Allergy treatment while pregnant

5 Allergy Treatments Safe for Pregnant Women – Cleveland Clinic

If you’ve lived with seasonal allergies you already know what usually eases your symptoms. But if your allergies flare up while you’re pregnant, your choices may become more limited.

It’s hard to predict how things you normally experience will affect your baby (and yourself) differently during your pregnancy. It also takes time and a little digging to learn what’s safe, and what can pose a risk.

For allergy sufferers, the good news is that whether your seasonal allergy symptoms are mild or severe during pregnancy, the actual symptoms themselves likely won’t affect your baby, says OB/Gyn Salena Zanotti, MD. But you may need to change up how you’d normally treat those symptoms to limit any risks to your child.

Dr. Zanotti offers some interesting facts about how allergies can change when you’re pregnant.

One-third of lucky women find that their allergy symptoms clear up.
Another one-third of women find that their allergy symptoms worsen.
The remaining one-third find that their allergy symptoms are about the same as before pregnancy.

“It’s funny, with pregnancy we see allergies go all three ways,” says Dr. Zanotti. “And we see that with asthma as well.”

Whichever way it goes for you, make sure to choose treatments that are safe for you and your baby.

Dr. Zanotti suggests five ways to safely manage your symptoms while you’re expecting.

1. Avoid allergy triggers as much as possible

Environmental allergens such as mold, pollen and animal dander are most often to blame for allergy symptoms. They’re also the most difficult allergens to avoid.

Dr. Zanotti’s advice when pollen or pollution levels are high is to limit your time outside. Keep your windows closed and turn on your air conditioning or a fan to help limit your exposure.

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For mold and animal dander that commonly occur indoors, you may want to try the opposite and open your windows (during times when pollen and pollution levels are low outside).

2. Treat mild symptoms with home remedies

Nasal congestion is common during pregnancy, Dr. Zanotti says.

Using a humidifier in your home can sometimes help solve this problem. It won’t remove allergens from the environment but it will moisten the air. And that can help soothe your irritated nasal passages.

You can also try a saline or salt water nasal spray to help ease your congestion, she says.

3. Be picky about over-the-counter allergy medications

Many allergy medications really aren’t safe to take during pregnancy.

But loratadine (found in Claritin®) and cetirizine (found in Zyrtec® and Alleroff®) are two over-the-counter (OTC) antihistamine medications that doctors consider as being safe to use during pregnancy and while breastfeeding, Dr. Zanotti says.

Antihistamine medications work by blocking the effects of histamine, which is a trigger for allergy symptoms.

“These medications are really the first-line medications for treating allergies in pregnant women,” she says.

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4. Try an intranasal steroid spray

If your allergies are severe and you aren’t getting relief from OTC allergy drugs, there’s still hope. You can try an intranasal steroid spray like Nasonex® or Flonase®.

These sprays are safe to use throughout pregnancy and the regular recommended dosage is still appropriate, Dr. Zanotti says.

5. Take care with allergy shots, pseudoephedrine and herbal remedies

“If you’ve received allergy shots before pregnancy and thought they helped your symptoms, it’s safe to continue them,” says Dr. Zanotti. “But we don’t recommend starting allergy shots during your pregnancy, because you don’t know what reaction you’ll have.”

Many expectant mothers ask about taking decongestants or pseudoephedrine (Sudafed®). She recommends that you avoid it in your first trimester. But you may take it in the second and third trimesters as long as you don’t have high blood pressure, she says.

As for herbal remedies and aromatherapy, Dr. Zanotti says their effects on pregnant women haven’t been studied sufficiently. It’s best to just steer clear of these, she says.

Hang in there

If you’ve tried Dr. Zanotti’s treatment options but aren’t getting much relief, remind yourself that the problem is only temporary.

“Your symptoms may be unpleasant but bear in mind that neither pregnancy nor seasonal allergy symptoms last forever,” she says. “There’s light at the end of the tunnel, and you’ll be happy you made the rights choices for your little one.”

Pregnancy and Allergies | Symptoms & Treatment

First comes excitement, then comes the worrying. Women have many things to think about when they’re pregnant. However, the most important thing to know is that asthma and other allergic problems are among the most common of potentially serious illnesses complicating pregnancy. About one of every 100 pregnant women suffers from asthma during their pregnancy. Many more suffer from hay fever and other allergies.

