Should You Take Probiotics During Pregnancy?

Pregnancy can be an exciting time full of new experiences and learnings, especially when it comes to diet and supplements.

However, if you’re pregnant and feel overwhelmed by the sheer amount of information available, know that you’re not alone.

You’ve likely discovered that conflicting evidence abounds on health and wellness websites. Plus, many people — friends, family, co-workers, or even strangers — might feel warranted to give you their personal opinion on what’s safe and what’s not when you’re pregnant.

It’s understandable if this makes you wary about adding new foods and supplements to your diet, including probiotics.

This article breaks down the latest research on the safety of taking probiotics during pregnancy, enabling you to make an informed decision when choosing pregnancy supplements.

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Are they safe to use during pregnancy?

Probiotics are living organisms found in certain foods and drinks like yogurt, kefir, tempeh, and kombucha. You can also take them in supplement form (1).

Taking certain amounts may offer health benefits like improved digestive health and reduced risk of heart disease (2).

Research has found most strains of probiotics, including Lactobacillus and Bifidobacterium, to be safe to take long term (2).

However, some researchers are exploring if the overuse of probiotic supplements could lead to the transfer of genes resistant to infectious pathogens, antibiotic resistance, and other negative health consequences (3, 4).

Regardless, rest assured that studies have found that taking probiotic supplements during pregnancy is safe and not associated with adverse outcomes.

Firstly, a large 2018 review that included 49 publications found that taking probiotic supplements during pregnancy wasn’t associated with an increased risk of preterm birth or other adverse pregnancy outcomes in mothers or babies (5).

Similarly, many other studies show that probiotic use is well tolerated if you’re pregnant or breastfeeding (1, 6, 7, 8, 9, 10).

A 2020 review that evaluated the safety of probiotics in pregnancy and newborns detected adverse effects in 3 of the 21 included studies. That said, all 3 reported adverse effects were from probiotic use in infants, not during pregnancy (11, 12, 13, 14).

Two of these cases involved bacterial infection in the bloodstream of low birth weight infants, while the last case involved the use of probiotics in a low birth weight infant after a surgical procedure (12, 13, 14).

Ultimately, the review concluded that probiotics appear to be safe for pregnant women and full-term newborns, but cautioned that more research is needed — especially in the most vulnerable populations like low birth weight infants (11).

If you’re pregnant and considering taking probiotics, we recommend running this by your healthcare professional first to make sure they’re the right choice for you and your baby.

Summary

Probiotic supplements appear safe to use if you’re pregnant or breastfeeding, although researchers agree that larger, high quality studies are needed to confirm this.

Benefits of taking probiotics during pregnancy 

Perhaps you found this article because you’ve heard that taking probiotics during pregnancy is linked to health benefits.

This is supported by research. In fact, it’s believed that these supplements may improve certain aspects of maternal health, reduce the risk of pregnancy complications, and benefit newborns.

May benefit gut health

Keeping your gut bacteria healthy is always important, including when you’re pregnant. Some evidence suggests that taking probiotics during pregnancy may be one way to improve gut bacteria composition and digestive health.

One 2020 study in 49 pregnant women with obesity found that those who took a multi-strain probiotic supplement from an average of 17 weeks pregnant until delivery experienced increased gut bacteria diversity, compared with those who took a placebo (15).

More specifically, the probiotic group had more of the beneficial bacteria lactobacilli, bifidobacteria, and S. salivarius (15).

Having high bacterial diversity is a sign of a healthy gut, while low bacterial diversity has been linked to negative health outcomes like metabolic disorders. That said, more research in this area is needed (15, 16, 17).

May reduce the risk of preterm delivery and other pregnancy complications

Promisingly, taking probiotic supplements may help protect against preterm delivery and other pregnancy complications.

A 2020 review that included 18 randomized control trials found that the length of pregnancy was significantly longer in those taking probiotic supplements, compared with those receiving placebo treatments (18).

The review also found that those who took probiotics had a significantly reduced risk of death and necrotizing fasciitis, a rare but life threatening infection that can occur during pregnancy (18).

May reduce the risk of eczema in infants

If you’re pregnant, taking probiotics may help reduce the risk of eczema — a condition characterized by red and itchy skin — in you and your baby.

For example, a 2020 review associated probiotic supplements with a significantly reduced risk of eczema during pregnancy (18).

Plus, a 2019 review of 28 studies associated the use of probiotics during and after pregnancy with a significantly reduced risk of eczema in infants and children (19).

In line with this, the World Allergy Organization recommends probiotic use in those who are pregnant and infants with a family history of allergic disease (20).

Combined, this suggests that taking probiotic supplements may help prevent eczema in people who are pregnant and babies. That being said, the available evidence is considered low quality, and more research is needed to confirm these potential benefits.

May reduce depression and anxiety

Perhaps you’re researching probiotic supplements because you’ve heard that they can reduce the risk of or treat symptoms of depression and anxiety during and after pregnancy.

Unfortunately, even though it’s speculated that some strains of probiotics may have these effects, not all studies agree.

In a 2017 study in 380 women, taking a probiotic called Lactobacillus rhamnosus HN001 (HN001) from weeks 14–16 of pregnancy until 6 months after birth led to significantly lower depression and anxiety scores, compared with placebo (21).

