This sheet is about exposure to lice and scabies in a 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 are lice? 

Lice are small wingless insects, the size of a sesame seed, that can live on the body or in hair. Head lice are the most common type of lice. Lice hatch out of eggs that are called nits. You can sometimes see adult lice crawling through hair or on the scalp. You can also look for the nits attached to the hair close to the scalp. Lice usually cause itching and rashes, but head lice are not known to spread disease. 

You can get lice by touching someone who has lice, mainly from head-to head-contact. It might also be possible to get lice from sharing an infected person’s clothing, towels, combs, brushes, or other personal items. Lice crawl; they cannot jump or fly. Lice cannot live more than 2-4 days off the human body. Lice cannot be passed from you to the fetus while you are pregnant. Lice itself is not expected to increase risks to a pregnancy. 

What is scabies? 

Scabies is the spread of a small insect, called a mite, on the skin. Mites are so small they usually cannot be seen with the naked eye. The mites burrow into the skin. Scabies causes itching all over the body and it is usually most severe at night. You might see a rash or raised S-shaped lines on the skin. Your healthcare provider can tell if you have scabies by taking a scraping of the skin and looking for the mites or their eggs under a microscope.    

You can get scabies by touching someone who has scabies, but usually you must be in physical contact for a long time (more than just a quick handshake). You can also get scabies by sharing clothes, towels, or bedding with someone who has scabies. Scabies cannot be passed from you to the fetus while you are pregnant. Scabies itself is not expected to increase risks to a pregnancy. 

How can I lower the chance of getting lice or scabies? 

If someone in your household or other close contact has lice or scabies, it is possible for you to get them too. To prevent this from happening, the person that has lice or scabies needs to be treated as soon as possible. All clothing and bed linens that the person wore or came in contact with in the two days before treatment should be dry-cleaned or washed in hot water and dried in high heat for at least 20 minutes, and/or removed from body contact for at least 72 hours. The person’s combs and brushes should be soaked in rubbing alcohol or a disinfectant for one hour. If they are heat resistant, they can be soaked in hot water (at least 130 degrees) for 5-10 minutes. Floors, furniture, car seats and other fabric covered items should be vacuumed.  

How are lice treated?

Lice can be treated with either over-the-counter or prescription lice medication. Over-the-counter lice medications are usually cream rinses for hair (shampoos). Usually, they contain either permethrin or pyrethrin and piperonyl butoxide. There are different brands available at the drugstore, and new medicines are coming onto the market. If over-the-counter treatments fail to kill the lice, you should see a healthcare provider about getting a prescription lice medication. Some prescription medications for lice are malathion, benzyl alcohol, spinosad, and ivermectin hair rinses. Talk with your healthcare provider about which treatment is right for you. 

How is scabies treated?

Scabies can be treated by several prescription medications. Some creams and lotions that treat scabies might include permethrin cream, benzyl benzoate, crotamiton lotion, and sulfur in petrolatum ointment. Lindane is sometimes used to treat scabies if other treatments fail. If all treatments fail, medication called ivermectin might be prescribed to treat scabies. Talk with your healthcare provider about which treatment is right for you.  

Does taking medications to treat lice or scabies 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 medications to treat lice or scabies, might increase the chance of birth defects in a pregnancy.  

Most of the creams, lotions, and shampoos used to treat scabies and lice are not expected to increase the chance for birth defects. The amount of the medications absorbed through the skin after topical use is typically low. Lindane, however, is generally avoided in pregnancy because, if not used correctly, it can cause toxic side effects for the person using it. The limited information regarding the use of oral ivermectin (when taken by mouth) has not suggested an increased chance of problems during pregnancy. Since it is not well studied for use in pregnancy, other, better studied treatments might be recommended first.  

