Taking antibiotics whilst breastfeeding? Here's what you need to know about you and your baby’s gut health

I receive countless messages from new mummies who find themselves in hospital beds hooked up to IVs, overwhelmed by panic being prescribed strong antibiotics. They are deeply worried about how they will affect their little one’s gut microbiome.

It is crucial to understand that being prescribed antibiotics while breastfeeding your baby can be vital for your health to clear a nasty bacterial infection, whether this is for mastitis or something more serious like sepsis. You will probably feel better quickly so that you can fully focus on raising your little one.

However, these antibiotics can have some unwelcome disruptions on both your gut microbiome and your baby’s gut health; this microbiome imbalance may have a knock-on effect on mood, temperament, sleep and immunity in both mother and baby, making those early months of motherhood harder than they should be.

When my mother took a round of antibiotics shortly after giving birth to me, she said I developed terrible reflux, and I became very unsettled, fussy and irritable for quite a while afterwards. We didn’t know back when I was little that antibiotics taken whilst breastfeeding can have such a negative effect on a baby’s digestion, sleep and demeanour. Fortunately, we now know a great deal more, and there are simple ways to get you and your baby’s gut microbiomes back in balance and to help you both keep healthy and well.

The post-partum weeks and months are a time of life when a new mum’s immune system can be very fragile, dealing with grabbed sleep and we naturally prioritise keeping a small human alive over our own health. Infections such as mastitis or pneumonia can hit even when you are breastfeeding your toddler, and my recommendations apply just as much at this stage. So, this is why your doctor will prescribe antibiotics so readily, as they do usually work fast and effectively.

However, to cover all bases, it is important to support your immune system with healthy gut-friendly food and some tweaks to your daily habits as well as consider supplements to help you get through challenging immune issues. This combination can really help your resilience and help you and your baby to thrive. With the right knowledge and this dual approach, there is less worry if you really must take antibiotics while breastfeeding.

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How your microbiome becomes your baby’s

In the final weeks of pregnancy, the body undergoes some truly incredible changes to prepare for your baby’s arrival. One of the most fascinating processes is the way the mother’s gut microbiome communicates with her breast milk ducts: through the action of dendritic cells, a special channel is created between the gut and the breasts, allowing beneficial probiotic bacterial strains from mum’s gut microbiome to travel and populate the breast milk.

This ‘enteromammary’ pathway is a natural mechanism and is the way a mother’s body passes on essential good bacteria from her to her baby. This helps to seed their gut microbiome and lay the foundation for a healthy immune system and optimal development.

This sharing of microbes is one of the many reasons why breastfeeding is so beneficial (if you able to do so), and equally why taking care of your gut health during this time is so important. Remember, the healthier your microbiome, the better equipped your milk will be to give your little one the very best start in life.

These bacteria not only help you to break down food, but they also communicate with your nervous and immune systems to support your immunity, hormones and even brain chemicals called neurotransmitters. These neurotransmitters include Serotonin to lift the mood, GABA to reduce anxiety and aid sleep and also Acetylcholine to help reduce mummy brain fog. Your gut microbiome has such a strong influence that some scientists refer to it as a second brain; that’s why keeping your gut microbiome balanced is important.

What happens when you take antibiotics

Even though antibiotics can be a lifesaver as you have learnt they can also disrupt the delicate balance of bacteria in the microbiome. If you don’t restore the beneficial bacteria, then this can pose a risk for getting another bacterial infection as your immune defences are down. There is also a higher risk for acquiring antibiotic resistant infections such as C-Difficile or MRSA.

One of the side effects of taking antibiotics is the development of yeast infections. For example, candida albicans can lead to nipple, vaginal and oral thrush in both mum and baby. This can affect the baby’s latch and feeding and make them unsettled and affect their sleep and growth.

Also, a healthy and diverse gut microbiome helps to curb the effects of chronic inflammation such as pain, fatigue, brain fog, anxiety and a low mood. Inflammation over time can build up in the body reacting to exposures from infections, environmental pollution and the over consumption of emulsifiers and preservatives in ultra-processed foods. Beneficial bacteria such as lactobacilli and bifidobacterium have an anti-inflammatory effect on our gut and the rest of our body and can help to keep some of the negative effects from our diet and environment in check. If we take antibiotics, then we need to focus on building these back up quickly.

Antibiotics exposure early on in life have also been linked with a higher likelihood for developing inflammatory atopic conditions such as allergies, rhinitis, asthma and eczema as well as inflammatory bowel disease and diarrhoea. Early antibiotic exposure has also been associated with an increased risk of coeliac disease, being overweight and living with obesity.

