Gut health in pregnancy – the microbes I’m hoping to pass to my babies (and how)

As The Ribbon Box CEO and founder, and mother of three – with twins on the way – (yep, phew!), Eloise is all about optimising for healthy pregnancy.

Going into her final round of IVF in summer 2023, Eloise took a good look at her vaginal microbiome, using the Invivo® Vaginal EcologiX™ test, which provides cutting-edge insight into your unique vaginal health and microbiome profile. 

We wrote up her experience and results here – skip back to check if you’re in IVF prep or testing mode – and did some 101 coverage on the importance of optimising vaginal microbiome for fertility and IVF outcomes. 

Me & my microbes

Fast-forward from IVF, Eloise is pregnant with twins and fully focused – alongside steering The Ribbon Box and and looking after three young children – on goals for a healthy pregnancy and birth in the spring. 

And it’s these factors which drive her keen interest in building and maintaining a healthy microbiome during pregnancy. Eloise says, 

“Running a business, working pretty long hours and parenting three young children whilst pregnant with twins is exactly why I need to get my microbiome in ship-shape order. 

Stress has a proven impact on our microbiome, and I’m conscious too that my own microbial health can have a huge impact on my babies’ health, both in-utero and throughout their lives.

Plus, it’s very possible I’ll give birth via c-section, in which case they may miss out on some of the amazing microbiome passed from mother to baby during vaginal birth. So I want to do everything possible now in pregnancy, to support my babies’ own microbiome.” 

For deep understanding of her microbiome profile, and the supplements to support it pre, during and after pregnancy, Eloise’s trusted go-to is Invivo Healthcare. Picking back up where testing left off, we asked for their 101 – what can we do to optimise newborn microbiome, during pregnancy? 

We caught up with Debbie Cotton, Head of Clinical Innovation at Invivo, for cutting-edge insight across gut health in pregnancy, plus tips and strategies to get newborn microbiome off to a roaring start. 

Over to Debbie. 

Gut health in pregnancy – why do we care?

Pregnancy involves a few pretty seismic shifts in the way our bodies work, across many aspects of our health and deep within our cellular structure, plus our microbiome. 

What do we mean by ‘microbiome’? In baseline terms, this is the collective term for the communities of microbes which live within our body. We have a gastrointestinal or ‘gut microbiome’ – which has been under the spotlight for several years, now – but also an oral microbiome, skin microbiome and others. 

And crucially for female health, preconception, pregnancy and supporting our baby’s health into childhood, we have the vaginal microbiome. 

Your baby’s first 1,000 days – what’s the link?

A baby’s first 1,000 days of life are seen as a critical window of opportunity to boost their health for future life. The timeline starts at conception – so yes, pregnancy is very much part of it! – and finishes up at a child’s second birthday. 

It’s during this time that a baby’s brain is established, and begins to grow and develop, as well as a vast range of other functions and core aspects of health. And we know that the gut microbiome – both maternal and fetal – plays a crucial part in this process.

Vaginal focus

A baby’s microbiome is partially determined by their mother’s own microbiome, during vaginal delivery at birth – or, if you’re having a c-section, by using a technique called ‘vaginal seeding’. Babies use the vaginal microbes they pick up during birth to begin building their own colonies of bacteria in their gut, setting up the foundations of infant gut health and beyond. 

For a healthy vaginal microbiome, we need good gut health. And for good gut health, we’re primarily talking about building and maintaining a thriving, diverse gut microbial community.  

Crucially, gut health is something we can work on, look after and improve. Other aspects of our pregnancy health can be tricky to crack – and hacking our genetics even more so – but gut health really is a factor we can take away and work on at home for dynamic results, in many cases. 

Let’s look at how. 

1. Microbial diversity is key

Science Direct recently published fascinating insight into maternal gut microbiome and infant health, a few highlights being its impact on fetal neurodevelopment, metabolic health and links to allergic disease in children. Further investigation is needed, but as the article notes, we’re increasingly seeing associations between maternal gut microbiome and infant outcomes. 

So, gut health is crucial. But what are the building blocks for a healthy gut – and ones we can work on in pregnancy? In general, we focus on: 

• a balance between potentially beneficial and harmful bacteria in the digestive system
• diversity and abundance within the microbiome

It makes sense to look for balance between the ‘good’ and ‘bad’, but the point around diversity is also key to good gut health. Studies show that having a broad range of microbes in our digestive tract optimises our microbiome, making it more effective at key functions like supporting immune and brain health. 

