{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T01:54:54Z","timestamp":1783648494069,"version":"3.55.0"},"reference-count":41,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2025,9,2]],"date-time":"2025-09-02T00:00:00Z","timestamp":1756771200000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Allergy Immunology"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Infants born via Cesarean section (C\u2010section) often have a distinct gut microbiome and higher risks of atopic and immune\u2010related conditions than vaginally delivered infants. We evaluated whether a microbiome\u2010based program could shift gut microbiome composition and improve microbiome\u2010associated health outcomes in C\u2010section born infants.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This open\u2010label, randomized, controlled trial included full\u2010term C\u2010section\u2010born infants aged 0\u20133\u2009months, randomized to an intervention (<jats:italic>n<\/jats:italic>\u2009=\u200925) or control arm (<jats:italic>n<\/jats:italic>\u2009=\u200929). Over 6\u2009months, the intervention arm received two microbiome reports, personalized recommendations based on their microbiome, educational materials, and coaching calls focused on microbiome health. Parents reported health conditions via surveys. Primary outcome: Difference between study arms in relative abundance of key gut microbiome taxa and functional genes. Other outcomes: Changes in a C\u2010section index\u2014a taxonomy\u2010based metric comparing C\u2010section\u2010associated taxa to vaginally\u2010associated taxa\u2014and prevalence of atopic conditions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Compared to controls, the intervention arm had higher <jats:italic>Bifidobacterium<\/jats:italic> (<jats:italic>p<\/jats:italic>\u2009=\u2009.025, <jats:italic>q<\/jats:italic>\u2009=\u2009.121) and higher abundance of genes associated with human milk oligosaccharide degradation (e.g., \u03b1\u2010L\u2010fucosidase, <jats:italic>p<\/jats:italic>\u2009=\u2009.019, <jats:italic>q<\/jats:italic>\u2009=\u2009.046) at timepoint 2. In the intervention arm, the C\u2010section index decreased to a level similar to vaginally born infants (<jats:italic>p<\/jats:italic>\u2009=\u2009.807, <jats:italic>q<\/jats:italic>\u2009=\u2009.807). At the end of the intervention, atopic dermatitis prevalence was lower in the intervention arm than in controls (odds ratio, 0.17 [95% CI, 0.023\u20130.723], <jats:italic>p<\/jats:italic>\u2009=\u2009.031).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>A personalized microbiome\u2010based program can modulate the gut microbiome of C\u2010section\u2010born infants and may reduce the risk of atopic conditions (<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/clinicaltrials.gov\">ClinicalTrials.gov<\/jats:ext-link>: NCT06424691).<\/jats:p><\/jats:sec>","DOI":"10.1111\/pai.70182","type":"journal-article","created":{"date-parts":[[2025,9,3]],"date-time":"2025-09-03T03:38:45Z","timestamp":1756870725000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Improving immune\u2010related health outcomes post\u2010cesarean birth with a gut microbiome\u2010based program: A randomized controlled trial"],"prefix":"10.1111","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-2157-0272","authenticated-orcid":false,"given":"Pamela A.","family":"Nieto","sequence":"first","affiliation":[{"name":"Seeding Inc, Doing Business as Tiny Health  Austin Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Nakama","sequence":"additional","affiliation":[{"name":"Seeding Inc, Doing Business as Tiny Health  Austin Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2357-7737","authenticated-orcid":false,"given":"Julian","family":"Trachsel","sequence":"additional","affiliation":[{"name":"Seeding Inc, Doing Business as Tiny Health  Austin Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Goad","sequence":"additional","affiliation":[{"name":"Seeding Inc, Doing Business as Tiny Health  Austin Texas 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