Find an Allergist.

Allergists are specially trained to help patients control their asthma and allergy symptoms during pregnancy and beyond.

Here are answers to some of the most common questions pregnant patients ask their allergist.

Can allergy medications safely be used during pregnancy?

Antihistamines may be useful during pregnancy to treat the nasal and eye symptoms of seasonal or perennial allergic rhinitis, allergic conjunctivitis, the itching of urticaria (hives) or eczema, and as an adjunct to the treatment of serious allergic reactions, including anaphylaxis (allergic shock). With the exception of life-threatening anaphylaxis, the benefits from their use must be weighed against any risk to the fetus. Because symptoms may be of such severity to affect maternal eating, sleeping or emotional well-being, and because uncontrolled rhinitis may pre-dispose to sinusitis or may worsen asthma, antihistamines may provide definite benefit during pregnancy.

Chlorpheniramine (ChlorTrimeton®), and diphenhydramine (Benadryl®) have been used for many years during pregnancy with reassuring animal studies. Generally, chlorpheniramine would be the preferred choice, but a major drawback of these medications is drowsiness and performance impairment in some patients.. Two of the newer less sedating antihistamines loratadine (Claritin®), and cetirizine (Zyrtec®) have reassuring animal and human study data and are currently recommended when indicated for use during pregnancy.

The use of decongestants is more problematic. The nasal spray oxymetazoline (Afrin®, Neo-Synephrine® Long-Acting, etc.) appears to be the safest product because there is minimal, if any, absorption into the blood stream. However, these and other over-the-counter nasal sprays can cause rebound congestion and actually worsen the condition for which they are used. Their use is generally limited to very intermittent use or regular use for only three consecutive days.

Although pseudophedrine (Sudafed®) has been used for years, and studies have been reassuring, there have been recent reports of a slight increase in abdominal wall defects in newborns. Use of decongestants during the first trimester should only be entertained after consideration of the severity of maternal symptoms unrelieved by other medications. Phenylephrine and phenylpropanolamine are less desirable than pseudophedrine based on the information available.

A corticosteroid nasal spray should be considered in any patient whose allergic nasal symptoms are more than mild and last for more than a few days. These medications prevent symptoms and lessen the need for oral medications. There are few specific data regarding the safety of intranasal corticosteroids during pregnancy. However, based on the data for the same medications used in an inhaled form (for asthma), budesonide (Rhinocort®) would be considered the intranasal corticosteroid of choice, but other intranasal corticosteroids could be continued if they were providing effective control prior to pregnancy.

When women with asthma and allergies get pregnant, one-third find their asthma and allergies improved, one-third find they worsen and one-third remain unchanged.
Allergist James Sublett, MD

Immunotherapy and influenza vaccine

Allergen immunotherapy (allergy shots) is often effective for those patients in whom symptoms persist despite optimal environmental control and proper drug therapy. Allergen immunotherapy can be carefully continued during pregnancy in patients who are benefiting and not experiencing adverse reactions. Due to the greater risk of anaphylaxis with increasing doses of immunotherapy and a delay of several months before it becomes effective, it is generally recommended that this therapy not be started during pregnancy.

Patients receiving immunotherapy during pregnancy should be carefully evaluated. It may be appropriate to lower the dosage in order to further reduce the chance of an allergic reaction to the injections.

Influenza (flu) vaccine is recommended for all patients with moderate and severe asthma. There is no evidence of associated risk to the mother or fetus.

Should I continue my allergy shots during pregnancy?

It is appropriate to continue allergy shots during pregnancy in women who are not having reactions to the shots, because they may lessen your allergic or asthma symptoms. There is no evidence that they have any influence on preventing allergies in the newborn. It is not generally recommended that allergy shots be started during pregnancy.

To summarize: It is extremely important to monitor closely any asthma or allergic problems during your pregnancy. In the vast majority of cases, you and your child can look forward to a good outcome, even if your asthma is severe, so long as you follow your doctor’s instructions carefully. At the very first signs of breathing difficulty, call your doctor.

Remember the danger of providing an inadequate supply of oxygen to your baby is a much greater risk than taking the commonly used asthma medications.

