Poring over the fine print on medicine packets isn’t much fun if you feel poorly during pregnancy. A simple ‘yes’ or ‘no you can’t take this’ would be just splendid. So, we called on GP and TV star Dr Dawn Harper to explain what you can and can’t take while you’re pregnant for ten common health niggles (stick this one on the fridge!).
Thrush (a yeast infection in the vagina) is very common, with around three quarters of women having a least one bout in their lifetime. It is even more common in pregnancy. You may notice a creamy white discharge, often described as being like cottage cheese, and an itchy sensation around the vagina. As Dr Dawn advises, “You can reduce your chances of developing thrush with the usual self-help measures, such as avoiding perfumed products, wearing loose fitting clothes and cotton underwear. While thrush won’t harm your unborn baby, fluconazole tablets available over-the-counter are not recommended during pregnancy. Instead, stick to anti-fungal creams.”
Cystitis is an inflammation of the bladder, usually caused by an infection, recognisable by an urgent need to wee and a burning sensation when you do. One in five women will contract cystitis at least once and it’s more common during pregnancy. Dr Dawn says, “If you develop cystitis, drink plenty of fluids. Most sachets aimed at neutralising the urine, which are available over-the-counter, are safe to be taken during pregnancy.
“If you do need antibiotics, double check with the doctor prescribing them that they are safe during pregnancy. One of the commonly used antibiotics for urinary tract infections (nitrofurantoin) can cause problems with the red blood cells of your baby if taken towards the end of pregnancy. Plus, symptoms of cystitis can be caused by a condition called urethritis, which is often treated with antibiotics called tetracyclines, which should not be taken while you’re pregnant as they cause discolouration of babies’ adult teeth,” Dawn continues.
3. Bacterial Vaginosis (BV)
Dr Dawn has been working with Balance Activ (an over-the-counter BV treatment) to raise awareness of the implications of BV in pregnancy. Dawn says, “BV causes a greyish watery discharge with a classic fishy odour and should be taken seriously in pregnancy as it increases the risk of miscarriage and premature labour. One in three women will experience BV and it is easily treated with antibiotics on prescription from your GP – either clindamycin or metronidazole. Personally, I would rather take clindamycin as metronidazole is not recommended in high dose in pregnancy. Alternatively you can buy lactic acid gel from the pharmacist, or get it on prescription. The gel is inserted into the vagina to restore the naturally slightly acidic environment and treat the condition. This is completely safe to use in pregnancy, but it is always advisable to seek advice from a GP if you experience an abnormal vaginal discharge or odour when pregnant.”
It probably comes as no surprise that 10 million people in the UK get headaches, meaning they are one of the most common health complaints. Dr Dawn notes, “Headaches are common in pregnancy and – contrary to popular belief – don’t usually signify high blood pressure (although this should always be checked out). Paracetamol is safe during pregnancy as long as you don’t exceed the recommended daily dose. I would avoid ibuprofen or products containing aspirin, especially towards the end of pregnancy, as they can affect circulation in your baby when he is born. Stronger painkillers containing codeine may make your baby sleepy if taken towards the end of pregnancy, too.”
5. Flu or cold
If you get flu while you’re pregnant, it could lead to a premature birth or your baby could have a low birthweight. It can even lead to stillbirth or death. Dr Dawn says, “Hopefully if you are pregnant you will have taken your GP up on the offer of a flu vaccine, but if you should develop flu or a cold, take plenty of fluids. Paracetamol is safe but check the labels of any flu and cold remedies. Avoid aspirin and ibuprofen, and products containing phenylephrine, as this has been shown to cause malformations if taken in the first trimester of pregnancy.”
6. Stomach upsets/ diarrhoea
Diarrhoea (loose and more frequent passing of stools) is often the result of a virus or bacteria, which could be passed on from someone else or from contaminated food. Diarrhoea is usually nothing to worry about, but the key is to avoid dehydration. Dr Dawn says, “Fluids and rehydration sachets are the best way to deal with a simple stomach upset. Most over-the-counter remedies are safe, but always check with your pharmacist. Some products, for example those containing hyoscine or atropine, should be avoided during pregnancy. No specific problems have been reported in the low doses that are in these remedies, but it is always best to follow the manufacturer’s advice.”
7. Hay fever
Hay fever, also known as seasonal allergic rhinitis, is an increasingly common allergic reaction to pollen, affecting one in five people at some point in their lives. Hay fever can cause itchy eyes, a runny nose and sneezing. “The mainstay of treating hay fever is with antihistamines and the manufacturers of most advise that they should be avoided during pregnancy,” warns Dr Dawn. “This isn’t because of any evidence that they cause harm to your unborn baby (with the possible exception of products containing hydroxyzine, which has been shown to cause problems in animals). Sedating antihistamines, such as those containing chlorpheniramine can cause irritability and tremors in your newborn if taken towards the end of pregnancy. Hay fever can be miserable, but if you can, manage it by staying indoors when the pollen count is high, wearing wraparound sunglasses, using petroleum jelly to trap pollen around your nose, and avoiding hanging clothing and bed sheets outside to dry,” adds Dr Dawn.
Water makes up over two-thirds of your body. If you lose more water than you take in, you will upset the balance of minerals (salt and sugar) in your body and become dehydrated. This can affect the way your body functions and you may notice your eyes are sunken or you feel light-headed and thirsty. Dr Dawn notes, “It is important that you stay well hydrated during pregnancy so drink plenty – if your urine is darker than straw colour, you are not drinking enough and should increase your fluid intake.” This should be water, rather than fizzy drinks or caffeine. If you are dehydrated due to diarrhoea, follow the advice in point six.
9. Food poisoning
Food poisoning is the result of eating contaminated food and symptoms (such as vomiting) usually occur between one and three days later. As Dr Dawn notes, “It’s important to take extra precautions to avoid food poisoning when pregnant so be extra vigilant about hand washing and food handling. Check your meat is well cooked and avoid food that has been out of the fridge for long periods. If you think you have food poisoning during pregnancy, you should always speak to your GP who will advise you depending on your symptoms and which particular bug you have caught.”
Currently 1.1 million children in the UK suffer asthma, and it commonly continues into adulthood. Dr Dawn explains, “Anyone with a long-term condition worries about the implication of their medication on their unborn baby and asthma is no different. As a general rule, it is more harmful for the baby if your asthma is not well controlled than it is for you to be taking your medication. But it is important that you tell your GP if you are planning a pregnancy or as soon as you become pregnant so they can advise you.”