Why Probiotics are a Must During Pregnancy and Beyond

Having a strong and healthy abdomen (“gut”) is important for both mother and baby. Being pregnant automatically causes the immune system to work double time. It is a proven fact the health of the mom’s gut has tremendous impact on the infant’s gut health. If the mom has a poor diet, high in processed foods, low intake of fruits and vegetables, consumes coffee and/or carbonated beverages, has taken antibiotics or low-quality prenatal vitamins, or has experienced high stress level during pregnancy, the immunity of the baby changes and will be affected for life. Each of the aforementioned factors can alter the good bacteria inside our systems, which ultimately is passed down to the baby.


The impact to the baby’s immunity is dramatically increased when the baby is born via C-section. Babies born vaginally have a higher diversity of gut bacteria in their intestinal track verses those born via C-section. This bacteria lies within the vaginal canal and kick starts the baby’s immunity, which is crucial to the life of the immunity. Because of this, babies born via C-section have a higher rate of:


• Allergies
• Asthma
• Eczema/Psoriasis
• Diabetes
• Obesity
• Colic


Taking a high cultured probiotic is a step in the right direction when it comes to supporting the immunity of both mother and baby. In fact, many studies have found the importance of adding probiotics to the mother’s supplement regimen before conception. This has resulted in the baby’s health having increased immunity. Studies show how mothers who increase their probiotic intake during pregnancy reduce their child's risk of allergies by as much as 50%, specifically in eczema, asthma and atopic dermatitis. There are benefits to the mother as well as she may decrease the risk of colds and respiratory infection since her immune system is suppressed. Here are some other reasons to take a high dose of probiotics during pregnancy:


Probiotics reduces risk for preeclampsia

Preeclampsia is the number one reason for maternal death in the United States. A study published in the American Journal of Epidemiology did an analysis of over 33,000 women in Norway to find that women who ate 4.7 ounces of fermented milk products during the first half of their pregnancy had a reduced risk for developing preeclampsia. Probiotics helps to reduce inflammation in the intestines, which has proven to reduce blood pressure.


Probiotic intake during first trimester helps lose postpartum weight faster: Research in the British Journal of Nutrition has found that mothers supplementing with probiotics that contain Lactobacillus and Bifid bacterium during their first trimester and continuing until they stopped breastfeeding (up to 6 months) were associated with less central obesity one year after giving birth. (Central obesity is defined as a body mass index (BMI) of 30 or more).


Probiotics helps digestion and nutrient absorption:

Probiotics helps to break down proteins, carbs and fats and converts fiber into healthy fatty acids that nourish the cells that lines the intestinal wall. This helps to reduce gas, bloating, heartburn and constipation. When the intestines are sealed (aka leaky gut syndrome) the better our bodies absorb the nutrients from the foods we consume. The more nourishment mothers get, the more the baby gets too. Probiotics also help the intestines make short-chain fatty acids, which contribute to the overall health of the body.

Probiotics can help reduce the risk for postpartum depression:

Medscape Medical News reported the connection between the gut and brain is very real and becoming well researched. Many of our neurotransmitters lie within our intestinal track that affects the brain chemistry. Preliminary research is finding the importance that taking probiotics can alter the neurotransmitters in the gut boosting the ability to deal and cope with anxiety and depression.

While it is important to take a probiotics during pregnancy, it is more important that both mother and baby take probiotics postpartum. Renew Life Critical Care Blend is a high dose blend that can be beneficial to take. New Chapter Prenatals also has probiotics in their vitamins, but it may not be high enough to support the immunity for both mother and baby. For more information, consult a nutritionist that specializes in maternal and infant health and find out what nutrition is best for you and your baby.

Written by:


Jasmine Jafferali
MPH, ACE-CPT, Certified Total Control Instructor




The Body Eclectic by Richard Conniff

British Journal of Nutrition. Certain Probiotics Could Help Women Lose Weight. Universite Laval. January 28, 2014. http://www.sciencedaily.com/releases/2014/01/140128103537.htm.

American Journal Of Epidemiology: Intake of Probiotic Food and Rick of Preeclampsia in Primiparous Women: The Norwegian Mother and Child Cohort Study. April 21, 2011. http://aje.oxfordjournals.org/content/174/7/807.

Probiotics Linked to Lower Risk of Allergies for Kids. Written by Kathy Doyle New York. August 22, 2013. http://www.reuters.com/article/2013/08/22/us-probiotics-linked-to-lower-risk-of-alidUSBRE97L0UK20130822.





