Your gut health is not only the foundation for your overall health—it’s also the basis of your baby’s long-term health and immunity. New research reveals that mother-baby microbiomes are so closely intertwined that they are one. Your breast milk is full of beneficial bacteria that reflect your gut health. Can taking probiotics provide additional benefits to your baby via breast milk?
Disclaimer: This post is for informational purposes only. None of the information here should be taken as medical advice. Even if a remedy is classified as safe in Herbal Doula blog posts, that doesn’t mean it’s safe for you. The classifications in the database are just a general reference point. Follow your body, keep track of your response, and consult an herbalist, holistic practitioner, or anyone else you feel may be qualified to help you if you need expert advice.
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New Microbiome Science, You & Your Baby
I’ve been personally and professionally fascinated with the microbiome for over a decade. This series of posts was long in the making and is meant to be the most in-depth resource on probiotics and the microbiome during pregnancy and breastfeeding.
Science about the microbiome has come out with some incredible findings that mirror millennia-long intuitive knowledge. The interplay between mother-baby microbiomes reflects how physiologically inseparable mother and baby are during the first months after birth (Alemu et al., 2023).
Your vaginal, gut, and breast milk microbiome are imprinted into your baby’s skin and gut microbiomes. The complex web of bacteria that form your and your baby’s microbiomes communicate with your and your baby’s immune systems, brains, and whole bodies. According to new estimates, we have at least as many bacterial cells as human cells (specifically, 1.3 bacterial cells for every human cell) (Gilbert et al., 2018).
According to new research, your baby’s gut microbiome may even start to form before birth. Studies suggest that your microbiome during pregnancy helps develop your baby’s microbiome while still in utero (termed the prenatal microbiome), but this yet needs to be confirmed (Walker et al., 2017).
What’s certain is that your baby’s foundational microbiome is formed during the first year after birth. The first big event for your baby’s microbiome is birth—your vaginal microbiome at birth (in case of vaginal birth) transfers to your baby. Your baby’s microbiome then continues to be shaped by your breast milk microbiome if you’re breastfeeding (Alemu et al., 2023; Notarbartolo et al., 2022).
Since your gut microbiome directly affects your breast milk microbiome, there are various steps you could take to improve your gut microbiome and boost your baby’s immunity and long-term health. A healthy and wholesome diet naturally high in fiber and fermented foods should be the foundation. Probiotic supplements may also be beneficial, and that’s what we’ll explore in this post.
Is it safe to take probiotics while breastfeeding?
A recent, large systematic review and meta-analysis of 24 clinical trials (with 2761 mothers and 1756 babies) concluded that probiotics during breastfeeding are safe and offer a range of benefits to both mothers and babies (Alemu et al., 2023).
Another systematic review of 11 studies concluded that both probiotic and prebiotic products are safe for use during pregnancy and lactation (Sheyholislamii & Connor, 2021).
Probiotic supplementation increased the detection of beneficial bacteria in breast milk by 24%. Breastfed babies of women who took probiotics also had more beneficial gut bacteria, better-controlled weight gain, and were less likely to experience colic (Alemu et al., 2023).
The following probiotics and yeast were identified: Lactobacillus, Bifidobacterium, Streptococcus thermophilus, and S. boulardii. Lactobacillus and Bifidobacterium are large probiotic families (called genera) with many strains that may offer specific benefits (Alemu et al., 2023).
Do probiotics transfer from the gut to breast milk?
Yes! We now know that a woman’s gut microbiome transfers to her breast milk. The beneficial microbes found in breast milk are collectively called the human milk microbiota (Notarbartolo et al., 2022).
We have come a long way from long-standing thinking that breast milk is sterile or that probiotics in the gut are not absorbed into the body. It’s hard to believe that just a few centuries ago, scientists claimed that the bacteria in breast milk were from outside contamination and that milk needed to be heated to be “bacteriologically safe” (Leyva et al., 2020).
Despite this, some studies still claim that probiotics “are rarely absorbed” from the gut. If you Google the safety of probiotics while breastfeeding, this study will come up (Elias et al., 2011).
Let’s look at the actual science. New research shows that beneficial bacteria and other microbes enter breast milk both from the baby and mother (Leyva et al., 2020).
When breastfeeding, the baby’s oral microbiome and mom’s breast skin transfer bacteria into breast milk. Bacteria from the mother’s gut microbiome can also travel into breast milk. Only in the late 2000s did scientists discover the mother’s gut and breast milk microbiomes intermingle via the blood and lymphatic systems (Leyva et al., 2020).
