1. Avoid unnecessary exposure to nasal allergens and pollutants, such as smog and cigarette smoke.
2. Drink even more water each day.
3. Flush your nasal passages with saltwater nose drops several times a day. These are available without prescription, or you can make your own: a quarter teaspoon of salt to a cup of water.
4. Use a facial steamer (basically a hot mist vaporizer attached to a face mask) to “steam clean” your nasal passages and sinuses.
5. Consider nasal sprays (decongestants, antihistamines). In theory, medicines that constrict the blood vessels of the nose may enter the bloodstream and constrict the blood vessels of the uterus or placenta; therefore, decongestants should be used only under a doctor’s supervision, and only in the dosage and frequency your doctor recommends. (Women with decreased placental circulation should be particularly careful about taking any form of inhaled or oral decongestants.) Some nasal sprays are safer than others but except for saltwater (or saline) nasal spray, none should be used without first consulting your doctor.
- AfrinR (oxymetazoline) when used only twice a day and for a couple of days have not been shown to cause harmful effects on the developing baby.
- Inhaled nasal steroids (e.g., Vancenase and Beconase) are in the “probably safe” category, especially when taken only a couple of times a day and for a short period of time. Best to stick with the lower potency inhaled steroids unless advised by your doctor.
- Cromolyn (Intal) is safe to take during pregnancy. It is not a decongestant, a steroid, or antihistamine, but rather a medication that when taken over a long period of time lessens nasal congestion due to allergies. It is especially helpful during seasonal allergic rhinitis or hayfever. It is not helpful during an acute attack of a stuffy nose.
- Nasal or oral decongestants that contain the following compounds have been shown to be possibly harmful to the developing baby and should not be taken unless all other alternatives have been tried and your doctor judges that the benefits outweigh the risks: ephedrine, phenylpropanolamine, Neo-synephrine, phenylephrine. The main worry with these decongestants is that because they constrict the vessels in the airway passages, they may also constrict the blood vessels delivering blood to the baby.
- Antihistamines. Some antihistamines, such as chlorpheniramine and tripelennamine, are categorized as safe to take during pregnancy (green light). Others are recommended only with reservation (yellow light), such as those containing brompheniramine, diphenhydramine, terfenadine, and clemastine. These have been implicated in causing eye damage in premature infants if taken in the last two weeks of pregnancy, yet this is a rare finding.
- If you have been taking allergy shots before becoming pregnant, your doctor may advise continuing these shots during your pregnancy, but because reactivity to these injections may change during pregnancy, your doctor may elect to change the dosage. It is unlikely that your doctor would advise starting allergy shots during a pregnancy.
- Cough syrups should be taken with caution while pregnant and are best limited to nighttime-use or to severe coughs. Available studies have shown no link between guaifenesin and fetal defects.