Stuffy nose and allergies during pregnancy

During pregnancy, 18 to 20 percent of women report suffering from nasal congestion.

What causes congestion during pregnancy?

Pregnancy hormones may be to blame, as they increase blood flow to the airways and stimulate mucus production. This type of congestion occurs only during pregnancy and typically goes away within 5 days of delivery.

Allergies during pregnancy

Congestion and runny nose can also be due to respiratory allergies present before pregnancy. It’s even possible for new allergies to develop or to be detected for the first time while you are pregnant. Some experts go so far as to say that pregnancy could trigger or aggravate these allergies. Others dispute this idea, noting that levels of allergy antibodies are no different during pregnancy.

Pregnancy can, however, exacerbate certain allergy symptoms due to the effects of hormones on nasal congestion. About 15 percent of women report that their symptoms worsen during pregnancy. In general, things return to normal after delivery. Conversely, almost half of pregnant women notice no change in their allergy symptoms, while 34 percent say they actually improve.

Nasal congestion due to allergies should be taken seriously. Uncontrolled allergies can affect a mother-to-be’s sleep, nutrition, and emotional well-being. Allergies can also cause or aggravate asthma. Poorly controlled asthma during pregnancy may decrease the amount of oxygen the baby receives and potentially lead to other complications. Don’t hesitate to contact your health care provider if you’re experiencing symptoms of nasal congestion.

How to relieve nasal congestion

There are several steps you can take to alleviate the discomfort of nasal congestion or allergies during pregnancy.

• Cleanse your nose using a saline nasal spray or a Sinus Rinse^TM device, which can be found in pharmacies. Studies have shown that using these products reduces the need to take antihistamines. You can make your own saline solution at home by adding 2 teaspoons (10 ml) of salt and half a teaspoon (2.5 ml) of baking soda to 4 cups (1 L) of boiled water that has cooled. It’s important to use exact measurements. Store the solution in the refrigerator in a clean, sealed glass container for up to 7 days. You can keep a bit of solution in a small bottle at room temperature. Discard it once it has been out of the refrigerator for more than 24 hours.
• Use nasal strips to open up your nasal passages while you sleep.
• Raise the head of your bed.
• Do moderate exercise to help reduce nasal inflammation.
• Whenever possible, avoid allergens that could cause an allergic reaction. The main culprits are pollen (trees, grass, ragweed), mould, pet dander (cats, dogs), and dust mites. If possible, keep the windows in your home closed and use a fan or air conditioner in hot weather. Keep the car windows closed when you’re driving, too.

Medications to use for nasal congestion

If the tips above don’t help to ease your allergy symptoms, certain medications can be used at no risk to your baby.

• Antihistamines
  Approximately 10 to 15 percent of pregnant women say they take antihistamines. In fact, this is the most common type of medication used during pregnancy. To date, no link has been reported between the use of antihistamines during pregnancy and birth defects. Experts recommend choosing second-generation antihistamines (Claritin^® and Reactine^®), as they don’t cause drowsiness and are considered safe during pregnancy and breastfeeding.
• Decongestants
  If saline solutions aren’t cutting it, decongestants sold as sprays (e.g., Otrivin^®, Dristan^®) are safe to use for less than 3 consecutive days in your third trimester. However, a few recent studies indicate that there are risks to using these products, particularly in the first trimester but also in the second trimester. It’s best to consult a professional before trying them. In addition, certain decongestant tablets containing pseudoephedrine or phenylephrine can be used, but only from the second trimester onwards (e.g., certain Tylenol^® Cold & Sinus products). Ask a pharmacist for more information. Note that products containing ibuprofen should not be taken during pregnancy.
• Corticosteroid nasal sprays
  For more severe or persistent allergies, corticosteroids may be an option. They are the main form of treatment considered for pregnant women with asthma. If you were already using corticosteroids to control your symptoms before pregnancy, it’s safe to continue doing so. However, you should mention this to your doctor at your first pregnancy appointment.

Things to keep in mind

• Pregnancy hormones can cause nasal congestion.
• Some pregnant women find that their allergies get worse during pregnancy.
• Certain medications can be used to relieve nasal congestion during pregnancy.

Scientific review: Dr. Chantal Ouellet, family doctor Research and copywriting: The Naître et grandir team Updated: May 2021

Photo: iStock.com/momcilog