What You Need to Know About Probiotics During Pregnancy

Can you take probiotics while pregnant? Read this article to find out if probiotics are safe during pregnancy, learn about their health benefits, and discover the best probiotics to take while you’re pregnant. 

By: Cara Everett, MS, RDN, LDN
Published: July 12, 2024
Estimated Reading Time: 6-7 minutes

Key Takeaways

  • Taking probiotics during pregnancy is one way to support gut health and immune function for both mom and baby.
  • Research is ongoing to discover whether probiotics can prevent or treat conditions like acne, eczema, asthma, and obesity.
  • Different probiotic strains have different effects on the body, and a healthcare professional can guide you to the type and dosage that’s best for your needs.
  • Taking probiotics while pregnant is considered safe for most people, with the exception of immunocompromised individuals and those with serious infections.

Probiotics have long been a hot topic on health forums and social media, and for good reason. They’re the third most-popular dietary supplement sold in America behind vitamins and minerals, according to data from the National Health Information Survey.[1] But are they safe and effective, particularly when you’re pregnant? Read our article for evidence-based information on the roles of probiotics in body, who should (and shouldn’t) take them, and what to look for when choosing a probiotic supplement during pregnancy.

What Are Probiotics?

According to the International Scientific Association for Probiotics and Prebiotics (ISAPP), probiotics are “live microorganisms that, when administered in adequate amounts, confer a health benefit on the host.”[2] Simply put, probiotics are “good” bacteria and yeasts that offer a number of health benefits. They can be added to foods and found in supplement form as capsules, powders, and liquids.

To be classified as a probiotic, products must include one or more specific, measurable microbial strains that:

  1. Are viable (alive) and able to survive in the body
  2. Provide a proven health benefit to the person or animal ingesting them

An important distinction here is that probiotics are not prebiotics (we’ll discuss those in a moment) or live cultures that are unmeasured and unspecified in fermented foods like kimchi and sauerkraut or convenience foods such as nutrition bars, shakes, and cereals. 

Probiotic Types

These are the seven most common types, or strains, of probiotics added to foods and supplements:[3]

  1. Lactobacillus
  2. Bifidobacterium
  3. Bacillus
  4. Saccharomyces
  5. Streptococcus
  6. Enterococcus
  7. Escherichia
White probiotic capsules on a pink background.

Credit: Anna Shvets on Pexels

Probiotic-enhanced foods and supplements may contain individual strains or a combination of several. According to experts at the Cleveland Clinic, some of the most studied and commonly recommended probiotic strains are:[4]

  • Lactobacillus (L. acidophilus, L. rhamnosus, L. casei and L. plantarum)
  • Bifidobacterium (B. longum and B. breve)

Bacillus coagulans, which is found in the Genate Essential Prenatal Multivitamin, can be used for constipation and irritable bowel syndrome (IBS). It may also be helpful for reducing gas and indigestion.[5]

Different probiotic strains have different effects in the body, so if you’re looking for a probiotic to prevent or treat a specific health condition, talk to a healthcare provider about which strain would be the most effective for you.

Health Benefits of Probiotics

The intestine, particularly the large intestine (colon), is home to trillions of microbes that are collectively called the gut microbiome.[6] Most of these microbes are bacteria, and some of them are good for your body while others are not so good. 

Probiotics are considered “good” microbes. They promote gut health by:

  • Limiting the amount of “bad” bacteria in your intestines 
  • Aiding in digestion of food and medications
  • Supporting bowel regularity
  • Maintaining the intestinal barrier to keep germs out of your body

Because of the many ways probiotics work to keep the gut healthy, they’re sometimes used in the treatment of gastrointestinal (GI) conditions characterized by gut dysbiosis, or an imbalance in the microbiome.[7,8] Diarrhea, C. difficile (a bacterial infection of the intestine), irritable bowel syndrome (IBS), and ulcerative colitis are a few conditions that may be successfully treated with probiotics.[3] 

Researchers are finding that probiotics may also offer benefits outside the GI tract. Let’s take a look at some of the ways probiotics can promote overall health.

