Intestinal microbiota development begins immediately following birth.¹ The composition of the infant’s evolving microbiota is initially defined by the mother, the source of the newborn’s first microbial inoculum. Colonising bacteria rapidly adapt to breast milk and epithelial mucins as sources of nutrients.

The prevalence of caesarean section delivery in Western countries is increasing. Caesarean born babies are deprived of contact with the maternal/vaginal microbiota and the first exposure is characterised by a lack of strict anaerobes and the presence of facultative anaerobes such as Clostridium species.² Caesarean born infants have a more slowly diversifying microbiota, with differences reported from normally born infants, even after six months of age. Aberrancies in early microbiota acquisition can affect immunophysiological development with a heightened disease risk.^2,3 This …