While many strides have been made to research the health effects of probiotics, many of the existing findings are unclear on the benefits of specific species or strains on human health for different patient populations, leaving many feeling the information on this topic is still like the wild west. For this discussion post, I researched the health impact on the mother and fetus/infant from administering probiotics for pregnancy and fetus/infant development. Because this field has been evolving fast, I referenced some of the most recent high-level literature articles, and here are my findings in two focus areas:
Is it safe to use probiotic supplements during pregnancy? What are the potential risks and benefits of probiotic and/or prebiotic supplementation during pregnancy?
A 2021 article, the first systemic review/meta-analysis to report adverse effects from probiotic, prebiotic, or synbiotic supplements during pregnancy and lactation, found no evidence of mortality or severe reactions from the administration of probiotics in pregnant mothers. However, 20 adverse effects were reported in 11 studies, with most related to GI symptoms in the 3rd trimester of pregnancy. No serious adverse effects were reported in both mothers or infants. Overall, the reviewed data suggest that probiotic and prebiotic supplementation is considered relatively safe to use during/after pregnancy and during lactation. (Sheyholislami & Connor, 2021).
The authors of a 2018 systemic review reviewed twenty-one RCTs. The interventions used in these clinical studies for pregnant women included single-strain or multi-strain probiotics involving Lactobacillus species, Bifidobacterium species, Streptococcus species, and Lactococcus lactis. The result of the review suggested no difference between intervention groups and control groups, concluding no evidence of either harmful or beneficial effects from using probiotics and/or prebiotics during pregnancy. No adverse effect was reported in any studies reviewed (Jarde et al., 2018).
Are there benefits of probiotics for fetuses and infants?
A 2022 systemic review provided reviews on the outcome of using probiotics during pregnancy on the intestinal microbiota of children born by C-section. The conclusion was unclear whether the prenatal probiotic intervention affected C-section infants. Even though a multi-strain probiotic supplementation positively influenced the microbiota of mothers’ breast milk, it’s less evident about the same effect on C-section newborns (Martín-Peláez et al., 2022).
My Final Thoughts:
Overall, my findings on this topic from reading the literature are inconsistent and less exciting than I thought they would be. I have been a fan of probiotic therapy and have no doubts about its great potential for human health. However, like anything else, there is a balance, and taking a personalized approach is key. In recent years, I’ve observed a pattern of increased adverse reactions to probiotics in my client population. This may be because many of them have food sensitivities, mast cell activation syndrome, and histamine intolerance associated with gut dysbiosis, and a downside of consuming fermented foods is that they are very high in histamine.
I learned that it’s essential to first test the gut microbiome to assess the current gut terrain, combine the data with the person's symptoms and health history, and then make a targeted recommendation. We know that every probiotic specie and strain has its unique effect on human health. Therefore, choosing the right specie(s) and strain(s) for a particular purpose is vital. More and more single-strain probiotic products have entered the marketplace, and I find them helpful and necessary in making probiotic therapy more personalized and targeted, especially for those in sensitive situations, and pregnancy definitely falls in this category.
Jenny Noland, MS, CNS, CNGS, CKNS, LDN, MBA
Functional Nutritionist in Eugene, Oregon
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References:
Jarde, A., Lewis-Mikhael, A. M., Moayyedi, P., Stearns, J. C., Collins, S. M., Beyene, J., & McDonald, S. D. (2018). Pregnancy outcomes in women taking probiotics or prebiotics: A systematic review and meta-analysis. BMC Pregnancy and Childbirth, 18(1), 1–14. https://doi.org/10.1186/S12884-017-1629-5/TABLES/3
Martín-Peláez, S., Cano-Ibáñez, N., Pinto-Gallardo, M., & Amezcua-Prieto, C. (2022). The Impact of Probiotics, Prebiotics, and Synbiotics during Pregnancy or Lactation on the Intestinal Microbiota of Children Born by Cesarean Section: A Systematic Review. Nutrients, 14(2). https://doi.org/10.3390/NU14020341/S1
Sheyholislami, H., & Connor, K. L. (2021). Are probiotics and prebiotics safe for use during pregnancy and lactation? A systematic review and meta-analysis. Nutrients, 13(7). https://doi.org/10.3390/NU13072382/S1