What to do for allergies during pregnancy

Though about a third of fortunate expectant allergy sufferers discover a temporary respite from their symptoms during pregnancy, another third discover their symptoms get worse, while a final third discover their symptoms stay about the same.


Can I get allergies while I’m pregnant?

Yes, you can get allergies while you’re pregnant, sometimes for the first time and certainly if you own a history of them. Allergies are extremely common in pregnancy, and not every women who experience them are long-term allergy sufferers. Numerous women with no known prior allergies only complain of their symptoms during pregnancy.


Diagnosis of Allergic Rhinitis During Pregnancy

Allergy testing includes skin testing or blood tests, called a RAST.

In general, allergy skin testing is not done during pregnancy, given the little chance of anaphylaxis which may occur. Anaphylaxis during pregnancy, if severe, could result in a decrease in blood and oxygen to the uterus, possibly harming the fetus.


Treatment of Rhinitis During Pregnancy

  1. Medicated Nasal Sprays: Cromolyn nasal spray (NasalCrom®, generics) is helpful in treating allergic rhinitis if it is used before exposure to an allergen and prior to the onset of symptoms.

    This medication is pregnancy category B and is available over the counter. If this medication is not helpful, one nasal steroid, budesonide (Rhinocort Aqua®), received a pregnancy category B rating (all others are category C), and therefore would be the nasal steroid of choice during pregnancy. Rhinocort became available over-the-counter without a prescription in early 2016.

  2. FDA Drug Safety Communication: FDA has reviewed possible risks of pain medicine use during pregnancy. U.S. Food and Drug istration. 01/19/2016

  3. Dzieciolowska-baran E, Teul-swiniarska I, Gawlikowska-sroka A, Poziomkowska-gesicka I, Zietek Z.

    Rhinitis as a cause of respiratory disorders during pregnancy. Adv Exp Med Biol. 2013;755:213-20. doi: 10.1007/978-94-007-4546-9_27

  4. Decongestants: Pseudoephedrine (Sudafed and numerous generic forms) is the preferred oral decongestant to treat allergic and non-allergic rhinitis during pregnancy, although should be avoided during the entire first trimester, as it has been associated with baby gastroschisis. This medication is pregnancy category C.
  5. Pali-Schöll I, Namazy J, Jensen-Jarolim E.

    Allergic diseases and asthma in pregnancy, a secondary publication. World Allergy Organ J. 2017;10(1):10. Published 2017 Mar 2. doi:10.1186/s40413-017-0141-8

  6. Nasal Saline: Rhinitis of pregnancy tends not to reply to antihistamines or nasal sprays.

    What to do for allergies during pregnancy

    This condition seems to reply temporarily to nasal saline (saltwater), which is safe to use during pregnancy (it is not actually a drug). Nasal saline is available over the counter, is inexpensive, and can be used as often as needed. Generally, 3 to 6 sprays are placed in each nostril, leaving the saline in the nose for up to 30 seconds, and then blowing the nose.

  7. FDA Pregnancy Categories. U.S. Department of Health and Human Services. Updated: Wed Jun 26 2019

  8. Immunotherapy:Allergy shots can be continued during pregnancy, but it is not recommended to start this treatment while pregnant.

    What to do for allergies during pregnancy

    Typically the dose of the allergy shots is not increased, and numerous allergists will cut the dose of the allergy shot by 50 percent during pregnancy. Some allergists feel that allergy shots should be stopped during pregnancy, given the risk of anaphylaxis and possible harm to the fetus as a result. Other than anaphylaxis, there is no data showing that the allergy shots themselves are actually harmful to the fetus.

  9. Antihistamines: Older antihistamines, such as chlorpheniramine and tripelennamine, are the preferred agents to treat allergic rhinitis during pregnancy, and are both category B medications. Newer antihistamines such as over-the-counter loratadine (Claritin®/Alavert® and generic forms) and cetirizine (Zyrtec® and generic forms) are also pregnancy category B medications.
  10. National Middle for Complimentary and Integrative Health.

    Is Rinsing Your Sinuses With Neti Pots Safe? September 24, 2017

Allergy skin testing is generally deferred during pregnancy, although a RAST would be a safe alternative if the results are needed during pregnancy.

Before any medication is taken during pregnancy, the doctor and patient must own a risk/benefit discussion. This means that the benefits of the medication should be weighed against the risks—and the medication should only be taken if the benefits outweigh the risks.

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What to do for allergies during pregnancy

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  • Pali-Schöll I, Namazy J, Jensen-Jarolim E. Allergic diseases and asthma in pregnancy, a secondary publication. World Allergy Organ J. 2017;10(1):10. Published 2017 Mar 2. doi:10.1186/s40413-017-0141-8

  • FDA Pregnancy Categories. U.S. Department of Health and Human Services. Updated: Wed Jun 26 2019

  • FDA Drug Safety Communication: FDA has reviewed possible risks of pain medicine use during pregnancy. U.S. Food and Drug istration. 01/19/2016

  • Dzieciolowska-baran E, Teul-swiniarska I, Gawlikowska-sroka A, Poziomkowska-gesicka I, Zietek Z.

