MEDICINES – PROCEED WITH CAUTION

Q: I just know that I’m going to get sick this winter, but I’m so nervous about what I can take now that I’m pregnant. I don’t want to run to the doctor for every little sniffle. A: Dr Trudy Smith answers: All pregnant women should have the flu vaccine at the start of winter. For colds there is really no good medication as it is viral. For symptomatic relief rest and fluids are best, and paracetamol if really needed. Pregnancy is a time to take extreme care. Medicines and supplements that you use while pregnant could affect the health of your growing baby. The medicines that are the riskiest during pregnancy include:

• Aspirin

• Ibuprofen

• Isotretinoin, taken for acne (formerly sold as Accutane)

• Thalidomide, to treat a type of skin disease and multiple myeloma

• Vitamin A derivatives

• Certain anti-cancer drugs and immune-system-modifying medicines

• The epilepsy drug Phenytoin

• The anticoagulant Warfarin

• Mood stabilisers Valproate and Lithium

• Alcohol in chronic or high doses In once-off, dire situations when you must take a medicine to safeguard your own health, chances are good that you and your baby will be fine. Just take care to do so in consultation with your healthcare professional. The medicines you use change the natural state of your body. And when you consider the fact that your body is doing all kinds of incredible things to grow a baby, this can be serious. For many substances, there’s insufficient data to make a call on safety. It is best to avoid all unnecessary medication while pregnant. Also keep in mind that just because a treatment is natural doesn’t mean it’s safe. We have no randomised controlled trials on herbal medication in pregnancy. Plus, on a list of herbal remedies to use and avoid while pregnant, supplied by the BabyCentre Medical Advisory Board (2015), there are more herbs marked as “risky” than as “safe”. Proceed with caution, and only with the insights of your pharmacist, GP or obstetrician. When it comes to supplements during pregnancy folic acid (a manmade form of folate) is one of the most important. Folic acid supports red blood cell production and neural tube development in the baby’s brain and spinal cord. Supplementing your diet with folic acid even before you fall pregnant can make a significant difference to your baby’s health. Find a good prenatal multivitamin that contains folic acid, iron, iodine, and calcium, as these minerals are particularly important to your baby’s development. If you can find one with omega-3 fatty acids in it, that’s a plus too.