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Pregnancy and its Effects on Asthma & Allergies

Pregnancy and its Effects on Asthma & Allergies

Pregnancy and its associated changes may affect either your asthma or rhinitis, or both. Should you become pregnant please notify your OAAC physician as soon as possible. This will allow us to work closely with the physician providing your obstetrical care. A team approach to the assessment and care of the pregnant allergic patient will result in the best care for your condition.

Remember, the final decisions on your medications and treatments are always made by the physician providing the obstetrical care. However, your OAAC physician should follow your asthma closely during the pregnancy. We can provide advice about continuation or discontinuation of treatments you are already on for your allergy/asthma prior to the pregnancy.

Allergy Immunotherapy (Shots)

There is no reason to discontinue immunotherapy during pregnancy. It does not pose a risk to the development of your baby. However, we do not want to present an increased risk for systemic reaction during the pregnancy.

Therefore all immunotherapy during a pregnancy must be at a stable or maintenance dose. We do not build or increase the dose of your shots during pregnancy. If you are on build-up of your immunotherapy and you become pregnant, contact your OAAC provider immediately to discuss how to proceed. If you are on your maintenance dose and are having symptoms from the injections or other concerns, contact your OAAC provider.

Rhinitis (Nasal Symptoms)

Your nasal allergy symptoms may improve (15%), worsen (34%) or stay unchanged (46%) during your pregnancy. Some patients develop unrelated non-allergic nasal congestion (rhinitis of pregnancy) during the second half of their pregnancy. If you are having problems please contact your OAAC physician. Some medications are considered safer than others during pregnancy. Non-medical approaches like saline nasal rinses and external nasal dilator strips are very safe.

Asthma

Asthma symptoms during pregnancy appear to worsen, improve or remain unchanged in roughly equal proportions (1/3, 1/3, 1/3). This means that some patients with even very mild asthma may develop more severe symptoms when pregnant. The period of greatest increased incidents of increased symptoms is the third trimester (2436 weeks).

Since the well-being of the baby depends on the severity of the asthma in the mother, close monitoring is necessary. We want to work with your obstetrical physician to maintain your asthma control with the least amount of medications possible. However, because uncontrolled asthma presents the greatest risk to the baby (versus drug side effects) it is imperative not to discontinue or change your asthma medications without the consultation of your OAAC physician. Inhaled steroids for example are considered safe and effective in pregnancy.

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Don’t Forget the Drinks if you have Food Allergies

Managing food allergies requires constant avoidance of allergens, emergency preparedness and effective communication. Going out to eat with food allergies can be challenging but is completely doable. When it comes to avoiding allergens while out to eat, the focus in the minds of patrons and eating establishments is often the food, but it is important to keep in mind that beverages can contain allergens as well. Outlined below are key points and tips to consider before you take your sips.

Avoid Cross Contact
Remember that allergens can remain in someone's saliva for several hours after eating and for some people even small amounts of an allergen can cause a severe allergic reaction. To prevent the chance of cross contact drink from your own cup and don't share with others around you. Also remember cross contact can occur with drink stirrers, shakers and other utensils used to mix drinks as with condiments like sprigs of mint or slices of fruit.

Be Aware of All Ingredients Added to the Beverage
This is especially true in the case of mixed drinks. For example if you are allergic to dairy and cream is added to your pina colada, then this can cause an allergic reaction. Some drinks contain raw egg whites - the white 'fuzz' of a Pisco sour, for example, is from beaten egg whites. Raw eggs are particularly dangerous in people with egg allergies.

Know What Ingredients Are in the Beverage
The drink itself may have an allergen in it (for example, wheat in beer). Things to consider here are that since alcohol is not regulated by the Food and Drug Administration (FDA), beverage companies that are bottling alcoholic products do not need to follow current labeling laws and do not need to disclose allergens. In fact, many alcoholic beverages do not list ingredients at all. This certainly becomes an issue for those allergic to wheat, rye, and barley as well as those with celiac disease who need to avoid wheat, rye and barley because of gluten. Similar concerns can arise with wine. If ingredients are unclear then consider calling the company for a list of ingredients. Distilled alcohol is a bit less of an issue but still worth discussing with your healthcare team.

Consider Sulfites
Also, keep in mind that sulfites can exacerbate asthma and in rare cases can cause allergic reactions. Sulfites are commonly found in many alcoholic beverages including wine, beer, ciders and drink mixes added to the alcohol.

Know Alcohol’s Effects
Another issue to take into consideration is the effect of the alcohol itself. Alcohol can decrease our ability to make good decisions and communicate effectively. Other things to consider are that alcohol can decrease the threshold level to trigger an allergic reaction, can decrease the time to develop an allergic reaction, and increase severity. However, alcohol itself is an unlikely allergen.

If you have been prescribed an epinephrine autoinjector, remember to carry this with you at all times, even if you're just going out for a drink.

This article is for educational purposes only. Talk to your healthcare provider before any change in food allergy management.

Find out more about food allergies.

The post Don’t Forget the Drinks if you have Food Allergies appeared first on Oklahoma Allergy and Asthma Clinic.

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