This sheet is about exposure to propranolol in pregnancy and while breastfeeding. This information is based on published research studies. It should not take the place of medical care and advice from your healthcare providers. 

What is propranolol? 

Propranolol is a medication that has been used to treat high blood pressure, some heart conditions, overactive thyroid, tremors, glaucoma, and migraines. It belongs to the class of medications called beta-blockers. Some brand names for propranolol are Inderal®, InnoPran XL®, Detensol®, Novo-Pranol®, Deralin®, and Cardinol®.  

Sometimes when women find out they are pregnant, they think about changing how they take their medication, or stopping their medication altogether. However, it is important to talk with your healthcare providers before making any changes to how you take this medication. Your healthcare providers can talk with you about the benefits of treating your condition and the risks of untreated illness during pregnancy. 

I take propranolol. Can it make it harder for me to get pregnant?  

It is not known if propranolol can make it harder to get pregnant. 

Does taking propranolol increase the chance of miscarriage?  

Miscarriage is common and can occur in any pregnancy for many different reasons. Studies have not been done to see if propranolol can increase the chance of miscarriage. 

Does taking propranolol increase the chance of birth defects?  

Birth defects can happen in any pregnancy for different reasons. Out of all babies born each year, about 3 out of 100 (3%) will have a birth defect. We look at research studies to try to understand if an exposure, like propranolol, might increase the chance of birth defects in a pregnancy. It is not known if propranolol can increase the chance for birth defects. Studies on the use of beta-blockers in general during pregnancy have not reported an increased chance of birth defects.  

Does taking propranolol in pregnancy increase the chance of other pregnancy-related problems? 

Propranolol has been linked to low birth weight (weighing less than 5 pounds, 8 ounces [2500 grams] at birth. However, it is not clear if this happens because of the medication, the condition being treated, or other factors.  

The use of propranolol in late pregnancy might increase the chance for the baby to have symptoms of beta-blockade. These symptoms can appear shortly after birth and include slowed heart rate, low blood pressure, and low blood sugar. Not all babies exposed to propranolol will have these symptoms. It is important for your healthcare providers to know if you are taking propranolol so that your baby can get the care that is best for them. 

Does taking propranolol in pregnancy affect future behavior or learning for the child?   

Studies have not been done to see if propranolol can increase the chance of behavior or learning issues for the child. 

What screenings or tests are available to see if my pregnancy has birth defects or other issues? 

Ultrasound can be used to watch the growth of pregnancy. Talk with your healthcare provider about any prenatal screenings or testing that are available to you.  

Breastfeeding while taking propranolol: 

Propranolol passes into breastmilk in small amounts and is not expected to cause problems in full-term breastfed infants. If you suspect that the baby has symptoms such as being too sleepy or having trouble with feeding, contact the child’s healthcare provider. Be sure to talk to your healthcare provider about all your breastfeeding questions. 

If a man takes propranolol, could it affect his fertility or increase the chance of birth defects? 

Propranolol may cause some males to develop erectile dysfunction (ED), which could make it harder to conceive a pregnancy. In general, exposures that men have are unlikely to increase risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/.

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This sheet is about exposure to phenylephrine in pregnancy and while breastfeeding. This information is based on available published literature. It should not take the place of medical care and advice from your healthcare provider.

What is phenylephrine?

Phenylephrine is a decongestant. Decongestants have been used to treat nasal congestion (“stuffy nose”) caused by colds or allergies. Phenylephrine can be found in different products, including Sudafed PE®. Phenylephrine has also been used to treat temporary low blood pressure caused by anesthesia used during surgeries.

Sometimes when women find out they are pregnant, they think about changing how they take their medication, or stopping their medication altogether. However, it is important to talk with your healthcare providers before making any changes to how you take your medication. Your healthcare providers can talk with you about the benefits of treating your condition and the risks of untreated illness during pregnancy.

Some decongestants or other over-the-counter medications might have multiple active ingredients. Be sure to look at the ingredients on your medications.

I take phenylephrine. Can it make it harder for me to get pregnant?

It is not known if phenylephrine can make it harder to get pregnant.

Does taking phenylephrine increase the chance of miscarriage?

Miscarriage is common and can occur in any pregnancy for many different reasons. Studies have not been done to see if phenylephrine can increase the chance of miscarriage.

Does taking phenylephrine increase the chance of birth defects?

