Ask the Expert: Curious About How C-Section Deliveries May Affect Your Child’s Immunity?

Many parents wonder if babies born via C-section have weaker immunity compared to those born naturally. Does the gut microbiome differ? Should you give extra probiotics, supplements, or delay childcare to protect their health?

We asked Dr. Alison Snodgrass, Consultant Paediatrician at Parkway East Paediatric Clinic, to address parents’ most common concerns about C-section babies and their immunity.

Do C-section babies need different vaccinations or extra supplements to catch up on immunity?

C-section babies follow the same vaccination schedule as other babies. However, it’s recommended to encourage optional vaccines, such as influenza and chickenpox, to maximise protection against infections.

As for supplements, probiotics can help optimise the infant’s gut microbiome, which differs in C-section babies compared to vaginally delivered babies.

Are there specific nutrients or habits that can help boost a C-section baby’s immunity in the first year?

Yes, Dr. Snodgrass recommends:

1. Breastfeeding – Human milk contains substances that enhance infant immune development.

2. Probiotics – Especially important during the first 1,000 days of life to optimize the gut microbiome.

3. Timely weaning & exposure to dietary allergens – This encourages oral tolerance, which can help protect against autoimmune diseases and allergies.

I gave birth via C-section. I saw a video saying my baby’s spine wasn’t “activated” at birth and it affects health. Is this true?

C-section delivery lacks the natural compression and movement of the infant’s spine that occur during vaginal delivery, which are important for adaptation after birth.

During vaginal birth, perinatal stress increases cortisol and catecholamine production in the baby’s blood, which is essential for lung maturity and circulatory adaptation.

However, there’s no evidence that spinal “activation therapy” is necessary or effective.

My C-section baby falls sick more often than my other kids. What else can I do to boost immunity?

C-sections and antibiotics can alter the early gut microbiome and immune development. Dr. Snodgrass recommends:

1. Breastfeeding – Shapes the infant’s microbiome and modulates immunity.

2. Probiotics & prebiotics – Growing-up milk formulas (for 1 year and above) can help optimize gut microbiota.

3. Healthy lifestyle – Balanced nutrition, adequate sleep, and age-appropriate exercise.

4. Limit antibiotics – Only when medically necessary.

5. Maternal health during pregnancy – A healthy maternal microbiome and diet can positively influence the baby’s developing immune system.

How does a C-section affect the baby’s gut microbiome? Should C-section babies get extra health checkups?

Babies born vaginally have higher gut microbiome diversity, dominated by Lactobacillus from maternal vaginal flora.

C-section babies are colonised mainly by Staphylococcus and Acinetobacter, which are found on maternal skin and in the environment.

No additional checkups or immune screenings are needed solely because of a C-section birth.

Does an emergency C-section affect immunity differently than a planned one?

It depends on factors such as the reason for the C-section, timing of membrane rupture, and presence of placental infection. Each case should be discussed individually with your doctor.

Should I delay childcare if my baby was born via C-section?

C-section babies may have reduced gut microbiome diversity and altered immune development, making them slightly more prone to infections in early months.

Caring for your baby at home initially may give their immune system more time to mature. Introducing prebiotics, probiotics, and a nutrient-rich diet also supports gut and immune health.

Will my C-section baby’s immunity catch up over time?

Yes. While C-section babies may be more susceptible to infections in the first months due to a suboptimal gut microbiome, their immune systems usually catch up by 3–4 years of age, and long-term health outcomes generally converge with vaginally delivered babies.

Does breastfeeding matter more for C-section babies?

Yes, breastfeeding is highly recommended. Breast milk contains beneficial bacteria (Bifidobacterium, Streptococcus, Lactobacillus) and immune-supporting compounds like IgA antibodies, leukocytes, lactoferrin, and lysozyme. These help provide both passive immunity and strengthen the infant’s own immune system.

Does the mode of delivery affect long-term immunity?

While C-sections can influence early immune development, most babies’ immune systems eventually catch up. Long-term health outcomes are generally similar between C-section and vaginally delivered babies.

Are C-section babies more likely to develop allergies or asthma?

Yes, studies show a higher risk of asthma, allergic rhinitis, eczema, and food allergies in C-section babies. This may be due to altered gut microbial colonisation and immune responses in early life.

What can I do to boost my baby’s gut health after a C-section?

• Breastfeed if possible

• Introduce solid foods after 6 months (timely weaning)

• Expose baby to dietary allergens gradually to encourage oral tolerance

• Ensure adequate sleep for overall immune development

Any special care needed during confinement after a C-section?

Focus on establishing breastfeeding early. Sometimes breastfeeding is delayed due to maternal recovery or anaesthesia effects, which can temporarily reduce the newborn’s reflexes. Support from a lactation consultant can help.

When does a C-section baby’s own immune system fully develop?

Maternal antibodies protect babies up to around 6 months, after which their own immune system gradually develops, reaching full maturity around 3–4 years of age.

My paediatrician mentioned gut health is important. What should I look out for?

Signs of an unhealthy gut include:

• Digestive issues (bloating, gas, constipation, diarrhoea)

• Frequent infections

• Tiredness

• Skin issues like eczema

To support gut health, introduce prebiotics, probiotics, and a diverse diet rich in fruits, vegetables, whole grains, and lean proteins.

Should Parents Worry About C-Section Immunity?

C-section babies may have slightly different gut microbiomes at birth, but with breastfeeding, probiotics, and a healthy diet, their immune systems typically catch up by early childhood. Consult your paediatrician for personalised guidance, especially if your baby has frequent infections or allergies.

About the Expert

Dr. Alison Snodgrass is a Consultant Paediatrician in Parkway East Paediatric Clinic, focusing on infant immunity and gut microbiome development. With years of clinical experience, she provides evidence-based advice to help parents support their babies’ health from birth to early childhood.