The best way to take control of your allergies and have a healthy pregnancy is to speak with an allergist.

This page was reviewed for accuracy 4/17/2018.

What can be done for allergies during pregnancy? What to treat?

Contents:

General recommendations
What can you do?
Treatment
Allergy medicines during pregnancy
Use of antihistamines during pregnancy

General recommendations

Today, even bronchial asthma is not considered a contraindication for pregnancy. The most important thing is the constant monitoring of the attending physician and compliance with all his recommendations, as well as reasonable prevention before pregnancy and during 9months of waiting for a baby. In addition, there are a number of drugs that, if necessary, are used in the second and third trimesters during pregnancy.

If a woman has a predisposition to allergies, three types of influence of pregnancy on allergies can be distinguished:

pregnancy does not affect the course of allergies;
during pregnancy there is an improvement in the course of allergic diseases;
during pregnancy exacerbation of allergic diseases is observed. nine0011

In the first case, allergy symptoms are not aggravated by pregnancy, but arise, just as in normal times, from contact with allergens. If you know what you are allergic to, be very careful and attentive and avoid contact with allergens. If you don't know what you're allergic to and you're planning a pregnancy, see an allergist. Carrying out special tests with a high degree of probability will help to identify allergens and, thus, prevent allergy attacks. When planning pregnancy, also consider the time of year - most often exacerbations of allergies occur in April-May, the time of flowering of most plants. nine0006

The second variant of pregnancy is also quite common. Scientists have proven that during pregnancy, a woman increases the production of the hormone cortisol, which has anti-allergic effects. Therefore, in pregnant women, allergies can occur in a milder form, and even the manifestations of bronchial asthma and hay fever can become much weaker. After childbirth, the level of cortisol in the blood gradually returns to normal, and the manifestations of allergies resume. During the last 4 weeks before delivery, in almost all women, the course of any allergic diseases improves significantly. nine0006

A more severe variant is also possible, when pregnancy negatively affects allergies. According to statistics, the most common allergic symptoms are runny nose and congestion, which usually occur from the 12th week of pregnancy. Allergic rhinitis, even if you haven't suffered from it before, can be related to plant blooms, house dust, or animal dander. In this case, you should try to avoid contact with the allergen as much as possible.

Another allergic disease - bronchial asthma - occurs in 2% of pregnant women. If a woman has never suffered from asthma, the likelihood that it will suddenly appear during pregnancy is very small. If there is bronchial asthma, then its exacerbation should be expected from the 24th to the 36th week of pregnancy. Of course, if you have bronchial asthma, you need regular consultations with an allergist when planning and during pregnancy. During the last 4 weeks before delivery, asthma almost always improves. nine0006

There are a number of allergic skin manifestations (eg urticaria) that often occur during the first pregnancy. Do not panic: if the manifestations of hives are minor, they are likely to pass on their own. If the allergy bothers you, do not take any measures on your own and consult an allergist.

If the allergen cannot be identified, doctors sometimes talk about an allergy to the pregnancy itself. There is an assumption (albeit controversial) that the hormonal surge that accompanies pregnancy may be the cause of the exacerbation of allergic reactions. According to statistics, pregnancy allergies are more likely to occur in women who are expecting the birth of their sons. In this case, it remains only to wait until the hormonal background returns to normal, the body gets used to the new situation and the manifestations of allergies, as well as toxicosis, subside and disappear. As a rule, relief occurs at 12-14 weeks, when the placenta is formed. nine0006

Prevention

One of the main ways to prevent allergies in mothers and unborn children is a hypoallergenic diet. All pregnant women are advised to observe it, starting from the seventh month. If the expectant mother suffers from allergies, then she needs to adhere to such a diet from the first days of pregnancy.

The main principle of this diet is the elimination of allergenic foods from the diet. These include: milk, eggs, nuts, honey, seafood (crabs, shrimp, crayfish, oysters), fish, red and black caviar, soybeans, raspberries, strawberries, tomatoes, chocolate, cheese, citrus fruits, canned foods, everything spicy, salted, smoked and pickled, as well as ready-made juices. nine0006

Allowed: cereals, cereals, lean meat and boiled poultry (veal, turkey, chicken), fresh and cooked vegetables and fruits of a soft color (potatoes, cabbage, cucumbers, zucchini, green and yellow apples, pears, etc. .).

