What Every New Mum Needs to Know About Their Gut - Tasha D'Cruz
/What Every New Mum Needs to Know About Their Gut
The first 1000 days of a baby’s life - from conception to age 2 - is a period of enormous developmental change. It’s considered one of the most important stages of development, and as parents, we play a role in providing what they need nutritionally, mentally and physically. It’s an enormous responsibility because how well our children are in these first 1000 days impacts their health for life.
I also believe that the first 1000 days are important for the mother. How well a mother is looked after - by society, by her network and by herself - informs how well she mothers. Because inadequate nourishing during pregnancy, traumatic or unsatisfactory birth experience, incomplete healing and recovery from birth and insufficient replenishment of lost nutrients throughout the first two years of her child’s life can be the difference between just about coping and surviving, and flourishing and thriving as a mother.
Right now, there is an epidemic of chronic diseases. Allergies, asthma, heart disease, obesity, diabetes, neurological conditions. While it’s accepted that lifestyle risk factors play a part - smoking, alcohol, poor diet, lack of exercise - it’s also known that how you were conceived, how healthy your mother was during pregnancy, how you were born and how you were fed in the first two years of life - has an enormous part to play in driving this epidemic.
And one part of your health in those first 1000 years that is vital, yet not talked about enough, is the state of your gut - and necessarily by extension - that of your mother.
Why the gut matters
There are 10 times more bacteria in your body (known as the microbiome) than there are cells, and they are everywhere - from your gut, to your skin, to your vagina. The bacteria in your gut is affected by what you eat, how you sleep, how stressed you are, who you live with, the environment you live in, as well as how you were born and fed as a baby.
Your microbiome now, as a mother, plays a role in your risk for pregnancy complications as well as informing your baby’s microbiome while he’s in the womb, and in the early stages of infancy. In addition, it’s estimated that 70% of the immune system resides in your gut. This means that the health of your gut has an influence on how well you fight off infections and recover after giving birth.
The microbiome during conception and pregnancy
Throughout the nine months of pregnancy, your microbiome goes through some astonishing changes. In the first trimester your gut looks just like it did before you became pregnant. But by the third trimester the bacteria in your gut is less diverse than before, with an increased weighting towards bacteria that make energy from the food we eat. This makes sense because pregnancy is a very energy-hungry process, so being able to make some extra energy via our bacteria is a bonus.
However, this can cause problems if we were already having issues with weight gain and a poor diet before pregnancy. Many mums go into pregnancy with high blood sugar levels and so are more prone to excess weight gain during pregnancy and at risk of developing gestational diabetes. During pregnancy our bodies naturally run slightly lower in blood sugar, and elevated blood sugar carries risks for both mum and baby. And while gestational diabetes usually goes away once we’ve given birth, it increases the risk for obesity, diabetes and heart disease both for us and out baby.
The bacteria in our vagina changes in pregnancy too. We have a reduced diversity, with a preference towards lactobacilli bacteria that creates an acidic atmosphere, making it less favourable for bacteria to thrive - this protects against urinary tract infections and sets our vagina up for the optimum balance of bacteria needed to colonise baby when he is born through the vaginal tract. Low levels of lactobacilli bacteria in the vagina is linked to increased risk for premature birth.
Previously thought sterile, the placenta has also found to contain bacteria. It’s not clear what role they have to play, but amazingly the bacteria in the placenta resemble that in your mouth. And just like your gut and vagina, the bacteria in your mouth changes throughout pregnancy. So while research is on the fence about why the placenta contains bacteria, it’s clear that maintaining a healthy digestive tract, starting in the mouth, is key.
Factors that can cause an imbalance of bacteria in pregnancy include a diet high in fat and sugar, use of antibiotics during pregnancy and childbirth, and stress.
Birth: the single more important step on the journey
It probably won’t come as a surprise to know that how your baby is born affects their microbiome. When a baby is born naturally, he is coated in and swallows the fluid from the vagina which is rich in bacteria, particularly the species associated with immunity. So before he has even fully entered the world, his gut is being primed for its lifelong role in immune health.
Babies born via caesarean section are first exposed to bacteria in the environment - in other words, the bacteria in the hospital, and c-section babies often have higher levels of pathogenic microbes. In addition, the use of antibiotics plays a role too, as this can affect the balance of bacteria in both your and your baby’s gut, affecting what is passed on via the breastmilk and potentially causing gut issues in the baby’s immature gut.
However, no matter how they’re born, by one month postpartum babies’ microbiomes look fairly similar. So while there is a delay in getting the correct, balanced ratio, it does happen. The effects of this delay is not known but has been suggested to be an underlying cause of long term health complications of C-section babies, such as higher risk of weight management issues, gut issues, diabetes and asthma, although other factors such as genetics and lifestyle factors have an influence too.
We are extremely fortunate to live in a world where C-sections are possible as they can save the life of mother and baby. And while having a C-section impacts the colonisation of the gut, you can mitigate the effects by establishing breastfeeding, having immediate and regular skin-to-skin time with your baby, doing a vaginal swab before the operation and taking probiotics yourself and giving them to baby once they are born.
