This sheet is about exposure to over-the-counter (OTC) topical acne treatments 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 are over-the-counter (OTC) topical acne treatments?

Over-the-counter (OTC) refers to medication that can be bought without a prescription. OTC topical acne treatments are products that are put directly on the skin to treat acne. Topical acne treatments are available in lotion, gel, cream, or ointment form. There are many different topical acne treatments with different generic and brand names. Common active ingredients in OTC topical acne treatments include adapalene, azelaic acid, benzoyl peroxide, glycolic acid, and salicylic acid. Products can vary in how strong the active ingredient is and in how much of the medication is in the product.

This fact sheet focuses on OTC acne treatments. Prescription treatments might have higher amounts of the active ingredients than over-the-counter products. For information on prescription acne medication, MotherToBaby has some fact sheets available, and always feel free to contact a MotherToBaby specialist.

Clindamycin fact sheet link: https://mothertobaby.org/fact-sheets/clindamycin-pregnancy/.

Erythromycin fact sheet link: https://mothertobaby.org/fact-sheets/erythromycin/.

Isotretinoin fact sheet link: https://mothertobaby.org/fact-sheets/isotretinoin-accutane-pregnancy/.

Tetracycline fact sheet link: https://mothertobaby.org/fact-sheets/tetracycline-pregnancy/.

Topical tretinoin fact sheet link: https://mothertobaby.org/fact-sheets/tretinoin-retin-a-pregnancy/.

Are topical medications absorbed through the skin?

In general, the skin serves as a good barrier, so only a small amount of the acne medication is likely to be absorbed with topical exposure. However, 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 baby by absorption through the skin is usually much lower than with medications taken by mouth.

Are there OTC topical acne treatments that maybe used during pregnancy?

The American College of Obstetricians and Gynecologists (ACOG) has recommendations for the treatment of acne during pregnancy, and you can discuss them with your healthcare providers. In general, ACOG has suggested OTC topical products containing the following ingredients for use during pregnancy, if needed: benzoyl peroxide, azelaic acid, salicylic acid, or glycolic acid. In addition to those recommended by ACOG, there are many other ingredients found in OTC topical acne treatments. If you have any questions about your OTC topical acne treatment, please contact MotherToBaby.

Are there any topical acne medications that should be avoided during pregnancy?

It has generally been recommended to avoid the use of topical retinoid medications, such as tretinoin (Retin A®) and adapalene. This is because retinoids, when taken by mouth, are known to cause birth defects.

I use an OTC topical acne treatment. Can it make it harder for me to get pregnant?

It is not known if the use of OTC topical acne treatments can make it harder to get pregnant. However, since only small amounts are typically expected to be absorbed through the skin, use of OTC acne treatments is unlikely to affect fertility.

Does using OTC topical acne treatments increase the chance of miscarriage?

Miscarriage is common and can occur in any pregnancy for many different reasons. Based on the data available, the use of OTC topical acne treatments is not expected to increase the chance for miscarriage since only a small amount of the active ingredients are expected to be absorbed with topical exposure.

Does using OTC topical acne treatments increase the chance of birth defects?

Every pregnancy starts out with a 3-5% chance of having a birth defect. This is called the background risk. While not well studied, OTC topical acne treatments have not been associated with an increased chance for birth defects. In many cases, only a small amount of the active ingredient is likely to be absorbed with topical exposure, which means little medication gets into the blood stream. Because only small amounts applied on the skin are absorbed into the body, it is not likely to increase the chance for birth defects or cause problems for the baby.

Does using OTC topical acne treatments in pregnancy increase the chance of other pregnancy-related problems?

When used as directed, OTC topical acne treatments are not expected to increase the chance for pregnancy complications, 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 OTC topical acne treatments in pregnancy affect future behavior or learning for the child?

Studies have not been done to see if using OTC topical acne treatments can cause behavior or learning issues for the child. However, because the active ingredient is not expected to reach the fetus in significant amounts when applied topically, an increased risk for long-term problems is not expected.

Breastfeeding while using OTC topical acne treatments:

Use of OTC topical acne treatments have not been well studied in women who are breastfeeding. However, since most topical treatments are poorly absorbed by the skin, little, if any, of the treatment is expected to pass into the breast milk. Make sure that the product is not placed on the breast area or in any area that may come in contact with your baby’s skin. Be sure to wash your hands well after applying the treatment. Be sure to talk to your healthcare provider about all your breastfeeding questions.