And, this gut-supporting diversity is tightly linked to building a healthy vaginal microbiome. 

How can we boost microbial diversity?

We are what we eat, in so many ways. And for this reason, what we eat is a vital part of fetal health and development. We can support microbial diversity with a diet that, in turn, packs in a diverse range of foods. 

Here are a few good starting points for really boosting up your microbial diversity (all pregnancy-friendly): 

• eat the rainbow, and a variety of foods, every day – think different fruits and veggies, grains and pulses, cultured foods and dairy products, depending on your overall dietary choices 
• if you need to take antibiotics – and some women do, during pregnancy – try to balance out the impact using my tips below, and a clinically-researched probiotic supplement (Bio.Me Femme V helps support a normal vaginal microbiome after antibiotic use) 
• avoid diets which cut out entire food groups, if you can – for example, diets which may reduce your fibre intake 

If diversity is your target – and for most of us, it will be – Bio.Me Prebio GOS provides dynamic support – it’s a clinically-researched formula rich in galactooligosaccharides, targeted towards increasing Bifidobacterium and Lactobacilli.

2. Go for fibre-rich

Speaking of fibre intake – give it some real value in your meal-planning, grocery list and every quick snack you pack in during pregnancy. 

Fibre is a crucial support for healthy gut microbiome. Go for whole grains, fruits and veggies, beans and pulses for a varied intake rich in the prebiotic fibres our microbiome loves to metabolise, including those all-important Lactobacilli. 

The added bonus here during pregnancy is digestive support, too, from dietary fibre. Think whole grain toast with eggs, strawberries topped with yoghurt and adding lots of beans and chickpeas to nutrient-dense one-pot curries. 

My top tip here is looking into a water-soluble prebiotic fibre, for really targeted support when building microbial diversity. Bio.Me Prebio PHGG is a fantastic option – it’s colourless, flavourless and easily dissolves in hot water, meaning you can literally boost intake in your morning cup of tea, or soup at lunchtime. 

3. Consider what you’re putting inside your vagina

Your vagina houses a complex and delicately balanced microbial ecosystem, and a whole range of things – from sex to ‘feminine hygiene’ products, can throw this off. Here are my top no-nos and watch points in pregnancy, for vaginal healthcare: 

• vaginal douches, soaps and washes – avoid these, unless you’re using them for a targeted purpose (and always triple-check anything you’re using is safe during pregnancy)
• sex is fine, just take care – practice good hygiene after sex, and ensure your partner is screened for STIs too
• using lube? Go for one that’s pH-appropriate for your vagina (3.8 to 4.5), and has a short and simple ingredients list. Water-based if often best, and some contain ingredients like lactic acid – a plus for our microbiome – so shop around and find one you trust and like

4. Think cultured, fermented products

First things first, take care during pregnancy with your intake here. Anything unpasteurised isn’t recommended, due to risk of food-borne illness which can cause serious problems in pregnancy. 

It’s still very easy, however, to ramp up your intake of ‘live’, fermented and cultured foods – from everyday options like yoghurt – go for plain Greek yoghurt for less sugar and higher protein intake, and top with berries for a one-two fibre punch – to added goodies like kombucha, kefir, miso and kimchi or sauerkraut. 

All of these options are packed with natural dietary probiotics – including that gold dust Lactobacilli species – and building them into your diet can help support the amazing colonies you’re already cultivating, inside your gut and, in turn, your vagina. 

5. Hydrate, hydrate, hydrate

Good hydration is a crucial part of pregnancy health. But did you know that getting enough water is important for gut health too? 

Constipation is an all-too common feature in trimesters one and three, and can disrupt gut health, so if in doubt, fill your glass and add in lots of herbal teas, sparkling water with a squeeze of citrus and gut-loving options like kombucha and water kefir. 

Want a clear picture of your own, unique microbiome? Alongside all the tips and strategies we’ve worked through, it can really help to deep-dive your microbiome, and find out exactly what’s going on inside your vagina. 

If you’re keen to test, and build a pinpoint plan to optimise your microbiome – pre, during or after pregnancy – read TRB founder Eloise’s experience with the Vaginal EcologiX Vaginal Health & Microbiome Profile here, and order your test here. Plus, get 15% off the entire Invivo supplement range with code RIBBON15*.

*15% off RRP on any supplements purchased through the Invivo website. The offer expires January 31st 2024 and is limited to 1 use per person and cannot be used in conjunction with other any other offers. Invivo promotional T’s and C’s apply. To be advertised on The Ribbon Box Website only.