Breastfeeding while using lice and scabies medications: 

The Centers for Disease Control and Prevention (CDC) has previously suggested that breastfeeding women use pyrethrin or permethrin to treat lice and scabies, because the amount absorbed after topical use is expected to be low. Ivermectin passes into breast milk in small amounts. Lindane is usually avoided during breastfeeding because it is not recommended for use in young children. Malathion is not well studied in breastfeeding. If you are breastfeeding, talk to a healthcare provider or contact MotherToBaby about your specific medication. Be sure to talk to your healthcare provider about all your breastfeeding questions. 

If a man has lice or scabies, can it make it affect his fertility or increase the chance of birth defects?  

Having lice or scabies is not expected to affect a man’s fertility (ability to get a person pregnant) or increase the chance of birth defects. Lice or scabies cannot be directly to the fetus during pregnancy but can spread from one person to the other through sexual intercourse. Any household member that has lice or scabies should be treated to prevent spreading to other household members. It is not known if medications used to treat lice or scabies can affect a man’s fertility. 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/. 

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This sheet is about exposure to iodine 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 iodine?

Iodine is a naturally occurring element. It can be found in some foods, supplements, medications, and topical disinfectants. The body uses iodine to make thyroid hormones. The thyroid gland cannot work properly without the right amounts of iodine. People who are pregnant or nursing need more iodine than most other people do. The Recommended Dietary Allowance (RDA) for iodine is between 220 micrograms (mcg) and 290 mcg in pregnancy, and is 290 mcg when breastfeeding.

How do I know if I am getting enough iodine?

An easy way to get iodine in your diet is to use iodized salt when cooking or seasoning foods. You can also take a daily prenatal vitamin that contains at least 150 mcg of iodine if you are pregnant or planning to get pregnant. Be sure to check the label on your prenatal vitamins since some do not contain iodine. Potassium iodide is the preferred source of iodine for prenatal vitamins.

If you have a known thyroid disease or concerns about your thyroid, talk with your healthcare provider before taking iodine supplements.

Your healthcare provider might test your thyroid hormone levels during pregnancy. People with normal thyroid hormone levels who are taking supplements containing 150 mcg of iodine daily are expected to have good iodine levels.

What can cause low levels of iodine in the body?

Low levels of iodine in the body (iodine deficiency) can be caused by not getting enough iodine through foods or supplements. For people who already have low iodine, eating a diet high in foods that reduce iodine levels, such as cassava or cabbage, can lower their iodine even more.

Does having low iodine levels make it harder for me to get pregnant?

Not having enough iodine in the body can cause low levels of thyroid hormone (hypothyroidism). People with low levels of thyroid hormone can have a harder time getting pregnant.

Does having low iodine levels increase the chance of miscarriage?

Miscarriage is common and can occur in any pregnancy for many different reasons. Low levels of iodine in the body can cause low levels of thyroid hormone (hypothyroidism). People with low levels of thyroid hormone during pregnancy have an increased chance of miscarriage.

Does having low iodine levels 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 or condition, like low iodine levels (iodine deficiency) might increase the chance of birth defects in a pregnancy.

Having low levels of iodine during pregnancy is not expected to increase the chance of birth defects above the background risk.

Would having low iodine levels increase the chance of other pregnancy related problems?

Low levels of iodine in the body can cause low levels of thyroid hormone (hypothyroidism). Low levels of thyroid hormone during pregnancy might lead to poor growth of the baby and increase the chance of preterm delivery (birth before week 37). Some studies suggest that severe iodine deficiency (very low levels of iodine) could increase the chance of stillbirth or of infant death around the time of delivery. Severe iodine deficiency during pregnancy can increase the chance of hearing problems in the child. However, it is very rare for people in developed countries (such as the United States) to have severe iodine deficiency.

Does having low iodine levels affect future behavior or learning for the child?

It is possible that mild iodine deficiency during pregnancy could lead to problems with learning and behavior, but this has not been clearly proven in studies. Severe iodine deficiency during pregnancy can increase the chance of serious learning problems in the child.

What can cause high levels of iodine in the body?