If a man uses OTC topical acne treatments, could it affect fertility or increase the chance of birth defects?

Studies have not been done to see if use of OTC topical acne treatment could affect a man’s fertility (ability to get a woman pregnant) or 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/.

Please click here for references.

This sheet is about group B strep infections in pregnancy or 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 are group B strep infections?

Group B strep infections are caused by group B Streptococcus bacteria (also called group B strep or GBS). Most of the time, the bacteria do not cause symptoms or make people feel sick. Some people, including some women who are pregnant, have GBS without knowing or having symptoms.

Can GBS be passed to the fetus during pregnancy or at the time of delivery?

When a pregnant woman passes an infection to the fetus, it is called vertical transmission. Vertical transmission can happen at any time in pregnancy, but it is usually more likely to happen when the woman has the infection close to the time of delivery.

GBS bacteria can live in the vagina and rectum. Usually, having group B bacteria in these areas of the body does not cause illness. GBS bacteria can be passed to a newborn when they pass through the birth canal (vaginal delivery) or after delivery. GBS infections can be passed to newborns during or after delivery and can cause severe problems.

In newborns, GBS infections can cause GBS disease. Depending on how old the baby is when they develop GBS disease, it can be called ‘early onset’ (within 6 days of birth) or ‘late onset’ (from 7 days of birth up to a few months after birth). Early onset GBS disease can cause meningitis (swelling of the covering around the brain or spinal cord), pneumonia (lung infection), and sepsis (serious disease where the immune system attacks the body instead of the infection). An infant with early onset GBS disease has a higher chance of developing necrotizing enterocolitis (serious condition where tissue in the intestines begins to die, which can lead to a hole in the intestines). Late onset GBS disease can cause meningitis.

What screenings or tests are available to see if I have GBS bacteria before delivery?

The American College of Obstetricians and Gynecologists (ACOG) and the Centers for Disease Control and Prevention (CDC) recommend that all women get tested for GBS between 36 and 38 weeks of pregnancy. If someone tests positive for GBS bacteria, ACOG and CDC recommend treatment with antibiotics before giving birth. MotherToBaby has a fact sheet on penicillin G, a medication commonly used to treat GBS: https://mothertobaby.org/fact-sheets/penicillin-g/.

I have a GBS infection. Can it make it harder for me to get pregnant?

It is not known if having a GBS infection can make it harder to get pregnant. Some other bacterial infections during pregnancy have been associated with trouble getting pregnant. Also, being very sick in general might make it harder to get pregnant. Talk with your healthcare provider about the best way to treat your condition and your plans for pregnancy.

Does having a GBS infection increase the chance of miscarriage?

Miscarriage is common and can occur in any pregnancy for many different reasons. It is not known if GBS infections can increase the chance of miscarriage.

Some bacterial infections that are similar to group B bacteria have been associated with an increased chance of miscarriage. Also, being very sick in general might increase risks to a pregnancy. Talk with your healthcare provider about your condition and the treatment that is right for you during pregnancy.

Does having a GBS 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 GBS infection, might increase the chance of birth defects in a pregnancy. Studies have not been done to see if having a GBS infection can increase the chance of birth defects.

Would having a GBS infection increase the chance of other pregnancy-related problems?

It is not known if having a GBS infection can 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).

One study suggested a link between GBS infection and stillbirth. However, this study cannot confirm that a stillbirth was due to the infection or if other factors were also involved.

Rarely, GBS infections have been linked to necrotizing enterocolitis (serious condition where tissue in the intestines begins to die, which can lead to a hole in the intestines) in the newborn.

Some bacterial infections that are similar to group B bacteria during pregnancy have been associated with an increased chance of other pregnancy-related complications, such as preterm delivery and growth restriction (fetus is smaller than expected). Also, being very sick in general might increase risks to a pregnancy. Talk with your healthcare provider about your condition and the treatment that is right for you during pregnancy.

Does having a GBS infection in pregnancy affect future behavior or learning for the child?

Studies have not been done to see if exposure to a GBS infection in pregnancy can affect future behavior or learning for the child.

Breastfeeding while I have a GBS infection:

Strep bacteria can get into breast milk. There is 1 report on 3 preterm infants who developed late onset GBS disease after being exposed to GBS bacteria through breast milk. All infants recovered after treatment with antibiotics.