If mum or baby take antibiotics during pregnancy or during the early months, there is now evidence that this might pose a higher likelihood for the child to be diagnosed with a behavioural issue or may experience mental health challenges later down the line. These include sleep disorders, attention and focus challenges, antisocial and aggressive behaviours, mood and anxiety disorders as well as other behavioural and emotional disorders.

The role of live bacteria supplements for mummy and baby

If you struggle to consume plenty of fruits and vegetables or fermented and cultured foods then you can turn to live bacteria supplements. These are now freely available with probiotic blends suitable for post-partum women and for young babies. Repopulating the gut microbiome with friendly bacteria supplements is advisable at this point, as these can provide the scaffolding needed until you have the time and the bandwidth to be more creative with your diet and cook more.

Babies only consume milk in the first few months of life, and even though they will benefit from you eating a diet geared towards supporting your gut microbiome, there is good evidence that supplements play an important role at this stage.

How do you choose which live bacteria to give your baby?

Bifidobacterium strains are important if your baby was born prematurely or by caesarean section, or if antibiotics were given to you or them around the time of birth. For your baby, Bifidobacterium infantis and brevis are both wonderful strains to look out for, as they can protect your little one from significant infection and help to build great foundations for their gut microbiome.

Lactobacillus strains help with overall immunity for your baby as well as helping them if they develop a gassy tummy after you or they have taken antibiotics. It is helpful for encouraging milk tolerance as lactobacilli help with milk and dairy digestion.

There are suitable product combinations containing both lactobacillus and bifidobacterium strains, and it is ok to give more than one friendly bacteria supplement in tandem daily if they contain different probiotic strains.

Practical tips on how to give probiotics to your little one

The live bacteria supplements for your baby need to be dropped onto your nipple or into your baby’s mouth direct. If the product is in powder form you can mix the friendly bacteria powder into a little bit of expressed milk. Once your baby has weaned onto solids you can mix the live bacteria into some yoghurt, fruit puree or any cold food. Most live bacteria supplements need to be stored in a cool place at a heat less than 20⁰C and some need to be stored in the fridge.

How do you choose which live bacteria to take yourself?

Again, it is important for you to take a combination of both lactobacilli and bifidobacterium. I like to include some kefir strains and now you can source dairy and soya free kefir strains for the mummies and babies with allergies, intolerances or are strictly plant-based.

I generally avoid products containing inulin or Fructooligosaccharides (FOS) which are prebiotics and fibres that normally help the gut microbiome, but in my clinical experience I have found that these may make mummy and baby a little gassy, bloated and uncomfortable. This is just the case when the baby is tiny, and their tummy is more sensitive. Prebiotics tend to be better tolerated once the baby is three months old, but every baby is different and unique.

Nutrients and habits to restore your gut health

If you have needed to take a course of antibiotics whilst breastfeeding your baby, then here is how you can effectively restore your own gut microbiome via your diet and in turn influence your baby’s gut microbiome. Now more than ever, the phrase “you are what you eat” rings true when you are breastfeeding.

For you and your baby’s microbiome to thrive, aim for variety – a diverse diet is key. For breastfeeding mums, try to include as many different plant-based foods each week to feed the wide range of microbes in your gut. If you’re making your baby’s first weaning foods, aim to introduce a rainbow of tastes and textures to them right from the start.

To help restore your own and your baby’s microbiome after a course of antibiotics, fill your plate with fresh and vibrant vegetables and fruits as well as pulses, beans, nuts, seeds and natural gentle herbs and spices. These will help feed and nurture the healthy gut bacteria that are essential for immunity, digestion, and overall wellbeing.

You may have heard that farmed meat contains antibiotics and some mums think they should avoid it. Happily, this is not true for British meat. In most countries antibiotics have been routinely used to maintain the health of herds or grow faster. But the UK has led the way in reducing this and the UK now uses fewer antibiotics than any European country with a significant livestock farming industry. Furthermore, on the rare occasions when antibiotics are clinically needed for an individual animal, each antibiotic product has a specific withdrawal period measured to allow for it to disappear before slaughter is allowed. I have seen cattle withdrawal periods of 18-42 days. Organic withdrawal periods are typically double the statutory period as an extra precaution.

As you may know I am a big fan of organic food. Outdoor and organically-reared animals are less likely to have needed antibiotics if they have led a healthy natural life.

Hand sanitisers, anti-microbial wipes and disinfectants are thought to deplete the skin microbiome which can in turn influence the gut microbiome, as there is a bidirectional pathway between the two. This is not the case for washing with soap and water, so do your best to avoid the anti-bacterial products and switch to using soap instead.

