This sheet is about exposure to vaccines in pregnancy and while breastfeeding. This information should not take the place of medical care and advice from your healthcare provider.

What are vaccines?

Vaccines help protect you from diseases. Vaccines cause your body’s immune system to make antibodies against bacteria or viruses. Once these antibodies are made, your body has an easier job of stopping you from getting sick if you are exposed to these bacteria or viruses in the future. Most vaccines are given by injection (shot), but some can be taken orally (by mouth) or given with a nasal spray. Vaccines may require multiple doses and periodic boosters to provide the best protection.

What are the different types of vaccines?

A “live” vaccine is made from viruses or bacteria that have been weakened, but not killed. Given the small possibility that a live vaccine might cause the disease itself, live vaccines are not routinely given to women who are pregnant. Some “live” vaccines include the human papillomavirus (HPV) vaccine, measles, mumps, and rubella (MMR) vaccine, varicella (chickenpox) vaccine, live influenza vaccine (nasal flu vaccine), and certain travel vaccines like typhoid fever, and yellow fever.

An “inactivated” vaccine is made from viruses or bacteria that have been killed. An inactivated vaccine cannot cause the disease that it is given to prevent. Many vaccines are in the “inactivated” category including the injected influenza vaccine (flu shot) and the Tdap vaccine.

Other kinds of vaccines, such as messenger RNA (mRNA) and viral vector vaccines, use only certain material from the virus. These vaccines cannot cause the diseases they are given to prevent. Some of the COVID vaccines are in this category.

Are there any vaccines that are recommended in pregnancy?

It is recommended that women who are pregnant receive the seasonal inactivated influenza vaccine (flu shot). Women who are pregnant have a higher chance of developing serious complications from influenza (flu). Getting the seasonal inactivated influenza vaccine (flu shot) is the best way to protect yourself and your baby. You can get the influenza vaccine anytime during your pregnancy. For more information, please see the MotherToBaby fact sheet on the Seasonal Influenza Vaccine (Flu Shot) at https://mothertobaby.org/fact-sheets/seasonal-influenza-vaccine-flu-shot-pregnancy/.

The Tdap vaccine, which protects against whooping cough, is also recommended in pregnancy. You can get the Tdap vaccine anytime during pregnancy; but getting it during the third trimester (between weeks 27-36) may help protect your baby from illness after being born. For more information, please see the MotherToBaby fact sheet on the Tetanus, Diphtheria and Pertussis (Tdap) Vaccine at https://mothertobaby.org/fact-sheets/tetanus-diphtheria-pertussis-tdap-vaccine-pregnancy/.

The American College of Obstetricians and Gynecologists (ACOG), the American Society for Reproductive Medicine, and the Society for Maternal-Fetal Medicine all recommend that women who are pregnant be vaccinated against COVID-19. Women who are pregnant are at increased risk for severe illness and are more likely to have a preterm delivery (before 37 weeks) if they are infected with COVID-19 during pregnancy. For more information, please see the MotherToBaby fact sheets at https://mothertobaby.org/pregnancy-breastfeeding-exposures/covid-19/.

The Centers for Disease Control and Prevention (CDC) recommend the Abrysvo^TM RSV vaccine for women who are 32-36 weeks pregnant during RSV season. In most regions of the continental US, RSV season is from September to January. However, the timing and severity of RSV seasons can be different from year to year. For more information, please see the MotherToBaby fact sheets at https://mothertobaby.org/fact-sheets/respiratory-syncytial-virus-rsv-vaccine-abrysvo/.

The need for other vaccines during pregnancy will vary. Talk to your healthcare providers about the potential risks and benefits of any other vaccines you might need.

Are there any vaccines that should be avoided, if possible, in pregnancy?

Live vaccines are usually not given in pregnancy because of the small possibility that the woman who is pregnant or the developing baby could get the disease from the vaccine. However, if there is a high chance of exposure to an infectious agent that might be dangerous in pregnancy, the benefits of getting a live vaccine might outweigh any risks.

If you require a specific vaccine, contact MotherToBaby for more information. You can also refer to recommendations from the Centers for Disease Control and Prevention (CDC): https://www.cdc.gov/vaccines/pregnancy/index.html.