Optimizing Neonatal Skin Care-

Key Points from AWHONN's 2013 Practice Recommendations

Late Winter/Early Spring 2014

In This Issue:
     Why Probiotics are a Must
     During Pregnancy and


     Optimizing Neonatal Skin
     Care- Key Points From
     AWHONN’s 2013 Practice
    Educational Spotlight:
     Tips for Bathing and
     Diapering Infants (2014)











About 6 months ago, AWHONN released their updated evidence based clinical practice guidelines. This third edition replaces previous recommendations from the 2007 clinical practice guidelines. The goal of this Guideline is to optimize neonatal skin integrity by providing nurses with guidelines based on the best available evidence. The Guidelines encompass all neonates (birth to 28 days of life), regardless of gestational age. Exclusion criteria include neonates with congenital skin disorders.


What are the important principles and changes for L & D, mother baby, and NICU nurses to be aware of? This summary focuses on the full term infant – additional practice recommendations for premature infants can be found within the full practice guidelines. Some of these care guidelines may reshape how you practice as well as how you educate parents.


Essential physiologic and anatomic concepts are highlighted:


• Vernix caseosa helps develop the ‘acid mantle’ of the skin, which inhibits the growth

of harmful microorganisms.


• The newborn’s stratum corneum is 30% thinner than the adult’s and does not

function as well as the adult skin throughout the first year of life. The premature

infant has less layers of stratum corneum, especially at less than 30 weeks

gestation. The dermis in the newborn is also thinner than and not as developed

as the adult dermis, with fewer and shorter collagen fibers.

• Full term newborns are born with an alkaline skin surface, but the pH falls to less

than 5.0 within the first 96 hours of life. This process takes longer in premature


• New technology has helped us to understand that there are many helpful

microorganisms colonizing the newborn’s skin. This colonization varies in vaginal

vs. cesarean deliveries. More research is needed in this area, but potential

consequences may involve the colonization of pathogens, such as MRSA.

• Atopic dermatitis is rising in prevalence, with an incidence of 20% in children. In

infants, it usually begins on the cheeks, forehead, or scalp. The presence of pruritus

can help distinguish this from other rashes. The etiology is multifactorial and

allergens may play a role. Further research is being done to evaluate if a daily

emollient use may help prevent atopic dermatitis.


Specific education and practice tips for nurses around bathing/diapering:


• Immersion bathing does NOT need to wait until after the umbilical cord stump falls

off. Research shows no differences in healing time or complications.


• Use of a mild liquid baby soap has similar effects on skin parameters vs. using water

alone. In fact, soap cleans better than water, may result in less rubbing to remove

debris, and may help to maintain the skin’s pH better than water alone. However,

preterm infants less than 32 weeks gestation, should be bathed using warm water

ONLY during the first week of life.


• Bathing significantly influences thermoregulation during the early neonatal period,

especially for those infants born less than 37 weeks. The bath water should be

between 100 – 104 F; the room temperature between 79 – 81 F; and the newborns

temperature and cardiorespiratory status should be stable (for full term babies, the

babies’ temperature should be at least 98.2 and the bath should be delayed for at

least one hour after birth). Sponge bathing may cause an increase in heat loss vs.

immersion bathing. This has implications for mother baby nurses who are moving

away from a central nursery model and conducting the first bath in the mom’s room.

Controlling the room environment, using prewarmed towels, and changing the

infants clothes 10 minutes after the bath can also help prevent heat loss.


• Infants who were bathed in a tub showed a reduction in crying vs. sponge bathing.

Additionally, swaddled bathing has been shown to prevent uncontrolled motor

activity in the newborn as well as decrease parental stress.


• Do not attempt to remove residual vernix during the bath, as it protects the skin.

Vernix should be allowed to wear off with normal care.


• Mild, liquid bath soaps have been validated as safe to use. Avoid getting the product

in the baby’s eyes, as the blink reflex is delayed until 4 months of age. Use a pH

neutral or slightly acidic product. Additionally use products with preservatives that

have demonstrated safety and tolerability in newborns. The Environmental Working

Group’s skin deep data base rates more than 2000 baby care products for toxicity

and tolerability.


• Diapers should be changed every 1-3 hours. Appropriate methods to clean the

diaper area include disposable diaper wipes, soft cloths and water, or soft

clothes/water/liquid cleanser. Alcohol free diaper wipes are preferred. Additionally,

water along may be insufficient in removing feces and may cause more dryness vs.

water and a cleanser.


• Zinc Oxide based products work well as a barrier product in treating diaper rash. But

emphasis is placed on applying it thickly – like frosting on a cake. Petroleum

products can also be used for mild diaper rash or as a preventive during times when

there is an increased risk for developing diaper dermatitis.


Article Written By:


Kim Wilschek, RN, CCE



AWHONN’s Neonatal Skin Care Guidelines, 3rd edition.