Asthma - pregnancy and breastfeeding

During pregnancy, some mothers-to-be may feel uneasy about taking medications. However, it is important to the health of both mother and baby that the mother’s asthma is well managed.

Your baby will do best if you are breathing well and easily. Uncontrolled asthma during pregnancy, and the stress and worry about uncontrolled asthma, has been linked to poorer outcomes for both baby and mother. Work with your doctor to create a written asthma action plan and have it reviewed at regular times during your pregnancy to make sure you are getting the best asthma care possible.

Your asthma may change

Pregnancy can mean a change in a woman’s asthma. For some women, their asthma worsens and for others it improves, while others experience no change at all.

As the baby grows and the womb gets bigger, some women feel breathless, particularly with physical activity. This is part of the normal changes that occur during pregnancy. If you are concerned, speak to your doctor.

Asthma medications are safe

Asthma medications are extremely safe and appropriate for use during pregnancy. Most asthma medications are inhaled, which delivers medication directly to the airways where it is needed, so a small dose can often be enough. Asthma medication is not dependent on circulation through the bloodstream and, to some extent, bypasses the baby.

Discuss any concerns you have with your doctor before stopping any asthma medications, to make sure your asthma is controlled throughout your pregnancy.

Asthma during labour

Asthma attacks during labour are rare. However, you should make sure your asthma medication is always accessible, including when you are in hospital. If you have asthma symptoms during labour, take your reliever medication as usual.

Severe or unstable asthma

Uncontrolled asthma has been linked with premature births and low-weight babies. If your asthma is severe or unstable, your asthma action plan should include a plan for labour that takes anaesthetic options into account. This action plan needs the input of both your obstetrician and your asthma specialist.

Don’t smoke

You can improve and better manage your asthma if you don’t smoke. Cigarette smoking also has many damaging effects on your developing baby, including:

• risk of a premature birth
• reduced birth weight, which can bring about other complications
• risk of fetal death, stillbirth and sudden infant death syndrome (SIDS)
• risk of asthma and respiratory infections.

Asthma and breastfeeding

Most asthma medications are safe to take during breastfeeding. If you are concerned, speak with your doctor.

Australia has one of the highest asthma rates in the world. The Australian Bureau of Statistics estimates that more than 2.2 million Australians are affected by asthma. Some of the factors that may have contributed to the rise in childhood asthma over the past decade include:

• increased exposure to viral infection while young
• changes in lifestyle
• exposure to house dust mites
• not enough oily fish in the Australian diet
• less women breastfeeding their newborn babies.

Breastfeeding your newborn baby for at least the first six months can significantly reduce your child’s risk of developing childhood asthma and other allergies. Breastfeeding is a learned skill and it may take time for you and your baby to get it right. Some women give up trying to breastfeed because they are worried their baby might not be getting enough milk during the learning and establishing process.

If you are having trouble breastfeeding your baby, there are lactation experts available to help you, such as your midwife or maternal and child health nurse.

• Continue to take your asthma medications as prescribed when you are pregnant. Poorly controlled asthma is more of a risk to your baby.
• Discuss any concerns with your doctor and work together to develop an asthma action plan.
• Feeling breathless in late pregnancy is common, even in pregnant women who don’t have asthma.
• Breastfeeding for at least the first six months can significantly reduce your baby’s risk of developing childhood asthma and other allergies.