Probiotic Balance
By reinforcing the balance of probiotic microorganisms during pregnancy, you can pass on a healthier microbiota to your baby for a healthy start in life.
Your microbiota and your baby’s health
Your baby’s digestive and immune function depends on the health of the gut flora they acquire at birth. As babies pass through the birth canal, they take in the microbial strains that reside there. Some of the parents’ microbiota passes on to the baby before birth. However, the probiotic template is set during and shortly following birth. The healthier, more diverse and more balanced your microbiota, the better start your baby gets in life.
This maternal sharing of healthy microbial strains is so important that during the third trimester, the vaginal flora of healthy pregnant women actually changes in composition, with the population of the strain Bifidobacterium infantis multiplying significantly in preparation for birth.
Breast milk as prebiotic
Bifidobacterium infantis is a probiotic strain that is abundant in the gut of healthy babies. It has a vital role in good digestive and immune health. Did you know that in the mid-1900s, artificial formula was touted as being superior to breast milk? Why? Because the baby’s immature digestive system can’t break down the complex sugars present in human milk. Thus, doctors advised that parents feed their babies formula instead of breast milk.
What doctors and scientists didn’t know is that the “undigestible” complex sugars (oligosaccharides) in mother’s milk are actually prebiotics. In other words, it is food for Bifidobacterium infantis. So in a sense, the sugars in the mother’s milk mediate a symbiotic exchange between mother, baby and B. infantis. During pregnancy, mothers grow extra B. infantis to pass on at birth. After birth, the baby’s digestive tract offers the microbes a warm and comfy home. The milk provides nourishment to the microbes. In exchange, they help the baby develop a strong digestive system and healthy immune function. Truly amazing!
If you want to learn more about human breastmilk’s prebiotic and probiotic properties, I highly recommend this excellent free course by the knowledgeable and talented Dawn Whitten.
How can I optimize my vaginal flora during pregnancy?
Beyond good nutrition and lifestyle measures covered in the Feed Your Pregnant Body!™ Program, I sometimes recommend the use of a good multi-strain probiotic during the third trimester of pregnancy. If your partner takes probiotics along with you, the two of you are less likely to pass undesired bacterial strains back and forth to each other.
The probiotics I recommend during the third trimester contain a variety of healthy and balanced microbial strains, including Bifidobacterium infantis. Of course, your specific needs are unique.
Breastfeeding, if at all possible and as long as possible, will help keep your baby’s gut flora healthy. Additionally, breastfeeding provides numerous health and emotional benefits. Read my nutritional tips to support breastfeeding in this post on milk production.
Reducing the risk of Group B strep
Group B strep (GBS), or beta strep, is a group of microorganisms in the streptococcus family, which also includes a lot of healthy strains such as Streptococcus thermophilus. S. thermophilus is a common and unproblematic ingredient in yogurt and cheese, as well as one of the strains in many probiotics. The vast majority of people don’t need to worry about this healthy strain.
When Group B strep overgrows in your birth canal, you can pass it on to your baby during vaginal birth. In rare cases, this group of bacteria can cause serious infections in babies. This is why it is common practice to conduct a vaginal swab of pregnant mothers 36 weeks into the pregnancy. If you have a positive swab or go into labor before obtaining your results, you may receive antibiotics during labor.
By taking a good probiotic, you can create a healthy environment that is less hospitable to group B strep and other potentially pathogenic strains. Obviously, this does not guarantee a negative group B strep test, but it does improve your odds tremendously.
If you have a history of vaginal yeast or bacterial infections
I recommend taking additional precautions if you have a history of previous positive Group B strep, bacterial vaginosis or vaginal yeast infections.
First, consider taking a probiotic containing one or more of the patented strains proven effective at “colonizing the vaginal mucosa, adhering to uroepithelial cells, competing against pathogenic organisms, and producing compounds that inhibit the growth of urogenital pathogens” (Alan R. Gaby, “Probiotic May Prevent Group B Streptococcus Colonization in Pregnant Women” Townsend Letter, January 2017, p. 112).
Second, consider taking probiotics orally and vaginally during late pregnancy. To take probiotics vaginally, you can simply insert the capsule into your vagina (suppository style). Do this once you’re settled in bed so as to allow the capsule to dissolve and its contents to absorb while you lie down. You can also purchase vaginal probiotic suppositories, but they are more expensive and not necessarily more effective.
Two widely available probiotic products that contain specific strains that performed well against GBS overgrowth are Metagenics Ultra and Jarrow FemDophilus.
A word of caution if you do use vaginal suppositories: do not use vaginal suppositories that contain boric acid without the guidance of a competent and experienced practitioner. While it is admittedly effective in eradicating stubborn vaginal yeast infections, boric acid can disrupt the endocrine balance in mom and baby. Y’all, the vagina is not Las Vegas. What happens in the vagina doesn’t stay in the vagina. I’ve seen thousands of mineral tests alongside contextual history and can tell you that the vaginal application of boric acid can and does have system-wide implications.
How do C-sections affect the gut flora?
So you’ve heard a lot about the role of healthy gut flora and vaginal birth in providing your baby with healthy gut flora for good digestion and immune function. Yes, vaginal birth is definitely preferable over a C-section, and C-sections really should only be performed when necessary for a whole variety of reasons beyond the integrity of gut flora. But don’t worry that having a C-section will be catastrophic for your baby.
If you need a C-section, you need a C-section—and remember, necessary C-sections can and do save lives. The same applies to antibiotics in situations that require them, including C-sections. With some issues, such as a full placenta previa, you’ll almost certainly know ahead of time. However, unpredictable issues can come up last minute. No matter what type of birth you are planning for, remember that there is some element of unpredictability. So prepare to address surprises, both pleasant and unpleasant.
That being said, babies born by C-section come into the world with a nearly-sterile gut. Thus, they typically develop a combination of gut flora based on the strains on their parents’ skin. The microbes that live on our skin are different from the ones that live in our gut. So this is admittedly not our first choice. The microorganisms your baby encounters during the hours after birth set the template for his or her microbiota. It can be worked on and improved, but it’s best to help set the healthiest template possible to begin with.
Practical steps to improve gut flora in mom and baby
I recommend doing two things, regardless of what type of birth you plan to have.
- Stock a bottle of professional-quality probiotics that replicate the strains present in the gut of healthy infants. If you’re not able to breastfeed, apply the powder to the nipple of the bottle, or mix it directly into the formula at feeding time.
This is crucial if you have a C-section (planned or unplanned) or if you need antibiotics during labor and delivery. In this case, begin using the probiotic as soon as possible after birth.
If you don’t have a C-section but your gut flora isn’t optimal, or your baby needs antibiotics, or your baby develops digestive symptoms or colic or thrush or needs antibiotics at some point, the probiotics will be extremely valuable in restoring health and balance. Of course, you should not use probiotics as a substitute for appropriate medical care for yourself or your baby. They are an adjunct, not a replacement, for medical care.
Breastfeed your baby if at all possible, as long as possible, within reason, and on your own terms. The definition of “within reason” depends on many factors, but ultimately the most important ones are your and your baby’s health and comfort, stress, your work situation and how much support you have. Do your best here, and don’t feel guilty or inadequate for what you’re not able to do!
If you want to learn more, you can read this study about supplementation with probiotics in newborns within 72 hours of their delivery via C-section.
Learn more about the Feed Your Pregnant Body!™ Program
If you’re a practitioner wanting to learn how to support your clients with confidence through common nutrition and health concerns that occur during pregnancy, you can learn more about my training program here and can read the full program outline.