Keep it in check! How to manage your allergies during pregnancy

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Pregnancy and illness. Sick pregnant woman blowing nose in tissue having fever sitting on sofa indoor.
Pregnancy and illness. Sick pregnant woman blowing nose in tissue having fever sitting on sofa indoor.

The good news is that if you were taking an antihistamine (over-the-counter, prescription or homoeopathic) before you fell pregnant to manage your eczema or allergic rhinitis, you can carry on taking one.

Nose sprays, (saline and steroid) and steroid creams are safe too but always discuss with you doctor just to be sure.

"The antihistamine with the best track record is Loratadine. It’s non-sedating and has never been proven to be unsafe in early pregnancy and when you’re breastfeeding," says allergy specialist Dr Adrian Morris who runs allergy clinics in Cape Town and Johannesburg.

"It’s better to manage your allergies with an antihistamine or steroid cream than to struggle with them. Suffering from allergies will only keep you up at night, and make you feel worse in the long run. A pregnant woman needs to be well-rested for the sake of her baby," he says. 

What about shots?

Allergy shots are also considered safe in pregnancy, but only if you'd been on the receiving end of them for a while before you conceived.

Most allergists say it's not a good idea to start allergy shots during pregnancy because they trigger changes in your already-fluctuating immune system and may cause unexpected reactions.

Anything that contains the decongestant pseudoephedrine (for example, Sudafed) is, however, not advisable during pregnancy and should be avoided during your first trimester in particular, when the theoretical risks to your baby are highest.

It also works by expanding and contracting your blood vessels and could restrict blood flow to the placenta.

What if I have asthma?

"As far as asthma is concerned, it’s better to take your medication during pregnancy and manage your asthma than struggle to breathe, risk an asthma attack and potentially bring on early labour which would be far worse for you and your baby," urges Dr Morris, adding that you want to be as healthy as possible during your pregnancy.

He stresses, though, that if you’re using an inhaler or taking a steroid-based medication like Celestamine to control your asthma during pregnancy then it needs to be done so under medical supervision.

"Yes, your baby will get some of your asthma medication, but it isn’t bad for your baby and in fact steroids are often given to moms to help their babies’ lungs mature faster – if they know they’re going to have to deliver before 37 weeks – and can be beneficial in late pregnancy," says Dr Morris.

"Salbutamol – the mainstay of asthma treatment – may also relax the uterus and is a treatment for premature labour," he says.

That said, so long as you’re managing your asthma, it shouldn’t have an effect on how you birth your baby, and it’s not likely that you’ll have an attack during labour.

If you do and you need to be nebulised, then you can rest easy knowing that your baby will be just fine.

Also, although asthma is hereditary, a baby can’t be born with asthma (it’s only diagnosed much later in life) and just because you have it, it doesn’t necessarily mean your baby will develop it.

However, new evidence suggests that if you want to decrease your child’s chances of developing asthma, then taking a probiotic while you’re pregnant and breastfeeding, and giving one to him or her from birth is a good idea.

"Probiotics have been shown to switch on your baby’s gut immunity and switch off eczema," says Dr Morris.

"While the probiotics won’t help you with your allergies, they could stop your baby from developing eczema and prime his or her immune system."

Did you know?

Even if you have never had allergies, there is rhinitis that is specifically associated with pregnancy, and you might only develop it for the first time when you are pregnant as it is hormonal.

"A baby is a foreign thing in your body and causes a switch in your immune system that could bring on allergies," says Dr Morris. "That said, your allergies might also improve during pregnancy and return once your baby is born. It really can go either way!"

How to avoid allergy attacks

The best way to manage your allergies when you’re pregnant is to avoid your known triggers – for example, house dust mites, mould, animal dander and pollen. You also need to stay away from people who smoke – and not only because of allergies but also because secondhand smoke is bad for you and especially bad for your baby.

That said, since you can’t lock yourself in a glass cage for nine months, you can certainly minimise triggers in your home hotspots.

Dust mites

"House dust mites, for example, hate temperature changes, so if you put your mattresses and pillows out in the sun or wash your linen in hot water it will kill them," says Dr Morris.

Don’t forget to put dust mite covers over all of your mattresses, buy hypoallergenic pillows and get a house dust mite spray.

Also, carpet pile and fibres harbour skin scales and trap dust mites effectively, eliminating them from circulating in the air, for easy removal by daily vacuuming.

"You need to make sure, then, that if you do have carpets, you have a high-quality vacuum cleaner with a HEPA filter (5ugm)," he says.


Lastly, if the damp and black mould is your allergy triggers, then you need to try and keep your home well-ventilated and reduce indoor humidity for the duration of your pregnancy.

Also, check your tiles, plumbing fixtures, shower curtains, and bathroom for mould too and wipe down with Jik or Milton should you see it begin to emerge.

It will not eliminate your allergies, but it might just improve them marginally, and enough to get you through the duration of your pregnancy.

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