Allergy and Pregnancy

Top 3 Tips

  • Avoid triggers to help decrease medication needs during pregnancy.
  • Uncontrolled asthma is more risky than taking asthma and allergy medication during pregnancy.
  • Avoid cigarette smoke for your and your baby’s health. Quit and do not restart.

Why is avoiding triggers important during pregnancy?

Avoiding triggers decreases inflammation as well as prevents symptoms and therefore trigger management decreases medication needs.

 

Allergens are major triggers of asthma. Avoiding allergens such as house-dust mites, animals, pollen, as well as cold air or long periods in hot humid air is very important during pregnancy. Carry out measures for indoor allergen management. Do not smoke and do not expose yourself to smoke.

 

GERD (Gastro Esophageal Reflux Disease), commonly known as heartburn, can trigger asthma. In GERD, stomach acid flows back into the esophagus and can cause coughing; you may also have heartburn and/or a sour taste in your mouth. However, reflux can be “silent” with no sensation of heartburn. Pregnancy can worsen GERD or give one more frequent heartburn which can trigger asthma.

 

Sinusitis and the common cold worsen asthma. Treating rhinitis, avoiding allergens, and avoiding individuals with colds will lessen the chances of developing sinusitis and having to add more medicine for sinusitis or asthma.

 

Does pregnancy worsen asthma or rhinitis?

Then asthma develops for the first time, and you happen to be pregnant, symptoms can be confused with the shortness of breath some women feel with pregnancy. It is important to get a correct diagnosis and begin a program for asthma control as soon as possible. An allergist can work with your OBGYN.

 

Statistics show that asthma stays the same in about a third, worsens in about a third, and improves in about a third of pregnant women with pre-existing asthma. When asthma worsens, it is usually late in the second trimester or early in the third. Some women have less asthma during the last four weeks of pregnancy. If your asthma changed for the better or worse in previous pregnancies, it is likely to follow a similar pattern during subsequent pregnancies.

 

Common causes of nasal symptoms are allergic rhinitis, sinusitis, rhinitis medicamentosa (rebound symptoms from chronic use of an over-the-counter decongestant nasal spray), and vasomotor rhinitis (nonallergic). Preexisting allergic rhinitis may worsen, improve, or stay the same. Hormonal rhinitis may occur during pregnancy with symptoms typically present from the second month to term; it disappears after delivery if there was no rhinitis prior to pregnancy. The primary symptom is nasal congestion.

 

Can diagnostic tests for asthma or allergy be performed during pregnancy?

Normally, skin testing for allergy can be done during pregnancy. Selected skin testing of the mother is done to help determine which ones or if allergens are triggering symptoms. Specific avoidance measures can then be recommended.

 

Will asthma worsen during labor and delivery?

 

It is rare to have asthma become a problem during labor and delivery if asthma has been controlled adequately during pregnancy.

 

Should I avoid taking drugs for asthma or allergy?

Uncontrolled asthma during pregnancy can lower birth weight, increase the chances of your baby being born too soon (premature baby), and even cause death of the fetus. It is important to have sufficient lung function during pregnancy so that the mother and baby get adequate oxygen. A constant supply of oxygen to the fetus is required for the fetus to grow normally and to survive. If asthma is uncontrolled, decreased oxygen in the mother’s blood and in fetal blood can occur.

 

An experienced physician can choose drugs to control asthma or allergy which pose little or no risk to the fetus. While inhaled are preferred to oral, drugs that treat asthma or rhinitis (nasal symptoms) can be taken by pregnant women. Drug therapy for asthma during pregnancy is much safer for the mother and fetus than uncontrolled asthma. Even taking oral or inhaled corticosteroids during pregnancy, when needed to control asthma, appears safe for mother and baby.

 

Nasal cromolyn or a nasal corticosteroid is a good first choice for treating allergic rhinitis; it is best to avoid decongestants during the first trimester and pseudoephedrine is the preferred decongestant during pregnancy. It is safe to get flu shots which are made from dead viruses.  ALWAYS get a physician’s advice before taking any over-the-counter medicines even if the OTC product is to treat a headache, cough, or cold.

 

The rate of spontaneous abortions is relatively high and these unavoidable occurrences are not related to allergies, asthma or their treatment.

 

Should I take allergy shots during pregnancy?

Allergy shots do not adversely affect the pregnant woman or the fetus. A severe reaction to an allergy shot during pregnancy can be risky. Allergy shots are carefully increased or may remain at the same or lower dose during pregnancy. The mother usually does not begin allergy shots while pregnant. These precautions are taken to avoid risk. It is strongly recommended that allergy shots be continued during pregnancy with the dose monitored carefully. Continuing immunotherapy that has been helping control allergy or asthma symptoms can decrease need for medication.

 

Can I do Lamaze or other exercise if I have asthma?

Lamaze is a breathing technique. Yes, women typically are able to do Lamaze even if they have asthma. A mother-to-be should be able to exercise. Notify your physician if asthma is not under good enough control to exercise.

 

Should I avoid breast-feeding?

Common drugs taken for asthma (beta2-agonists, corticosteroids, cromolyn) and rhinitis (certain antihistamines and decongestants) have not been shown to adversely affect the nursing infant. Human studies in nursing mothers have not been done on each drug, but experience indicates mothers taking such drugs should not avoid breast-feeding. Generally, small amounts that get to the baby have not been found to cause a problem.

 

Help prevent eczema and food allergies in children born into moderately-to-severely allergic families by delaying exposure of your newborn to allergenic foods. Only alter your or your baby’s diet under medical supervision to avoid nutritional deficiencies. Suggestions include the following:

  • Breast feed for at least six months.
  • Delay solid foods until 8-12 months of age.
  • Introduce one food at a time watching a few days for reactions before introducing another food.
  • Introduce allergenic foods much later than six months.
  • Nursing mothers may help the infant by staying off highly allergenic foods (i.e., peanut, seafood, tree nuts).
  • Use hypoallergenic formula such as Nutramigen, Alimentum, or Good Start to supplement breast feeding or for infants not being nursed. (hypo means low)

Proteins in these formulas have been hydrolyzed or modified to render the formulas hypoallergenic (less likely to cause allergy). They are less sensitizing than switching to a soy-based formula.

 

Will my baby have asthma or allergy?

Your baby will not necessarily have asthma or allergies. However, a child is more likely to develop asthma or allergies if one parent has either; the risk is greater if both parents have allergy or asthma. You may delay the onset of eczema or food allergy by the diet recommendations above; respiratory allergies may be delayed by not exposing your infant to indoor allergens and by carrying out dust mite avoidance measures in the nursery.  Do not expose your infant to smoke.