The benefits of breastfeeding your child might outweigh possible risks. If you have GBS, talk with your healthcare provider and your baby’s pediatrician about the best way to feed your baby. Be sure to talk to your healthcare provider about all your breastfeeding questions.

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

Studies have not been done to see if a GBS infection could affect a man’s fertility (ability to get a woman pregnant) or increase the chance of birth defects. Some other bacterial infections might affect a man’s fertility. Also, being very sick in general may make it harder to get a woman pregnant. Be sure to talk to your healthcare provider about the best way to treat your condition and you and your partner’s plans for pregnancy. For more general information on paternal exposures in pregnancy, please see the MotherToBaby fact sheet at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/.

Please click here for references.

This sheet is about having H5N1 flu in a pregnancy or 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 H5N1 flu?

The flu (influenza) is an infection of the respiratory (breathing) tract. The flu is caused by a group of viruses called influenza virus. H5N1 flu is caused by an avian (bird) influenza virus primarily found in wild birds, poultry, and U.S. dairy cows.

How do you get H5N1 flu?

H5N1 can be spread to humans through exposure to infected animals. This includes contact with an infected animal’s saliva, mucous, feces (poop), and milk. People can get H5N1 flu from the virus getting into their eyes, nose, and mouth, or when it is breathed in. At this time, most people are not considered to be at high risk of getting H5N1 flu. People that work with or have close contact with animals or animal products are at a higher risk of being exposed to H1N1 flu. H5N1 flu can be spread from person to person, but this is rare.

What are the symptoms of H5N1 flu?

Common symptoms of H5N1 flu include fever, cough, sore throat, runny or stuffy nose, muscle or body aches, headaches, fatigue, eye redness, shortness of breath, or trouble breathing. Less common symptoms include diarrhea, nausea, vomiting, or seizures. A severe case of H5N1 flu can be fatal. Women who are pregnant are more likely to experience severe symptoms and death than those who are not pregnant.

People who think they have been exposed to H5N1 infected birds, other animals, or humans should monitor themselves for respiratory symptoms and eye redness for 10 days after their exposure. Anybody who develops symptoms after exposure to H5N1 should seek medical attention immediately. It is important to treat H5N1 flu as early as possible.

How can I protect my pregnancy from H5N1 flu?

To help prevent H5N1 flu infections, the Centers for Disease Control and Prevention (CDC) recommends that people avoid exposure to sick or dead animals, including wild birds, poultry, other domesticated birds, and other domesticated and wild animals (including cows). It is also recommended to avoid exposures to animal feces, bedding, litter, unpasteurized (“raw”) milk, and materials that have been touched or were close to infected animals.

People who come in contact with domesticated and wild animals (such as poultry and livestock workers, veterinary staff, bird flock owners, and emergency responders) should use appropriate protective gear and avoid direct physical contact or close exposure with infected or potentially infected animals or materials. Personal protective equipment (PPE), such as thick disposable gloves, protective clothing, and a mask, should be worn when in contact or near sick birds, livestock, other animals, animal carcasses (dead bodies), feces, litter, raw milk or surfaces and water that may be contaminated. All staff members should wear PPE whether they are pregnant or not. Proper hand washing is also critical. For more information, please visit CDC’s page on reducing risk for people working with or exposed to animals: https://www.cdc.gov/bird-flu/prevention/worker-protection-ppe.html. MotherToBaby also has a general fact sheet on working as a Veterinarian or Veterinarian Technician at https://mothertobaby.org/fact-sheets/vet-vettech/ and a general sheet on workplace safety tips at https://mothertobaby.org/fact-sheets/reproductive-hazards-workplace/.

Poultry, eggs, and beef should be cooked to a safe internal temperature to kill bacteria and viruses. Pasteurized milk and foods made with pasteurized milk are not expected to be contaminated with H5N1 flu. Unpasteurized “raw” milk and unpasteurized milk products (such as soft cheeses, ice creams, and yogurts) can be contaminated with H5N1 virus and other bacteria. Pasteurization kills H5N1 virus.

How can I find out if I am infected with H5N1 flu?

If you think you are infected with H5N1, seek medical attention as soon as possible. A healthcare provider can order H5N1 laboratory testing for you. Over-the-counter rapid flu tests will not be able to tell the difference between seasonal flu and H5N1 flu.

What should I do if I think I have been infected with H5N1 flu?

