A Prospective Observational Study to Assess the Impact of Various Childcare Practices on the Development of Microbiota in Neonates

Introduction: The human microbiota develops from newborn time period as a neonate is not born with any microbiota. Colonization of the infant gut represents the de novo assembly of a complex microbial community. This process is influenced by several environmental and host factors. Different child rearing practices like early initiation of breastfeeding, administration of colostrum, ghutti, ghasa and prelacteal feed are likely to affect the microbiota. Aim and Objective: To evaluate impact of different antenatal, natal, postnatal factors and various childcare practices on the development of microbiota in neonates. Primary Objective: To find out proportion of various organisms that first colonise the neonate. Secondary Objective: To evaluate whether there is any change in development of microbiota with gestational age, sex, mode of delivery and method of feeding. Methodology: Type of study was prospective quantitative cross-sectional observational clinical research with a prospective design and was conducted in Department of Paediatrics, Dr S. N. Medical College, Jodhpur, and Rajasthan, India. Samples of 128 newborns were taken. Seven samples (skin of right upper limb, skin of left lower limb, surface of umbilical cord, mucosa of oropharynx, mucosa of conjunctiva, stool sample, air sample) of each baby with swab were taken. Result: In babies with initiation of feeding less than 24 hours first bacterial growth appeared in within first three days of life in 77 babies in pharynx which was statistically significant (P value - 0.00001), in 78 babies in stool (P value - 0.014958) which was statistically significant. The first microbiota isolated in stool in babies with initiation of breastfeeding in less than 24 hours was E. coli (77.5%), in pharynx streptococcus (65%), in skin nonpathogenic staphylococcus (57.5%). Conclusion: Our study concluded that early initiation of feeding helps in early establishment of microbiota in pharynx and stool and the first organism isolated in stool, skin and pharynx in babies with early initiation of breastfeeding is E coli, non-pathogenic staphylococcus and streptococcus respectively.