The postpartum period and the microbiome
Once you’ve given birth, other factors come into play that influence your baby’s gut, most significantly, how you feed them and their environment. But your microbiome also continues to be important for your health too. The balance of bacteria in your gut can affect your risk for postnatal depression and anxiety, your immunity and how well you heal and recover, your ability to cope with stressful situations (like sleepless nights!), and whether you’ll suffer from vaginal infections such as thrush, and gut issues such as constipation. Your microbiome doesn’t return to normality for about six months, so symptoms of bacterial issues in the gut and vagina might surface in this time. You could give it a helping hand by taking targeted probiotics to help mitigate the effects.
Your baby’s microbiome continues to develop over the first month of his life, and is affected by the bacteria naturally present in the environment, on your skin and in your mouth (i.e. from kissing) and, most importantly, in your breastmilk.
Amazingly, microbes travel from the mother’s gut into the breastmilk, so getting the balance right for yourself will help your baby’s gut. As well as containing bacteria, breastmilk carries a type of sugar that cannot be digested by your baby but is there solely for the benefit of the gut bacteria. Breastmilk has evolved over time to nurture the infant’s immature microbiome in a way that formula milk cannot. While we are very fortunate to have formula milk as an option when breastfeeding cannot be established or is delayed, from a purely optimal health point of view, formula is unlikely to ever be able to match breastmilk for its adaptability and specificity.
As your baby grows and begins to eat solid food and move around, they become exposed to more bacteria and there is a shift in their microbiome. The diversity increases with the greater diversity of food and environment - both due to exposure and due to the need to increase diversity to support an increased digestive need. On the flip side, exposure to antibiotics can be detrimental at any age but the effects in the first 1000 days can be lifelong, with an increased risk of asthma, allergies, weight gain and gut issues. Whereas the effects of antibiotic use in adults is short term, for infants the effects are much longer lasting. Again, we are privileged to live in an era where antibiotics undoubtedly save lives, but they need to be used mindfully, only when absolutely needed, and steps taken to minimise disruption where possible.
Targeted probiotics for both you and your baby can mitigate the effects of antibiotics, as well as improving other issues such as digestive discomfort, colic, allergies and asthma (for baby) and postnatal mental health issues, immune function, pregnancy complications and gut and vaginal bacterial issues (for you).
How to preserve your and your baby’s microbiome
So now you have an in-depth understanding of why the microbiome is so important. The good news is that as human beings we are supremely adaptable. This means that no matter what goes on in our world, we can and do thrive. It’s what makes us such a successful species. And while life-saving interventions like c-sections, antibiotics and formula milk can disrupt the microbiome, we can take simple steps to mitigate their effects to give us and our babies the best start to out motherhood journey.
1. Avoid unnecessary exposure to antibiotics. Only take them when they’re absolutely needed and finish the full course. Take targeted probiotics before, during and after a course of antibiotics and eat a diet that will feed the good bacteria
2. Eat fermented food. Examples include fermented dairy such as kefir, yoghurt and cheese; fermented vegetables such as sauerkraut and kimchi; and fermented drinks such as water kefir and kombucha.
3. Eat a variety of vegetables. Colourful vegetables, nuts, seeds, beans and lentils, and fruit are vital sources of food for bacteria in the gut. Aim for 30-50 different plant foods over a week.
4. Eat resistant starch. This is a specific type of fibre that we can’t digest but is used as a fuel by our gut bacteria. They’re found in green bananas, beans and lentils, and cold, cooked potatoes.
5. Limit added sugar and refined carbohydrates. These feed harmful bacteria in the body and helps prevent against yeast infections
6. Take targeted probiotics. During pregnancy you can take probiotics that are specific to vagina to prevent harmful bacteria from growing. If you have to take antibiotics, you can take probiotics before, during and after the course. If you have a history of mental health issues you can take probiotics known to help with postnatal depression and anxiety. After giving birth you can take probiotics that can improve immune health, help with gut issues and improve stress. If you need targeted support, it’s best to work with a nutritionist or health practitioner to ensure you get the best strain for your needs.
While the first 1000 days of your baby’s life is important from a developmental point of view, the colonisation of his gut by bacteria in utero, during childbirth, in the first six months via breastmilk and throughout the first two years from his environment are also foundational for his long term health. As mothers we have a terrifying, yet exciting, responsibility to shape the health of our children, and it’s an invaluable opportunity to take seriously. Fortunately, the microbiome is flexible and can be influenced using targeted diet and lifestyle changes. In the long term, good gut health for both of you is really important for life, so getting it right early is key.
Bio:
I'm a nutritional therapist specialising in maternal health. I help mums to eat well, sleep well and rest well, so they can heal, recover and restore their energy during and after pregnancy. I work with mums throughout the first 1000 days of motherhood to overcome overwhelm and exhaustion and emerge stronger, healthier and more resilient for the challenges and joys motherhood brings.
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