High levels of iodine in the body can be caused by having a thyroid condition, taking a medication that has a high amount of iodine in it, or applying topical antiseptics that contain iodine to the skin or vagina. It is hard to reach very high levels of iodine from diet alone unless a person very often eats foods that contain a lot of iodine (such as fish, seaweed, and dairy products).

Does having high levels of iodine cause pregnancy-related problems?

Very high levels of iodine in the body can cause high levels of thyroid hormone (called hyperthyroidism). Hyperthyroidism can lead to medical problems for both the person who is pregnant and the fetus. The fetus could develop low levels of thyroid hormone (hypothyroidism), or their thyroid gland could grow too large (called a goiter). Some goiters can cause breathing or swallowing problems in newborns.

Breastfeeding and iodine:

Babies receive all their iodine (for making their own thyroid hormone) from their diet, including breast milk. The amount of iodine in breast milk depends on the amount of iodine taken in by the person who is breastfeeding. That means it is important to get enough iodine while breastfeeding a child.

The Recommended Dietary Allowance (RDA) for iodine during breastfeeding is 290 mcg daily. Some of this amount will come from foods. People who follow vegan or vegetarian diets might get less iodine from foods they eat. The American Thyroid Association recommends that anyone who is breastfeeding a child should continue to take a daily supplement that contains 150 mcg of iodine to help them reach the recommended intake. Talk with your healthcare provider and your baby’s pediatrician about how much iodine is right for you and your baby.

It is not recommended to get more than 500 mcg to 1100 mcg of iodine per day for long periods of time while breastfeeding. If a baby gets too much iodine in the breast milk, it can cause problems with their thyroid gland. Be sure to talk to your healthcare provider about all your breastfeeding questions.

If a man has high or low iodine levels, can it affect his fertility or increase the chance of birth defects?

One small study in men reported that those who had high iodine levels also had some changes in their sperm. It is not clear if the changes were due to the iodine levels or other factors. It is also not clear if the changes had long-term effects on their fertility (ability to get a woman pregnant). Studies have not been done to see if high or low iodine levels in men could increase the chance of birth defects above the background risk. 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/.

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This sheet is about exposure to melatonin 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 melatonin? 

Melatonin is a hormone made by the body that helps with the natural sleep-wake cycle (circadian rhythm). Melatonin is made by the body mostly during periods of darkness. During pregnancy, the body typically makes more melatonin. Studies suggest that melatonin levels are highest in the third trimester of pregnancy and are expected to return to previous levels after delivery. 

Melatonin is also available as a supplement sold over the counter. Taking melatonin supplements during pregnancy has not been well studied. In general, many supplements are not recommended for use during pregnancy unless your healthcare provider has prescribed them to treat a medical condition. This is because supplements are regulated differently than prescription medications and are not well-studied for use in pregnancy. For more detail on supplements, please see our fact sheet at https://mothertobaby.org/fact-sheets/herbal-products-pregnancy/.  

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

One older study found that daily doses of melatonin in the 75–300 mg range affected ovarian function in women by lowering levels of key hormones needed to conceive a pregnancy. This could make it harder to get pregnant.  

Does taking melatonin increase the chance of miscarriage?  

Miscarriage is common and can occur in any pregnancy for many different reasons. Studies that have looked at melatonin use for infertility have not shown an increased chance of miscarriage.  

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

It is not known if taking melatonin can increase the chance of birth defects. The few studies that have been done in humans looking at the use of melatonin have not suggested an increased chance of birth defects.  

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

Studies have not been done to see if taking melatonin supplements can increase the chance of low birth weight (weighing less than 5 pounds, 8 ounces [2,500 grams] at birth). 

One study, among women with Polycystic Ovary Syndrome (PCOS) [now called Polyendocrine Metabolic Ovarian Syndrome (PMOS)] who were given 3 mg of melatonin along with other medication, suggested that melatonin in combination with other treatment might help improve pregnancy outcomes, including lowering the risk of preeclampsia (high blood pressure and problems with organs, such as the kidneys), fetal growth restriction, preterm birth (before 37 weeks of pregnancy), and stillbirth among women with PMOS.  

