If you’re currently trying to conceive or think you will be in the near future, you probably have already given some thought to improving your diet. It’s well established that good nutrition helps grow healthy babies (and prevents many pregnancy complications). You’ve heard it from me, you’ve heard it from your doctor, and it just makes good sense right? But, what you may not know is there is another critical area to focus on prior to conceiving and while pregnant. It’s something that I work on with all of my clients in my practice who are trying to conceive…

 

Your microbiome -especially, you’re gut health.

 

What does your gut have to do with getting pregnant or having a healthy baby? Actually, the health of your gut can impact your pregnancy a lot. Let me explain why addressing digestive health issues should be a focus before you get pregnant.

 

What is the Microbiome?

 

Let’s start with the basics. The microbiome is basically all the bacteria that live on and inside your body. In the digestive system alone there are 100 trillion of them. The number of bacterial cells actually outnumber our body’s own cells! We are, in fact, more bacteria than human. Most of these microbes are great, they do a lot for our health. But, some of them are not. Regardless, the microbiome influences almost every aspect of your overall health and metabolism. They can impact:

– Digestive health: gas, bloating, constipation, diarrhea.

– Body weight

– Energy levels

– Risk of autoimmune disease

– Immune system function

– Inflammation or risk of chronic diseases, such as type 2 diabetes

– Ability to absorb nutrients from food

– Skin health

– How well you manage stress

– Allergies

 

As you can see, those are a lot of responsibilities for little tiny microbes! A healthy well-balanced microbiome can help keep the body running smoothly and reduce your risk of disease. The problem is that many of us have an imbalance of good and bad bacteria in our microbiome, which is called “dysbiosis”, and we don’t even know it. Most of us just think if we don’t have digestive problems we are ok, but the symptoms are much more than that.

 

The imbalance doesn’t just influence your own health, it can impact pregnancy outcomes and the long-term health of your baby. The good news is that you can restore the balance and improve your microbiome and overall gut health prior to pregnancy (and maintain the balance during pregnancy) with some key strategies. We’ll talk about these strategies a bit later, but let’s take a look at the connection between the microbiome and a healthy pregnancy.

 

The Microbiome during Pregnancy

 

During pregnancy your immune system changes, inflammation increases, and your microbiome is also impacted by this shift. Estrogen and progesterone, two hormones that increase during pregnancy, can also alter the microbiome and impact gut health. If you have ever been pregnant before, you may have experienced a change in your normal digestion, which is by design; digestion slows so you can extract more nutrition from the foods you eat. But, this change is also partially due to the shift in the microbiome (and hormones).

 

Depending on what happens to the microbiome during pregnancy, meaning which bacteria are allowed to take over, this can increase your risk of certain complications and impact the health of your baby.

 

Here are a few pregnancy complications that have been connected to the health of the microbiome:

Risk of preterm birth.

Preterm birth is when birth occurs before 37 weeks. It is the leading cause of long-term disability and mortality for infants. The health of the microbiome in the gut, vagina, and even the mouth have been linked to an increased risk of preterm birth. In the vagina, a healthy microbiome prevents infections that could lead to pregnancy complications, including Group B strep, a common cause of antibiotic use during labor. Gum disease, or an excess of unhealthy bacteria in the mouth, has been associated with a 2 to 7 times increase in preterm birth. Yes, even your mouth! Gut bacteria have been found in the amniotic fluid of women who had preterm births, meaning they also may have an influence. And important thing to point out here is that all of our systems are connected and when there is a microbiome imbalance found in one part of your body, it is usually reflective of systems wide imbalance.  

 

Risk of Preeclampsia

Preeclampsia is a condition that happens late in pregnancy that leads to dangerous high blood pressure and spilling of protein in the urine. It affects 10% of pregnancies and can cause serious complications for the mother. Gum disease, which is influenced by bacterial balance in the mouth, in the mother has been linked to an increased risk of preeclampsia.

 

Risk of Gestational Diabetes

Gestational diabetes (GDM), a type of diabetes that happens during pregnancy, impacts 14% of all pregnant women. If left untreated, GDM can lead to severe complications for the infant and mother, a too-large fetus, and an increased risk of C-section. Women who develop GDM have been found to have less diversity and more inflammation-triggering microbes in their gut microbiome.

 

Weight Gain During Pregnancy

The gut microbiome has been associated with a high pre-pregnancy weight and weight gain during pregnancy. Research has found that those who are overweight have a different microbiome, with different types of bacterial strains and usually less diversity, compared to those who are not. Women with more Lactobacillus strains in the gut tend to not gain as much weight during pregnancy as women who have fewer. Healthy weight gain during pregnancy lowers risk of diabetes, preeclampsia, and other pregnancy-complications.

 

A healthy microbiome can reduce your risk of a lot of pregnancy-related complications. Making sure your microbiome is healthy, in your gut and throughout your body, you can increase your odds of having a healthy pregnancy and delivery.

 

The Microbiome and Infant Health

 

Babies receive 100% of their initial microbiome from their mother. It was formerly believed that infants were born with a sterile gut and were not exposed to microbes until they were born. But, new studies have found that there is actually an entire unique microbiome in the placenta and amniotic fluid. The type of bacteria found in the uterus and placenta are most similar to found in the human mouth.

