By Rebecca M. Duron, MD, MSPH
Pregnancy is such an incredible state of anticipation. Each day it seems like you’re finding something new to wonder or worry about! Having an allergic or immune system condition can certainly add a few questions and considerations to the list, though.
– Is my nose congested from seasonal allergies?
It could also be something called rhinitis of pregnancy- fluctuating hormones and increased blood volume lead to increased nasal congestion independent of allergies. Fortunately, over the counter nasal steroid sprays (such as fluticasone, triamcinolone, or budesonide) and oral antihistamines (such as cetirizine and loratadine) are still safe for most while pregnant.
– Will my asthma get worse while pregnant?
For about of third of patients, the answer is unfortunately yes. However, another third of patients experience improvement in their asthma control! It is very important to have the medical team managing your asthma ready to manage either situation.
– What if I have a severe allergic reaction while pregnant, such as to a bee sting or a food?
Please do still use your epinephrine device and get in touch with your allergist and obstetrician!
– What if I need an antibiotic while pregnant, but I have a penicillin allergy?
Penicillins are usually the preferred antibiotic class for many common situations in pregnancy, because they are very effective and safe for both mom and baby. The allergy should be evaluated by a specialist, especially if the initial reaction occurred a long time ago! Many people who think they are allergic to penicillins no longer are.
– Why am I so itchy!?
There are unfortunately many reasons this can happen in pregnancy, some more serious than others. Talk to your obstetrician first, but if it seems like it may be classic hives know that this is unfortunately common in the postpartum period. If the hives just aren’t going away, an allergist should help you manage them in the long term.
– What if I have an immunodeficiency?
Ideally, your immunology team has had the chance to optimize your care prior to pregnancy, limiting the number and severity of infections as much as possible with treatments that will be safe for mom and baby. During pregnancy, you will likely need to be followed closely and have medication doses adjusted frequently leading up to and after delivery.
– Is there anything I can do to prevent my baby from having allergies?
Unfortunately, if you have an allergic condition, then your child is at higher risk to also have one. Eczema is a very common infant condition and may not be lifelong- a good start would be to use very gentle soaps and bland, thick creams or ointments regularly. To prevent food allergy, allergists recommend introduction and regular ingestion of commonly implicated foods between 4 and 6 months of age (once you have clearance from your pediatrician to begin solid foods). Small servings of cow’s milk yogurt, scrambled or boiled egg, and peanut butter which has been thinned with a liquid are all that’s needed! Just remember to feed these items at least 2-3 times per week, long term.
Don’t forget to enjoy your pregnancy! Before you know it you’ll have a newborn to enjoy instead.
Dr. Durón provides allergy and asthma care for patients of all ages in Sioux Falls at Dakota Allergy & Asthma. She is board-certified by the American Board of Allergy and Immunology and completed her fellowship at the University of Texas Southwestern Medical Center in Dallas, Texas. She is a new mother to twins. Follow The Prairie Doc® at www.prairiedoc.org, Facebook, Instagram, YouTube, and Tik Tok. Prairie Doc Programming includes On Call with the Prairie Doc®, a medical Q&A show (most Thursdays at 7pm on YouTube and streaming on Facebook), 2 podcasts, and a Radio program (on SDPB, Sundays at 6am and 1pm).