Studies on melatonin use during C-section delivery have shown mixed results, with some studies reporting reduced blood loss and another finding no difference. 

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

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

Breastfeeding while taking melatonin: 

Melatonin made by the body is present in breastmilk in higher amounts at night. Taking melatonin supplements while breastfeeding has not been well studied. Melatonin has been given to infants in doses higher than those expected in breastmilk after maternal supplementation. There is one case report of an infant with a bleeding problem while being breastfed by a woman who was taking a supplement with melatonin and valerian. This bleeding problem has not been reported in other cases, including when melatonin was given directly to infants.  

Talk with your healthcare provider before taking any supplements while breastfeeding. Many supplements are not recommended for use during breastfeeding because they are regulated differently than prescription medications and are not studied for use in breastfeeding. Be sure to talk to your healthcare provider about all your breastfeeding questions. 

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

It is not known if melatonin supplements could affect male fertility (ability to make healthy sperm) 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 benralizumab 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 benralizumab?

Benralizumab is a monoclonal antibody (man-made proteins that work like natural antibodies in the body to boost the immune system). It belongs to a group of medications known as biologics and is given by an injection under the skin (subcutaneous). Benralizumab has been used to treat patients with severe eosinophilic asthma. It is sold under the brand name Fasenra®.

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.

Asthma that is untreated or not well controlled can increase the chance of complications for both the woman who is pregnant and the pregnancy. For more information about asthma, please see the MotherToBaby fact sheet at https://mothertobaby.org/fact-sheets/asthma-and-pregnancy/.

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

Studies have not been done to see if taking benralizumab can make it harder to get pregnant.

Does taking benralizumab 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 benralizumab can increase the chance of miscarriage.

Does taking benralizumab 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 benralizumab, can increase the chance of birth defects in a pregnancy.

Studies looking at use of benralizumab during human pregnancy have not been done. There is 1 report of a woman with hypereosinophilic syndrome, who became pregnant while receiving benralizumab and delivered a healthy baby. Animal studies did not show an increase in birth defects after exposure to benralizumab during pregnancy.

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

Studies have not been done to see if benralizumab 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).

There is a theoretical (not proven) concern that monoclonal antibodies could affect a baby’s immune system (the body’s ability to fight off infections). Animal studies have not reported any changes to the immune systems after exposure to benralizumab during pregnancy.

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

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

Can my baby receive live vaccines before one year of age if I take benralizumab while pregnant?

Since benralizumab might suppress the immune system of the person taking it, there is a theoretical (not proven) concern that the same thing could happen to the baby if they are exposed during pregnancy. Live vaccines contain a small amount of live virus, so there is a small chance that a person could get the infection from the vaccine. If someone has a weakened immune system, they might be more likely to develop an infection from the vaccine.

Most vaccines given in the first 6 months of life are inactivated vaccines. Inactivated vaccines do not contain any live virus, so they cannot cause the disease they protect against. If possible, live vaccines are avoided in the first year of life, in case the child’s immune system does not respond to the vaccine. In the United States, rotavirus is the only live vaccine routinely given in the first year of life, because it is the best way to protect infants against rotavirus.

Research that suggests that babies exposed to biologics in pregnancy build antibodies as expected and have the same typical response to vaccines as babies not exposed to these medications. Talk with your healthcare provider and your child’s pediatrician about your exposure to benralizumab during pregnancy. They can talk with you about the vaccines your child should receive and the best time for your child to receive them.

Breastfeeding while taking benralizumab:

Benralizumab has not been well studied for use during breastfeeding. It is expected to pass into breast milk in small amounts. Benralizumab is not well absorbed by the gut, so any of the medication that gets into breast milk would be unlikely to enter the child’s system. Be sure to talk to your healthcare provider about all your breastfeeding questions.

