When I had my son, I had no clue about this. I thought it was normal for the hospital to wash the baby after birth. I had also tested positive for group b strep. Now reading all of these studies that show that the vernix actually helps to protect against the bacteria from group b step I wish I would have known then not to have the baby bathed. He never had any problems but the hospital made a huge deal about it because we are against antibiotics. We are having a wonderful homebirth this time around and we are definitely leaving the vernix on our baby. Here are a few studies:
Antimicrobial Properties of Amniotic Fluid and Vernix Caseosa Are Similar to Those Found in Breastmilk
Akinbi, H. T., Narendran, V., Pass, A. K., Markart, P., & Hoath, S. B.
(2004). Host defense proteins in vernix caseosa and amniotic fluid.
American Journal of Obstetrics and Gynecology, 191 (6), 2090-2096.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi? cmd=Retrieve&db=pubmed&do\pt=Abstract&list_ uids=15592296
Summary: In this study, researchers analyzed samples of amniotic fluid and vernix caseosa (vernix) from healthy, term gestations to determine the immune properties of these substances. Participants were pregnant women admitted for elective cesarean section after 37 weeks gestation with no prior labor and no signs of chorioamnionitis (intrauterine infection). Women with a history of prenatal fever or premature rupture of membranes, or who received steroids prenatally or antibiotics during delivery were excluded, as were women whose babies passed meconium in utero, had congenital malformations, or required prolonged resuscitation after birth. Amniotic fluid was obtained by amniocentesis to determine fetal lung maturity prior to elective delivery. Vernix was gently scraped from the newborn’s skin with a sterile implement immediately following delivery. There were 10 samples of amniotic fluid and 25 samples of vernix obtained.
Tests (Western analysis and immunochemistry) revealed that lysozyme, lactoferrin, human neutrophil peptides 1-3 and secretory leukocyte protease inhibitor were present in the amniotic fluid samples and in organized granules embedded in the vernix samples. These immune substances were tested using antimicrobial growth inhibition assays and found to be effective in inhibiting the growth of common perinatal pathogens, including group B Streptococcus, K pneumoniae, L monocytogenes, C albicans, and E coli.
The authors point out that the innate immune proteins found in vernix and amniotic fluid are similar to those found in breast milk. As the baby prepares for extrauterine life, pulmonary surfactant (a substance produced by the maturing fetal lungs) increases in the amniotic fluid, resulting in the detachment of vernix from the skin. The vernix mixes with the amniotic fluid and is swallowed by the growing fetus. Given the antimicrobial properties of this mixture, the authors conclude that there is therefore “considerable functional and structural synergism between the prenatal biology of vernix caseosa and the postnatal biology of breast milk.” They also suggest that better understanding of these innate host defenses may prove useful in preventing and treating intrauterine infection.
Significance for Normal Birth: It is well understood that routine artificial rupture of membranes increases the likelihood of intrauterine infection because it eliminates the physical barrier (the amniotic sac) between the baby and the mother’s vaginal flora. This study suggests an additional mechanism for the prevention of infection when the membranes remain intact: a baby that is bathed in amniotic fluid benefits from antimicrobial proteins that are found in the fluid and in vernix caseosa.
The results of this study also call into question the routine use of some newborn procedures. Early bathing of the baby removes vernix, which contains antimicrobial proteins that are active against group B streptococcus and E. coli. Delaying the bath and keeping the newborn together with his or her mother until breastfeeding is established may prevent some cases of devastating infections caused by these bacteria.
The fact that preterm babies tend to have more vernix than babies born at or after 40 weeks might mean that healthy, stable preterm babies derive even greater benefit from staying with their mothers during the immediate newborn period.
Finally, this study illustrates how the normal physiology of pregnancy and fetal development is part of a continuum that extends beyond birth to the newborn period. The immunologic similarities between amniotic fluid, vernix and breast milk provide further evidence that successful initiation of breastfeeding is a critical part of the process of normal birth.
Antimicrobial polypeptides of human vernix caseosa and amniotic fluid: implications for newborn innate defense.
Yoshio H, Tollin M, Gudmundsson GH, Lagercrantz H, Jornvall H, Marchini G, Agerberth B.
Department of Woman and Child Health, Karolinska Institutet, Stockholm, Sweden.
http://www.ncbi.nlm.nih.gov/sites/entrez? cmd=Retrieve&db=PubMed&list_uids=12538777& dopt=Abstract
Antimicrobial peptides/proteins are widespread in nature and play a critical role in host defense. To investigate whether these components contribute to surface protection of newborns at birth, we have characterized antimicrobial polypeptides in vernix caseosa (vernix) and amniotic fluid (AF). Concentrated peptide/protein extracts were obtained from 11 samples of vernix and six samples of AF and analyzed for antimicrobial activity using an inhibition zone assay. Proteins/peptides in all vernix extracts exhibited strong antibacterial activity against Bacillus megaterium (strain Bm11), in addition to antifungal activity against Candida albicans, whereas AF- derived proteins/peptides showed only the former activity. Fractions obtained after separation by reverse-phase HPLC exhibited antibacterial activity, with the most pronounced activity in a fraction containing alpha-defensins (HNP1-3). The presence of HNP1-3 was proved by dot blot analysis and confirmed by mass spectrometry.
Lysozyme and ubiquitin were identified by sequence analysis in two fractions with antibacterial activity. Fractions of vernix and AF were also positive for LL-37 with dot blot and Western blot analyses, and one fraction apparently contained an extended form of LL-37. Interestingly, psoriasin, a calcium-binding protein that is up- regulated in psoriatic skin and was found recently to exhibit antimicrobial activity, was characterized in the vernix extract. The presence of all of these antimicrobial polypeptides in vernix suggests that they are important for surface defense and may have an active biologic role against microbial invasion at birth.
Publication Types: Research Support, Non-U.S. Gov’t PMID: 12538777 [PubMed - indexed for MEDLINE]
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