We sat down with Dr. Heather Finley for a Q&A on all things gut health during pregnancy and postpartum. These questions were submitted by our Needed customer community.
What digestive challenges are normal to expect during pregnancy?
It can be common to experience constipation, indigestion (heartburn) and increased gas during pregnancy. It is also common to experience morning sickness and nausea which can greatly impact appetite. Most commonly women experience constipation, nausea and gas in the first trimester from the increase in progesterone while indigestion happens in later weeks due to the growing belly.
How do I know when these challenges change from “normal” to concerning?
Good question! Like I mentioned in the previous question, it can be common to have these symptoms, but that does not mean they have to be your normal. If you are going multiple days without a bowel movement or experiencing indigestion that is preventing you from eating enough calories to meet yours and the baby's nutritional needs, this would be concerning.
What can I do about constipation during pregnancy? What about postpartum?
- Hydration is key. Most women need to be drinking at least 80oz of water and can benefit from also adding electrolytes to their water. Needed has a great electrolyte + trace mineral powder that could be beneficial for your constipation (psst: if your stools are hard and pebbly this is a sign you need more water!).
- Eat soft, well cooked fruits and vegetables versus large raw salads and fruits
- Consider using extra Magnesium (citrate or glycinate), but always check with your doctor on dosing and if this is appropriate for you. (Check out Needed’s Sleep + Relaxation Support for an extra boost of Magnesium).
- Ginger tea in between meals can help both nausea and constipation
- If you are still constipated you will want to also look at how you are eating…meaning are you taking your time, chewing your food well and spacing your meals out 3-4 hours if possible
- Use a prebiotic fiber supplement like sunfiber. Sunfiber is gentle enough to encourage the growth of “good” bacteria in the gut while also helping to bulk and move stools.
What can we do about nausea and fatigue during pregnancy? Is this linked to gut health?
There are some studies that show that maternal H Pylori can increase nausea in pregnancy so this actually starts at preconception. That being said, if you are already pregnant you are not “doomed” and there are many things that you can do.
Once you become pregnant, estrogen and progesterone increase which alters the gut microbiota. Your metabolism also slows to extract more nutrients from foods (which is a good thing!)
Here’s what you can do:
- Eat enough protein (try for 4-5 oz per meal)
- Drink plenty of water with electrolytes
- Eat as soon as you wake up
- If needed, eat small more frequent meals
- Give yourself grace about what you are eating (stressing about it isn’t going to help!)
- Drink ginger tea
- Get morning sunlight
- SLEEP as much as you can
- Sleep and nap as you can
- Give yourself grace for needing to say “no” to things so you can rest
- Balance your blood sugar by including protein, fat and carbohydrates with each meal
- Eat carbs with friends (aka protein and/or fat): No lonely carbs!
- If you are having food aversions prioritize fruits and vegetables by blending them into smoothies
- Get morning sunlight
- Consider scaling back workouts and focus on lighter and less intense workouts
What can I do about heartburn during pregnancy and why does it happen?
Heartburn can happen for several reasons but most commonly:
- The belly expanding and putting extra pressure on the digestive tract
- Hormonal shifts
What you can do:
- Eat smaller, more frequent meals
- Use digestive enzymes that are safe for pregnancy to aid digestion
- Drink slippery elm tea (ask your provider first!)
- Use a supplement or tea that contains spearmint, ginger, lemon balm, marshmallow or milk thistle (ask your provider)
- Chew, chew, chew your food (to applesauce consistency)
- Eat slowly and take your time
- Take 2-3 deep breaths before eating to relax your digestive system and get into “rest and digest”
- Keep your bowels moving–constipation will only worsen constipation
- Don’t eat right before bed
- Avoid spicy foods, caffeine and any other triggers you notice if needed
What can I do before and during pregnancy to support gut health for me and baby?
There is so much you can do while pregnant to support both your microbiome and the baby’s microbiome.
The first and most important is to reduce stress as much as possible. An anxious mind = an anxious gut. An anxious gut cannot digest and absorb as it is designed
The second most important thing is to eat a wide variety of foods (particularly plant foods). This may not be possible in your first trimester and I totally get this. I was super sick and nauseated for 18 weeks in both of my pregnancies, so give yourself grace. Ideally prioritize 30 different plants per week from fruits, vegetables, whole grains, beans, nuts, seeds, legumes and herbs.
You can also take a probiotic tailored to pregnancy to support both yours and baby’s gut health. Spore based probiotics are a great option and there are several strains shown to both improve gut health in babies as well as gut health for prevention of GBS.
