AH-CHOOsing the Best Way to Stifle Seasonal Allergies During Pregnancy
By Lorrie Harris-Sagaribay, MPH, MotherToBaby North Carolina
Welcome, spring! In most of the United States, this fair season means wildflowers popping up! Trees blooming! Fresh grasses turning hillsides green! (Sniffle)…Umm, did someone say wildflowers?...(AHHH…?)…trees?…(AHHH…?)…grasses?…(CHOO!) Ugh! While many people enjoy renewed energy brought on by the bursting forth of spring color, others feel only the misery associated with seasonal allergies due to pollen, mold and other springtime triggers. Combine seasonal allergy symptoms with pregnancy, and you can end up short on sleep, long on fatigue, and with an increased risk of respiratory complications if you have asthma: none of which are good for mom or baby.
So what causes these pesky, sometimes debilitating, seasonal allergy symptoms? Airborne pollen is the most common culprit, along with mold spores that thrive indoors and out in the humid conditions brought on by spring rains. Symptoms can recur in late summer and fall, when ragweed and grasses are in bloom. People with seasonal allergies suffer the effects of their immune systems overreacting to these "invaders," thereby producing chemicals called histamines. Histamines cause such symptoms as runny nose, itchy eyes, sneezing and, in some cases, wheezing associated with asthma.
Such was the case for Marta, who recently called MotherToBaby to ask about her options for relief of seasonal allergy symptoms during her first pregnancy. With Mother’s Day just around the corner, she was looking forward with both anticipation and trepidation to her large family’s annual Mother’s Day picnic, where she would take her place of honor as a "mother" for the first time. But how could she possibly celebrate the occasion when she was all sniffles and sneezes? Would allergy medications possibly harm her baby? Did she have to stay indoors all spring? What else could she do? (Achoo!)
After talking with us about her options, Marta felt reassured that she didn’t have to suffer through allergy season just because she was pregnant, as there are ways to reduce symptoms without increasing risk to a developing baby. We recommended minimizing exposure to allergens in the first place and using certain non-medicinal remedies to mitigate her body’s response to allergens. We also discussed medication options if Marta needed further relief. Here’s some of what we shared with her:
An Ounce of Prevention…
Some experts believe that avoiding the outdoors between 5am and 10am, again at dusk, and on dry, windy days can reduce your exposure to airborne pollen. The best time to be outdoors might be right after it rains, when pollen spores have been washed from the air. If exercise, soccer games, family picnics or other realities of life require you to be outside at other times, consider wearing sunglasses and a super-trendy facemask to keep pollen out of your eyes and airway. (Seriously, a quick online search can yield some cute, reusable face masks designed to filter out dust and pollen!) Help keep pollen out of your home during allergy season by keeping doors and windows closed, removing your shoes and washing your face and hands when you come in from outdoors, bathing before going to bed to wash away pollen spores and keep them off of your bedding, and avoiding the use of outdoor clotheslines. A high-quality air filter in the home can also help reduce pollen, mold spores and other impurities in your indoor air.
Wash Your Cares Away…
Assuming you don’t live in a plastic hamster ball, you will be exposed to allergens despite your best efforts to avoid them. One way to minimize resulting allergy symptoms is by using a simple over-the-counter saline nose spray to rinse the sinuses clear of pollen, dust and other allergy triggers, or by using a neti pot purchased at your local pharmacy or natural health store. Never used a neti pot? It looks like a little tea pot, and can be used daily to rinse the nasal passages. After filling the pot with a sterile saline solution, you stand over a sink, tilt your head to one side, and pour the solution into one nostril, letting it run out the other one. Repeat on the other side. It might take a few times to get the hang of it, but you’ll be an expert in no time. Is rinsing the nasal passages with saline solution okay to do during pregnancy? You bet!
