Are digestive enzyme supplements safe during pregnancy?

What does the evidence say about digestive enzyme supplements during pregnancy?

1. The FDA is not authorized to review dietary supplements for safety and effectiveness before they are marketed, and manufacturing rules for them are less strict than for prescription or over-the-counter drugs. 1
2. NIDDK advises checking with your doctor before using lactase products, noting that some people, including pregnant and breastfeeding women, may not be able to use them. 2
3. Broad wellness claims made for digestive enzyme products oversimplify digestion and skip proper assessment, and lighter regulation lets these products be marketed without robust scientific evidence. 3
4. Slow digestion in pregnancy comes from progesterone relaxing smooth muscle, which causes hypomotility of the small and large bowel and delays gastric emptying, rather than from a shortage of digestive enzymes. 4
5. Supplement labels carry no standards for ingredients and strength, products can contain contaminants or ingredients not listed on the label, and the word natural does not mean a product is free from harmful effects. 5

Is digestive enzyme supplements safe in each trimester?

• First trimester. Bloating and slow digestion in early pregnancy trace back to progesterone relaxing smooth muscle and delaying gastric emptying. An enzyme blend does not address that mechanism.
• Second trimester. If dairy is the specific trigger, lactase products are the one enzyme with a defined use, and NIDDK explicitly says to check with your doctor first during pregnancy.
• Third trimester. Digestion slows further as the uterus takes up more room. Smaller, more frequent meals tend to do more here than a supplement, and your provider can rule out anything that needs attention.