Birth defects can happen in any pregnancy for different reasons. Out of all babies born each year, about 3 out of 100 (3%) will have a birth defect. Studies involving more than 1,500 women who were pregnant and took phenylephrine in the first trimester did not show an increased chance of birth defects. In another study looking at 1,249 women who took phenylephrine in the first trimester, a slightly higher chance for minor differences of the eyes or ears were reported (small changes that are not birth defects). Studies on other medications that work in the same way (make blood vessels smaller) have raised questions about a small increased chance of birth defects.

Does taking phenylephrine in pregnancy increase the chance of other pregnancy-related problems?

It is not known if phenylephrine might increase the chance of other pregnancy-related problems, such as preterm delivery (birth before week 37) or low birth weight (weighing less than 5 pounds, 8 ounces [2500 grams] at birth).

Phenylephrine can make blood vessels smaller (constrict). There are theoretical (not proven) concerns that using this medication could reduce blood flow through the placenta (organ that grows during pregnancy to supply the developing baby with food and oxygen).

Taking phenylephrine could raise your blood pressure. If you have high blood pressure, be sure to talk to your healthcare provider about medications that would be best for you.

Does taking phenylephrine in pregnancy affect future behavior or learning for the child?

Studies have not been done to see if phenylephrine can increase the chance of behavior or learning issues for the child.

Breastfeeding while taking phenylephrine:

Studies have not been done to see if phenylephrine gets into breast milk. Studies in animals have shown that phenylephrine might reduce milk supply. Because there is little information about the use of oral phenylephrine while breastfeeding, use of nasal sprays or other medication might be preferred. Be sure to talk to your healthcare provider about all your breastfeeding questions.

If a man takes phenylephrine, could it affect fertility or increase the chance of birth defects?

Studies have not been done to see if phenylephrine could affect a man’s fertility (ability to get a woman pregnant) or increase the chance of birth defects. In general, exposures that men have are unlikely to increase risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/.

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This sheet is about exposure to cetirizine in pregnancy and while breastfeeding. This information is based on available published literature. It should not take the place of medical care and advice from your healthcare provider.

What is cetirizine?

Cetirizine is an antihistamine. Antihistamines are medications that have been used to treat symptoms of allergies, like sneezing, itching, runny nose, and watery eyes. Cetirizine is sold over the counter under brand names including Zyrtec® and Reactine®.

Sometimes when women find out they are pregnant, they think about changing how they take their medication, or stopping their medication altogether. However, it is important to talk with your healthcare providers before making any changes to how you take your medication. Your healthcare providers can talk with you about the benefits of treating your condition and the risks of untreated illness during pregnancy.

I take cetirizine. Can it make it harder for me to get pregnant?

It is not known if cetirizine can make it harder to get pregnant.

Does taking cetirizine increase the chance of miscarriage?

Miscarriage is common and can occur in any pregnancy for many different reasons. Several small studies done on the use of cetirizine during pregnancy did not find a higher chance of miscarriage.

Does taking cetirizine increase the chance of birth defects?

Birth defects can happen in any pregnancy for different reasons. Out of all babies born each year, about 3 out of 100 (3%) will have a birth defect. We look at research studies to try to understand if an exposure, like cetirizine, might increase the chance of birth defects in a pregnancy. Studies involving over 1,300 pregnancies exposed to cetirizine did not show an increased chance of birth defects.

Does taking cetirizine in pregnancy increase the chance of other pregnancy-related problems?

Studies on a small number of pregnancies did not find a higher chance of pregnancy-related problems, such as preterm delivery (birth before week 37) or low birth weight (weighing less than 5 pounds, 8 ounces [2500 grams] at birth).

Does taking cetirizine in pregnancy affect future behavior or learning for the child?

Studies have not been done to see if cetirizine can increase the chance of behavior or learning issues for the child.

Breastfeeding while taking cetirizine:

Cetirizine gets into breast milk in small amounts. Most reports show no problems for babies who are exposed to cetirizine through breast milk. Compared to some other antihistamines, cetirizine is thought to have a lower chance of causing drowsiness for the breastfeeding woman and the nursing baby. For this reason, cetirizine may be preferred for breastfeeding over other antihistamines that cause sleepiness. With repeated use, babies can be checked for signs of being too sleepy (hard to wake up). If you suspect the baby has any symptoms, contact the child’s healthcare provider.

