Immune Support in Pregnancy
Lately it seems every other day I have someone reaching out for pregnancy immune support. Most are looking for ways to boost their immune system to prevent infections while pregnant, however, many are unfortunately in the throes of a current cold or viral infection and are wondering what they can safely take to ease their symptoms. Women are often extra cautious with what they take and consume when pregnant (and rightly so!) so I wanted to break down my recommendations for immune support during pregnancy to make this topic a little less scary for anyone who is currently pregnant or trying to conceive.
Firstly, what is the immune system?
The human immune system is a complex and highly sophisticated network of cells, tissues and even bacteria (the microbiome) that work together to protect the body. There are two branches of our immune system:
Innate - this is our first line of defense which includes our skin and mucous membranes as a physical barrier to protect us from the outside world. When we are exposed to a cold causing virus, the innate immune system tries to block the invader from going further down the respiratory tract by producing extra mucous. A runny nose is the way our body tries to package up the virus into our snot so that we can expel it out of the body when blowing our nose.
It also includes immune cells that essentially eat invading pathogens, and chemicals/hormones that begin the inflammatory response. Inflammation is an important part of our immune system as it signals all of the necessary cells to deploy to the site of injury or invasion to begin the healing process.
Adaptive - this is our back up system when the innate response is not successful. This part of our immune system is a little slower to act as it has to identify and recognise the invading pathogen before mounting an “attack”. This is how vaccines work, by exposing the body to something similar or identical to the pathogen, the immune system can now recognise it more quickly as it has already been exposed to it. These cells will break down the pathogen and eliminate it from the body.
When we develop a cold, the virus has essentially gotten through the innate immune system’s defense and our adaptive immune system is working rapidly to identify and remove it from our body. As this can take some time, the cold lingers around for a few days while our cells are working extra hard to break down the invaders.
The body is utilising both sides of the immune system every day as we continually expose ourselves to different foods, environments and microbes.
Does the immune system change in pregnancy?
In previous times, the medical community was under the assumption that the mother’s immune system would weaken when she falls pregnant to allow the foreign cells from the other parent or donor to develop into a baby. It was thought that these foreign cells would cause a similar response within the body as in organ transplants. This requires the suppression of the immune system so that it does not attack and reject the new organ or in pregnancy, the developing embryo. However, as research progresses, little evidence has been found to support this theory in pregnancy and it appears, in fact, that the exact opposite is the case.
For the embryo to properly implant into the uterus, an inflammatory immune response must be activated and sustained for the first 12 weeks. This initiates a complex communication channel between the mother’s uterine cells, the embryo’s cells and the immune system. If this response is not inflammatory enough, the communication is unsuccessful and this can result in miscarriage or unsuccessful implantation.
Due to the ethical considerations of scientific testing in pregnant women, it has only been in recent years that the tools and equipment for safe research has been implemented. Thankfully, this has taught us a lot about the pregnant woman’s body. Rather than a reduction in immune capacity, in many areas it actually strengthens. The reason why pregnant women experience more severe symptoms in relation to colds and flus is not because their immune cells aren’t responding, it is because they are having a very strong response. This is a good thing! Even though it may not feel like it when in the throes of a snotty cold.
Further research is needed to understand why certain autoimmune conditions are worsened or triggered during pregnancy and others are improved. It appears that the major changes occurring in circulation and hormone levels may have something to do with this.
Due to the above mentioned theory that a pregnancy will be rejected because of the maternal immune system, during the use of assisted reproductive technologies such as IVF, it has been common practice to use immune suppressing medications in women who have undergone several unsuccessful rounds. The evidence behind this theory is mixed, with no absolute conclusion amongst the medical community. In non-assisted/”natural” conception an embryo will successfully implant on average every 1-6 times. Therefore, several rounds of IVF can be comparable to these statistics and may indicate an over-prescription of these medications.
How can we support the immune system during pregnancy?
Even though it has been found that the mother’s immune system strengthens in many ways when she is pregnant, there are still greater risks for infections and many (such as UTIs) are
more common. Thankfully, there are many wonderful tools in the naturopathic kit that we can safely implement to reduce severity, frequency and risk of infections.
Vitamin C - many of us are familiar with the use of this wonderful nutrient for supporting our immune system. Vitamin C works by enhancing certain immune cell functions, helping to clear away broken down foreign cells or pathogens, and improving the integrity of our barrier defences such as our skin. The recommended daily intake for pregnancy is 60mg which is equal to about one large orange or six large strawberries every day. However, when we are sick our body uses and therefore requires more Vitamin C to function adequately. A safe dose of supplemented Vitamin C during pregnancy is up to 2000mg.
Echinacea - the roots of the purple cone flower (Echinacea angustifolia) have been shown to increase the number of innate and adaptive immune cells in the body helping to both prevent and support the recovery from infections. There have been a number of small scale studies that show Echinacea to be safe for short term use in pregnancy. It is recommended that you consult a qualified practitioner before self administering herbal medicine during pregnancy to ensure you are getting the correct dosage.
Stress Support - there is a lot happening in the female body during pregnancy (hello growing a whole human!) and it is important to pace yourself and accept your body’s natural changes. Many women feel the need to tie up a lot of loose ends and get things done before entering this next phase of life. We can often feel extra creative during pregnancy and want to start new projects. However, overwhelming the body with a never-ending to-do list and limited rest depletes our immune defenses. Try slowing down, resting and say no to more commitments.
Vitamin D - low levels of Vitamin D during pregnancy have been shown to increase risks of pregnancy complications and baby’s health. Vitamin D plays a really important role in our immune system by supporting both our innate and adaptive immune responses. Our main source is from skin exposure to the sun, unfortunately leaving many of us low after lockdowns and rainy weather events. Having your levels during pregnancy is essential and if you are low supplementing with 1000 IUD daily. If you are very deficient, a higher dose may be necessary.
Omega 3 Fatty Acids - found predominantly in oily fish, omega 3 fatty acids are not only beneficial for bub’s development but also for mum’s immune system. It is recommended to consume wild caught/good quality fish at least twice a week. The varieties which have the highest omega 3 content are salmon, mackerel, and sardines. If you are vegetarian or don’t like seafood, taking a fish oil or an algae based supplement containing 500-1000mg per day is recommended.
Apart from Echinacea, all of these supplements are considered safe to take throughout the IVF process. We recommend speaking to a naturopath to confirm the correct dosage and keeping your fertility doctor in the loop on what supplements you are taking.
If you are pregnant and want to ensure you are doing everything you can to avoid nasty infections or seem to have every bug under the sun during your pregnancy, it might be worth exploring some of these options. Having said that, there is no substitute for good general health through a balanced diet, good quality sleep, regular movement and building connections and tools to support your mental and emotional wellbeing.
Please reach out if you would like an appointment, I offer free 15 minute base chats so that we can meet before booking your initial consultation.