This post is part of our ongoing Five Questions With series, in which we interview a pregnancy, postpartum, or baby health and wellness expert. The information included in this post is for educational purposes only. It is not intended nor implied to be a substitute for professional medical advice. Consult your healthcare provider to determine the appropriateness of the information for your own situation, including beginning a new supplement, or if you have any questions regarding conception, pregnancy, or your prenatal treatment plan. 

Gut health … a trendy topic, but what does it mean? Research is increasingly showing the connection between gut health and overall wellness. We’re beginning to understand how the bacteria in our gut plays a role in physical health (like obesity and diabetes) and mental health (such as autism, anxiety, and depression). This has important implications in preconception, pregnancy, and postpartum.

We also know that mom’s gut health and nutrition is important for the development of baby, too. We sat down with Dr. Michael Ruscio, a Functional Medicine Doctor, gut health expert, and author of Healthy Gut Healthy You, and he answered our questions related to gut health for mama and baby.

What are a few practices a woman can take during each stage of her journey (preconception, pregnancy, and postpartum) to optimize gut health?

Diet is the foundation, and the Whole30 is a great place to start. Some women, especially those with digestive symptoms, may do better on either the standard low FODMAP or Paleo Low FODMAP diets. Exercise can also promote the growth of healthy bacteria in the gut, so remember to keep moving.

Interested in learning more about the importance of nutrition during pregnancy? Stephanie dives into this topic and more in our HMHB handbook. Check out the full Table of Contents here.

Probiotics are a good option preconception all the way through postpartum and may have dual benefit for mother and child.  I’ll talk more about probiotics below! Outside of supplementation, fermented foods are another great way to obtain probiotics in the diet. Strive for at least one serving of a probiotic rich food per day, such as kombucha, sauerkraut (we like Whole30 Approved Farmhouse Culture), kimchi or yogurt (if you tolerate dairy).  

If you aren’t pregnant or nursing and are experiencing digestive symptoms, fasting can help hit the reset button and calm down a gut flare.  This can be via an intermittent fast, essentially skipping a meal or two and only consuming water or tea or via a juice/liquid fast with bone broth. This can be done for anywhere from 1/2 a day to 3-4 days. Only fast as long as you need in order to calm down your gut, and make sure to work with your healthcare provider. 

You may have heard of functional medicine doctors treating gut conditions like SIBO (small intestinal bacterial overgrowth) or candida with antimicrobial herbs. However, these are not recommended at anytime during pregnancy or nursing.

How does a woman know if she’s having gut issues during her pregnancy or postpartum?

The easiest way to assess this is with symptoms like bloating, constipation and heartburn, but this can also be challenging as some digestive upset is normal during pregnancy.  If a women is experiencing more than occasional digestive symptoms, she might want to employ the strategies we discussed; namely diet (a modified Whole30 or low FODMAP) and probiotics.

Unfortunately, functional medicine testing doesn’t provide much useful data when it comes to the pregnant population, because most treatments are off limits when pregnant or nursing.

Are there special considerations women should take during pregnancy or postpartum when it comes to optimizing their gut health?

In order to optimize gut health during pregnancy and postpartum, moms can consider probiotic supplementation.

Probiotic supplementation has benefits for both mom and baby.  For mom, probiotics can help with general symptoms of GI upset: gas, bloating, abdominal pain and/or altered bowel function.  Some evidence suggests probiotics can also prevent UTIs. For baby, they may reduce colic, the incidence of eczema, and the symptom severity of allergic rhinitis. They may also aid in healthy development of the child’s immune system.

Additionally, antibiotics should be used only when absolutely necessary, as they have been shown to impair development of the child’s gut bacteria and subsequently their immune system.  The older the child, the less risk antibiotics pose.

What are the most beneficial forms/strains of probiotics for mamas?

Probiotics can be confusing because there are hundreds of products; however, we can simplify all the products into roughly three categories of probiotics.  

1 – Lactobacillus and Bifidobacterium predominated blends. These contain various strains of Lactobacillus and Bifidobacterium probiotics. The Lacto-Bifido class might be most beneficial during pregnancy and postpartum.

2 – Saccharomyces Boulardii. Contains solely S. bouldardii, a healthy fungus probiotic.  

3 – Soil based probiotics. Contains various strains of Bacillus species probiotics.    

You can see my preferred formulation for each of these classes here.  Using a low dose of each of these covers most of your probiotic bases.  

What can moms do to optimize their baby’s gut health?

Breastfeeding is very beneficial for gut health. Breastfeed for at least 6 months, if able. Additionally, make sure not to shelter your children from germs.  Allow your children exposure to old dirt (i.e. things that a hunter gatherer might have been exposed to; literal dirt, bugs, animals, and nature), but be cautious with new dirt (things that humans are only recently having exposure to such as public restrooms and trash).

Food reintroduction is a controversial topic and the data here appear mixed. Perhaps one of the main takeaways for health conscious mothers is to understand that delaying the introduction of foods may actually increase the likelihood the child will develop an allergy to said food—even for a food one may view as ‘unhealthy’ like gluten or peanuts.

There is some evidence showing that it’s best to “avoid both early (<4 months) and late (≥7 months) introduction” of gluten. Since this the research is relatively mixed, each mother should approach food introduction in a way that she is comfortable with.

Interested in learning more about wellness, nutrition, and how to be the healthiest version of yourself during your pregnancy? Stephanie keeps us up to date in our members-only Whole30 Healthy Mama, Happy Baby group. We’d love to have you join us today!

Photo: Dominik Martin


Dr. Michael Ruscio is a functional medicine practitioner, clinical researcher, and international lecturer. He is a leader in the movement to make integrative medicine and natural health solutions more accepted and accessible. His clinical practice is located in Northern California.

Find out more about his simple, evidence-based approach to healing chronic illness at www.drruscio.com. Purchase Dr. Ruscio’s latest book, Healthy Gut Healthy You on Amazon today.