ASTHMA AND PREGNANCY

All the evidence suggests that women with asthma should expect a normal pregnancy and a healthy baby. However, the changes that pregnancy can cause sometimes make women worry and can lead them to seek reassurance.

Here we aim to answer many of your questions, but if you have any others then talk to your doctor or midwife, or call the Asthma Helpline on 0345 01 02 03 between 9am and 9pm, Monday to Friday. Calls are charged at local rates.

Will my asthma get worse in pregnancy?

Asthma, like pregnancy itself, varies from person to person: during pregnancy your asthma may get better or it may get worse. A mother whose asthma has got better during one pregnancy will not necessarily have the same experience during another and vice versa.

Sometimes women with asthma can become somewhat breathless towards the end of their pregnancy. This is probably because of the extra weight they are carrying.

A very small number of women whose asthma is severe enough to require high doses of steroid tablets regularly may find it difficult to cope with the added strain of pregnancy. For the vast majority, however, it causes no problems.

Complications in pregnancy

Regular ante-natal care is important for all mothers, including those with asthma. Asthma does not increase the risk of complications, such as high blood pressure or bleeding, during pregnancy.

Smoking during pregnancy

There are at least four reasons why parents should avoid smoking during pregnancy and afterwards:

1. Smoking is a health hazard for everyone.
2. Smoking during pregnancy can increase the chances of your child developing breathing problems and asthma in infancy.
3. Passive smoking is a health hazard for young babies.
4. Smoking during pregnancy is known to be associated with babies of low birth weight.

Giving up smoking can be difficult no matter how strong your reasons are. Get help by telephoning Quitline on 020-7487 3000 between 9.30am and 5.30pm, Monday to Friday.

Taking control of asthma

Having asthma will not normally affect your baby. However, a pregnant woman needs to follow her asthma management plan, because if her asthma gets out of control then the baby could be a little under weight at birth.

Asthma treatment during pregnancy

Asthma treatments do not harm the baby. In fact they play an important part in keeping both mother and baby healthy.

There are two types of medicine

Preventers are those medicines that guard against asthma symptoms happening at all.

Relievers are those that rescue people from breathing difficulties when they occur by opening up the airways.

The safety of medicines
Preventers

Modern preventers are inhaled and come in two forms: steroid and non-steroid. Many people worry about the effects of steroids. Inhaled steroids such as Becotide and Becloforte (beclomethasone), Pulmicort (budesonide) or Flixotide (fluticasone) act only in the lungs and very little of the medicine is absorbed into the bloodstream (the only way that the medicine can pass from mother to baby). If higher-dose inhaled steroids are used, then to reduce further the risk of absorption it is sensible to use a spacer device (Volumatic or Nebuhaler).

Steroid tablets such as prednisolone act through the mother's blood but do not harm the baby at doses of less than 45mg per day. Even higher doses are not necessarily harmful; if you are worried discuss your treatment with your doctor or midwife.

Tilade (nedocromil) and Intal or Cromogen (sodium cromoglycate) are non-steroid preventers. They are also safe to use.

Relievers

Relievers such as Ventolin (salbutamol) or Bricanyl (terbutaline) are perfectly safe to use during pregnancy. Amionphylline tablets may also be used safely during pregnancy.

Chest infections may occasionally need to be treated with antibiotics. Commonly used antibiotics, such as amoxycillin, are safe, although there are some, such as tetracycline, which are not used during pregnancy.

Coping with labour

Severe asthma attacks during labour itself are extremely rare because the body produces natural hormones (cortisone and adrenaline) which prevent asthma.

However, many women find that drawing-up a birth plan with their midwife or doctor, which takes asthma into account, can help to reduce their fears.

Breathing and relaxation

Exercises that reduce labour pains through relaxation can help women with asthma to breathe more easily. But care should be taken to avoid some breathing exercises that require rapid, shallow breaths. Taking a reliever inhaler before starting the breathing exercises will help you to avoid the symptoms of asthma.

Controlling labour pains

There are a number of different ways to control pain during labour, including epidurals, all of which are safe for women with asthma. If an operation is necessary, it will not cause problems providing that the anaesthetist knows that the mother has asthma.

Asthma and breast-feeding

There is absolutely no reason why women with asthma should not breast-feed and indeed you are encouraged to do so. Usual doses of inhaled medicines do not enter the bloodstream and therefore will not be present in breast milk. Even asthma medicines taken by mouth (including steroid tablets) will only be found in small quantities, and these will not upset the baby. Medicines used for the treatment of asthma have not been found to hinder the production of breast milk.

The chances of your baby having asthma

Like other allergic conditions, such as hayfever or eczema, asthma often runs in the family. It seems that we can pass on a tendency for our children to develop allergies; this is more likely to happen if both parents are allergic, rather than just one of them. However, passing on a tendency does not automatically mean that your child will develop asthma and the severity of asthma is not inherited.

For more information about asthma in general please see the 'Take control of asthma' booklet, produced by the National Asthma Campaign or call the Asthma Helpline on 0345 010203.