Mothers and healthcare practitioners will agree— treating any infection or other illness while pregnant needs to be done safely. Specifically, with baby in mind. As a pregnant mother, you’re not just thinking about the effects of treatment and medications on your body. You're worried about how it’s affecting the growing life inside you. To that end, I wrote up this blog for you, to teach how to heal your gut while pregnant, safely.
Many of my patients – even some who are already pregnant – will present with gut infections, bacterial overgrowth (small intestinal bacterial overgrowth or SIBO), or yeast overgrowth. Usually, I would approach a situation like SIBO, for instance, with antimicrobials or antibiotics, along with a custom gut-healing protocol.
But when it comes to pregnant patients, we use more gentle herbal and dietary approaches. These will control and heal infection and overgrowth— remedies that are safe for mom and baby.
6 Ways to Promote a Healthy Gut While Pregnant
A Gluten-Free or Grain-Free Diet:
Grains and gluten-containing grains in particular are higher in the fermentable sugars known as FODMAPs, which are known to feed bacterial and yeast overgrowth and contribute to IBS and SIBO.
Gluten may cause or contribute to conditions like intestinal permeability or “leaky gut” because it contains proteins that are difficult to digest and are known to interact with with the tight junctions of the gut lining. Gluten can also activate immune cells to trigger inflammation. Many people with gut conditions can benefit from a gluten-free or grain-free diet to give the gastrointestinal system a rest and to cut down on starchy grains that tend to feed yeast and bacteria.
If you decide to try any restricted diet while pregnant or breastfeeding, work with a qualified nutrition expert to ensure that you’re getting adequate nutrition, especially in the form of whole-foods carbohydrates such as dense tubers and squash.
A Low-FODMAP Diet for IBS/SIBO:
Fermentable sugars from high FODMAP foods can feed bacterial overgrowth and exacerbate symptoms of IBS and SIBO. In fact, low-FODMAP diets have been used for decades to help treat chronic IBS symptoms. Many practitioners will also use a low-FODMAP diet in conjunction with other treatments for SIBO.
Two pilot trials done by Monosh University have even found that mothers who switch to a low-FODMAP diet report significant improvement in colic-related symptoms in their infant.
Probiotics can be beneficial in the treatment and management of gut conditions of all kinds and can have a positive benefit on the child. After all, mom’s gut microbiome is ultimately baby’s microbiome. Probiotics can also help to boost the immune system and ward off inflammatory responses in the gut.
Herbal antimicrobials are sometimes used in place of antibiotics during pregnancy and lactation or anytime a more natural approach is preferred. Garlic is a safe alternative, as is the stronger, biologically active isolate of garlic, allicin. Please check in with your doctor before beginning any antimicrobial protocols as they may not be indicated or effective for your condition.
Iberogast, ginger, or magnesium citrate are the safest motility agents during pregnancy. If you’re experiencing gut motility issues (sluggish digestion) or constipation, some of these natural remedies may suffice. Constipation is especially prominent in the first trimester when progesterone is high. Magnesium will also help with muscle soreness and sleep, while ginger is also helpful for nausea.
Adequate vitamin D3 provides benefits to the microbiome, including maintaining the homeostasis of the gut lining and preserving the tight-junctions which are involved in leaky gut. Having your levels testing and then supplementing as needed is the ideal.
And remember, getting some good ‘ol sunshine boosts your vitamin D production in your skin and gives your mood a little love too!
The Use of Erythromycin in Pregnant
and Lactating Women
Erythromycin is one of several motility agents used in the treatment and prevention of SIBO. Contrary to what some practitioners say, I do not find erythromycin to be safe at any level. That means during pregnancy or breastfeeding. I would only use it if it was absolutely necessary, SIBO not being one of those cases.
Erythromycin crosses the placenta, as shown by low concentrations of the drug found in fetal serum. And there is some evidence that exposure in early pregnancy can result in cardiovascular anomalies.
Erythromycin is also excreted in breast milk, and should be used with the utmost caution in breastfeeding women. Use may result in decreased appetite, diarrhea, rash, and drowsiness in infants exposed to macrolide antibiotics. There is also some evidence that suggests a connection with pyloric stenosis, a gastrointestinal condition, in infants who receive erythromycin via breast milk.
Talk to your doctor about alternative antibiotics or antimicrobial treatments if you are pregnant or actively breastfeeding.
Ideally, we work together to optimize gut function pre-pregnancy. Life doesn’t always work that way and sometimes gut healthy is compromised during pregnancy. If that is the case for you, I sincerely hope these tips help you bring your gut back into balance.
What About Breastfeeding?
We are always cautious about herbs used during nursing. Many herbs can pass through the breastmilk, while others have not been well studied in humans. Oregon Grape, for example, is used commonly to treat gut infections because of the high concentration of berberine, an anti-microbial. But Oregon Grape has been shown to be a category C herb. Which means that animal studies have shown an adverse effect on the fetus. It also means there are no adequate and well-controlled studies in humans for us to evaluate its use in pregnancy.
In my book, Healing Your Body Naturally After Childbirth, I provide practical information about the use of herbs, supplements and treatments that help your body heal and support gut health.
There are many ways to support your gut through pregnancy and breastfeeding. I recommend beginning with the list above and implementing the recommendations in my book. If you continue to experience symptoms, it is important that you meet with a licensed health care provider who understands how to naturally treat gut symptoms during pregnancy and breastfeeding.