It has been suggested that use of an antihistamine might lower the amount of breast milk made by a woman’s body, but this has not been proven.

A product label for cetirizine recommends breastfeeding women not use this medication. But the benefit of using cetirizine might outweigh possible risks. Your healthcare providers can talk with you about using cetirizine and what treatment is best for you. Be sure to talk to your healthcare provider about all your breastfeeding questions.

If a man takes cetirizine, could it affect his fertility or increase the chance of birth defects?

One report suggested that long-term use of antihistamines like cetirizine might lower sperm counts. Low sperm counts might lower a man’s fertility (ability to get a woman pregnant). In general, exposures that fathers or sperm donors have are unlikely to increase risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/.

Please click here for references.

This sheet is about exposure to benzocaine in pregnancy and while breastfeeding. This information is based on published research studies. It should not take the place of medical care and advice from your healthcare provider. 

What is benzocaine?

Benzocaine is a topical local anesthetic. Local anesthetics are used to numb specific areas of the body for short periods of time. Benzocaine can be found in some over the counter pain relieving products, including Anbesol®, Orabase®, Orajel®, Hurricaine®, and Topex®. 

Are topical medications absorbed through the skin?

In general, the skin serves as a good barrier, so only a small amount of the medication is likely to be absorbed with topical exposure. More of the active ingredients can be absorbed into the person’s blood stream if the skin is broken or irritated and when it is used over a large area of the skin. The more times the medication is applied on the skin, more can be absorbed. The amount of the medication that can reach the developing fetus by absorption through the skin is usually much lower than with medications taken by mouth. 

Benzocaine has not been well-studied for use in pregnancy. When used as directed, very little benzocaine is expected to be absorbed. That means it is unlikely that a significant amount would reach the developing fetus, and that the chance of birth defects or other pregnancy complications is expected to be low. 

I use benzocaine. Can it make it harder for me to get pregnant? 

It is not known if benzocaine use can make it harder to get pregnant. 

Does using benzocaine increase the chance of miscarriage?  

Miscarriage is common and can occur in any pregnancy for many different reasons. Studies have not been done to see if benzocaine can increase the chance of miscarriage. 

Does using benzocaine increase the chance of birth defects?

Birth defects can happen in any pregnancy for different reasons. Out of all babies born each year, about 3 out of 100 (3%) will have a birth defect. We look at research studies to try to understand if an exposure, like benzocaine, might increase the chance of birth defects in a pregnancy. Two reports did not find a greater chance of birth defects in children of women who reported using benzocaine in the first trimester of pregnancy.  

Does using benzocaine in pregnancy increase the chance of other pregnancy-related problems?

Studies have not been done to see if benzocaine can increase the chance of pregnancy-related problems such as preterm delivery (birth before week 37) or low birth weight (weighing less than 5 pounds, 8 ounces [2500 grams] at birth).  

Does using benzocaine in pregnancy affect future behavior or learning for the child?  

Studies have not been done to see if benzocaine can increase the chance of behavior or learning issues for the child. 

Breastfeeding while using benzocaine:

Benzocaine has not been well studied for use during breastfeeding. It is not recommended to apply benzocaine to the breasts or nipples because of the risk for a serious blood disorder if the baby ingests it. However, if benzocaine is not applied to these areas and the baby does not get it in their mouth, then topical benzocaine use is unlikely to affect a baby who is breastfed. Wash hands well after using benzocaine. Be sure to talk to your healthcare provider about all your breastfeeding questions.  

If a man takes benzocaine, could it affect fertility or increase the chance of birth defects?

Studies have not been done to see if benzocaine could affect a man’s fertility (ability to get a partner pregnant) or increase the chance of birth defects. In general, exposures that men have are unlikely to increase risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/.  

Please click here for references. 

This sheet is about exposure to Escherichia coli (E. coli) in pregnancy or while breastfeeding. This information is based on published research studies. It should not take the place of medical care and advice from your healthcare provider. 

What is Escherichia coli? 