Is it ok for my child to be vaccinated while I am pregnant?

A child’s vaccine does not increase risk to other people around them, including women who are pregnant. In addition, if you have received the recommended vaccines during your lifetime, you are highly protected from becoming infected by others.

Can vaccines make it harder for me to become pregnant?

Limited studies on this question have not shown that vaccines would make it harder to become pregnant.

Do vaccines increase the chance of miscarriage?

Miscarriage can occur in any pregnancy. Many studies have not shown an increased chance of miscarriage.

Do vaccines increase the chance of birth defects?

Every pregnancy starts out with a 3-5% chance of having a baby with a birth defect. This is called the background risk. Studies on vaccines in pregnancy have not shown an increased chance of any pattern of birth defects.

Do vaccines increase the chance of other pregnancy complications?

Studies on vaccines have not shown that they cause pregnancy complications.

Does getting vaccines cause long-term problems in behavior or learning for the baby?

Based on the studies reviewed, vaccination during pregnancy is not expected to cause behavioral or learning issues for the baby.

What about thimerosal in vaccines?

Thimerosal is a preservative. It is found in very small amounts in some vaccines to help stop the growth of harmful bacteria in the vaccine. Large studies have not found thimerosal to cause any harmful effects. Women who are pregnant can receive vaccines containing thimerosal. The CDC answers questions about thimerosal here: https://www.cdc.gov/vaccine-safety/about/thimerosal.html.

Breastfeeding and getting a vaccine:

Studies have shown that most live and inactivated vaccines that are routinely given in the United States and Canada are not harmful during breastfeeding. Smallpox and yellow fever vaccines should not be given to a woman who is breastfeeding unless travel to certain countries is unavoidable and your healthcare provider determines that the benefits of the vaccine outweigh the risks. Be sure to talk to your healthcare provider about all your breastfeeding questions. You can also refer to recommendations from the CDC: https://www.cdc.gov/breastfeeding/breastfeeding-special-circumstances/vaccinations-medications-drugs/vaccinations.html.

If a man receives a vaccine, could it affect fertility (ability to get a woman pregnant) or increase the chance of birth defects in a woman’s pregnancy?

There is no evidence to suggest that vaccines affect the sperm or are transmitted to the developing baby through the semen. In general, exposures to fathers or sperm donors are unlikely to increase risks to a pregnancy. For more information, please see the MotherToBaby fact sheet on Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/.

Please click here for references.  

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

What is influenza?  

Influenza is commonly called the “flu.” It is an infection of the respiratory (breathing) tract. Symptoms of the flu are fever, headache, chills, muscle aches, cough, congestion (stuffy nose), runny nose, sore throat, and feeling tired (fatigue). The flu sometimes causes vomiting and diarrhea. The typical flu season lasts from October through May of each year, with most cases of flu happening between December and February. The types (strains) of viruses that cause seasonal influenza can change from year to year.  

Why is an influenza infection (the flu) a concern during pregnancy?  

The body can have a harder time fighting infections during pregnancy. The flu can cause serious problems in women who are pregnant, such as respiratory distress (severe breathing problems) and even death. Being very sick from the flu can also increase the chance of pregnancy complications, such as preterm delivery (birth before week 37). While having the flu during pregnancy does not appear to increase the chance of birth defects, some symptoms of the flu, such as a high fever, could affect the fetus. For more information, see the MotherToBaby fact sheet on Seasonal Influenza (the Flu) at https://mothertobaby.org/fact-sheets/seasonal-influenza-the-flu-pregnancy/.  

What is the seasonal influenza vaccine (flu shot)?  

The seasonal influenza vaccine lowers the chance of getting the flu or getting very sick from the flu. The vaccine is updated every year to protect against the flu strains that are expected to be common that season. It is necessary to get the influenza vaccine (flu shot) each year in order to stay protected against the flu strains that are currently active.  

The injected seasonal influenza vaccine is commonly known as the “flu shot”. The flu shot is an inactivated vaccine, which means it does not contain live flu virus. The flu shot cannot cause you to get the flu. Major medical groups recommend that women who are pregnant (whether in their first, second, or third trimester) get the flu shot.  

A nasal spray flu vaccine might also be available, but it is not recommended for use during pregnancy. Unlike the flu shot, the nasal spray vaccine contains a live, but weakened, flu virus (live attenuated influenza vaccine).  

