Medicines in Pregnancy: To Take or Not to Take

What can the expectant mother do when she doesn't feel well?

Dr. Robert Carpenter, obstetrician/ gynecologist at St. Luke's Episcopal Hospital, advises women to avoid taking over-the-counter medications until at least the eighth week of pregnancy. "Everything the mother takes into her body is passed through the placenta into the baby's blood," says Dr. Carpenter. "It is very important to avoid taking medications, if possible, during the first eight weeks when the baby's heart, lungs, and brain system are being formed since some medications might affect the baby's development."

Dr. Carpenter recommends first using other ways to relieve symptoms:

Try treating a cold by drinking extra fluids, sleeping with your head propped up, using a cool-mist vaporizer, or trying a saline-type nasal spray; suck on hard candies for a persistent cough or make your own honey and lemon cough syrup (4 tsp honey, 1 tsp lemon, 2 tsp hot water); recuperate from a headache by lying down in a quiet, dark room and putting an ice pack on your forehead or applying heat to the back of your neck.

Sometimes it may be necessary for the doctor to prescribe medicines during pregnancy. If so, it is important to follow the doctor's prescription exactly as given, advises Dr. Carpenter. "If you are prescribed an antibiotic, take all of it, unless you can't tolerate it. In that case, be sure to let your doctor know."

Some over-the-counter medications are considered safe to take beyond the first eight weeks of pregnancy, including:

Chlortrimeton, Sudafed, and Actifed for cold symptoms and hay fever; Robitussin or Robitussin DM for coughs; Docusate, Metamusil, Citrucel, Fibercon or Milk of Magnesia for constipation; Datril, Tylenol or acetaminophen for headaches or body aches (do not take aspirin since it may interfere with blood clotting, and, because it readily crosses the placenta, it can potentially cause such problems as intercranial hemorrhage or pulmonary hypertension; do not take ibuprofen unless instructed by your physician); Anusol-HC or Preparation H for hemorrhoids; Amphogel, Gelusil, Rolaids, Tums or Maalox for heartburn; Tylenol for fever less than 100.5 degrees that lasts less than 48 hours (if the fever lasts longer or is higher, call your doctor).

"Expectant mothers should remember that if their primary symptoms do not go away, or if they experience other symptoms, they should check with their doctor. The occasional, moderate use of medications is generally considered safe during pregnancy, but when in doubt ask your doctor, or try to avoid taking any medications altogether," adds Dr. Carpenter. "During pregnancy, decreasing stress and increasing rest is the most important thing an expectant mom can do - whether she is sick or not."

- From St. Luke's Episcopal Hospital

Pregnant Asthmatics Should Continue Inhalant Medication

Pregnant women with asthma who don't use their inhalant medication could endanger their babies' lives.

Physicians at Baylor College of Medicine and Ben Taub General Hospital reviewed patient records of 25 pregnant women who had to be admitted to the hospital for asthma-related problems between 1990 and 1995. Five of the patients were hospitalized more than once.

Only 28 percent of the women had been using steroid inhalants to open up their lung airways.

"Limited use of inhaled steroid medication was probably the main reason these patients developed asthma-related breathing problems that warranted treatment in the hospital," says Dr. Ather Siddiqi, a Baylor resident specializing in pulmonary and critical care. He conducted the study with Dr. Nicola Hanania, assistant professor of medicine at Baylor and a member of the emergency center staff at Ben Taub.

Asthma attacks occur when muscles in the bronchial walls contract, causing partial obstruction of the bronchi, the tubes entering the lungs.

The obstructed airways can cause low levels of oxygen in the blood, which can be life-threatening to the fetus and mother, Dr. Siddiqi says. Four of the women in his study required treatment in the intensive-care unit, and two needed a respirator. None of the mothers or babies Dr. Siddiqi studied died, but the babies were more likely to have low birth weight (under 6 pounds).

- From Baylor College of Medicine

Researchers Find a Way to Ease Oral Feeding in Premature Infants

Researchers have found a way to facilitate oral feeding in low-birth weight infants.

The study, being conducted at the USDA/ARS Children's Nutrition Research Center at Baylor College of Medicine, looked at 171 infants born 26 to 29 weeks after conception.

"We used a specially designed apparatus that measured how much pressure the baby was applying to the nipple and how much breast milk or formula was flowing through it," says Dr. Robert Shulman, a Baylor professor of pediatrics and director of the nutrition support team at Texas Children's Hospital. "We found that it is easier for premature infants to ingest milk if they regulate the flow of milk out of the nipple themselves by squeezing off the nipple.

Premature infants cannot leave the hospital until they can take all of their feedings independently either by breast or bottle. Generally, premature infants are not bottle-fed until 34 weeks after conception because they cannot coordinate sucking, swallowing, and breathing to eat. Traditionally, when bottle feeding begins, the bottle is tilted so the milk pressure produces a continual drip in the infant's mouth.

"We believe letting infants regulate the milk flow themselves will help them learn how to coordinate sucking, swallowing, and breathing," says Dr. Shulman. "It will allow infants to pace themselves and decide when it's time to take a breather from swallowing milk."

- From the USDA/ARS Children's Nutrition Research Center at Baylor College of Medicine

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©2006 Texas Medical Center

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