Escherichia coli (E. coli) are a group of bacteria that naturally live in the intestines and vagina. There are many different types (strains) of E. coli bacteria. Most strains of E. coli are harmless to humans, but some can cause severe illness and infection. The most common ways people can get infected with E. coli are by:  

• Eating raw and unwashed fruits and vegetables that are contaminated with E. coli
• Drinking unpasteurized milk, fruit juices, or cider (pasteurization involves heating liquids to kill any bacteria contamination)
• Eating soft cheeses made from unpasteurized milk 
• Eating raw or undercooked meat 
• Drinking or swimming in infected water 
• Coming into contact with feces from infected farm or petting zoo animals 

How can I find out if I am infected with E. coli? 

Eating or drinking contaminated products might cause some people to have stomach cramps, fever, diarrhea, and/or vomiting. In severe cases, there can be bloody diarrhea, which requires medical care right away. Rarely, people with E. coli infection can develop a form of kidney failure called hemolytic uremic syndrome. This condition is serious and can lead to kidney damage and death.  

If you have symptoms of an E. coli infection, a healthcare provider will likely need a stool sample (feces) from you to test for E. coli. Most healthy people recover in a couple of days without the need for medications. If you are very ill your healthcare provider might prescribe medications including antibiotics.   

I have E. coli. Can it make it harder for me to get pregnant?

E. coli might increase the chance of inflammation in the reproductive tract and intestines, blockages in the fallopian tubes, or endometriosis (when tissue that usually lines the uterus grows outside the uterus). It might also affect fertilization (when the egg and sperm join to create an embryo). These issues can make it harder to get pregnant.

Does getting an E. coli infection increase the chance of miscarriage?

Miscarriage is common can occur in any pregnancy for many different reasons. Having an E. coli infection in the stomach or urine would not be likely to directly cause a miscarriage. An E. coli infection in the uterus might increase the chance of miscarriage. If you think you have an E. coli infection, talk with a healthcare provider right away so that you can be diagnosed and treated, if needed.  

Does getting an E. coli infection increase the chance of birth defects?

Birth defects can happen in any pregnancy for different reasons. Out of all babies born each year, about 3 out of 100 (3%) will have a birth defect. We look at research studies to try to understand if an exposure, like E. coli, might increase the chance of birth defects in a pregnancy. 

Studies have not been done to see if an E. coli infection can increase the chance of birth defects.  

Would having an E. coli infection increase the chance of other pregnancy-related problems? 

An E. coli infection in the vagina or uterus might increase the chance of pregnancy-related problems, such as preterm delivery (birth before week 37) or low birth weight (weighing less than 5 pounds, 8 ounces [2500 grams] at birth). There might be an increased chance for bleeding, preterm rupture of membranes (a breaking of the amniotic sac, which holds the amniotic fluid around the fetus), or stillbirth with severe E. coli infection. Sepsis (serious widespread bodily infection) during pregnancy has also been reported. Babies born with E. coli infections are sometimes very sick. 

Does having an E. coli infection in pregnancy affect future behavior or learning for the child?  

Studies have not been done to see if E. coli in pregnancy can increase the chance of behavior or learning issues for the child.  

How can I prevent getting an E. coli infection? 

To help prevent eating or drinking contaminated food and/or drink products: 

– Wash your hands with soap and water often. Always wash your hands after handling raw meat, using or cleaning the bathroom, changing diapers, handling dirty towels or linens, and touching animals or items in the animals’ setting.  

– Clean any surface touching raw meat with a disinfectant or bleach and water solution.  

– Cook meat thoroughly, especially ground beef, to 160°F. 

– Wash all vegetables and fruits before eating.  

– Drink only pasteurized (not raw) milk, juice and ciders.  

– Avoid swallowing water when swimming.  

Breastfeeding with an E. coli infection:

The E. coli bacteria do not get into the breast milk, so breastfeeding can be continued. There are important immune factors in breast milk that can help protect your baby from infections. Having diarrhea and other symptoms of E. coli infection might cause a decrease in your milk supply, so drink plenty of fluids. Make sure that you wash your hands well before you hold or breastfeed your baby. If your baby gets diarrhea or other symptoms of E. coli infection, contact your pediatrician right away. Be sure to talk to your healthcare provider about all your breastfeeding questions.   

If a man has an E. coli infection, can it affect fertility or increase the chance of birth defects?  

E. coli can be passed from person to person. Wash your hands often to help lower the chance of passing the infection to others in your home. E. coli infections of the genital tract might cause inflammation and problems with sperm. This could affect men’s fertility (ability to get a partner pregnant). For more information on paternal exposures in pregnancy, please see the MotherToBaby fact sheet here https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/. 

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