I got the nasal spray flu vaccine before I knew I was pregnant. Should I be concerned?  

The nasal spray flu vaccine is a live attenuated vaccine (contains live but weakened flu virus). In general, it is suggested that women avoid live vaccines during pregnancy. However, accidentally getting the nasal spray vaccine while pregnant is not expected to increase the chance of birth defects or pregnancy complications. Talk with your healthcare provider in the unlikely case that you have any symptoms of the flu after receiving the nasal spray vaccine. 

One of my family members just got the nasal spray flu vaccine. Can I be around them while I am pregnant?  

Women who are pregnant can be in close contact with others who have gotten the nasal spray flu vaccine. 

When should I get the flu shot?  

The flu shot usually becomes available in August and is offered throughout flu season. Protection begins about 2 weeks after you get the flu shot and lasts at least 6 to 9 months. It is necessary to receive the seasonal flu shot each year to be protected during flu season. 

In general, September and October are good times to get the flu shot each year. Getting it in July or August can be considered for women who are in the 3rd trimester of pregnancy during those months. Talk with your healthcare provider about the best time for you to get the flu shot. 

I am pregnant and my due date is only a couple weeks away. Do I still need to get the flu shot? 

It is important to protect yourself from getting sick both during your pregnancy and after your baby is born. Getting the flu shot lowers the chance of getting sick and passing influenza to your baby. Getting vaccinated during pregnancy can also pass antibodies (protection) to the baby to help protect them from getting the flu during their first 6 months of life. This is important because infants cannot receive their own flu vaccine until 6 months of age.  

I just got the flu shot. How long should I wait before trying to get pregnant?  

There is no recommended waiting period before trying to get pregnant. The flu shot can be given at any time before or during pregnancy.  

Can getting the flu shot make it harder for me to get pregnant? 

Studies have not been done to see if getting the flu shot can make it harder to get pregnant. 

Does getting a flu shot increase the chance of miscarriage?   

Miscarriage is common and can occur in any pregnancy for many different reasons. Studies have shown that getting the flu shot during pregnancy does not increase the chance of miscarriage. 

Does getting the flu shot 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 the flu shot, might increase the chance of birth defects in a pregnancy. In the United States (U.S.), the flu shot has been given in pregnancy since the 1960s. Studies of thousands of women in the U.S. and around the world who have received the flu shot just before or during pregnancy have not found an increased chance of birth defects.  

Does getting the flu shot in pregnancy increase the chance of other pregnancy-related problems? 

Studies have not found a higher chance for 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) after getting the flu shot during pregnancy.  

Does getting the flu shot in pregnancy affect future behavior or learning for the child?  

Studies have not found an increased chance of behavior or learning issues for the child after getting the flu shot during pregnancy.   

Breastfeeding after getting the flu vaccine: 

Major medical groups state that women who are breastfeeding can receive the flu shot or nasal spray influenza vaccine. The combination of receiving the influenza vaccination during pregnancy and then breastfeeding your baby can reduce the chances for your baby to get influenza by up to 60%. Be sure to talk to your healthcare provider about all your breastfeeding questions.  

If a man gets the flu shot, could it affect his fertility or increase the chance of birth defects?

There is no evidence that getting the flu shot or nasal spray influenza vaccine would affect a man’s fertility (ability to make healthy sperm) or increase the chance of birth defects. When everyone who is around the baby after delivery is vaccinated against the flu, it helps protect the baby from being exposed to the flu virus. 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 methotrexate in pregnancy and while breastfeeding. This information is based on available research studies. It should not take the place of medical care and advice from your healthcare provider. 

What is methotrexate?

 

Methotrexate is a medication that has been prescribed to treat many conditions, including cancer and autoimmune conditions like rheumatoid arthritis https://mothertobaby.org/fact-sheets/rheumatoid-arthritis/, lupus https://mothertobaby.org/fact-sheets/lupus-pregnancy/ and psoriasis https://mothertobaby.org/fact-sheets/psoriasis-and-pregnancy/. Some brand names for methotrexate are: Otrexup®, Trexall®, Rheumatrex®, and Rasuvo®.  

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. 

