Morning sickness and… allergy symptoms?

There are a million questions about pregnancy; for most people, allergy and asthma aren’t at the top of the list. But, it seems to be a reoccurring theme online.

• Can I take my allergy medication?
• Is my asthma getting worse during my first trimester?
• I’ve never had allergies, but now that I’m pregnant, I can’t stop sneezing!

Why do allergies change during pregnancy?

Dr. Giana Nicoara, allergist at Allergy Associates of La Crosse, explains that a woman can go through many changes during pregnancy. Body changes, emotional changes, hormonal changes, and even allergy and asthma changes. From the allergy and asthma perspective, she says women can go three directions — some get better, some stay the same, and some get worse. Some women who have never had allergy or asthma symptoms develop them during pregnancy, and some who usually have crazy hay fever go symptom-free for nine months.

“There’s no way to know who’s going to get better and who’s going to get worse,” Dr. Nicoara says. There’s not much research into why this change happens, but Dr. Nicoara says it’s most likely due to the hormonal influence.

What about after pregnancy?

My next question, as you would expect, is — will they go back to “their normal” after giving birth? That’s also unknown. Dr. Nicoara has seen patients who go back to their pre-pregnancy allergy symptoms after giving birth, but has also seen women keep the symptoms they gained during pregnancy. Again, there’s no way to know who will experience which scenario, or if they will simply stay the same.

For those whose allergies do go back to normal, it isn’t instantaneous. “In the first few months, your hormones are getting themselves back on track. If you’re breastfeeding, the rearrangement of the hormones takes a little longer, so going back to ‘normal’ takes a little longer. That may affect your allergies and asthma too,” Dr. Nicoara explains.

How can you treat newly developed allergy?

The good news to coincide with this “what if” information is that you can still treat your allergy during pregnancy. Dr. Nicoara assures, “There are safe treatments for allergy and asthma before, after, and during pregnancy. You can definitely use your medications and continue your sublingual immunotherapy.” Most antihistamines are good to go, with no effect to the child, other than a less sniffly mom, but it’s always a good idea to check with your provider before beginning any new medication during pregnancy.

As for immunotherapy, it’s generally seen as safe to continue subcutaneous immunotherapy (SCIT), also known as allergy shots, if you were using them before pregnancy. But, Dr. Nicoara says “you wouldn’t typically want to increase the shots when you’re pregnant and progress your treatment,” as there is a chance for anaphylaxis or other severe adverse reactions with this method. Typically treatment isn’t started during pregnancy.

With custom sublingual immunotherapy (SLIT), or allergy drops using the La Crosse Method Protocol, there has never been a life-threatening reaction or anaphylaxis reported, as the drops are personalized to the patient’s specific allergy sensitivity. Because of this, Dr. Nicoara says, “it’s a lot more convenient and we can actually increase treatment during pregnancy.” By treating the underlying allergy with allergy drops, asthma symptoms can be controlled, too.