Expectant mothers who have asthma and allergies frequently wonder about what kind of medicines are safe during pregnancy and breastfeeding. It is crucial that expectant mothers work closely with their board-certified allergist and an OB to develop a personalized asthma and allergy plan for the pregnancy and directly after giving birth.
Controlling your asthma and allergies is extremely important throughout your pregnancy. If you have uncontrolled asthma, it may be dangerous for you and the baby.
Asthma is unpredictable during pregnancy — some peoples’ conditions may get worse, some get better, and others stay the same.
Most medications used for asthma—rescue medications, inhaled corticosteroids (like Aerospan or Alvesco), or combination inhalers—are recognized by the Food and Drug Administration as category C, which means while there may be some risk, the benefits usually outweigh them.
Some exceptions include medications such as budesonide (Pulmicort) and montelukast (Singulair), which are category B. This means there is no evidence of risk with use in pregnancy.
Uncontrolled allergies may lead to worsening of asthma; therefore it is important to maintain your allergy control as well.
Allergen immunotherapy, also known as allergy shots, is one of the methods to help maintain your allergy control and is safe during pregnancy and breastfeeding. Allergen immunotherapy is one of the natural ways to change the way your body perceives the triggers by developing tolerance and no longer reacting to them.
Notify your allergist immediately of your pregnancy so that your injections will be managed appropriately. Taking your injections during pregnancy may allow you to use less medication throughout your pregnancy to control your allergies. The American College of Allergy, Asthma, and Immunology reported a study that shows allergy injections during pregnancy may even reduce the risk of allergy in the child.
Over the counter antihistamines such as loratadine (Claritin) or cetirazine (Zyrtec) are category B and considered generally safe to use. Decongestants may be used in small doses, but should be avoided in the first trimester due to risk to the baby.
Many medications may be excreted into the breast milk. However, most are very small amounts. In general, maintenance medications may be used during breastfeeding, but the timing of when you take the medications may help decrease the amount excreted into the breast milk.
Discussing your family planning needs early with your allergist will alleviate many of your concerns. Your board-certified allergist will help you identify your triggers and provide an individualized plan for your asthma and allergies, including trigger avoidance, environmental measures, and allowing for adjustments of medications safely as you need them.
There is no love more powerful than one between mother and child. The urge to protect our children is in our DNA. Keeping your allergies and asthma under control during your pregnancy is one of the best ways to start protecting your little one. Find a board-certified allergist to help you reach your goals starting early in your pregnancy.
Dr. Lily G. Hwang, M.D., sees patients at Atlanta Allergy and Asthma’s Northlake and Powers Ferry offices. She lives in Sandy Springs with her husband, John, and is the proud mother of a newborn baby girl and young daughter.