What can I do to support gut health for me and my baby if I have to take antibiotics?
If you have to take antibiotics first, don’t panic. You could benefit from including a supplement like Saccharomyces Boulardii into your supplement regimen while on antibiotics and 4 weeks afterwards (just take it 4 hours away from your antibiotic).
Also, prioritize eating a wide variety of plant foods with a particular focus on prebiotic fiber from onions, garlic, asparagus, jicama, etc.
What can support gut health for me and my baby if I have a cesarean?
If you have a cesarean you may consider looking into vaginal seeding. Vaginal seeding refers to the practice of inoculating a cotton gauze or cotton swab with vaginal fluids to transfer the vaginal flora to the mouth, nose, or skin of a newborn infant. The procedure is most often performed in conjunction with cesarean delivery. Consult with your doctor to request this.
You can also support your baby’s gut health afterwards via breastfeeding, if you are able to. Breastfeeding is going to continually transfer beneficial bacteria to your baby and promote an optimal microbiome.
After delivery it is helpful to continue taking a prebiotic and probiotic to encourage diversity in your microbiome, which will in turn impact your baby’s health if you are breastfeeding
If you are not able to breastfeed, introducing a probiotic into your baby’s formula can be beneficial.
A well-functioning gut microbiome affects a baby's brain, immune system, skin and gastrointestinal systems. And a happy gut = a happy baby = a happy mama.
What are the benefits of digestive enzymes for pregnancy and postpartum?
Digestive enzymes are beneficial in aiding food breakdown. If you are struggling with heartburn, constipation, slow motility or even seeing undigested foods in your stool, you may benefit from a digestive enzyme.
What are the benefits of Collagen for pregnancy and postpartum?
Collagen Protein is beneficial for aiding protein intake in pregnancy and postpartum when needs are higher. Collagen is also beneficial for those that struggle with breaking down “harder to digest” proteins like meats due to heartburn or early fullness. Remember to include collagen with Vitamin C to aid in absorption.
Is more gas and bloating postpartum normal? What can I do about it?
Yes, it can be. After delivering a baby your body experiences the most significant and quick change in hormones that it could ever experience, so it's normal for things to feel “off”. Postpartum gas should resolve on its own, especially once the bowels are moving daily again and the rapid hormone changes start to slow down.
What are the top things moms can do to support gut health?
The top things include:
- Include stress reducing activities in your day. Even if for 5 minutes it is important to reduce your stress “load” because stress is the worst thing for your gut. Stress comes in all forms and during the postpartum period there are a lot of stressors as you navigate taking care of yourself and baby. Take 5 minutes to take a walk, call a friend, do a meditation, journal, etc.
- Eat a variety of foods. I know it is much easier to eat the same things everyday but try switching up your variety and include 30 different plants in your diet per week (remember: fruits, vegetables, nuts, seeds, beans, legumes, and herbs count!)
- Don’t under eat and stay hydrated. I know there are so many pressures in today’s society to “get your body back” but this pressure is only hurting you. Under-eating and not drinking enough water is one of the top things we see as a trigger for gut symptoms in the clients we work with. And fixing this is easier said than done (especially if you have digestive issues present). Focus on nourishing yourself versus restricting yourself and hydrating like you mean it!
Why do things like collagen, bone broth, and fermented foods cause symptoms?
Bone broth, collagen and fermented foods may cause symptoms because they are higher in histamine. There are specific gut bacteria that degrade histamine in the gut so if your gut health is not optimal it can be harder to degrade histamine.
Intestinal inflammation and gut imbalances can cause a deficiency in DAO enzyme. DAO is responsible for breaking down histamine. For adequate DAO production the body requires adequate intake of beneficial fats, phosphorus, magnesium, iron and Vitamin B12. Not having enough DAO increases your risk of histamine intolerance. Some individuals can benefit from a DAO enzyme and a histamine degrading probiotic.
Dr. Heather Finley is a registered dietitian who helps people struggling with bloating, constipation, and IBS find relief from their symptoms and feel excited about food again. Heather struggled with her own digestive issues for nearly 20 years and understands firsthand the impact that nutrition, lifestyle, and mindset have on digestive health. Gut health shouldn’t be restrictive, stressful, and all-consuming. She developed a simple way that individuals can reduce digestive symptoms and add foods back into their diet using her trademarked gutTogether method. Dr. Heather has a doctorate in clinical nutrition from Maryland University of Integrative Health. Her work has been featured in Mind Body Green, Yahoo! Life, and Very Well Health.