Immune Function

Studies show that probiotics influence immune function by “talking” to immune cells and microbes in the GI tract.[9] Not only do they support a healthy immune response to viruses, bacteria, and other pathogens, but probiotics may also help decrease the risk of autoimmune disorders like type 1 diabetes and lupus by regulating the immune system. 

Allergies, Atopic Dermatitis, and Eczema

Research is inconclusive on whether probiotic use by lactating mothers and/or their infants helps reduce the risk of atopic dermatitis.[10] One meta-analysis did show that probiotics are helpful in treating atopic dermatitis in adults.[11] 

Experts say that although probiotics have not been found to cure existing eczema, they can reduce the chances of an infant developing the condition.[12] A 2015 meta-analysis (a large review of multiple studies) found that infants exposed to probiotics in pregnancy and early infancy had a lower incidence of eczema, although there was no effect on the risk of asthma, wheezing, or allergic rhinitis.[13]

Hypercholesterolemia

Probiotic use in adults has been linked to lower total and LDL cholesterol in some studies. Research is still ongoing in this area, and current indications are that multiple strains must be used over weeks or months to produce a beneficial effect.[3]

Are Probiotics Safe During Pregnancy?

Probiotics have a wide range of health benefits, but are they safe for pregnant women? Let’s see what the research shows.

A wide range of studies indicates that probiotics are indeed safe in pregnancy. When used by healthy people, they aren’t absorbed into the blood or transferred into breast milk. Multiple studies have shown that there is no increased risk of adverse events for mother or baby when women take probiotics during pregnancy.[14]

Probiotics and Pregnancy Outcomes

Research is inconclusive on whether probiotics influence pregnancy outcomes. For example, a 2018 meta-analysis of 21 clinical studies found that the use of probiotics in pregnancy neither raised or lowered the risk of preterm birth, birth weight, gestational diabetes, or preterm premature rupture of membranes (PPROM). The studies in this meta-analysis used Lactobacillus, Bifidobacterium, and/or Streptococcus.[16] The only significant finding was that of blood sugar control, but other research results have been inconsistent on whether probiotics affect blood sugar or the risk of gestational diabetes in pregnant women.[17] 

Another meta-analysis of 25 studies conducted in 2021 found similar results: probiotic use during pregnancy did not influence perinatal outcomes (those occurring before, during, and after pregnancy) either positively or negatively.[18] Research is also inconclusive on whether probiotic use in pregnancy affects maternal weight gain, obesity, or the risk of preeclampsia.[17]

Impacts on Infant Health

Probiotic use by mothers during pregnancy and breastfeeding can have beneficial effects on their babies. As mentioned above, probiotics may help reduce the risk of developing eczema early in life. They have also been shown to lower the severity of necrotizing enterocolitis (NEC) and sepsis in preterm infants.[19]

However, the use of probiotics in preterm infants is controversial because there have been reports of fatal illness in low birth weight, preterm infants linked to probiotic administration.[15] Talk to your doctor or other healthcare provider before using probiotics when breastfeeding or giving your baby a product containing probiotics if they were born preterm.

Do I Need a Probiotic Supplement During Pregnancy?

Should you take a probiotic during pregnancy? Most people can benefit from probiotics both when pregnant and at other life stages. That’s because they have many health benefits and can help prevent gut dysbiosis, which if untreated can lead to contributes to inflammation, lowered immune function, small intestinal bacterial overgrowth (SIBO), constipation and/or diarrhea, and other GI symptoms like gas and bloating. 

If you’re experiencing any of these symptoms or have recently taken antibiotics (which can also lead to gut dysbiosis), talk to your healthcare provider about whether a probiotic could be helpful for you.