The product label for methotrexate recommends women who are pregnant not use this medication unless it is being used for cancer treatment. However, the benefit of using methotrexate might outweigh possible risks. Your healthcare provider can talk with you about using methotrexate and what treatment is best for you.  

Methotrexate lowers the body’s ability to use folic acid. During pregnancy, folic acid is important for the growing fetus. If you have recently stopped taking methotrexate and are planning to get pregnant, talk with your healthcare provider about taking a folic acid supplement and what dose you should take. More information on folic acid can be found in our fact sheet here: https://mothertobaby.org/fact-sheets/folic-acid/.  

I am taking methotrexate, but I would like to stop taking it before getting pregnant. How long does the drug stay in my body?

 

The time it takes the body to metabolize (process) medication is not the same for everyone. In healthy non-pregnant adults, it takes up to 1 week, on average, for most of the methotrexate to be gone from the body. Certain medications might affect how long methotrexate takes to clear from the body. Also, having reduced kidney function or other conditions that lead to extra body fluid might cause methotrexate to clear more slowly from the body. 

How long do I need to wait to get pregnant after I stop taking methotrexate?

 

Some healthcare providers have suggested waiting 1 to 3 months after stopping methotrexate to make sure the medication has been cleared from the body. The drug label recommends waiting 3 to 6 months after stopping the medication. However, there are no reports of methotrexate-related birth defects in babies born to women who stopped taking methotrexate any time before conception (when the egg is fertilized by the sperm).  

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

 

One study on women undergoing fertility treatment found that those who had been treated with methotrexate for ectopic pregnancy (when a fertilized egg implants and grows outside the uterus) within the last 6 months had a lower number of eggs. Those who were treated with methotrexate longer than 6 months ago did not have a lower number of eggs. This suggests that any effect of methotrexate on the number of eggs might be temporary. Other studies have not shown a higher chance of problems with fertility (ability to get pregnant) with the use of methotrexate.  

Does taking methotrexate increase the chance of miscarriage?  

 

Miscarriage is common and can occur in any pregnancy for many different reasons. Small studies looking at women who used methotrexate to treat rheumatic diseases have reported an increased chance of miscarriage.  

Does taking methotrexate 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 methotrexate, might increase the chance of birth defects in a pregnancy.  

Taking methotrexate in the first trimester could increase the chance of a specific pattern of birth defects of the head, face, limbs, and bones. It is not clear if methotrexate could cause other kinds of birth defects. Heart defects and oral clefts (cleft lip and/or cleft palate) have been reported in some infants exposed to methotrexate during pregnancy; however, there is not enough information to know if methotrexate could have caused these birth defects.  

Not all babies exposed to methotrexate during pregnancy will have birth defects. A published review of studies reported no increase in birth defects among infants born to 101 women with rheumatoid arthritis taking 5 to 25mg of methotrexate per week in the first trimester.  

Although birth defects could occur with exposure to methotrexate any time in the first trimester, limited evidence suggests that methotrexate-related birth defects are more likely to occur if a pregnancy is exposed to 10 mg or more of methotrexate per week between 6 and 8 weeks after conception (8 to 10 weeks after the first day of the last menstrual period).  

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

 

Poor growth of the fetus (being smaller than expected for the weeks of pregnancy) has been reported in pregnancies affected by methotrexate-related birth defects.   

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

 

Developmental delay, learning problems, and intellectual disability have been reported in some children who have birth defects related to methotrexate exposure during pregnancy. 

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

 

Prenatal ultrasounds can be used to screen for some birth defects, such as birth defects of the head, face, limbs, bones, heart, lips, and palate. Ultrasound can also be used to track the growth of the pregnancy. Talk with your healthcare provider about any prenatal screenings or testing that are available to you. There are no tests available during pregnancy that can tell how much effect there could be on future behavior or learning. 

Breastfeeding while taking methotrexate: 

 

Methotrexate passes into breast milk in small amounts. The product label for methotrexate recommends women not use this medication while breastfeeding. But the benefit of using methotrexate and breastfeeding might outweigh possible risks. Your healthcare providers can talk with you about using methotrexate and what treatment is best for you. Some healthcare providers recommend not breastfeeding while receiving high doses of methotrexate (such as those used to treat cancer) and for 1 week after receiving the last dose. 

