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. 

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

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

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

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. 

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]

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]

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]

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]

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.

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.

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)

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.

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.

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.

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.

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. 

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 

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*

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.

Cara Everett, MS, RDN, LDN

Cara 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.

LinkedIn: https://www.linkedin.com/in/cara-everett-ms-rdn-1900b0210/