Smoking (both active and passive) of a pregnant and lactating woman is completely unacceptable. Ventilate the room more often, do wet cleaning daily, vacuum carpets and upholstered furniture at least once a week, knock out and dry pillows. Try to limit contact with cats and dogs during pregnancy, as well as remove cockroaches and ants. nine0006

What can you do?

An allergist should be consulted even before pregnancy. The doctor will prescribe you a comprehensive allergological and immunological examination, give you a referral for allergy tests. By finding out which substances cause a similar reaction in the body, you can protect yourself from them during pregnancy.

To get rid of an allergy, you must first identify the allergen and eliminate or minimize contact with it. Try taking vitamins that can relieve allergy symptoms (see article). Follow the recommendations of an allergist, do not self-medicate, lead a healthy lifestyle - and the pregnancy will go well. nine0006

Treatment

What can a doctor do?

An allergist can use special tests to find out what the expectant mother is allergic to, and thus prevent exacerbations. To identify the allergen, an allergist conducts special examinations: skin scarification tests and, if necessary, determines the blood levels of IgE antibodies specific to certain allergens.

Although it is impossible to get rid of the predisposition to allergic diseases, it is quite possible to alleviate the symptoms of allergies. To relieve symptoms during pregnancy, the doctor may recommend topical antihistamines, such as ointments, gels, sprays. If necessary, the allergist can also prescribe drugs for oral administration, but only during the second and third trimesters. nine0006

Allergy medications during pregnancy

Pregnant women should be very careful when taking medicines, including anti-allergic medicines. It is necessary to constantly consult with an allergist and take medication only if the possible risk of affecting the fetus does not exceed the benefit received. All drugs are strictly not recommended to be taken in the first trimester of pregnancy; in the second and third trimesters, the restrictions are less severe.

None of the antiallergic drugs guarantees complete safety for the unborn child. Take any drug only on the advice and under the supervision of a physician. The antihistamine drug tavegil, when tested on pregnant rats, caused heart defects and paw defects in pups.

The use of antihistamines during pregnancy:

SUPRASTIN - The use of the drug is possible if the potential benefit to the mother outweighs the possible risk to the fetus, that is, when the mother's allergic condition threatens the fetus more than taking the drug. This risk in each case is assessed by the doctor. If necessary, it can be used in the treatment of acute allergic reactions in pregnant women in the II and III trimesters of pregnancy under medical supervision. nine0006

PIPOLFEN - Not recommended during pregnancy and lactation.

ALLERTEK - The use of the drug is possible if the potential benefit to the mother outweighs the possible risk to the fetus.

TAVEGIL - During pregnancy, it is possible to use it only for health reasons, since a negative effect of this drug on the fetus has been revealed. Tavegil should be used only when an allergic reaction threatens the patient's life, and there is no possibility to use another drug for one reason or another. nine0006

CLARITIN - There is no absolute contraindication to the use of Claritin during pregnancy. The use of the drug is possible if the intended benefit to the mother outweighs the potential risk to the fetus.

FEXADIN - In pregnancy, the use is possible only if the effect of therapy outweighs the potential risk to the fetus.

ASTEMIZOL - Not recommended as this drug has a toxic effect on the fetus.

DIMEDROL - Should not be used as doses greater than 50 mg may cause uterine excitability or contractions. nine0006

TERFENADINE - Not recommended for use during pregnancy. Leads to weight loss in newborns.

Consult a healthcare professional before using any drug and read the instructions for use.

List of references

Therapeutic guide to dermatology and allergology. / P. Altmayer; per. with him. V. Yu. Khalatova / Ed. A. A. Kubanova. - M .: Geotar-Media, 2003. - 1244 p.
Clinical immunology and allergology. / L. Yeager. - M.: Medicine, 1990. T. - 327 p.
Allergology. Federal clinical guidelines. / Chief editors: acad. RAS R.M. Khaitov, prof. N.I. Ilyin. - M.: Farmarus Print Media, 2014: 126 p.
Evidence-based allergology-immunology. / P.V. Kolkhir - M.: Binom, 2010.

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