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Managing Seasonal Allergies During Pregnancy

Spring has sprung in North Carolina!  Unfortunately, that means the start of seasonal allergy season for many.

With blooming flowers and budding trees come sneezes, sniffles, and itchy eyes for many sufferers of springtime allergies. For pregnant women, allergy symptoms can seem worse than normal due to increased swelling of nasal tissue.

In fact, 25% of pregnant women suffer from congestion due to pregnancy hormones alone.

So what is a pregnant woman to do?

3 Ways to Manage Seasonal Allergies While Pregnant

#1 – Avoid allergic triggers.

This might mean saying “no” to a long walk outside or picnic lunch during the height of allergy season.

#2 – Turn on the A/C.

When possible, use air conditioning in your home or car instead of opening windows.

#3 – Use a mask when outdoors.

If you need to do yard work or gardening, paper masks are available at most hardware stores.

Avoidance is an important strategy for minimizing symptoms, and might be all that is necessary.

Severe Allergy Sufferers

If you suffer from severe allergies, speak with an allergist prior to pregnancy.

Skin testing is generally avoided during pregnancy, so having a plan in place prior to pregnancy is helpful. And of course, make sure your obstetrician or midwife is aware; they will offer guidance and make recommendations.

Also, if you suffer from asthma, it is very important that you tell your obstetrician or midwife, as allergies can exacerbate asthma symptoms.

So what can you do?

For symptoms of nasal congestion and runny nose (rhinitis) related to allergies, saline nasal sprays are very safe, effective, and widely available over the counter.

Another suggestion is to elevate of the head of the bed or mattress with books or other heavy, firm objects.  These measures alone are helpful, and sometimes all that is needed, to decrease symptoms.

Silhouette of pregnant women standing near a window

Safe Allergy Medications During Pregnancy?

A common misconception in pregnancy is that no medication is safe for mom and baby.

There are, however, some safe and effective options.  Be sure to discuss your symptoms, and any potential medication use, with your healthcare provider.

Chlorpheneramine (Chlor-Trimeton)

One of the most popular drugs, due to its long history of use and safety, is the oral antihistamine chlorpheneramine (Chlor-Trimeton).  This drug can cause severe drowsiness, so it needs to be used with caution, and probably only taken at night.

Non-Drowsy Antihistamines

Several newer, non-drowsy antihistamines are available. The most commonly recommended in pregnancy are loratadine (Claritin, Alavert) and cetirizine (Zyrtec). These are category B, and safety studies are very reassuring.

The antihistamine fexofenadine (Allegra) is less well studied, and category C, but may be appropriate.  Finally, avoid antihistamine nasal sprays, as there is limited safety data available.


Decongestants should be avoided in pregnancy. 

The most widely available oral decongestant is peudoephedrine (Sudafed), and there is some data that is causes birth defects in the first trimester.

Decongestant nasal sprays are sometimes recommended for very short-term use. One example of a nasal decongestant is oxymetazoline (Afrin, Neo-synephrine). The safety of these drugs in pregnancy is somewhat uncertain.  In addition, nasal decongestants can actually make symptoms worse with frequent use, causing dependence.

Finally, the anti-inflammatory nasal spray cromolyn (NasalCrom) is generally safe and well-tolerated, and may be prescribed by your doctor, especially if you have worsening or long-term symptoms.

Breathe Easy….

With avoidance of triggers, working alongside your obstetrician or midwife, most symptoms of mild seasonal allergies can be managed safely and easily.

About Lindsey Deschamps, MD

Dr. Deschamps is a board certified OB hospitalist at WakeMed North Women’s Hospital. Learn more about Dr. Deschamps, and schedule an appointment today.