Treating Allergies During Pregnancy

Stuffy nose, sneezing, watery eyes. The symptoms of allergies are no fun, whether you are pregnant or not. Treating allergies during pregnancy requires some special considerations for the safety of your growing baby. Fortunately, there are several safe treatment options to choose from, including medications and alternative treatments.

Allergy Symptoms During Pregnancy

If you've struggled with allergy symptoms in the past, they are likely to persist or even worsen while you're pregnant. Some people experience allergy symptoms for the first time during pregnancy. Symptoms can include:

• Runny nose
• Stuffy nose
• Sinus pressure
• Congestion
• Sneezing
• Itchy, watery eyes

There is also a phenomenon known as pregnancy rhinitis that causes allergy-like symptoms in pregnant people. Non-allergic rhinitis in pregnancy is likely due to fluctuating hormones and it typically resolves after you give birth. The symptoms may mimic allergies, but since they are non-allergic in nature, they do not respond to antihistamines.

If you have allergy symptoms during pregnancy, you may be concerned about the safety of allergy medications. It is important to talk to your healthcare provider before taking any over-the-counter (OTC) or prescription allergy medications while you are pregnant or breastfeeding.

Treating Allergies During Pregnancy

As with any illness or condition that occurs while you're pregnant, the goal of treatment is to maintain the health of both mother and baby. About half of all pregnant people take an OTC or prescription medication during pregnancy. Not all medications are safe to take while pregnant. The key is to weigh the risks against the benefits.

The good news is that environmental allergies, like seasonal and pet allergies, pose no risk to your developing fetus. But if allergy symptoms are driving you crazy, your healthcare provider may recommend a few treatment options to help minimize your discomfort.

Allergy Medications

It is best to avoid medication when possible, but there are some allergy medications that healthcare providers consider safe for use during pregnancy.

• Antihistamines: Older antihistamines, such as chlorpheniramine, dexchlorpheniramine, and hydroxyzine are considered safe for use by the American College of Obstetricians and Gynecologists (ACOG). The ACOG says the newer OTC antihistamines Claritin (loratadine) and Zyrtec (cetirizine) may also be safe.
• Decongestants: Pseudoephedrine and other decongestants should be avoided during pregnancy. Medications that include decongestants typically include a "D" in the name, such as Claritin D. Pseudoephedrine should never be used in the first three months of pregnancy, as it has been linked to a small risk of abdominal wall birth defects.
• Medicated nasal sprays: A steroid nasal spray like Nasonex (mometasone furoate) or Flonase (fluticasone propionate) is considered safe for use during pregnancy to treat severe congestion.
• Immunotherapy: Allergy shots can be continued during pregnancy, but it is not recommended to start this treatment while pregnant. Typically the dose of the allergy shots is not increased, and many allergists will cut the dose of the allergy shot by 50% during pregnancy. Some allergists feel that allergy shots should be stopped during pregnancy, given the risk of anaphylaxis and possible danger 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.

Alternative Treatments

Alternative, nonmedical allergy treatments are safe to use during pregnancy. Nasal saline, for example, is available over the counter, is inexpensive, and can be used as often as needed. Saline can be used as a soothing spray or for irrigation (washing out the sinus passages). You can buy various types of neti pots that help wash fluid and debris from the sinus passages. Be sure to follow the instructions to prepare the saline and clean the bottle.

Other alternative treatments include:

• Avoiding allergens: Stay inside with the windows closed when seasonal allergens are at their peak.
• Using a humidifier: Moist air can help soothe dry, irritated nasal passageways.
• Running an air purifier: Using a high-quality air purifier at home or in the office can reduce the number of allergens and pollutants in the air.
• Deep cleaning: A regular deep cleaning of the home will remove dust, dander, and pollen from its hiding places. Don't forget the bedding!