Testing of breast milk samples from women exposed to methotrexate at lower doses found low levels of methotrexate in the milk. As a result, some experts suggest that weekly low-dose methotrexate is unlikely to cause problems for the breastfed infant. If a woman uses low-dose methotrexate while breastfeeding, it is suggested that the baby’s blood count be monitored. Be sure to talk to your healthcare provider about all your breastfeeding questions.  

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

 

The product label for methotrexate states that men should use effective contraception (to prevent pregnancy) while on methotrexate and for 3 months after taking the final dose. Low sperm count has been seen in some men using methotrexate. Most of these men were using high doses of methotrexate to treat cancer, as well as other medications. Sperm levels returned to normal over time after the medication was stopped. Having low sperm count can affect a man’s fertility (ability to get a woman pregnant). Men who need to take methotrexate as part of cancer treatment can consider banking sperm before treatment. Studies looking at men taking lower doses of methotrexate to treat other health conditions have not agreed on whether these lower doses could affect a man’s fertility during the time of treatment.   

Studies have not found a higher chance of birth defects in the children of men taking methotrexate around the time of conception. In general, exposures that men 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 dextroamphetamine 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 dextroamphetamine? 

Dextroamphetamine, also known as dexamphetamine or d-amphetamine, is a prescription stimulant that belongs to a group of medications called amphetamines. Dextroamphetamine has been used to treat attention deficit hyperactivity disorder (ADHD), narcolepsy (a condition causing extreme daytime sleepiness), and some mental health conditions. Some brand names are Dexedrine®, Dexedrine Spansules®, Dextrostat®, Liquadd®, ProCentra®, and Zenzedi®.  

Lisdexamfetamine (Vyvanse®) is a medication that has been used to treat ADHD and binge eating disorders. In the body, lisdexamfetamine breaks down into dextroamphetamine. Information about dextroamphetamine in pregnancy can be used to help understand possible effects of lisdexamfetamine. Dextroamphetamine can be combined with amphetamine salts to create mixed amphetamine salts, a medication known by brand name Adderall®. For more information on Adderall®, please see our fact sheet at https://mothertobaby.org/fact-sheets/dextroamphetamine-amphetamine-adderall/. Dextroamphetamine is different from methamphetamine. Please see our fact sheet on methamphetamine at https://mothertobaby.org/fact-sheets/methamphetamine/. 

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. Stopping this medication suddenly can cause withdrawal. It is not known if or how withdrawal may affect a pregnancy. If you are going to stop using this medication, your healthcare providers may talk with you about slowly reducing your dose over time. Your healthcare providers can talk with you about the benefits of treating your condition and the risks of untreated illness during pregnancy. 

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

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

Does taking dextroamphetamine increase the chance of miscarriage? 

Miscarriage is common and can occur in any pregnancy for many different reasons. Studies that looked at pregnancies exposed to prescribed amphetamines as a group have not shown a consistent increase in the chance of miscarriage. One study that included 130 pregnancies exposed to dextroamphetamine did not find a clear increase in miscarriage. A study found that over 500 women who continued dextroamphetamine throughout pregnancy were less likely to have a threatened miscarriage (bleeding and/or cramping) than women who stopped the medication in pregnancy.  

Does taking dextroamphetamine 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 dextroamphetamine, might increase the chance of birth defects in a pregnancy. Studies looking at women who take dextroamphetamine as prescribed have not reported an increased chance of birth defects.  

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

A study of over 500 women who took dextroamphetamine in pregnancy found no significant increase in low birth weight (babies weighing less than 5 pounds, 8 ounces [2,500 grams] at birth) or preterm delivery (birth before week 37) when compared to women with ADHD who stopped their medication.  

Larger studies of pregnancies exposed to prescribed amphetamines have shown mixed results. One study reported an increased risk of preterm delivery, while two others found no such link. Some studies reported a higher risk of high blood pressure and preeclampsia (high blood pressure and problems with organs, such as kidneys), whereas others did not. It is also important to note that conditions treated with amphetamines, such as ADHD, may increase the chance of preterm delivery or high blood pressure during pregnancy. 

