Should you take probiotics for pregnancy?

Pregnancy is an exciting time but entering a new world full of conflicting information can also feel overwhelming. There is so much advice out there on how to keep yourself and your unborn baby healthy, including whether you should take probiotics for pregnancy. What does the evidence say, and are pregnancy probiotics safe?

Can you take probiotics while pregnant?

Probiotics are the 'good' bacteria found in your digestive system. As you may have seen on adverts for products such as Activia yoghurt, having a high amount of these microorganisms is a sign of a healthy gut. For this reason, many people consume probiotic foods and supplements.

Probiotics are an increasingly popular alternative therapy among those looking to ease uncomfortable and recurring digestive issues, such as bloating, constipation, diarrhoea, and long-term conditions like irritable bowel syndrome (IBS).

Yet, evidence suggests that the health benefits of taking probiotics may be even more extensive. If you're pregnant, probiotics may help to prevent pregnancy complications, reduce the likelihood of your baby developing certain conditions, and improve your own maternal health.

Possible benefits of probiotics for pregnancy

Every parent wants to give their unborn child the best start in life, but there are many ways to support your own and your baby's health during pregnancy. Probiotics for pregnancy are a promising yet under-researched complementary health therapy that you can explore in addition to - and not in replacement of - following a healthy lifestyle and listening to your pregnancy healthcare professional's advice.

Experts agree that more high-quality research is needed on the health benefits of probiotics for pregnancy, and in general. This said, there is a growing body of evidence that probiotics for pregnancy may have a role in preventing the following conditions.

Premature birth and infections during pregnancy

Changes in the balance of bacteria in your digestive system and vagina are normal during pregnancy. Sometimes, a large imbalance can lead to infections, which increase the possibility of you giving birth before your due date and of your baby becoming ill.

Several studies have investigated whether restoring a healthy balance of good bacteria with probiotic supplements reduces infections and premature delivery (early births).

For example:

  • Group B streptococcus (GBS) - group B strep is a bacterium that around a quarter of all pregnant people have. If you are ‘colonised’ with this type of bacteria, there is a risk that during birth your baby can become infected, which can result in serious illness or even death. One small but well-designed study suggested that probiotics can significantly reduce GBS in pregnancy.
  • Bacterial vaginosis (BV) - in BV, the vagina becomes inflamed and irritated due to an imbalance in vaginal bacteria. It is a common infection in pregnant and non-pregnant women, but in pregnancy it increases the risk of premature delivery. There is some evidence that probiotics may reduce the number of bacteria associated with BV in pregnant women who have BV. However, a study of 4,204 pregnant women with BV did not show a lower chance of giving birth early among women given probiotics.

Diseases of the digestive system

Your baby's gut microbiome (the microorganisms living in the digestive system) starts developing during pregnancy. This is a crucial phase in developing good gut health and good immunity.

Common gastrointestinal diseases include:

Studies indicate that smaller levels of probiotics are linked to diseases of the digestive system (gastrointestinal diseases) forming later in life.

For example:

  • Infant colic - in your baby's early life, the most common of these diseases is infant colic. Even though this goes away by itself, research has identified a link between infant colic and other gastrointestinal disorders, allergies, and sleep disturbance all appearing later in childhood. While trial results are mixed and limited in scope, some studies indicate that probiotics for pregnancy and for newborns can reduce the risk of infant colic.
  • Necrotising enterocolitis - this a rare but serious problem where the tissue in the intestines becomes inflamed and dies. Mostly affecting premature babies, it can lead to death. In an analysis of 18 trials involving 4,356 pregnant women, probiotic supplements for pregnancy appeared to decrease the risk of necrotising enterocolitis, premature births, and death significantly.

Allergies during early life

If your baby has high levels of probiotics, there is some evidence that they are less likely to develop allergies such as eczema, asthma, and food intolerances.

For example:

  • Eczema - this skin condition causes itchy, red, and dry skin. A 2019 review of 28 studies found that children whose mother took probiotic supplements during pregnancy and who were given probiotics for six months after birth were less likely to develop eczema.
  • Food allergies - common allergies include cow's milk, wheat, and peanuts. One review of studies showed limited evidence of benefit. The only study looking at pregnancy probiotics alone didn't show any benefit. However, a combination of pregnancy probiotics, along with giving probiotics to the baby for six months, might reduce the risk of food allergy in a small proportion of children.

The need for more evidence

You may now be feeling convinced that probiotics for pregnancy can benefit your little one. However, it is important to note that not all studies produce the same positive outcomes. Experts generally agree that more high-quality research is needed.

There are also several factors to consider - for example, some studies only note positive results for probiotic supplements that are taken during pregnancy and also given to babies after birth. There is also a range of mixed research into baby probiotics.

Experts are still working to understand the different strains of probiotics. It's likely that specific strains may be more effective than others at protecting your baby's health during and after pregnancy.

Are probiotics safe in pregnancy?

Taking probiotics is generally considered safe during pregnancy. Research suggests that most strains of probiotics, including Lactobacillus and Bifidobacterium, are safe to take long-term. Amongst these are Lactobacillus rhamnosus, Lactobacillus acidophilus, Lactobacillus bifidobacterium, and Bifidobacterium lactis.

This said, it's worth bearing in mind that the lack of research limits our knowledge in this area, just as it limits our knowledge of how beneficial they really are. It's also worth remembering that as probiotics are classed as supplements, they are not subject to the same strict regulations that medicines are.

From the evidence that's available, adverse reactions to probiotics in pregnant people are rare and generally not too serious. For example, a 2021 review of 100 studies identified adverse effects in only 11. The reported symptoms included vaginal discharge and changes in stool (poo) consistency.

Ultimately, the choice to take probiotics for pregnancy is entirely yours. If you are considering starting probiotic supplementation during pregnancy, it's always best to speak to your pregnancy healthcare advisor first.

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