The Vaginal Microbiome // A Whole New World Down Under

 

This blog is written by Stefanie Valakas an Accredited Practising Dietitian & Nutritionist. Stefanie is the founder of The Dietologist, a women’s health, fertility & pregnancy nutrition practice based in Sydney and consults online across Australia and the world! Stefanie has been kind enough to share with us her wisdom on the wonderful world downstairs, that's right, the vaginal microbiome! From understanding how the bacteria living below the belt affects our vaginal health, as well as the differences a vaginal versus C-section delivery can have on baby's health and some nutrition tips to keep your vaginal microbiome in tip-top shape!


Pelvic Floor Expert Hobart

By Dietitian & Nutritionist Stefanie Valakas

The community or residents of bacteria, viruses, fungi and other tiny things that live on your skin and in your gut also lives down there between your legs, that’s right in your vagina!  
 
What is this magical community known as the vaginal microbiome all about? And how can you optimise this environment before you deliver? Let’s talk about it in this blog post! 
 
The term microbiome refers to the genetic material of a community of microbes which may include bacteria, viruses and fungi amongst other microorganisms. The vaginal microbiome spans from the cervix to the external anatomy of the vulva. The vaginal microbiome is mostly made up of bacteria and is dominated by one particular group, called Lactobacillus. You may have heard this term on your yoghurt carton before, and a bit like its action in yoghurt it helps to maintain an acidic environment which protects it from less ideal bacteria growing there such as STIs and helps maintain healthy mucus production. 

There are several factors that can impact the composition of the vaginal microbiome, which differs between woman to woman. Some of these factors include: 

Menstruation 

Semen 

Sexual activity 

Antibiotics 

Lubricants 

Candida or Thrush 

The oral contraceptive pill 

Bacterial vaginosis – a type of imbalance in the microbial inhabitants around and in the vagina. 

When it comes to delivering your baby, if you end up delivering vaginally your baby’s first contact will be with the microbes living in and around your vagina, and we know that this is reflected in your baby’s own microbiomes. Whereas babies delivered via caesarean have a first exposure to the skin microbes instead. So, is there a difference for baby in the long-term? Well… research is in its infancy, but it looks like that a whole range of other factors may be even more important than the mode of delivery itself! 
 
Whether you can or choose to breastfeed once baby is born (yes, breastmilk has its own microbiome too!), the age during pregnancy, weight, and antibiotic use during and after pregnancy may be more important according to the latest research on the impact of your baby establishing an optimal gut microbiome. 

However, some research has suggested that C-section delivered babies may be at an increased risk of having cow’s milk allergy or intolerance due to having less of a particular strain of bacteria Lactobacillus johnsonii, found in the vagina.  

This calls into question the recent trend of “vaginal seeding”, which is not allowed in Australia FYI due to infection risk associated with Group B strep. Vaginal seeding is the practice of inoculating your baby delivered by Caesarean with some of your vaginal fluids on their lips to help encourage some exposure to the vaginal microbiota. Recent research is now calling this practice into question as to whether it is really having as much benefit as research initially indicated. 

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What CAN you do through lifestyle to give your vaginal microbiome a helping hand when it comes to promoting a healthy diversity? 
 
(1) If something isn’t quite right, funky discharge or smells, go and get yourself swabbed at your GP or family planning clinic just to be rule out any Candida, Bacterial Vaginosis or other imbalances in the microbiota downstairs.  You should be screened for Group B Streptococcus (known as Group B Strep or GBS) during your pregnancy and treated accordingly.  

(2) Eat plenty of high-fibre plant foods: think wholegrain breads, cereals and grains, legumes and beans, nuts and seeds and a wide variety of fruits and vegetables. These foods provide all important prebiotic fibre which helps feed the fibre-munching bacteria in our gut, and potentially may aid in our vaginal microbiota diversity. The more variety you have in the plant foods you eat, the better! 

(3) Include pregnancy-friendly fermented foods: think probiotic-rich yoghurt or kefir (ensure these products are pasteurised), miso, tempeh and sauerkraut. If you’re struggling to include many of these foods, speak to your GP, obstetrician or prenatal dietitian about a probiotic supplement that may work for you.

Need some help with your prenatal nutrition? Get in touch with Stefanie for a one-on-one dietitian consultation in Sydney or online via her website or social media pages.