Allergy sufferers also become pregnant – if you believe a Danish study, even faster than other women. It is possible that the allergy-typical changes in the immune system make it easier for a fertilized egg to implant in the uterus. Once pregnancy has occurred, the questions come. Can I still take my medication? What do I do if I have an asthma attack? Do I have to stop the hyposensitization now? Basically, allergies should also be treated during pregnancy. However, some special considerations must be taken into account. Pregnant allergy sufferers will find the best advice in this regard from an allergy-trained specialist.
No allergy skin tests during pregnancy.
Pregnant women who have previously suffered from hay fever know the typical symptoms:
- Sudden sneezing attacks
- Runny nose
- Itchy eyes
If the symptoms occur at the same time as usual, for example during the pollen flight, it is usually clear that they are caused by the allergy and not by a cold. However, if the signs of illness are present for the first time, the doctor must confirm the diagnosis by asking exactly what the symptoms are and where and when they occurred. Often, additional blood tests are necessary. The otherwise usual skin tests are forbidden during pregnancy because of the risk, however minimal, of allergic shock.
Nasal sprays with cortisone or cromoglicic acid.
Nasal sprays that contain some cortisone are suitable for treating hay fever during pregnancy. There is no evidence to date that they harm the baby. The same applies to nasal sprays containing the active ingredient cromoglicic acid, although they are less effective.
Antihistamines in pregnancy?
So-called antihistamines are also prescribed relatively frequently to pregnant women. The manufacturers of these preparations usually advise against their use because there are too few studies on them. The risks from antihistamines are considered unclear. Some older active substances have been shown to harm the unborn child in animal studies, and there is little experience with the use of newer preparations during pregnancy. In individual cases, the physician should select the drugs whose safety is most reliably documented. Particularly critical consideration should be given to whether medications are necessary at all.
Avoid allergy triggers
Apart from medications, the recommendation for pregnant allergy sufferers, as for all other allergy sufferers, is to avoid allergy triggers. This should include, for example, keeping windows closed during pollen season and washing hair before going to bed. However, it is practically impossible to completely avoid allergy triggers such as pollen or the excretions of the house dust mite. Therefore, even in pregnant women, medication is often impossible to avoid.
Therapy through hyposensitization
Currently, the only causally effective therapy against allergic diseases is specific immunotherapy (SIT), also called hyposensitization or allergy vaccination. For SIT, the substance to which the patient is allergic (the allergen) is regularly injected under the skin in increasing doses up to a maximum dose, or given in droplet form under the tongue. As a result, the immune system becomes accustomed to the allergen and no longer reacts with a pathological defense response.
Hyposensitization: do not start during pregnancy
According to the guidelines of the professional societies, an already ongoing SIT, which the patient has tolerated well in the maximum dose so far, can be continued after the onset of pregnancy. In any case, however, a particularly careful review of the benefit/risk ratio should then be performed. In particular, if there is a vital indication, especially in the case of severe allergy to insect venoms, continuation of SIT is recommended to prevent an anaphylactic reaction after an insect sting. In contrast, SIT should not be restarted in pregnant women. Background: In very rare cases an allergic shock reaction can occur. This is much more difficult to treat during pregnancy – mother and child are then at risk.
Hormones cause stuffy nose
Changes in hormone balance during pregnancy can increase allergic rhinitis.They cause the blood vessels of the nasal mucosa to dilate and the mucosa to swell. One in five women therefore suffers from a blocked nose during pregnancy, especially at the beginning of the second trimester. Women with allergies seem to be affected somewhat more frequently. Saline solution as a nasal spray or the caring substance dexpanthenol provide relief. In addition, plenty of fresh air, exercise and sleeping with the upper body slightly elevated help. In severe cases, decongestant nasal drops can be given for a short time – preferably alternately on one side only and in the lowest possible concentration. Nasal sprays containing cortisone are another therapeutic option.
When the baby is here: avoid allergies
Allergy sufferers should breastfeed because breast milk is the best food for the baby. In fact, breastfeeding is especially important for babies born to allergic women: the children, in turn, have an increased risk of allergy. Exclusive breastfeeding during the first four to six months prevents this risk. Allergy sufferers and especially asthmatics do not have to do without necessary medication during the breastfeeding period. To be completely sure, a brief consultation with the allergy-trained specialist is recommended.
Prevent allergic diseases in the child
To prevent allergic diseases in children of allergy-suffering mothers, the Medical Association of German Allergists (ÄDA) and the German Society for Allergology and Clinical Immunology (DGAKI) advise:
- Exclusive breastfeeding in the first four, if possible first six months.
- If breastfeeding is not possible: feeding the child with hypoallergenic infant formula.
- On strongly allergenic foods (for example, nuts, eggs, fish), the mother should refrain during breastfeeding only if a full diet is nevertheless ensured.
- No complementary food until the fourth month of life.
- Avoidance of active and passive smoking.
- No cats, rabbits and guinea pigs or other animals with fur in the household.
- Reduce exposure to dust mites.
- Prevent mold growth in the home.
- Vaccinate children according to the recommendations of the STIKO (Standing Commission on Vaccination at the Robert Koch Institute).