Image source: Sources of milk microbiota, Leyva et al., 2020
Baby and mother are so intertwined that the mother’s own vaginal microbiome “returns” to her breast milk from the baby. This is because the baby’s skin and mouth microbiome is affected by the mother’s vaginal microbiome in case of vaginal birth. Some studies even show higher bacterial diversity and richness in the milk of mothers who had vaginal births (Leyva et al., 2020).
If you’re preparing for a natural birth, be sure to read this post about the hidden history of obstetrics and how it affects you today (not an easy read, but you’ll thank me later!).
If you already gave birth—even if it wasn’t vaginally—there are still many steps you can take to support your and your baby’s microbiomes.
Benefits of taking probiotics while breastfeeding
Stronger Gut Immunity & Less Colic and Spit-up in Baby
Probiotic supplementation may improve the anti-inflammatory potential of breast milk, according to one study.
In one trial of 66 women, probiotics during late pregnancy and early breastfeeding increased levels of anti-inflammatory immune compounds TGF-β1 and IL-10 in breast milk compared to the placebo. Babies whose mothers took probiotics also had more IgA antibodies in the gut. How the women gave birth didn’t change these benefits (Baldassarre et al., 2016).
TGF-β1 (a mouthful to pronounce!) is extremely important for the development of your baby’s gut. It affects how well your baby’s gut can produce IgA antibodies, which are the main players in your baby’s initial gut immunity. These antibodies are the baby’s first line of defense in the gut. Scientists think that this is the reason babies in the probiotic group had more IgA antibodies in their stools (Baldassarre et al., 2016).
Babies of supplemented mothers also had less colic and regurgitation (aka spit-up). Higher TGF-β1 levels may help the baby’s gut muscles contract more effectively, reducing the chance of the milk moving back up through the intestinal tract and mouth (Baldassarre et al., 2016).
IL-10 is an anti-inflammatory immune compound. Higher IL-10 levels in the breast milk of probiotic-supplemented mothers may have contributed to a reduction in colic symptoms. Probiotics that boost IL-10 are being researched for preventing or reducing colic in babies (Baldassarre et al., 2016).
This study used a high-concentration multi-strain probiotic supplement with four different strains of lactobacilli available under the trade names Vivomixx® and Visbiome®.
In another study, probiotic supplementation in breastfeeding mothers increased various antibodies in babies (IgG, IgM, and IgA), suggesting a stronger immune boost (Rinne et al., 2005).
Summary
Probiotic supplementation during late pregnancy and early breastfeeding may help support the baby’s gut immunity and lower the chance of colic and spit-up. Larger studies would help confirm these findings.
Lower Eczema Risk in Baby
One of the first discoveries about the beneficial findings of probiotics during breastfeeding was related to reducing the risk of eczema. Eczema affects up to a fourth of all babies, and estimates say that up to 60% of people develop it during their first year of life.
In a 2002 study of 62 mother-baby pairs, probiotic supplementation in mothers reduced the risk of developing atopic eczema during the first two years of life. Babies of supplemented mothers had a 15% chance of developing eczema, compared to 47% in mothers who got the placebo. Whether or not the mother also had eczema was a big factor. Mothers in this study took probiotics both during pregnancy and breastfeeding (Rautava et al., 2002).
New studies voice these findings. For example, a 2013 study showed that the probiotic L. rhamnosus HN001 halved the prevalence of eczema at 2 and 4 years. Mothers took the probiotic from 35 weeks pregnant until 6 months if breastfeeding and babies received the probiotic up to 2 years of age. Supplementation also reduced the immune oversensitivity to other allergens (called atopic sensitization) in high-risk infants to age 6 years (Wickens et al., 2013).
However, the same probiotic given to mothers only failed to prevent eczema (Wickens et al., 2018).
A systematic review of 21 studies confirmed this. They found that giving probiotics to mothers during pregnancy and continued while breastfeeding and also given to babies reduced the risk of eczema in children. This was true for both high-risk and non-high-risk groups. They also discovered that single strains are not as effective as probiotic mixtures for eczema (Amalia et al., 2019).
Another 2023 analysis of 37 trials including over 6000 mothers and babies showed that there is evidence to claim that probiotics help prevent atopic dermatitis. Lactobacillus rhamnosus and mixed probiotics were most beneficial (Wang et al., 2023).
Summary
Specific probiotic strains and mixtures may reduce eczema risk in babies. To see an effect, it may be necessary for the mother to take probiotics during both pregnancy and breastfeeding and to additionally give probiotics to the babies during the first few years of life.
