Pregnancy and Allergies

By JoLyn Seitz, MD Apr 10, 2017

Spring is coming, and you’re pregnant. You know what’s coming. Your eyes will water. Your nose will run. You won’t stop sneezing. You’ve known how to battle your spring allergies before pregnancy, but now that you’re expecting, what options can provide relief and keep your baby safe?

When it comes to taking allergy medications while pregnant, you’re right to be concerned about your baby. You need to be very cautious about using any drugs during pregnancy and if at all possible, to avoid them completely in the first trimester. Most importantly, before you take any allergy drugs at any point during pregnancy, talk to your doctor.

Oral medications vs. nasal sprays vs. allergy shots

Use of oral decongestants is associated with increased risk of birth defects. Some oral antihistamines, like Allegra (fexofenadine), Benadryl (diphenhydramine), Chlor-Trimeton (chlorpheniramine), Claritin (loratadine), and Zyrtec (cetirizine) appear to be safe after the first trimester. By safe, I mean they have caused no known harm in studies that have been done. Avoid antihistamines combined with a decongestant. (Most have a D for decongestant after the name, like Claritin-D.)

Nasal sprays, as prescribed or recommended by your doctor, are applied only in the nose. That means their effects do not go throughout the body like oral medications. However, avoid nasal spray decongestants. There is not enough evidence to indicate whether or not they are safe.

Don’t start allergy shots during pregnancy. If you are already taking them when you become pregnant, you can continue.

Less is almost always best

The reality is, not taking any allergy medication is the best option. But if your allergy symptoms are leaving you sleepless and unable to function, taking medication with your doctor’s approval may be better for both you and baby. If you have allergic asthma, it’s important to use your prescribed medication. Uncontrolled asthma can cause serious problems during pregnancy.

Alternatives to medication

Primarily, pollens in the air cause spring allergies. Pollens come primarily from trees and grasses. When pollen grains get into your nose, your immune system mistakenly labels them as foreign and releases antibodies to attack these allergens. That leads to the release of chemicals called histamines into your blood. Histamines trigger your runny nose, itchy eyes and other symptoms. Avoiding triggers is your first and best option, although it is admittedly difficult. Pollens circulate more on windy days. The higher the pollen count, the more miserable you will be. Many cities publicize daily pollen counts. When counts are high or when it is windy, keep windows and doors closed. If you can, stay inside.

There are also some other steps you can take to minimize allergies without danger to your baby. Use an over-the-counter saline nasal spray and/or rinse your nasal cavity with a neti pot once or twice a day. (Follow the printed directions for safe, proper use.) Physical activity can help reduce nasal inflammation. Nighttime use of nasal strips and elevating the head of your bed can also help keep nasal passages more open while you sleep.

Try to keep a positive mindset. Two things are for certain. Seasonal allergies and pregnancy, both, do not last forever. While you’re pregnant, try to avoid what you can and use alternatives to medication to minimize the effects of your seasonal allergies. There is an end in sight, and soon you’ll be breathing easy and enjoying your healthy, happy baby.