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

Studies have not been done to see if benralizumab could affect men’s fertility (ability to get a woman pregnant) or increase the chance of birth defects. 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 relating to Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/.

MotherToBaby is currently conducting a study looking at asthma and the medications used to treat asthma in pregnancy. If you would like to learn more about this study, please call 1-877- 311-8972 or visit https://mothertobaby.org/join-study/.

Please click here for references.

This sheet is about having multiple sclerosis 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 multiple sclerosis?

Multiple sclerosis (MS) is a condition that affects the brain, spinal cord, and optic nerves and how they communicate with the rest of the body. Symptoms can include loss of balance, numbness, vision problems, muscle spasms, tingling, mood changes, memory problems, pain, fatigue, and/or paralysis. Symptoms can vary from person to person and might be temporary or long-lasting.

I have multiple sclerosis. What should I talk about with my healthcare team before I get pregnant?

It is important to talk to your healthcare team (including your obstetrician, rheumatologist, and neurologist) about plans for treating your condition before and during pregnancy, during delivery, and after delivery. If possible, talk with your healthcare team before getting pregnant. If your pregnancy is unplanned, contact your healthcare providers as soon as you find out you are pregnant.

Things to talk about with your healthcare team include:

• Ways to monitor your pregnancy and your disease symptoms
• Any medications you should take during pregnancy
• Getting any necessary vaccines before and during pregnancy. Many vaccines can be given in pregnancy. For more information, please see the MotherToBaby fact sheet on vaccines at https://mothertobaby.org/fact-sheets/vaccines-pregnancy/.
• Any other questions or concerns you have

I have multiple sclerosis. Can it make it harder for me to get pregnant?

Two studies reported lower rates of fertility (ability to get pregnant) in women with multiple sclerosis compared to those in the general population. Some women with multiple sclerosis might experience sexual dysfunction, such as a decreased desire to have sex or increased vaginal dryness. These symptoms might make it harder to get pregnant.

Does having multiple sclerosis increase the chance of miscarriage?

Miscarriage is common and can occur in any pregnancy for many different reasons. One study found that the rate of miscarriage among women with multiple sclerosis is similar to the rates of miscarriage in the general population.

Does having multiple sclerosis 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 multiple sclerosis, might increase the chance of birth defects in a pregnancy. Having multiple sclerosis is not expected to increase the chance of birth defects.

Does having multiple sclerosis increase the chance of other pregnancy-related problems?

Having multiple sclerosis has not been shown to increase the chance of pregnancy-related problems, such as pre-term delivery (birth before week 37). One study showed a small increased chance of low birth weight (weighing less than 5 pounds, 8 ounces [2500 grams] at birth). In rare cases, a woman with severe symptoms might need help during delivery if they are too weak to push through contractions.

Does having multiple sclerosis in pregnancy affect future behavior or learning for the child?

Information from two small studies suggests that having multiple sclerosis during pregnancy does not increase the chance of long-term developmental problems for the child.

Breastfeeding while I have multiple sclerosis:

Women with multiple sclerosis can successfully breastfeed. The chance of relapse can increase after delivery, so talk with your healthcare provider about your multiple sclerosis and breastfeeding. For information on the use of specific medications while breastfeeding, please see our fact sheets at https://mothertobaby.org/fact-sheets-parent/ or contact a MotherToBaby specialist. Be sure to talk to your healthcare provider about all your breastfeeding questions.

If a man has multiple sclerosis, can it affect fertility or increase the chance of birth defects?

For some men with multiple sclerosis, issues such as sexual dysfunction or lower quality of sperm can make it harder to conceive a pregnancy. 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/.

MotherToBaby is currently conducting a study looking at multiple sclerosis and the medications used to treat multiple sclerosis in pregnancy. If you are interested in taking part in this study, please call 1-877-311-8972 or sign up at https://mothertobaby.org/join-study/.

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