What should pregnant and lactating mothers with allergies do during birch flowering, especially those with asthma? What medications to take without hesitation and fear?
Recently I went to visit a pregnant friend who has hay fever and asthma. Childbirth is scheduled for mid-May, at the very peak of birch flowering in our city.
Over a cup of tea, we naturally talked about allergies. A friend complained that the therapist forbids her any antihistamines, predicts allergies to the child, prepares for artificial feeding or strict diets. They say any medicine for allergies will pass into breast milk and become poison for the baby.
And what to do, what the doctor advises, – I asked. Tolerate – said the expectant mother, rubbing her nose swollen from an allergic rhinitis.
Great advice!
The topic is new for me, so I asked the opinion of my friends, an allergist and a pulmonologist.
Well, a child doesn’t necessarily have to be allergic if mom is allergic. Allergy predisposition is genetically transmitted, not the disease itself.
Diets during pregnancy will also not protect a child from future allergies. If the child does not have a confirmed allergy, then the mother does not need to limit herself in nutrition. But do not forget about vitamin D, which is useful not only for children, but also for expectant mothers (before taking the vitamin, take an analysis for its content).
But the control of allergic rhinitis and especially bronchial asthma during pregnancy is very important.
If rhinitis is left unattended, it is close to the onset of symptoms of bronchial asthma.
Do not wait for the onset of symptoms, a couple of weeks before flowering, contact an allergist, let him prescribe the necessary medications.
During pregnancy and lactation, a woman’s body experiences a great hormonal load. And as we know, hormones directly affect the course of allergies. Hormones can relieve or worsen the symptoms of allergies and bronchial asthma. Sometimes the symptoms can disappear altogether, and sometimes they get worse.
Do not give up breastfeeding if you are taking medication for allergies or bronchial asthma.
There is a good site where you can find out what medications are allowed to be taken during pregnancy: https://e-lactanciya.org/
Recommendations for pregnant and lactating mothers
I suppose you don’t need to remind anyone – before doing anything, be sure to consult with your doctor.
With allergic rhinitis, pregnant and lactating mothers are allowed:
- antihistamines: claritin, zyrtec, erius, etc.;
- nasal steroids: nasonex, desrinitis, etc.;
- montelukast (singular).
To make life easier for the nasal mucosa when it is bombarded with steroids, ENTs recommend directing the spray to the side of the nose.
Inhaled glucocorticosteroids – budesonide and beclametozone are recommended if
bronchial asthma first appeared during pregnancy.
If a woman becomes pregnant during basic therapy, then the drugs continue to be taken in the prescribed dosages.
In expectant mothers, exacerbations of bronchial asthma are treated with steroids and bronchodilator drugs – all the same as in non-pregnant women.
Bronchial asthma attacks during childbirth are extremely rare.
Anti-asthma medications can be used during labor.
Local anesthesia will be better than general anesthesia.
Allergy immunotherapy in pregnancy
It is best not to start immunotherapy if you are planning a pregnancy. In the case when pregnancy occurs during allergy immunotherapy, the therapy can be continued:
- if a maintenance dose is taken,
- the medicine is administered with sublingual drops (sublingually),
- and the dosage is well tolerated.
It is not recommended for nursing mothers to start allergy immunotherapy. If the need for breastfeeding coincided with the successful completion of therapy, then you can continue immunotherapy and breastfeed.
At the end of the article, I publish several slides from the Congress of the European Academy of Allergy and Clinical Immunology (EACCI 2017 and 2018) with comments from an allergist
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