Hay fever in pregnancy: which treatments are safe?

4th May, 2022 • 8 min read

Hay fever symptoms, such as itchy eyes, a runny nose and sneezing, can get you down but even more so when you’re pregnant. Coping with hay fever can be more difficult as you deal with new demands on your body that can zap your energy levels, especially if you’re also feeling exhausted from a bad night’s sleep.

If you’re desperate to find something to help ease your hay fever symptoms but worried that hay fever treatment will affect your unborn baby, we’ve got you covered. As there are no official guidelines for how to treat hay fever in pregnancy, it’s important to get expert advice on taking medicines to manage your symptoms.

Here’s the lowdown to finding a hay fever treatment that works for you when you’re pregnant, including natural remedies and medicines that are safe to use.

Does pregnancy make hay fever symptoms worse?

When you’re

you may become more sensitive to hay fever. Around one third of pregnant women find their symptoms are worse than usual. This isn’t always the case as for a third of women the symptoms are the same, while for a third symptoms actually improve.

If your hay fever has got worse, this may be due to a link between hormonal changes that happen during pregnancy.

A condition called

pregnancy rhinitis
, where symptoms include a blocked nose may also be the reason your hay fever seems more severe. Around 20% to 30% of pregnant women suffer from it.

But however groggy hay fever makes you feel, you can set your mind at rest that there’s no evidence to show it will harm your baby or cause birth defects. Nor are there any links with preterm birth or stillbirth.

Many women feel tired during pregnancy, especially in the first 3 months. If your hay fever symptoms are disrupting your sleep, then your seasonal sniffles are going to feel even worse and affect your life more than usual.

Natural ways to relieve hay fever in pregnancy

It’s understandable that you may be worried about taking medication when you’re pregnant. Along with

self-care advice for hay fever
, give these ways to naturally ease hay fever symptoms a try before you consider antihistamines and other hay fever medicines:

  • Avoiding pollen:

    • staying indoors as much as possible when the pollen count is high, in the late afternoon and evening, can stop you getting symptoms
    • showering and washing your hair can get rid of pollen if you’ve been outdoors
    • rinsing your nose with a saline solution has been proved to be an effective way to clear irritants (buy this from a pharmacy for the correct salt-water ratio)
    • rubbing a little petroleum jelly or a wax-based ointment around your nostrils to trap pollen and stop it irritating your nasal passages. There is no evidence to back this claim, but you can try it and see if it helps you
  • Easing a blocked nose:

    • exercising earlier in the day can help clear your nose. This can be walking or other forms of activity, depending on your ability and fitness level, and what your doctor recommends
    • putting a nasal dilator strip on your nose can help clear your nasal passages, especially at night. This can help you breathe more easily and sleep better
    • making sure your head is raised to around 45 degrees will help your breathing at night if you’re prone to a running or blocked nose. Propping up the bed with objects under the legs is better than extra pillows
    • research has shown acupuncture can ease nasal inflammation

Can a pharmacist help?

If you find

preventative and natural measures
aren’t easing your hay fever symptoms, then your pharmacist can advise you about suitable medication.

A pharmacist may recommend eye drops or saline nasal sprays, but the medication that you usually buy, such as oral antihistamines and some steroid nasal sprays, will need to be prescribed if you’re pregnant. While a pharmacist can offer advice, you’ll need to see your doctor for a prescription.

When to see a doctor

If you think you’ve got hay fever for the first time during pregnancy, your doctor will be able to help. They can prescribe medicines to treat your symptoms if self care or pharmacy treatments haven’t worked for you.

If your seasonal hay fever symptoms are getting worse, making you tired, disturbing your sleep and disrupting your day, then make an appointment to see your doctor.

Can I get hay fever for the first time because I’m pregnant?

You can develop hay fever at any age, commonly in early adulthood, and it could happen for the first time during pregnancy. Pregnancy isn’t thought to be a cause of hay fever (also called

allergic rhinitis
), but it can cause pregnancy rhinitis which has similar symptoms.

It’s not fully understood what causes this blocked and runny nose in pregnancy, but it’s thought it could be related to hormonal changes and increases in blood flow. It could also be in part due to allergies triggered by a seasonal allergy such as pollen, or a year-round allergen such as dust mites. Smoking also puts you at higher risk of pregnancy rhinitis, so this could be another reason to quit smoking during pregnancy. Pregnancy rhinitis usually starts in the first 3 months of pregnancy, but ends 2 weeks after your baby is born.

If you have just started to get hay fever-like symptoms for the first time, such as an itchy, blocked nose and itchy, watery eyes, see your doctor. They can do an allergy test to check if you have hay fever and rule out any other causes such as a cold or pregnancy rhinitis.

Which hay fever treatments are safe in pregnancy?

Always check hay fever medication with your pharmacist or doctor before taking it in pregnancy.

Many medicines have not been studied extensively in pregnancy, so it’s important to discuss the evidence with your doctor. You can then weigh up potential benefits to your health alongside any possible risks.

Pregnant women are often advised to try eye drops or nasal sprays first as less of the medication is absorbed into your body. Non-drowsy medicines are usually best and certain antihistamines have fewer side effects than others. Your doctor will advise and prescribe the best option for you and at the correct dosage.

These are some hay fever medications that may be recommended by your doctor in pregnancy:

  • nasal sprays – if saline sprays don’t work your doctor may prescribe a nasal spray containing steroids. The dose of medicine in a steroid nasal spray may reach the baby in the womb, but in tiny amounts that it won’t cause harm. The effects are also minimised as you’re not taking the medicine orally
  • eye drops – you’ll need a prescription for eye drops that contain mast cell stabilisers or antihistamines. Eye drops are absorbed by the eye only in small amounts, so while they enter the bloodstream they shouldn’t cause harm to your baby
  • tablets – loratadine and cetirizine are the antihistamines often recommended in pregnancy. Although only small studies have been done, the available evidence doesn’t show they harm an unborn baby. There are fewer studies for fexofenadine, and your doctor will bear this in mind when assessing your symptoms and medical history to see which treatments might be best. Again there is no evidence to show fexofenadine causes birth defects

Treatments to avoid

As a general rule, these are the type of medications that are unsuitable for treating hay fever when you’re pregnant. Hay fever treatments that may be unsafe in pregnancy aren’t only limited to these medications, so always check with your doctor:

  • nasal decongestants used to unblock your nose should not be used by pregnant women as they could reduce blood flow in the placenta and to the baby
  • certain antihistamine tablets cause drowsiness and may not be suitable for use while pregnant. Antihistamines that make you feel drowsy include: chlorphenamine, cinnarizine, diphenhydramine, hydroxyzine and promethazine

Tip from a doctor

“Always be aware that medication for hay fever sold at your pharmacy may no longer be suitable when you’re pregnant. There should be a warning in the manufacturer’s small print, but this can be easily missed. It’s important for your health and the health of your baby to let your pharmacist know you’re pregnant when buying medication. This is especially so when you’re in the early stages of pregnancy and not visibly showing a bump.”-

Dr Adiele Hoffman

Important: Our website provides useful information but is not a substitute for medical advice. You should always seek the advice of your doctor when making decisions about your health.