Using amphetamine medications at higher doses or more often than prescribed, or using them without a prescription, can increase the chance of poor growth (babies born small and/or with small head size), low birth weight, and preterm delivery. These studies often included pregnancies that might have had other risk factors that can increase the chance of these pregnancy-related problems.  

I need to take dextroamphetamine during my pregnancy. Will it cause withdrawal symptoms in my baby after birth? 

Withdrawal has not been reported in the newborns of women who are taking dextroamphetamine as prescribed by their healthcare providers. Using amphetamine medications at higher doses or more often than prescribed, or using them without a prescription, can cause temporary symptoms in newborns soon after birth. These symptoms are sometimes referred to as withdrawal. They can include jitteriness, sleepiness, and trouble breathing at the time of birth. It is important that your healthcare providers know about your exposures in pregnancy so that if symptoms occur, your baby can get the care that is best for them.  

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

No studies have looked at future behavior or learning in children after exposure to dextroamphetamine alone. A study looking at over 7000 pregnancies in which the mother was prescribed dextroamphetamine-amphetamine mixed salts in the second half of pregnancy showed no increased chance of neurodevelopmental conditions, including autism and ADHD. Another study looking at over 300 pregnancies prescribed amphetamines as a group showed no increased chance of neurodevelopmental conditions compared to those who stopped their medication before getting pregnant. Prescription-based studies cannot tell us if the woman who filled the prescription took the medication during their pregnancy.  

Breastfeeding while taking dextroamphetamine: 

When dextroamphetamine is taken as directed, it passes into breast milk in small amounts. A small study of 4 infants who were breastfed by mothers taking dextroamphetamine for ADHD found no problems in the infants’ health and growth up to 6 to 10 months of age. Another study that included 13 infants breastfeed by mothers taking amphetamine medication found no problems with neurodevelopment at the average age of 18 months. If you suspect the baby has any symptoms such as trouble eating, trouble sleeping, extra sleepiness, or irritability, contact the child’s healthcare provider. 

The product labels for some dextroamphetamine products recommend women who are breastfeeding not use these medications. But the benefits of using dextroamphetamine and breastfeeding might outweigh possible risks. The product labels also suggests that large doses of dextroamphetamine could lower milk supply in women who are newly breastfeeding. However, there are no clear reports showing that this happens. Your healthcare providers can talk with you about using dextroamphetamine and what treatment is best for you. Be sure to talk to your healthcare provider about all your breastfeeding questions. 

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

Men’s fertility (ability to make healthy sperm) may be impacted by amphetamine medications. One study suggested using these medications may lower the amount of sperm that is made. Studies have not been done to see if dextroamphetamine specifically could affect fertility 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 having seasonal influenza in a pregnancy or while breastfeeding. This information is based on research studies. It should not take the place of medical care and advice from your healthcare provider. 

What is influenza?

Influenza is an infection of the respiratory (breathing) tract. It is often called the “flu”. The symptoms of influenza are fever, headache, chills, muscle aches, coughing, congestion, runny nose, and sore throat. Influenza sometimes causes vomiting and diarrhea. 

The typical flu season is from October through May of each year and usually has the most activity between December and February. The types (strains) of viruses that cause seasonal influenza can change each year.  

Is the flu contagious? How does the virus spread?

Yes, the flu is very contagious. The virus is spread through contact with respiratory droplets from the nose and mouth of infected individuals a day before they feel sick until their symptoms are gone. When people cough, sneeze, or talk, droplets containing the virus are spread through the air. These droplets can travel up to 6 feet from the person and can enter the mouth/noses of people nearby or land on surfaces, such as tables and toys. 

The time between exposure to a flu virus and the start of symptoms (incubation period) is between 1 and 4 days. Adults who have the flu are most contagious in the first 3 to 4 days after their illness begins. Children can be infectious for a longer period. 

Can having the flu make it harder for me to become pregnant?

It is not known whether having the flu can make it harder to become pregnant. 

Does having the flu increase the chance of miscarriage?

Miscarriage is common and can occur in any pregnancy for many different reasons. Some studies suggest a higher chance for pregnancy loss while other studies do not.  Based on the available data, it is not known if the flu will increase the chance for miscarriage.  

Does having the flu during pregnancy 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 being sick with influenza, might increase the chance of birth defects in a pregnancy. The influenza virus itself has not been proven to cause birth defects.  