Who Should Not Use Probiotics

Certain people are at risk of systemic infections from probiotics. Do not use probiotics if you:

  • Take an immunosuppressant medication
  • Are critically ill
  • Have a central venous catheter
  • Have a compromised intestinal barrier (common in people with undiagnosed celiac disease or IBD)

Rare cases of infections from probiotic use have occurred in individuals who met one or more of the above criteria.[14] As noted above, probiotics also are unsafe for preterm infants. This population is at increased risk of infection and shouldn’t be exposed to the live bacteria and/or yeasts in probiotics. The FDA issued a warning to healthcare providers in 2023 stating that the use of probiotics in preterm infants carries a risk of invasive disease.[15]

 Where to Find Probiotics

Probiotics can be found in supplements and added to foods. The Genate Essential Prenatal Multivitamin is one of the only prenatal vitamins on the market to include a probiotic. With two billion CFU of Bacillus coagulans per serving, it’s an easy way to get the probiotics you and your baby need without having to take a separate supplement.

Keep in mind that different probiotic supplements contain various strains and amounts of probiotic microbes. As with all nutritional supplements, probiotics aren’t regulated by the FDA. That makes it especially important to look for products from reputable companies that are manufactured in cGMP facilities and third-party tested for purity and potency.

How to Choose a Probiotic Supplement 

When shopping for a probiotic, read labels carefully to learn which strains the product contains and how much it provides. Supplement labels will list the amount of colony-forming units (CFU) per serving. This tells you how much live, active probiotic is in the product. Some labels also give the total weight of microorganisms, but CFU is a better indication of their effectiveness. 

Look for probiotics with a minimum of 1 billion CFU per serving. Some products go up to 50 billion or more CFU, but the specific strains included are more important than the number of CFU. As always, be sure to talk with your healthcare provider before starting any new supplement.

Other Ways to Keep Your Gut Healthy in Pregnancy

In addition to ingesting foods and supplements containing probiotics, you can take other measures to keep your gut healthy throughout your pregnancy and postpartum period.

Get Moving

Being physically active every day is important for a number of reasons in pregnancy, including gut health. Walking, swimming, bicycling, yoga, and stretching are all low-impact exercises you can do to help prevent constipation during pregnancy and keep your GI tract working as it should. 

Aim for at least 30 minutes of low-impact physical activity every day during pregnancy.

Stay Hydrated

In addition to physical activity, adequate water intake is important to combat constipation and promote a healthy gut.[20] It supplies the fluid your colon needs to absorb when producing stool, creating soft bowel movements that are easy to pass. And don’t wait until you feel thirsty to grab your water bottle: studies show that by the time people are thirsty, they may already be dehydrated. 

Try to drink at least 8 ounces of water per hour for a goal of 64-96 ounces of water per day. 

Keep in mind that caffeine and sugar are dehydrating, so it’s best to choose water, decaf coffee or tea, and other drinks that aren’t sweetened or caffeinated. 

Eat More Fiber

Dietary fiber offers the following benefits for pregnant women:[21]

  1. Encourages a diverse gut microbiome for GI health
  2. Supports a healthy pregnancy weight gain
  3. May reduce the risk of preeclampsia (high blood pressure in pregnancy) and gestational diabetes 

Aim for at least 30-35 grams of fiber per day by including fruits, vegetables, and/or whole grains with every meal and snack. 

Check out our prenatal nutrition guide for ways to get the fiber and other nutrients you and your baby need. 

Choose Gut-Friendly Foods

To support a healthy GI tract, it helps to know what to look for when grocery shopping and eating out. Not every food is a friend to your gut. Highly-processed foods and those with more than 4 grams of sugar per serving (i.e. sodas, other sweetened drinks, and many pre-packaged foods) may taste good, but they do your body more harm than good.

What foods should you look for instead? Foods with live and active cultures like yogurt include a variety of good bacteria that your gut needs to stay healthy. Fermented foods also naturally contain probiotics, though in amounts lower than what you’d find in a supplement. And foods like fruits, veggies, beans, and oats are a great source of prebiotics, which you can think of as “food” for probiotics. In other words, prebiotics are what the probiotic bacteria eat to grow and thrive. Check out our list below of gut-friendly foods. 