Maternal Depression and Anxiety
In one Australian study of 423 women, Lactobacillus rhamnosus HN001 supplementation during pregnancy and breastfeeding lowered depression and anxiety scores in the postpartum period (Slykerman et al., 2017).
It would be great to see more research about probiotics, the mother’s microbiome, and mood disorders.
Are there any risks to taking probiotics while breastfeeding?
Analyses of studies conclude that the adverse effects associated with probiotic and prebiotic use do not pose any serious health concerns to mothers or babies (Sheyholislami & Connor, 2021).
However, it’s always good to be mindful when starting a new supplement. Everybody responds differently and many probiotic strains are on the market.
Probiotic effects are likely strain, dose, and condition-specific. A person’s response to a probiotic may be unique and affected by their health status, age, genetics, and gut microbiome (Sheyholislami & Connor, 2021).
Mild side effects are possible, so be sure to track your and your baby’s response.
Gut symptoms in mothers
Most reported probiotic adverse effects in studies were related to gut health, mostly in mothers. These adverse effects include abdominal cramping, nausea, soft stools, flatulence, and taste disturbance (Sheyholislami & Connor, 2021).
This is in line with the general adverse effects that some non-pregnant, non-lactating people also experience when taking certain probiotics.
Vaginal discharge & stool consistency
One study reported an increased risk of vaginal discharge and changes in stool consistency in some mothers taking Lactobacillus rhamnosus and L. reuteri. The increased risk of these adverse effects was minimal (Sheyholislami & Connor, 2021).
Conflicting data on mastitis
The data on the effects of probiotics on mastitis is conflicting. Several studies point to beneficial effects, while others suggest caution.
A meta-analysis of six trials concluded that probiotics during pregnancy may reduce the risk of mastitis after birth, while probiotics given to women with mastitis may reduce the number of harmful bacteria in breast milk (Yu et al., 2022).
Another review of five studies found that probiotics may help prevent or reduce the symptoms of mastitis (Barker et al., 2020).
In one Norweigan study, women who drank probiotic milk during pregnancy were more likely to experience mastitis in the early postpartum. Yet they were less likely to stop breastfeeding before 4 months (Karlsson et al., 2019).
The associations in the Norweigan study were likely affected by other factors like socioeconomic status, education, diet, mode of birth, and breastfeeding support. Additionally, this study looked only at probiotic milk intake during pregnancy, not during breastfeeding (Karlsson et al., 2019).
Overall, more evidence points to the potential beneficial effects of probiotics on mastitis. Additional studies are needed to confirm this.
Caution about long-term gut effects in children
Although probiotics are generally considered safe and may have many benefits for your baby’s gut, some reports suggest caution. Probiotic supplementation might not always have a positive effect on babies.
In one study, probiotics were linked to higher incidences of mucosal-associated illnesses (e.g., Crohn’s disease, ulcerative colitis) in toddlers, raising concerns about their long-term effects. This is another reason to pay attention to specific strains and dosages (Quin et al., 2018).
However, this study didn’t look at the effect of probiotics transferred via breast milk but at direct supplementation in babies.
Caution in immune-compromised individuals
While probiotics are generally considered safe, caution is advised when used in immunocompromised individuals. There are rare cases of infections such as bacteremia or fungemia in vulnerable populations (Sheyholislami & Connor, 2021).
Best probiotics while breastfeeding
Here is a list of clinically tested probiotics mentioned in the studies cited in this article:
- Vivomixx® / Visbiome® (colic and spit-up in baby)
- Lactobacillus reuteri mixtures / Pink Stork, BioGaia Protectis (for colic and spit-up)
- Lactobacillus rhamnosus HN001 (eczema in baby, mood in mom)
- Bifidobacterium animalis ssp. lactis HN019 (baby gut health)
- Lactobacillus rhamnosus GG / Culturelle (baby’s immunity)
- Lactobacillus acidophilus La-5 (baby’s gut and immune health)
- Bifidobacterium animalis ssp. lactis Bb-12 (baby’s gut health)
- L. fermentum CECT5716 / BioGaia Elactia MUM (for mastitis)
>>>>> If you are looking to naturally boost your breast milk supply, be sure to read this article.
>>>>> Looking for a great safe remedy for your baby? Check out this post about chamomile tea.
Did you use probiotics while breastfeeding?
Let me know about your experience in the comments and share this article if you found it useful! <3
The founder of Herbal Doula.
Home-birthing mama, independent scientist, natural pharmacist, doula, birthkeeper, and holistic health and birthrights advocate. Endlessly passionate about creating and sharing empowering health information and birth support. Ana has written 150+ and edited 800+ articles, some of which reached over 1 million people
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