CDC has recommended that anyone with suspected or confirmed H5N1 flu receive an antiviral treatment for H5N1 as soon as possible. The World Health Organization (WHO) recommends that women who are pregnant and have suspected or confirmed H5N1 flu receive antiviral treatment, regardless of how far along in pregnancy they are. It is important that you seek medical attention if you think you have H5N1 flu. Because of the increased risk of death in women who are pregnant and have H5N1 flu, the benefits of antiviral therapy outweigh any potential risks. There is no vaccine available for H5N1 flu.

MotherToBaby has a general fact sheet on antiviral medications for the flu here: https://mothertobaby.org/fact-sheets/antiviral-medications-treatprevent-influenza-the-flu-pregnancy/.

I have H5N1 flu. Can it make it harder for me to become pregnant?

It is not known if H5N1 flu can make it harder to get pregnant.

Does having/getting H5N1 flu increase the chance for miscarriage?

Miscarriage is common and can occur in any pregnancy for many different reasons. It is not known if H5N1 flu can increase the chance of miscarriage. Miscarriage has been reported in 2 women who had H5N1 flu. It is important to talk with your health care provider if you are pregnant and have symptoms of the H5N1 flu to receive treatment.

Does having/getting H5N1 flu increase the chance of birth defects?

Every pregnancy starts out with a 3-5% chance of having a birth defect. This is called the background risk. Because getting flu from the H5N1 virus is rare in humans, it is not known if having H5N1 flu increases the chance for birth defects above the background risk. However, other types of influenza viruses have not been shown to cause birth defects.

Fever is a possible symptom of H5N1 flu. A high fever in the first trimester can increase the chance of certain birth defects. Acetaminophen has been recommended as an option to reduce fever in pregnancy. If you have H5N1 flu and develop a fever, talk with your healthcare provider about the best way to treat your fever. For more information about fever and pregnancy, see the MotherToBaby fact sheet about hyperthermia at https://mothertobaby.org/fact-sheets/hyperthermia-pregnancy/ and a fact sheet on acetaminophen here: https://mothertobaby.org/fact-sheets/acetaminophen-pregnancy/.

Would having/getting H5N1 flu increase the chance of other pregnancy-related problems?

It is not known if H5N1 flu can cause preterm delivery (birth before week 37) or low birth weight (weighing less than 5 pounds, 8 ounces [2500 grams] at birth). There have been 2 reports of preterm delivery in women who had H5N1 virus.

Can H5N1 flu be passed to the baby during pregnancy or at the time of delivery?

When a woman is pregnant and passes an infection to the fetus, it is called vertical transmission. Vertical transmission has been reported with H5N1 flu in pregnancy, but is thought to be rare. Vertical transmission can happen at any time in pregnancy, but is more likely to happen when someone gets the infection close to the time of delivery.

Does having/getting H5N1 flu in pregnancy affect future behavior or learning for the child?

Studies have not been done to see if H5N1 flu can increase the chance of behavior or learning issues for the child.

Breastfeeding while I have H5N1 virus:

CDC encourages women to continue to breastfeed or provide breast milk for their babies even if they have the flu. There are antibodies in breast milk that might help prevent a baby from getting sick with the flu. Women with H5N1 flu may feel too sick to breastfeed. CDC recommends that breastfeeding women who have the flu should continue to express milk when possible. A woman with the flu might have a lower breast milk supply than normal. There are no breastfeeding recommendations specific to H5N1 flu.

While sick, it is important to try to protect the baby from getting sick. Wash your hands with soap and water before holding your baby. Avoid coughing or sneezing on 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. CDC has more information on the flu and breastfeeding at https://www.cdc.gov/breastfeeding-special-circumstances/hcp/illnesses-conditions/flu.html. If you think your baby has symptoms of H5N1 flu, contact your child’s healthcare provider. Be sure to talk to your healthcare provider about all your breastfeeding questions.

If a man has H5N1 flu, can it make it harder to get a woman pregnant or increase the chance of birth defects?

Illnesses that cause fever, such as H5N1 flu, might cause a temporary reduction in the movement or number of sperm, which could make it harder to get a woman pregnant during that time. Close contact may not be recommended when you have H5N1 flu in order to avoid passing H5N1 flu to your partner. In general, however, exposures that men have are unlikely to increase the risk to a pregnancy. For more information, please see the fact sheet Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/.

Please click here for references.