  • Fruits (fresh or frozen without added sugar)
  • Vegetables (fresh or frozen)
  • Yogurt
  • Apple cider vinegar*
  • Kefir*
  • Kombucha*
  • Miso*
  • Pickles* (refrigerated varieties)
  • Sauerkraut*
Chopped vegetables in a salad bowl sitting on a wooden countertop.

Credit: Photo by Nadine Primeau on Unsplash

*These foods contain live cultures that may offer health benefits, but the National Institutes of Health notes that they aren’t classified as probiotics because their cultures are unspecified and studies haven’t confirmed their biological benefits.[3]

You may have heard that sourdough bread is a good source of probiotics. That’s actually a myth: The heat used to bake sourdough bread kills the bacteria that are formed during fermentation, rendering them ineffective as probiotics. The same is true for pickles that are heat-processed. Probiotics must be alive to stay active in the gut and provide health benefits, so these foods also don’t meet the definition of a probiotic. 

To make sure you’re getting the probiotic benefit from a fermented food, check for the phrase “live and active cultures” on the label, indicating the microbes haven’t been destroyed by processing.

Bottom Line

Probiotics can be a safe and useful addition to your prenatal diet and supplement regimen. Not only can a quality probiotic supplement and a diet high in probiotic-containing foods support your gut health and immune system, they may also lower your baby’s risk of health problems early in life. Research is ongoing to determine whether probiotics influence pregnancy outcomes, but their general health benefits are well-established. 

Check with a healthcare professional if you’re considering adding a probiotic to your nutrition plan, and learn more about the Genate Essential Prenatal Multivitamin if you’re looking for an all-in-one solution with the vitamins, minerals, and probiotics you and your baby need to thrive.  

This article is not intended as medical advice to treat or diagnose any health condition but rather as educational health information for the general public. It should not be used as a substitute for individualized medical care from your healthcare provider. 

