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Infant gut microbiota following cesarean section in the Middle East: a multidisciplinary expert consensus based on a

Wajeeh Aldekhail1, Mohammed Al-Beltagi2,3, Flavia Indrio4

  • 1Department of Pediatric Gastroenterology & Hepatology, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia.

Frontiers in Pediatrics
|June 4, 2026
PubMed

Insights

Cesarean section (C-section) delivery disrupts infant gut microbiota, increasing health risks. Strategies like breastfeeding and targeted nutrition support, especially within the first 1,000 days, can mitigate C-section-related dysbiosis.

Area of Science:

  • Microbiome research
  • Pediatric health
  • Nutritional science

Background:

  • Cesarean section (C-section) delivery is linked to early-life gut dysbiosis, impacting infant health outcomes.
  • The increasing global rate of C-sections necessitates understanding and addressing its effects on the infant microbiome.
  • The first 1,000 days of life represent a critical window for microbial development.

Purpose of the Study:

  • To summarize the clinical implications of C-section delivery on infant gut microbiota.
  • To propose evidence-based strategies for mitigating C-section-associated dysbiosis.
  • To provide expert consensus on optimizing microbial colonization in infants born via C-section.

Main Methods:

  • A multidisciplinary panel of 16 experts (pediatricians, neonatologists, gastroenterologists, nutritionists) conducted a literature review.
  • An online structured consensus process involving expert voting and commentary was utilized.
  • Seventeen consensus statements were developed and validated based on scientific evidence.

Main Results:

  • C-section delivery significantly impacts early microbiota composition, with rising C-section rates requiring urgent attention.
  • Exclusive breastfeeding is unanimously recommended as the primary strategy for infants born via C-section.
  • Evidence-based nutritional interventions, including specific prebiotics and probiotics, are recommended when breastfeeding is not feasible.
  • Microbiota support should extend throughout the first 1,000 days, emphasizing continuity of care.
  • Education for healthcare professionals and parents is crucial for adopting eubiosis-targeted strategies.

Conclusions:

  • Optimizing microbial colonization in C-section infants requires a multifaceted approach prioritizing breastfeeding and evidence-based interventions.
  • Aligning clinical practice with microbiome science can reduce dysbiosis-associated risks and improve long-term health.
  • Continuous support and education are vital for managing C-section-related gut dysbiosis throughout early life.
Abstract

Keywords:
breastfeeding (BF)cesarean sectionearly-life dysbiosisfirst 1,000 daysgut microbiotaprobioticsterm infant

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