This sheet is about exposure to oral prednisone or prednisolone 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 are prednisone and prednisolone?  

Prednisone and prednisolone belong to a group of medications called corticosteroids. In the body, prednisone is broken down into prednisolone. Prednisone and prednisolone have been used to treat many conditions, such as asthma, autoimmune diseases, and skin conditions. They help prevent or suppress inflammation (swelling and irritation) and immune responses. Prednisone and prednisolone are prescribed in a wide range of doses, depending on what condition is being treated. For more information on asthma, see our fact sheet here: https://mothertobaby.org/fact-sheets/asthma-and-pregnancy/.  

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 prednisone or prednisolone. Can it make it harder for me to get pregnant? 

Taking prednisone or prednisolone is not expected to make it harder to get pregnant.   

Does prednisone or prednisolone increase the chance of miscarriage? 

Miscarriage is common and can occur in any pregnancy for many different reasons. Taking prednisone or prednisolone is not expected to increase the chance of miscarriage. One study found that oral immunosuppressant medications, including prednisolone, might improve pregnancy outcomes in women with unexplained recurrent miscarriage (2 or more pregnancies that end in miscarriage) by lowering the chance of miscarriage. 

Does prednisone or prednisolone 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 prednisone or prednisolone, might increase the chance of birth defects in a pregnancy. 

Taking prednisone or prednisolone is not expected to greatly increase the chance of birth defects. Older studies suggested a very small possible increase in cleft lip and/or cleft palate (an opening in the upper lip or the roof of the mouth), when used in the first trimester. But newer studies and further review of the older studies have not confirmed this finding. If there is an increased risk, it appears to be very small, and most pregnancies would not be affected. 

Does taking prednisone or prednisolone in pregnancy increase the chance of other pregnancy-related problems? 

Taking an oral corticosteroid like prednisone or prednisolone long-term during pregnancy has been associated with an increased chance of preterm delivery (birth before week 37) and low birth weight (weighing less than 5 pounds, 8 ounces [2500 grams] at birth). However, it is hard to know whether these outcomes are related to the medications themselves or to the underlying medical conditions being treated. Conditions requiring corticosteroid treatment may also increase the chance of pregnancy complications. Other studies have shown that using prednisone or prednisolone might improve some pregnancy outcomes. The benefits of taking prednisone or prednisolone and treating your condition should be weighed against possible risks to the pregnancy. 

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

A review of 14 studies found no consistent evidence that corticosteroid use during pregnancy increases the chance of learning, behavior, or developmental problems in children. Most outcomes showed no differences between exposed and unexposed children. 

Breastfeeding while taking prednisone or prednisolone: 

Prednisone and prednisolone get into breast milk in small amounts. Prednisone is like the body’s natural hormones that are needed for milk production. High doses can sometimes cause temporary loss of milk supply. There are reports of ~190 infants exposed to prednisone or prednisolone through breast milk with no reported side effects. 

The amount of prednisone or prednisolone in breast milk might be higher in women taking higher doses. Waiting 4 hours after taking it before breastfeeding can also limit the amount of medication the baby gets in the breast milk. However, this is not necessary for everyone. Be sure to talk to your healthcare provider about all your breastfeeding questions.  

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

Small studies on men who had organ transplants and were being treated with medications that suppress the immune system (including prednisone and prednisolone) did not report lower rates of male fertility (ability to make healthy sperm). Studies have not been done to see if taking prednisone or prednisolone could 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 zinc from diet and dietary supplements 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 zinc? 

Zinc is an essential nutrient. This means the body cannot make zinc, so people need to get zinc from other sources. Zinc is naturally found in some foods such as meats and seafood and is added to some cereals. Zinc is also available as a dietary supplement and found in certain homeopathic products marketed for colds. Some denture adhesives also contain zinc.  

Talk with your healthcare providers about all vitamins and supplements that you take. Have the bottles or photos of the labels with you so that all ingredients and their amounts can be reviewed. Products that contain herbals are typically not recommended during pregnancy. For more information on herbal products please see our fact sheet at: https://mothertobaby.org/fact-sheets/herbal-products-pregnancy/.  

How much zinc do I need? 

The Recommended Dietary Allowance (RDA) is the amount people should aim to get each day. It is not recommended to take more zinc than the RDA in a day. The Tolerable Upper Intake Level (UL) is the dose at which people can start to have side effects. RDAs and ULs are there to help guide us in getting enough of a good thing but also to keep us from getting too much of a good thing. 