Sources

  1. National Center for Complementary and Integrative Health. Statistics from the National Health Information Survey. https://www.nccih.nih.gov/health/statistics-from-the-national-health-interview-survey Updated June 13, 2024. Accessed June 13, 2024.
  2. Hill C, Guarner F, Reid G, Gibson GR, The International Scientific Association for Probiotics and Prebiotics consensus statement on the scope and appropriate use of the term probiotic. Nat Rev Gastroenterol Hepatol 2014;11:506-514. https://doi.org/10.1038/nrgastro.2014.66
  3. National Institutes of Health. Probiotics. https://ods.od.nih.gov/factsheets/Probiotics-HealthProfessional/ Updated Novermber 3, 2023. Accessed June 11, 2024.
  4. Cleveland Clinic. Probiotics. https://my.clevelandclinic.org/health/treatments/14598-probiotics Updated October 30, 2023. Accessed June 13, 2024.
  5. Medline Plus. Bacillus Coagulans. https://medlineplus.gov/druginfo/natural/1185.html Updated November 8, 2023. Accessed June 13, 2024.
  6. National Institute of Environmental Health Sciences. Microbiome. https://www.niehs.nih.gov/health/topics/science/microbiome Updated March 22, 2024. Accessed June 12, 2024. 
  7. Wilkins T, Sequoia J. Probiotics for gastrointestinal conditions: A summary of the evidence. Am Family Phys. 2017;96(3):170-178 https://www.aafp.org/pubs/afp/issues/2017/0801/p170.html 
  8. Cleveland Clinic. Dysbiosis. https://my.clevelandclinic.org/health/diseases/dysbiosis Updated April 16, 2024. Accessed June 13, 2024.
  9. Mazziotta C, Tognon M, Martini F, Torreggiani E, Rotondo JC. Probiotics mechanism of action on immune cells and beneficial effects on human health. Cells. 2023;12(1):184. https://doi.org/10.3390/cells12010184
  10. Anania C, Brindisi G, Martinelli I, Bonucci E, D'Orsi M, Ialongo S, et al. Probiotics function in preventing atopic dermatitis in children. Int J Mol Sci. 2022;23(10):5409. https://doi.org/10.3390/ijms23105409
  11. Umborowati MA, Damayanti D, Anggraeni S, Endaryanto A, Surono IS, Effendy I, et al. The role of probiotics in the treatment of adult atopic dermatitis: a meta-analysis of randomized controlled trials. J Health Popul Nutr. 2022;41(1):37. https://doi.org/10.1186/s41043-022-00318-6
  12. National Eczema Society. Diet and eczema. https://eczema.org/information-and-advice/living-with-eczema/diet-and-eczema/ Accessed June 13, 2024.
  13. G. Zuccotti, F. Meneghin, A. Aceti, G. Barone, M. L. Callegari, A. Di Mauro, et al. Probiotics for prevention of atopic diseases in infants: systematic review and meta-analysis. Eur J Allergy CLin Immunol. 2015;70(11):1356-1371. https://doi.org/10.1111/all.12700
  14. Elias J, Bozzo P, Einarson A. Are probiotics safe for use during pregnancy and lactation? Can Fam Physician. 2011;57(3):299-301. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3056676/ 
  15. US Food and Drug Administration. Warning regarding use of probiotics in preterm infants. https://www.fda.gov/media/172606/download Published September 29, 2023. Accessed June 13, 2024.
  16. Jarde A, Lewis-Mikhael AM, Moayyedi P, Stearns JC, Collins SM, Beyene J, et al. Pregnancy outcomes in women taking probiotics or prebiotics: a systematic review and meta-analysis. BMC Preg Childbirth. 2018;18(14). https://doi.org/10.1186/s12884-017-1629-5 
  17. Obuchowska A, Gorczyca K, Standyło A, Obuchowska K, Kimber-Trojnar Ż, Wierzchowska-Opoka M, et al. Effects of probiotic supplementation during pregnancy on the future maternal risk of metabolic syndrome. Int J Mol Sci. 2022;23(15):8253. https://doi.org/10.3390/ijms23158253 
  18. Pérez-Castillo ÍM, Fernández-Castillo R, Lasserrot-Cuadrado A, Gallo-Vallejo JL, Rojas-Carvajal AM, Aguilar-Cordero MJ. Reporting of perinatal outcomes in probiotic randomized controlled trials. A systematic review and meta-analysis. Nutrients. 2021; 17(13):256. https://doi.org/10.3390/nu13010256 
  19. National Center for Complementary and Integrative Health. Probiotics: What You Need to Know. https://www.nccih.nih.gov/health/probiotics-what-you-need-to-know Updated August 2019. Accessed June 13, 2024.
  20. The American College of Obstetricians and Gynecologists. How Much Water Should I Drink During Pregnancy? https://www.acog.org/womens-health/experts-and-stories/ask-acog/how-much-water-should-i-drink-during-pregnancy Published October 2020. Accessed June 12, 2024.
  21. Pretorius RA, Palmer DJ. High-fiber diet during pregnancy characterized by more fruit and vegetable consumption. Nutrients. 2020;13(1):35. https://doi.org/10.3390/nu13010035

Author Bio

Cara Everett, MS, RDN, LDN is a registered dietitian nutritionist with a passion for helping people optimize their health with sustainable diet and lifestyle changes. She provides nutrition counseling to clients of all ages, with specialties in nutrigenetics, women's health, and chronic medical conditions.

Cara is also a health writer and editor with over 20 years of experience creating content for print and digital media outlets, nutrition and wellness blogs, and medical white papers. Her work has been featured on websites such as the National Council on Aging, Everyday Health, HelpGuide, MarketWatch, and Verywell. Cara's current writing covers women's nutrition and nutrigenetics in pregnancy and lactation.

As lead dietitian for SNP Therapeutics, Cara shapes content strategy, medically reviews and edits articles, and provides gene-focused medical nutrition therapy for clients. She holds Bachelor of Science and Master of Science degrees in Nutrition from Texas A&M University and completed her dietetic internship at the University of Kentucky Hospital.

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