Getting outside into nature, whether this is a walk your local park or through some woods, will benefit you and your baby’s gut microbiomes as you breathe in the beneficial bacteria from the great outdoors. Opening your windows to let fresh air into your home may also help to encourage a healthy gut microbiome for you both.

Vitamin D from sun exposure as well as outdoor reared meat, organic whole milk and oily fish helps to support the immune system and helps to repopulate the beneficial gut bacteria. Remember to take a vitamin D supplement during the post-natal months as you will likely be stuck indoors more even if it is sunny outside.

Omega 3 fatty acids from oily fish such as salmon, sardines, mackerel and anchovies as well as shellfish, walnuts, flax seeds and hulled hemp seeds also play a role at repopulating the gut with friendly bacteria. So, it is important to eat plenty of these or to supplement to help with your immune system and optimising your gut microbiome.

The beneficial bacteria in the gut microbiome are also pivotal for synthesising some of B vitamins including folic acid and vitamin B12. A healthy abundant gut microbiome can also produce some folate. These two vitamins are both vitality important for maintaining energy levels and supporting maternal mental health. Two of the first signs of not enough B12 being absorbed is obsessive and compulsive thoughts and anxiety; and emotional sensitivity and crying episodes can be some of the first signs of not enough folate being absorbed. So this is one more reason for supporting your gut microbiome after taking antibiotics, to help these vitamins be absorbed into your bloodstream efficiently via your gut.

Below, I’ve listed my favourite foods to incorporate into your diet (and your baby/toddler if they have been weaned onto solids) for a happier healthier microbiome:

Fermented & cultured foods

Probiotic-rich foods are a must for replenishing healthy gut bacteria after antibiotics. These foods introduce living bacterial cultures back into your gut, as opposed to prebiotics, which feed your existing gut bacteria.

To get more probiotics, include live yoghurt, kefir (dairy or non-dairy options like coconut or almond), apple cider vinegar, miso, pickles, sauerkraut and kimchi in your diet.

Vegetables

Your gut bacteria love to eat a rich variety of colourful veggies, so these are perfect for nourishing healthy gut bacteria. Dark green vegetables like spinach, kale and broccoli are packed with nutrients, as are sweet potatoes, beetroot, carrots (especially purple, and orange varieties), Brussels sprouts, red cabbage, garlic, onion, leek and asparagus.

Fruits

Fresh fruits bring natural sweetness and fibre to your diet. The brightly coloured pigments in the fruit – purples, reds, oranges etc are polyphenols that help to create a diverse and healthy gut microbiome. Choose options like blueberries, blackberries, raspberries, strawberries, pomegranate, cherries, apples (leave the skin on if you can), bananas, blackcurrants, and dark red or black grapes. These are wonderful for you and your baby’s developing gut via breast milk.

Nuts & seeds

These are brilliant little packages of nutrition for gut health adding in fibre. Try adding ground flaxseeds, pumpkin seeds, sunflower seeds, and nut butters to your meals. They’re particularly great for breastfeeding mums.

Legumes & beans

Lentils, chickpeas, black beans, kidney beans, and split peas are excellent for nourishing healthy gut microbes. Adding these to pasta sauces, curries, soups and stews can be easy ways to incorporate them into your diet.

Wholegrains

Wholegrains are rich in dietary fibre that feeds your microbiome, but these are lost in the process of refining. Opt for fibre-rich unrefined grains like brown rice, black rice, quinoa, buckwheat, millet, amaranth, teff, sorghum, spelt and oats to support digestion and a diverse microbiome.

Healthy fats

Don’t forget nourishing extras like high-quality extra virgin olive oil, olives, walnuts, flax seeds/flax oil, chia seeds, hemp seeds/hemp oil and avocados/avocado oil. Extra virgin olive oil and cold pressed flax seed oil have both been shown to support the gut microbiome and the gut mucosa where the gut immune system and gut-brain axis lie.

Round up

Your baby’s gut microbiome helps them to develop their immunity, nervous system, and gut health, so it’s vital to support its healthy balance. The best way to do this is through supporting your own microbiome while breastfeeding, as your body has an amazing method of sending beneficial microbes through the breast milk.

There are some great bacterial food supplements also that you and/or your baby can take after antibiotics. If you want helping picking them, you can contact us here.

You don’t need to panic if you or your baby need to take antibiotics in the early months post-partum. With these simple and delicious changes, you’ll be well on your way to supercharging your gut health – and passing on all the benefits to your little one, which should help to strengthen both you and your baby’s health and vitality so you can have more fun together.

If you are having a tough time post-partum and feel you really need individual and caring 1 to 1 support for your health, then work with our NatureDoc women’s health clinical team.

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Taking antibiotics whilst breastfeeding? Here’s what you need to know about you and your baby’s gut health