Pregnancy is a time of excitement, joy, but also a lot of worrying. Expecting mothers often have to deal with uncomfortable symptoms and several physical changes. Pre-existing conditions such as moderate to severe nasal allergies or asthma can further complicate things.
While a third of pregnant women experience a significant improvement in their allergies, the majority still have to deal with the same (or worse) allergic symptoms. So, a crucial question arises: Can you take your allergy medication as usual, or should you discontinue your treatment?
Visit Your Allergist
A visit to your doctor is the first step. A Board Certified allergist has trained to answer all your questions regarding pregnancy and allergies. Together you will review your medication, discuss the benefits as well as the potential risks (no drug is entirely risk-free), and examine all your options. Remember to always consult your allergist before taking any over-the-counter medication and follow their instructions to the letter.
Antihistamines are extremely useful for treating nasal allergies. They are occasionally prescribed during pregnancy, especially when dealing with severe symptoms that affect the mother’s health and well-being. At the same time, the doctor must assess the risk to the fetus. That’s why some physicians won’t prescribe any antihistamines during the first trimester.
Chlorpheniramine and diphenhydramine are two effective drugs commonly used for treating allergies. Since they may cause drowsiness, two newer medications, loratadine and cetirizine, are often recommended. Antihistamines are pregnancy category B medications, which means that there are good safety studies for them in pregnant animals, but, unfortunately, there are no human studies to rely on.
Oral decongestants treat allergic and non-allergic rhinitis. However, their use during pregnancy is problematic. Continuous use can prevent blood flow to the placenta and increase the risk of congenital disabilities. It’s best to avoid decongestants during the first trimester altogether. Some doctors allow minimal use when the benefits significantly outweigh the risks of the medication. Decongestants are category C drugs because animal studies have shown that they may result in adverse effects. If you have been using a specific decongestant for your allergies, check with your doctor before you continue its use.
Nasal sprays that contain steroids are generally considered safe for pregnant women, and they are a possible alternative to oral decongestants. Nevertheless, you must ask your doctor to recommend an appropriate product and its safe dosage before heading over to the pharmacy. Nonsteroidal nasal sprays are not suitable during pregnancy, and long-term use can make your congestion much worse. Nasal drops and saline sprays are safe options that can help you manage your symptoms.
If you had started your immunotherapy treatment before conceiving, you could continue to receive it under careful medical observation, provided you didn’t experience any adverse effects in the first place. Starting your allergy shots while pregnant is not a good idea, since your immune system is already undergoing many changes, and the therapy won’t have any benefits for your newborn baby.
Dealing with nasal allergy symptoms during pregnancy can be particularly stressful. However, with close monitoring and careful choices, you should expect a positive outcome for you and your baby. You should also make an effort to reduce your exposure to allergens. Try to avoid smoke, stay indoors as much as possible during days when pollen is at its peak, and keep your home allergen-free by regular and thorough cleaning (have someone else do that for you).
Don’t forget to relax and find ways to combat your stress. Nasal allergies can be very uncomfortable for you, but they don’t cause any discomfort to your baby, and they won’t keep you from having a safe, healthy pregnancy.
“Allergies During Pregnancy.” What to Expect, 29 Apr. 2019, whattoexpect.com/pregnancy/pregnancy-health/allergies-during-pregnancy/. Accessed 5 Feb. 2020.
More, Daniel. “Treating Allergies During Pregnancy.” Verywell Health, 24 Oct. 2019, verywellhealth.com/managing-allergies-during-pregnancy-82666. Accessed 5 Feb. 2020.
“Pregnancy and Allergies.” American College of Allergy, Asthma, and Immunology, acaai.org/allergies/who-has-allergies-and-why/pregnancy-and-allergies. Accessed 5 Feb. 2020.