Sleep, Magical Sleep…
Getting a good night’s sleep while pregnant can be a challenge even in the best of circumstances. Your growing baby bump limits comfortable positions, your mental pre-baby to-do list shows up on cue as soon as your head hits the pillow, and you probably have to pee (again). Add a stuffy nose and trouble breathing due to seasonal allergies, and you can be facing serious insomnia. To help you sleep better, consider using over-the-counter nasal strips to open your nasal passages at night. Also try sleeping with your head slightly elevated to help drain the sinuses and reduce inflammation.
If your seasonal allergy symptoms aren’t responding to non-medication treatments, then it’s worth having a conversation with your doctor about the pros and cons of various over-the-counter and prescription medicines, many of which have shown no increased risk to baby. Remember, the best thing you can do to ensure a healthy pregnancy is to take good care of yourself. For women who have asthma, keeping symptoms under control is especially important during pregnancy. As always, you want to use any medication for the shortest amount of time needed, and follow dosing instructions carefully.
Before grabbing an over-the-counter medication off the shelf to treat your symptoms, consider this:
- Antihistamines: Years of use and research have granted most antihistamines a strong safety profile during pregnancy. An older study linked diphenhydramine (sold under the name Benadryl® and other brands) to a slightly increased risk of cleft palate and other birth defects when used during the first trimester, but these results haven’t been found in other studies. The greatest drawback to using diphenhydramine is that you might fall asleep in the middle of folding those freshly washed onesies. Newer antihistamines (such as Claritin® and Zyrtec®) are less likely to make you drowsy.
- Decongestants: Because these medicines temporarily make your blood vessels narrower, they should be used sparingly during pregnancy, especially if you have high blood pressure, if you smoke, or if you are taking medications to reduce fever, pain or inflammation. Some studies have found a very small increased risk of abdominal wall defects in babies whose mothers took pseudoephedrine and phenylephrine (sold as Sudafed® , Sudafed PE® and other brands) early in pregnancy. So you generally want to avoid them during your first trimester unless your allergy symptoms are affecting your ability to sleep and breathe, both of which are important to a healthy pregnancy.
- Take the time to read your labels. Some allergy medications marketed for cough and cold contain alcohol, which should be avoided during pregnancy. Also, stay away from multi-symptom formulas that contain additional medications you might not need.
We’re glad that Marta called to talk about her options for relief, and she was, too. If you have questions about specific allergy medications during pregnancy, give us a call here at MotherToBaby toll-free (866) 626-6847. Then go out and enjoy the season! Happy spring, and happy Mother’s Day!
Lorrie Harris-Sagaribay, MPH, coordinates outreach for MotherToBaby North Carolina, and is training to become a teratogen information specialist. She received her master’s degree in public health at the University of North Carolina at Chapel Hill and has worked in the field of maternal and child health for over 20 years.
MotherToBaby is a service of the international nonprofit Organization of Teratology Information Specialists (OTIS), a resource suggested by many agencies including the Centers for Disease Control and Prevention (CDC). If you have questions about vaccines, medications or other exposures, call MotherToBaby toll-FREE at 866-626-6847 or visit MotherToBaby.org to browse a library of fact sheets and find your nearest affiliate.
The Teratology Society partners with the OTIS through joint sessions at our annual meetings as well as a shared interest in public health issues for expectant mothers.
- Garavello W, et al. Nasal lavage in pregnant women with seasonal allergic rhinitis: A randomized study. International Archives of Allergy and Immunology 2010;151:137.
- Joint Task Force on Practice Parameters for Allergy and Immunology. The diagnosis and management of rhinitis: An updated practice parameter. J Allergy Clin Immunol 2008;122:S1-84.
- REPROTEXT® Database (electronic version). Truven Health Analytics, Greenwood Village, Colorado, USA. Available at: http://www.micromedexsolutions.com/ (cited: April 23, 2015).
- Seasonal allergies. American College of Allergy, Asthma & Immunology. http://acaai.org/allergies/types/seasonal. Accessed April 21, 2015