Treatment of hay fever

(Date: September 2014. Version: 2a)

This factsheet has been written for members of the public by the UK Teratology Information Service (UKTIS). UKTIS is a not-for-profit organisation funded by Public Health England on behalf of UK Health Departments. UKTIS has been providing scientific information to health care providers since 1983 on the effects that medicines, recreational drugs and chemicals may have on the developing baby during pregnancy.

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What is hay fever?

Hay fever is an allergic reaction to breathing in pollen in the air. Hay fever tends to occur during the spring and summer months when pollen levels are at their highest. Symptoms can include sneezing, a runny and itchy nose, and itchy watery eyes.

How can I treat hay fever during pregnancy?

There are no official guidelines on the best way to treat hay fever during pregnancy. Treatment may not be necessary in cases of mild hay fever and no link between having hay fever during pregnancy and birth defects in the baby was shown in the one large study which investigated this. 

Pregnant women who are affected more severely with hay fever and who are not able to cope with their symptoms are generally advised to try the following steps one at a time:

(1) If possible avoid or limit exposure to pollen.

(2) If this does not help, nasal sprays and eye drops that contain medicines such as sodium cromoglicate, corticosteroids, or antihistamines (sometimes in various combinations) can be used. Although some of these can be bought without a prescription, it is still best to take advice from your doctor. The medicines in eye drops and nasal sprays enters the blood stream in very small amounts. The dose of medicine that reaches the baby in the womb is therefore very small and would not be expected to affect an unborn baby. However, sprays or eye drops containing decongestants should ideally not be used (see below).

(3) If the above measures are not effective, you could speak to your doctor about using antihistamine tablets in pregnancy. There is much more pregnancy safety information for some antihistamines compared to others, and some antihistamines cause drowsiness and may therefore not be suitable for use while pregnant. Your doctor will bear these things in mind, along with your specific symptoms and medical history when recommending the best antihistamine for you.

bumps leaflets are available on use in pregnancy of the antihistamines cetirizine, loratadine, fexofenadine and chlorphenamine.

Can I use decongestants during pregnancy?

Decongestant medicines (e.g. Sudafed®, Galpseud®) often contain pseudoephedrine which helps to relieve a blocked nose by causing the blood vessels to narrow, thereby reducing swelling of the nasal membranes and mucus production. Decongestants are not recommended for use at any stage of pregnancy as they could also reduce blood flow in the placenta and to the baby.

Will my baby need extra monitoring during pregnancy?

As part of their routine antenatal care most women will be offered a scan at around 20 weeks of pregnancy to look for birth defects and to check the baby’s growth.

There is no evidence that using treatments for hay fever during pregnancy will cause any problems that would require extra monitoring for your baby.

Who can I talk to if I have questions?

If you have any questions regarding the information in this leaflet please discuss them with your health care provider. They can access more detailed medical and scientific information from

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General information 

Up to 1 out of every 5 pregnancies ends in a miscarriage, and 1 in 40 babies are born with a birth defect. These are referred to as the background population risks.  They describe the chance of these events happening for any pregnancy before taking factors such as the mother’s health during pregnancy, her lifestyle, medicines she takes and the genetic make up of her and the baby’s father into account.

Medicines use in pregnancy

Most medicines used by the mother will cross the placenta and reach the baby. Sometimes this may have beneficial effects for the baby.  There are, however, some medicines that can harm a baby’s normal development.  How a medicine affects a baby may depend on the stage of pregnancy when the medicine is taken. If you are on regular medication you should discuss these effects with your doctor/health care team before becoming pregnant.

If a new medicine is suggested for you during pregnancy, please ensure the doctor or health care professional treating you is aware of your pregnancy.

When deciding whether or not to use a medicine in pregnancy you need to weigh up how the medicine might improve your and/or your unborn baby’s health against any possible problems that the drug may cause. Our bumps leaflets are written to provide you with a summary of what is known about use of a specific medicine in pregnancy so that you can decide together with your health care provider what is best for you and your baby.   

Every pregnancy is unique. The decision to start, stop, continue or change a prescribed medicine before or during pregnancy should be made in consultation with your health care provider. It is very helpful if you can record all your medication taken in pregnancy in your hand held maternity records.

Disclaimer: This information is not intended to replace the individual care and advice of your health care provider. New information is continually becoming available. Whilst every effort will be made to ensure that this information is accurate and up to date at the time of publication, we cannot cover every eventuality and the information providers cannot be held responsible for any adverse outcomes following decisions made on the basis of this information. We strongly advise that printouts should NOT be kept for any length of time, or for “future reference” as they can rapidly become out of date.

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