If you have asthma, being pregnant or breastfeeding should present no problems, providing you continue to control your asthma effectively. According to the National Asthma Council, you should continue taking your asthma medicines while you are pregnant.

Talk to your doctor about updating your asthma action plan and make sure you stick to it throughout your pregnancy.

Is it safe to take asthma medications in pregnancy?

Most asthma medicines have been shown to be extremely safe for both you and your developing baby, and will ensure that your asthma symptoms are not left untreated for the duration of your pregnancy. Untreated symptoms may be harmful for the baby. Your asthma management plan should be reviewed regularly throughout pregnancy. Uncontrolled asthma is usually far more of a danger to your pregnancy than any of your prescribed asthma medicines.

If your asthma is being treated with oral steroid medication (tablets or syrup, not puffers), check with your doctor about the safety of this treatment while pregnant.

Do not stop taking either your preventer or reliever asthma medicines without consulting your doctor first. Always check with your doctor before starting or stopping taking any types of medicines during pregnancy.

How will pregnancy affect my asthma?

Asthma often changes during pregnancy. The effect of pregnancy on women who have asthma is unpredictable. Around 1 in 3 pregnant women will see an improvement, 1 in 3 will see no change and 1 in 3 will experience a worsening of their symptoms.

Pregnancy is not likely to bring on asthma if you didn’t previously have it. Many women experience breathlessness during pregnancy due to hormonal changes, not asthma. Many women also experience breathlessness during the last trimester of their pregnancy due to the enlarging uterus restricting movement of their diaphragm. This is normal in many pregnant women, even those who do not have asthma.

The best way to ensure a healthy pregnancy is to keep your asthma well-controlled. As soon as you find out you’re pregnant, you should see your doctor for advice on how to manage your asthma. Some women with severe asthma may develop high blood pressure or pre-eclampsia during pregnancy. There is an increased risk of having a low-birth weight baby or a pre-term delivery in women with uncontrolled asthma.

Managing your asthma during pregnancy

If you have asthma, you should have a self-management plan, which means that you can adjust your treatment to meet your needs. For example, if you have a cough or cold, your asthma may get worse, in which case you can increase your ‘preventer’ (inhaled steroids), or start them if you don’t take them regularly. This is completely safe during pregnancy.

While you can continue to exercise and work normally, there are some steps you can take to try to prevent your asthma from getting worse during your pregnancy:

• avoid smoking (get tips on stopping smoking in pregnancy)
• avoid allergic triggers such as pet fur
• control hay fever with antihistamines — talk to your doctor or pharmacist about which antihistamines are safe to take in pregnancy
• avoid your usual hay fever triggers

Signs that your asthma may be getting worse include:

• a cough that is worse at night or in the early morning, or when you exercise
• wheezing
• breathlessness
• tightness in your chest

You are also more likely to suffer from acid reflux while you’re pregnant. This condition occurs when stomach acid leaks back up into your oesophagus (gullet), and tends to make asthma worse. If you have these symptoms speak to your doctor or asthma specialist, who will advise you on the best treatment.

Giving birth

Women with asthma can expect to have a normal delivery. Talk to your doctor before your labour about how your asthma may affect the birth, and ask them to advise other medical staff of your special needs. Asthma attacks do not usually happen during childbirth.

Breastfeeding

While asthma medicines do enter breast milk, the extremely small concentrations do not harm the baby in any way. See your doctor or healthcare professional if you have any concerns regarding breastfeeding your baby.

Will my child have asthma too?

The cause of asthma remains unknown, although there is an increased risk of a child developing asthma if they have a parent or brother or sister who has asthma. Protecting your child from cigarette smoke, during pregnancy and afterwards, is recommended to reduce the risk of your child developing asthma. Doctors also recommend breastfeeding for the first 6 months as a means of reducing the likelihood of your child developing asthma and allergy.