Asthma in Pregnancy and Breastfeeding

Pregnancy is usually a time that is filled with excitement in a woman’s life. However, if you are asthmatic, you might have concerns as to how your condition can affect the health of your unborn child.

Asthma is a common, yet often serious, medical condition that can potentially complicate pregnancy. During an asthma attack, the foetus may not receive enough oxygen. Even after the birth of your child, you might worry that the asthma medications you are taking might contain harmful substances that may leak into your breast milk; this may lead to negative consequences should your baby consume it.

Therefore, in order to manage your condition while avoiding serious complications to your baby, you must be aware of the precautions that need to be taken.

You should be aware that the advent of pregnancy can alter your asthma condition. If you have severe asthma, your condition is more likely to worsen; if you have mild asthma, your condition is more likely to improve or stay the same. Symptoms tend to become apparent during weeks 24-36 of pregnancy. Generally, an asthmatic woman tends to exhibit similar levels of asthmatic symptoms in all her pregnancies.

Effects of asthma medications on pregnancy

In general, inhaled medications are preferred due to their localised effect, with only small quantities entering the bloodstream. Numerous studies have indicated no increased risk of pre-eclampsia, premature birth, low birth weight and congenital malformations in women who used inhaled medications. Apart from this, older medications that have been tested to be safe during pregnancy are also preferred. During the first trimester, the foetus is forming so medication use should be limited as much as possible.

If your asthma was well controlled before your pregnancy, you may think of stopping your asthma medication out of worry that it might harm your foetus. Don’t do this, because the risks of uncontrolled asthma are much worse than the risks of taking asthma medications during pregnancy.

Consult your doctor so that an individualised treatment plan can be created and appropriate medication changes can be made, if necessary. If possible, asthma care should be integrated with obstetric care and the same health care provider should be used for both. If there is more than one doctor involved in your treatment and observation, a team approach between them should be used.

Your doctor will plan your treatment after taking these two factors into account: medication use and symptom control, and carefully balancing between the two to ensure the best effect for your health and for your unborn child.

Effects of asthma medications on breastfeeding

Medications that can be used during pregnancy are generally safe for consumption when breastfeeding as well. Oral steroids sometimes penetrate into breast milk, but only in small amounts, not in quantities that would be considered a danger to your baby.

Also, rest assured because your asthma medications will not affect your ability to produce breast milk.

Complications of uncontrolled asthma

Asthma that is not controlled (via medication) generally places both mother and child under serious risks. The mother might develop pre-eclampsia or hypertension during pregnancy, which in turn will put your baby at risk. Poorly controlled asthma can also lead to higher rates of caesarean sections and intrauterine growth retardation. Other risks include higher chances of the baby being born premature, to be underweight at birth and to need longer hospitalisation after birth. At worst, uncontrolled asthma can lead to a miscarriage because of the lack of oxygen to the foetus.

Managing asthma during pregnancy

It is best to avoid the specific triggers that you already know will cause your asthma attacks. Doing so can improve your symptoms and reduce the amount of medication you need to take. Use these tips to help you:

  • After you get pregnant, you may find that your asthma symptoms or sensitivity to some triggers have changed. So, sit down together with your health care provider and review the action plan for asthma you’ve been using before you were pregnant and make changes if needed.
  • Don’t smoke, as it would dangerously reduce oxygen supply to the foetus. Smoking can also significantly increase your likelihood of experiencing a severe asthma attack, which would be of great danger to your unborn child. Second-hand smoke is just as harmful, so stay away from smokers.
  • Avoid keeping allergy-causing pets, or at least restrict them to a part of the house, away from your bedroom.
  • Identify things you are allergic to and make it a point to avoid them.
  • Cover your pillows, mattresses and box springs in special dust mite-proof casings.
  • Any physical activity or exercise should be carried out carefully and under the supervision of a doctor.
  • Minimise your exposure to people with colds or flu to avoid being infected. Colds and flu can aggravate asthma symptoms.

On the whole, the asthma medications you take are not a major concern to the health of your baby. However, it’s highly important that you take them regularly, and in accordance to how your doctor prescribed them. Managing your asthma well will help ensure both a pregnancy and a delivery that is as healthy and normal as possible.

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