Influenza infections can cause fever. A high fever in the first trimester can increase the chance of certain birth defects. Acetaminophen has been a recommended medication to reduce fever in pregnancy. If you get sick with the flu or any other illness and develop a fever, talk with your healthcare provider to confirm if taking acetaminophen is okay for you. For more information about fever and pregnancy, see the related fact sheet at https://mothertobaby.org/fact-sheets/hyperthermia-pregnancy/, and for information on acetaminophen, please see https://mothertobaby.org/fact-sheets/acetaminophen-pregnancy/.  

Would having the flu increase the chance of other pregnancy related problems?

Being pregnant can increase the chance of developing serious complications from the flu compared to persons with the flu who are not pregnant. Some of the serious complications reported include respiratory distress (severe breathing problems) and may require being hospitalized. If a woman who is pregnant becomes very sick from the flu, this can also increase the chance of pregnancy complications, such as preterm delivery (birthbefore week 37). It is important to talk with your healthcare provider if you are pregnant and have symptoms of the flu. 

Does having the flu in pregnancy affect future behavior or learning for the child

Studies on long-term problems have looked at whether having the flu in pregnancy could lead to later mental health conditions like schizophrenia. These studies have not been able to prove that having the flu during pregnancy will increase the chance for the baby to later develop a mental health condition.  

How can I protect myself and my baby?

The most important thing you can do for you and your baby is to get the flu shot. Because women who are pregnant could have a greater chance for complications from the flu, individuals who are pregnant (whether in their first, second, or third trimester), or planning to become pregnant, should get the injected seasonal flu shot. A nasal-spray influenza vaccine is also available. This vaccine contains a live but weakened virus. The nasal-spray influenza vaccine is not recommended during pregnancy. For more information about the flu vaccines during pregnancy, see the MotherToBaby fact sheet on the Seasonal Influenza Vaccine (Flu Shot) at https://mothertobaby.org/fact-sheets/seasonal-influenza-vaccine-flu-shot-pregnancy/.  

In addition to getting the flu shot, be sure that you and others around you are doing the following to help prevent spread of the flu: 

• Wash your hands with soap and water often, or use an alcohol-based hand sanitizer if soap and water is not available 

• Do not touch your eyes, nose, or mouth 

• Try to avoid close contact with people who are sick 

• Cover your nose and mouth when you cough or sneeze and ask those around you to do the same. 

What should I do if I get sick?

If you have flu-like symptoms, call your healthcare provider right away. Your healthcare provider may recommend antiviral medications to lessen the symptoms of the flu and to reduce the chance of serious illness. These medications work best if taken early in the course of the illness. For more information about antiviral medications, see the MotherToBaby related fact sheet at https://mothertobaby.org/fact-sheets/antiviral-medications-treatprevent-influenza-the-flu-pregnancy/. If you are sick, stay home and avoid close contact with others to prevent passing the flu to other people.  

Breastfeeding while I have the flu.

The Centers for Disease Control and Prevention (CDC) encourages women to continue to breastfeed even if they have the flu. There are antibodies in breast milk that might help prevent a baby from getting sick with the flu. Be sure to talk to your healthcare provider about all your breastfeeding questions. 

While sick, it is important to try to protect the baby from getting sick. Wash hands with soap and water before holding your baby. Avoid coughing or sneezing on your baby and consider wearing a mask to help prevent infecting your baby. Cover your mouth/nose with a tissue when you cough or sneeze, then throw away the tissue and wash your hands. While you are ill, you may want to consider having someone who is not sick help you care for your baby. The CDC has more information on the flu and breastfeeding at https://www.cdc.gov/breastfeeding/breastfeeding-special-circumstances/maternal-or-infant-illnesses/influenza.html. If you think your baby has symptoms of the flu, contact your child’s healthcare provider.  

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

Illnesses that cause fever, such as the flu, might cause a temporary reduction in the movement or number of sperm which could make it harder to get a partner pregnant during that time. Close contact may not be recommended when you have the flu to try to avoid passing the flu to your partner. In general, exposures that fathers or sperm donors have are unlikely to increase risks to a pregnancy. For more information, please see the fact sheet Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/ 

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