 

After birth, the colonization of the infant’s gut is influenced by the type of delivery (vaginal vs. C-section), genetics, gestational age, and size of the infant. Preterm infants have been shown to lack to important bacterial strains and large infants tend to have different strains than those of normal weight. The type and variety of strains at birth can have a long-term impact on health.

 

The microbiome continues to develop even after birth. Breastfeeding or formula feeding change the microbiome of the infant as they age. Early antibiotic use, such as with Group B strep infection, can also impact long-term microbiome health.  How and when solids are introduced changes the microbiome. There are many different factors in the development of a healthy microbiome during the early years of life.

 

So, how does the microbiome impact the health of your baby? In so many amazing ways! Here are just a few:

 

Fewer allergies and eczema.

Allergies rates are on the rise and can be very scary for parents to deal with. But, a 2013 study in Pediatrics found that probiotics during pregnancy reduced the risk of food and environmental allergies by 12%. The reason may be that a healthy microbiome and early exposure to bacteria can help trigger a stronger immune system. It can also teach the immune system early on to react correctly to the environment, instead of overreacting to benign triggers, as in the case of allergies.  

 

Risk of Autism

Rates of autism diagnosis have been increasing, therefore there is a lot of interest in the research world to try to figure out the cause. There seems to be a connection between autism, the immune system, and the microbiome. How it all works together is still not totally understood. A recent study found that there is a connection between the prenatal maternal microbiome and the development of behavioral problems, including autism. At this time, more research is needed to figure out exactly how the microbiome is influencing the risk of autism.

 

Stronger Immune Function

A well-colonized microbiome, with a diversity of species, tends to also strengthen the immune system. Infants who were born vaginally and who experience skin-to-skin after birth, tend to have greater diversity. This helps keep your baby healthy throughout their first year and beyond because nothing is worse than a sick baby.

 

Less Inflammation and Chronic Disease

Inflammation has been linked to almost every chronic disease. A healthy microbiome helps control inflammation, even in infants, lowering risk of diabetes, obesity, heart disease, and cancer.

 

Lower Risk of Anxiety and Depression

A healthy microbiome can improve how we deal with stress by giving positive feedback to the nervous system. This may reduce the long-term risk of depression and anxiety.

 

Healthy Body Weight

A diverse microbiome has been linked to a healthier body weight throughout life.

 

Improved Memory and Social Functioning

Rat studies have found that the microbiome may even impact social functioning and memory. It may also impact healthy development throughout childhood. Further research is needed to determine the exact relationship between the microbiome and cognition.

 

During the first 2-3 years of life, the microbiome is taking shape and constantly changing. There are so many factors that can influence its development and so many opportunities to support its development.  So, yes, a healthy mother and a healthy pregnancy can have a big impact on long-term health of the infant, but what happens in the first few years also matters a lot. The microbiome grows as your child grows.

Are Probiotics Enough?

 

So, you are probably thinking you need to get on a probiotic right away and eat a ton of fermented foods to make sure your microbiome is in balance. Although that can be helpful, the health of your gut and microbiome is a lot more than just taking a pill.

 

The problem with probiotics is that it can be confusing to figure out which one to take. Each strain has a different function and benefit. If you have ever gone to the store looking for one, you probably left confused. The best thing to do when looking for a probiotic, particularly if you think you have a microbial imbalance, is to speak to a practitioner who is well-versed in specific strains and formulations. This person can make a tailored recommendation as to what you should focus on during preconception and into pregnancy.

Other than a probiotic there are plenty of other things you can do to improve your gut health before getting pregnant:

• Eat fermented foods daily: kombucha, sauerkraut, and yogurt are great choices. These have been associated with a lower risk of pregnancy complications.
• Manage your stress. Too much stress throws of the balance of the gut microbes. Try meditation, a walk in nature, or exercise to help reduce stress. Also, try not to stress about getting pregnant! Easier said than done, I know.
• Adopt a well-balanced, nutritious diet. Limit processed foods.
• Maintain a healthy weight.
• Avoid smoking and substance abuse.
• Maintain good oral hygiene.
• Avoid douching.
• Exercise regularly

 

Adopting a few of these habits will help keep your microbiome happy, increasing the likelihood of getting pregnant and having a healthy pregnancy. The health of our microbiome is a reflection of our health, and as you have learned, it also impacts the health of future generations.

How do I know if I need more than just some general tweaks to my diet to improve my gut health?

• Have you suffered with digestive issues for years?
• Do symptoms affect your daily life?
• Are you frequently constipated or have loose stools? Does it fluctuate between both?
• Have you tried probiotics and cannot tolerate them?
• Do you have a growing list of foods that you can’t tolerate? Do your food intolerances feel like a moving target?
• Do you have frequent acid reflux?

 

If you answered yes to any of the above or you simply know that something is just “not right” with your digestion, it’s likely that you’ll need to work with a functional medicine practitioner who is well versed in gut health issues and who can use appropriate testing to identify your specific imbalance.  If you want to talk through your symptoms and come up with a plan, I offer initial consults that can be done in-person or virtually from anywhere. Book your consult here.