Are probiotics and prebiotics safe during pregnancy & lactation?

Komal Bavaskar, Mumbai university

What are Probiotics?

Probiotics are living microorganisms (usually bacteria) that are comparable to helpful microorganisms present in the human gut. They are mostly available to consumers in the form of dietary supplements and meals, and when provided at sufficient levels, bestow a health advantage on the host. Probiotics are most often eaten in the form of live-cultured yogurt or as supplements.

They are also found in many fermented foods, most notably yogurt. Bacterially fermented foods, such as sauerkraut, kombucha, and kimchi, also contain probiotics. In Canada, the most often utilized probiotics are live bacteria such as Lactobacillus and Bifidobacterium species, as well as non-pathogenic yeast such as Saccharomyces.

They are available as pills, drops, liquids, and oral or vaginal capsules alone or in combination. Probiotics are usually regarded as safe and well-tolerated when taken orally or vaginally. One possible problem is the possibility of these microbes causing systemic illnesses. Probiotic-related bacteremia and fungemia have been reported, though they are uncommon.

Human health benefits by intaking probiotics:

Probiotics have been used to treat acute diarrhea, antibiotic-associated diarrhea, yeast and bacterial vaginosis, and other conditions. Lactobacilli are typically found in the oral cavity, ileum, colon, and vagina in healthy people. Probiotic supplementation during pregnancy has also been related to enhanced glucose metabolism, decreased inflammation, and a lower risk of infection.

Furthermore, probiotics may give pregnant women health benefits such as the prevention of gestational diabetes, mastitis, constipation, post-partum depression, and the development of Group B Streptococcus bacteria. Some probiotic products may change the microbial content of the vaginal and breastfeeding, which is thus utilized to avoid bacterial vaginosis recurrence and encourage the intestinal health of newborns by affecting their gut microbiota composition.

Systemic infection means blood-stream infection, i.e., instead of affecting a single organ or body part, it affects the whole body. Immunosuppression, severe illness, central venous catheters, and gut epithelial barrier degradation are all risk factors for systemic infections. Probiotics given orally to treat urogenital infections are not systemically absorbed but reach the site of action via the gastrointestinal system and climb into the vagina.

Analytic study on probiotics:

A meta-analysis of probiotics in pregnant women was done. The majority of women started probiotic treatment between 32 and 36 weeks of pregnancy and continued till delivery. The meta-analysis includes trials of Lactobacillus species alone or in combination with Bifidobacterium species with placebo. No case of miscarriages or deformities were predicted because probiotic usage was primarily in the third trimester and hence unlikely to impact organogenesis. There was no significant change in birth weight, gestational age, or cesarean section rate. There have been women exposed to probiotics from the first trimester to the end of exclusive breastfeeding.

Studies have been evaluated between the combination of Lactobacillus rhamnosus strain GG and Bifidobacterium lactis compared to placebo and abnormalities were not recorded. However, the clinical importance revealed that newborns whose mothers were exposed to probiotics had a significantly reduced chance of increased birth weight and birth length. For eight weeks throughout the first and second trimesters of pregnancy, maternal intake of a probiotic comprising L. rhamnosus and L. reuteri was related to an increased risk of vaginal discharge and changes in stool consistency, although the increased risk of adverse effects is low.

Benefits of probiotics in lactation:

Probiotics are not expected to pass into breast milk since they are seldom systemically absorbed. They aid digestion and contribute to the production of vitamin B, which is crucial for nervous and skin health and prevents anemia. It reduces chronic constipation in infants. Probiotics could help to minimize acid reflux in newborns. Thrush infection is found on the mother’s nipple caused by yeast could be prevented by these probiotics.

What are Prebiotics?

Prebiotics are distinct from probiotics. They are specific plant fibers that function as fertilizers in the gut, encouraging the development of beneficial microorganisms. Many fruits and vegetables contain prebiotics, particularly those high in complex carbohydrates such as fiber and resistant starch. Because these carbohydrates are not digested by your body, they pass through the digestive system and become food for bacteria and other microorganisms. Prebiotics are substances that stimulate the development or activity of helpful microorganisms such as bacteria and fungus.

Furthermore, many people are ignorant of prebiotic products and how they might enhance health. Prebiotics withstand hydrolytic action in the upper gastrointestinal tract and so reach the colon in an intact state. They are then exposed to selective fermentation by beneficial microflora, which alters the makeup of the intestinal microbiota. Prebiotics usually promote the growth of Bifidobacteria and Lactobacillus, which have a variety of positive benefits for the host, including improved digestion and immune system strength.

Benefits of prebiotics in pregnancy & lactation:

Prebiotics’ health effects are mostly attributable to increased synthesis of short-chain fatty acids (SCFA), which play a crucial role in intestinal barrier modulation, immune system, and inflammatory response regulation.Prebiotics are not just modulators of gut microbiota, but their potential is being explored in a variety of illnesses, including colorectal cancer and inflammatory bowel disease. They also help with the absorption of numerous minerals, the prevention of obesity, and the relief of constipation.The prebiotic impact has been attributed in part to the low content of proteins and phosphates, as well as the presence of lactoferrin, lactose, nucleotides, and oligosaccharides

Because human milk includes ready-made “prebiotics,” exclusively breastfed newborns have a higher concentration of these beneficial bacteria (which encourages the good bacteria). And it will remain that way until these newborns are fed anything other than mom’s milk. It makes no difference if a mother takes probiotic pills for her gut health.

Prebiotics have received less attention than probiotics in terms of research. Hence, probiotic and prebiotic supplementation is relatively safe for use during and after pregnancy, as well as throughout breastfeeding, and is not linked with any severe health consequences for the mother or baby.

Also read: Immune surveillance genes in Diffuse large B-cell lymphoma

Reference: –

1. 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), 2382. https://doi.org/10.3390/nu13072382

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