	Recommended Daily Allowance (RDA)	Upper Limit (UL)
14 to 18 years old and pregnant	12 mg per day	34 mg per day
19 years old or older and pregnant	11 mg per day	40 mg per day

When reviewing amount of zinc, it is important to include amounts from foods, drinks, and supplements. There are resources available online that list amounts of zinc typically found in foods. Labels on supplements will list the amount of zinc in the product.  

Most people get the RDA of zinc from a balanced diet. It is unlikely that a person would get too much zinc from foods and drinks. People who do not eat meat or seafood, have had bariatric surgery (such as gastric bypass), have medical conditions that might affect how their body absorbs nutrients (such as cancer, eating disorders, kidney disease, malabsorption, or substance misuse), or have exposure to cigarette smoke, should talk with their healthcare providers about their specific nutritional needs.  

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

Some studies have suggested that having zinc blood levels that are too low might make it harder for a woman to get pregnant. Studes have not been done to see if taking extra zinc (above the UL) can make it harder to get pregnant. If a woman is getting the recommended amounts of zinc (between the RDA and UL) it is unlikely to make it harder to get pregnant.  

Does taking zinc increase the chance of miscarriage?   

Miscarriage is common and can occur in any pregnancy for many different reasons. Some studies have suggested that having zinc blood levels that are too low might increase the chance of miscarriage. Studies have not been done to see if taking extra zinc (above the UL) can increase the chance of miscarriage. If a woman is getting the recommended amounts of zinc (between the RDA and UL) it is unlikely to increase the chance of miscarriage.  

Does taking zinc 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 zinc, might increase the chance of birth defects in a pregnancy. If a woman is getting the recommended amounts of zinc (between the RDA and UL) it is unlikely to increase the chance for birth defects. 

Some studies have suggested that women with zinc blood levels that are too low might have a higher chance of having a pregnancy with a neural tube defect (an opening anywhere along the spine). It is not known if taking extra zinc (above the UL) can increase the chance of birth defects.  

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

Some studies have suggested that having zinc blood levels that are too low might increase the chance of pregnancy-related problems such as: low birth weight (weighing less than 5 pounds 8 ounces [2500 grams] at birth), stillbirth, high blood pressure, and preeclampsia (high blood pressure and problems with organs, such as the kidneys, which can lead to seizures (called eclampsia)).  

Studies have not been done to see if taking extra zinc (above the UL) can increase the chance of other pregnancy-related problems. If a woman is getting the recommended amounts of zinc (between the RDA and UL) it is unlikely to increase the chance for other pregnancy-related problems. 

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

Studies have not been done to see if zinc intake below the RDA (too little) or at doses higher than the UL (too much) can increase the chance of behavior or learning issues. If a woman is getting the recommended amounts of zinc (between the RDA and UL) it is unlikely to affect future behavior or learning for the child.  

Breastfeeding while taking zinc:   

Zinc is a normal part of breastmilk. It is normal for zinc levels in the breast milk to slowly drop over time regardless of the amount of zinc that the mother gets. Women who are breastfeeding should continue to get the daily recommended amount of zinc. The RDA for breastfeeding is different from pregnancy. See the chart below for the Recommended Daily Allowance (RDA) and a Tolerable Upper Intake Level (UL) of zinc while breastfeeding. 

	Recommended Daily Allowance (RDA)	Upper Limit (UL)
14 to 18 years old and breastfeeding	13 mg per day	34 mg per day
19 years old or older and breastfeeding	12 mg per day	40 mg per day

Studies have not been done to see if extra zinc (above the UL) can affect breast milk or the breastfeeding child. Be sure to talk to your healthcare provider about all your breastfeeding questions.  

People who do not eat meat or seafood, have had bariatric surgery (such as gastric bypass), have medical conditions that might affect how their body absorbs nutrients (such as cancer, eating disorders, kidney disease, malabsorption, or substance misuse), or have exposure to cigarette smoke, should talk with their healthcare providers about their specific nutritional needs.   

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

Some studies have suggested that having blood zinc levels that are too low might increase the chance for problems with fertility (ability to get a woman pregnant). Zinc supplementation might help to improve fertility for some men but not for others. It is not known if extra zinc (above the UL) can affect a man’s fertility. Studies have not been done to see if too much or too little zinc intake for men could 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 Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/.

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