Yet, the study was funded by the supplement manufacturer, which may have influenced the results (21).

Interestingly, a 2021 study in 40 women who were pregnant found that taking a multi-species probiotic supplement from 26–30 weeks of pregnancy until delivery had no effects on depression or anxiety symptoms (22).

A 2020 study also showed that probiotic treatment with Lactobacillus rhamnosus GG and Bifidobacterium lactis BB12 had no effects on mental health outcomes in pregnant women (23).

In conclusion, there’s only limited evidence that probiotics may reduce depression and anxiety during or after pregnancy.

Experiencing depression or anxiety during or after pregnancy is not uncommon, and you don’t have to get through this tough time alone. Talk with a trusted healthcare professional for help and to get the right care as soon as possible.

May improve maternal metabolic health

If you’re pregnant, staying healthy is essential for reducing the risk of complications and of developing certain health conditions after delivery.

Thankfully, probiotic supplements may help reduce blood sugar and insulin levels in pregnancy, which could improve health and lower the risk of complications.

A 2018 review that included 12 randomized controlled trials found that the use of probiotics during pregnancy reduced blood sugar and insulin levels (10).

In a 2017 review of 4 randomized controlled trials in 288 women with gestational diabetes — characterized by elevated blood sugar levels during pregnancy — probiotics significantly reduced insulin resistance, though they didn’t reduce blood sugar levels (9).

The researchers suggested that this could help those with gestational diabetes reduce the need for blood sugar-reducing medication later in pregnancy (9).

Many other studies have also shown how probiotic supplements may benefit insulin and blood sugar levels when taken during pregnancy (24, 25).

Additionally, a 2017 study suggested that treatment with HN001 during pregnancy may reduce the risk of development of gestational diabetes, especially in women over the age of 35 years and those who previously had the condition (26).

These findings are promising, but keep in mind that research in this area is ongoing.

It’s understandable if you’re interested in taking probiotic supplements to help reduce blood sugar or insulin levels, but it’s important to talk with your healthcare professional first to check if that’s the best approach.

Summary

Taking probiotic supplements during pregnancy has been associated with several benefits, including reduced pregnancy complication risk and lowered blood sugar and insulin levels.

Should you take probiotics while pregnant? 

So, now that you know that probiotics are generally safe to take during pregnancy and may offer some health benefits, you’re probably wondering whether or not you should take them. The answer is, it depends.

For some, the supplements may be beneficial during pregnancy.

For example, if you’ve been taking probiotics before pregnancy to improve symptoms of gastrointestinal conditions like irritable bowel syndrome (IBS) or Crohn’s disease, it’s likely suitable to continue taking them (27, 28).

Additionally, these supplements may be helpful if you’re experiencing high blood sugar and insulin resistance or if you have a family history of allergic diseases.

Yet, even though some studies suggest that probiotics may reduce certain pregnancy complications, the evidence isn’t strong enough to recommend them to all who are pregnant.

Not necessary for most people

Even though some people may benefit from taking these supplements during pregnancy, they aren’t necessary for most.

Other supplements — including high quality prenatal supplements and omega-3 fatty acid supplements — are more important to support maternal and fetal health (29).

But what remains the most important is enjoying a nutrient-dense, well-rounded diet and a healthy lifestyle.

For example, make sure to eat plenty of protein-rich foods like eggs, chicken, fish, lentils, vegetables and fruits, and healthy sources of fats like full fat dairy, avocado, nuts, and seeds to provide your body with the nutrients it needs.

Additionally, even though most people don’t need to take a probiotic supplement during pregnancy, you’ll likely still benefit from eating foods naturally rich in probiotics such as kimchi, kefir, miso, and sauerkraut.

In addition, adding foods rich in prebiotics — fibers that help feed the good bacteria in your gut — like artichokes, garlic, onions, and asparagus to your diet can promote the overall health of your digestive system. Being rich in fiber, these foods can also help prevent constipation (30).

If you’re pregnant or are trying to get pregnant and have questions about which supplements to take, we recommend speaking with an experienced healthcare professional like your OB-GYN or a registered dietitian who specializes in nutrition during pregnancy.

They can provide customized recommendations and help you learn which supplements match your diet, lifestyle, and overall health. Plus, if they do recommend a probiotic supplement, they can advise you on which specific strains may be most effective.

On a final note, when purchasing supplements, including probiotics, make sure to choose products from reputable brands to ensure safety. Many brands are verified by third-party organizations including USP, NSF International, or Underwriters Laboratory.

Summary

Probiotics may provide some benefits during pregnancy, but they’re not always necessary. Oftentimes, a well-rounded diet and healthy lifestyle will do the trick, but make sure to raise any concerns you have with your healthcare professional.

The bottom line

Probiotics are popular supplements that are safe to take if you’re pregnant or breastfeeding.

In fact, taking them during pregnancy has been linked to benefits like fewer pregnancy complications, reduced risk of eczema in babies, and improved markers of metabolic health in expectant mothers.

Despite this, probiotics are not necessary or appropriate for all pregnant women. As such, we recommend that you ask your healthcare professional for advice if you’re interested in trying out probiotic supplements during pregnancy.

Just one thing: If you’d like to include more probiotics in your diet without taking supplements, stop by this article to learn more about which foods are naturally high in them.