    Rhinitis as a cause of respiratory disorders during pregnancy. Adv Exp Med Biol. 2013;755:213-20. doi: 10.1007/978-94-007-4546-9_27

  • National Middle for Complimentary and Integrative Health. Is Rinsing Your Sinuses With Neti Pots Safe?

    What to do for allergies during pregnancy

    September 24, 2017

Here are answers to some of the most common questions pregnant patients enquire 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®) own been used for numerous years during pregnancy with reassuring animal studies.

What to do for allergies during pregnancy

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®) own 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.

What to do for allergies during pregnancy

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 extremely intermittent use or regular use for only three consecutive days.

Although pseudophedrine (Sudafed®) has been used for years, and studies own been reassuring, there own 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 final 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 discover their asthma and allergies improved, one-third discover 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 every patients with moderate and severe asthma.

There is no evidence of associated risk to the mom 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 own 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 significant to monitor closely any asthma or allergic problems during your pregnancy.

In the vast majority of cases, you and your kid can glance forward to a excellent outcome, even if your asthma is severe, so endless as you follow your doctor’s instructions carefully. At the extremely first signs of breathing difficulty, call your doctor.

Remember the harm 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 own a healthy pregnancy is to speak with an allergist.

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

If sneezing, sniffling and itchy eyes began plaguing you for the extremely first time during pregnancy, you may be wondering whether having a baby bump triggered seasonal allergies.

If you are a known allergy sufferer, you’re probably wondering if and how your pregnancy might affect your symptoms.

For one, pregnancy-related nasal congestion, not allergies, could be behind every the sneezes and stuffiness. But how can you tell the difference? Here’s what you need to know about allergies during pregnancy, including what medications are safe to take while you’re expecting.

Here are answers to some of the most common questions pregnant patients enquire 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®) own been used for numerous 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®) own 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 extremely intermittent use or regular use for only three consecutive days.

Although pseudophedrine (Sudafed®) has been used for years, and studies own been reassuring, there own 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 final 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 discover their asthma and allergies improved, one-third discover 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 every patients with moderate and severe asthma. There is no evidence of associated risk to the mom 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 own 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 significant to monitor closely any asthma or allergic problems during your pregnancy. In the vast majority of cases, you and your kid can glance forward to a excellent outcome, even if your asthma is severe, so endless as you follow your doctor’s instructions carefully. At the extremely first signs of breathing difficulty, call your doctor.

Remember the harm 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 own a healthy pregnancy is to speak with an allergist.

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

If sneezing, sniffling and itchy eyes began plaguing you for the extremely first time during pregnancy, you may be wondering whether having a baby bump triggered seasonal allergies.

If you are a known allergy sufferer, you’re probably wondering if and how your pregnancy might affect your symptoms.

For one, pregnancy-related nasal congestion, not allergies, could be behind every the sneezes and stuffiness. But how can you tell the difference? Here’s what you need to know about allergies during pregnancy, including what medications are safe to take while you’re expecting.


How will my allergies affect my pregnancy and baby?

If you own allergies, you can definitely own a safe, healthy pregnancy. In fact, your baby likely won’t notice a thing in there, even if you’re feeling beautiful lousy. Tell your doctor about your symptoms, and always check before using any medication — even those you were regularly taking before conceiving (some are considered safe during pregnancy, while others won’t get the green light).

Also attempt as best as you can to steer clear of known allergy triggers when possible (tricky, yes, especially when the culprit is pollen or grass at the height of allergy season).


Safety of Allergy Medications During Pregnancy

According to the Food and Drug istration (FDA), no drugs are considered completely safe in pregnancy. The organization advises that women carefully consider the use of any medications, especially pain medications. This is because no pregnant lady would desire to sign up for a medication safety study while she is pregnant.

Therefore, the FDA has assigned risk categories to medications based on use in pregnancy:

  1. Category “B” medications show excellent safety studies in pregnant animals but there are no human studies available.
  2. Category “D” medications show clear risk to the fetus, but there may be instances in which the benefits outweigh the risks in humans.
  3. Category “C” medications may result in adverse effects on the fetus when studied in pregnant animals, but the benefits of these drugs may out weight the potential risks in humans.
  4. Category “A” medications are medications in which there are excellent studies in pregnant women showing the safety of the medication to the baby in the first trimester.

    There are extremely few medications in this category and no asthma medications.

  5. Category “X” medications show clear evidence of birth defects in animals and/or human studies and should not be used in pregnancy.


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