Children born by cesarean section are more likely to develop asthma by age three, according to a recent study published in the American Journal of Epidemiology. This study builds upon previous findings that cesarean delivery increases the risk of wheezing, asthma, and eczema, a related allergic disease common in childhood. Although allergic diseases tend to run in families, in this study children born of non-allergic mothers were even more likely to develop asthma.

One reason scientists think cesarean delivery may put infants and children at higher risk of allergic diseases is the difference in gut bacteria colonization in these children. During vaginal birth, the infant is colonized by bacteria from the mother. Infants born by cesarean birth are colonized with different bacteria, more like the bacteria found in the environments they were birthed in, like hospitals. This difference may set the stage for immune imbalance that leads to allergic diseases.

The study found that in both planned and unplanned cesarean births, the risk of asthma was similar. Folks, I know this is a sensitive topic. I am certainly not saying cesarean births are wrong—I know that they can be lifesaving. Some women go through pregnancy without a doubt in their mind that they will have a natural birth, only to end up having an emergency C-section. Sometimes this is unavoidable. We do what we can to raise healthy children, right? Not everything is up to us.

But many times C-section is opted for out of convenience. In these cases, it might be a good idea to consider to benefits of vaginal birth. That first inoculation of gut bacteria is very important to the underdeveloped immune system of the newborn. If you have the choice, give some good consideration to this. I don’t want to come off sounding preachy on this topic, which I know can strike a nerve in some people, but it’s a topic close to my heart—after all, it’s all about the gut. At least give it some thought.