This sheet is about exposure to estazolam 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 estazolam?

Estazolam is a medication that has been used to treat insomnia (having a hard time falling asleep or staying asleep). Estazolam is in a class of medications called benzodiazepines. A brand name for estazolam is Prosom®.

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 estazolam. Can it make it harder for me to get pregnant?

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

Does taking estazolam 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 estazolam can increase the chance of miscarriage.

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

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

Studies have not been done to see if estazolam 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).

I need to take estazolam throughout my entire pregnancy. Will it cause withdrawal symptoms in my baby after birth?

The use of estazolam during pregnancy can cause temporary symptoms in newborns soon after birth. These symptoms are sometimes referred to as withdrawal. Symptoms may include low muscle tone, trouble feeding, being too sleepy, trouble breathing, irritability, restlessness, tremors, and excessive crying. Not all babies exposed to estazolam will have these symptoms. It is important that your healthcare providers know you are taking estazolam so that if symptoms occur your baby can get the care that is best for them.

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

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

Breastfeeding while taking estazolam:

Estazolam has not been well studied for use while breastfeeding. If you suspect the baby has any symptoms (being too sleepy, poor feeding, and/or poor weight gain), contact the child’s healthcare provider. The product label for estazolam recommends that breastfeeding women not use this medication. However, the benefit of using estazolam may outweigh possible risks. Your healthcare providers can talk with you about using estazolam and what treatment is best for you. Be sure to talk to your healthcare provider about all your breastfeeding questions.

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

Studies have not been done to see if estazolam could affect male 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 Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/.

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

What is fluphenazine?

Fluphenazine is a medication that has been used to treat schizophrenia. It can be given orally (by mouth) or by injection (a shot). Some brand names for fluphenazine are Prolixin® and Permitil®.

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 fluphenazine. Can it make it harder for me to get pregnant?

In some people, fluphenazine might raise the levels of a hormone called prolactin. High levels of prolactin can stop ovulation (part of the menstrual cycle when an ovary releases an egg). This could make it harder to get pregnant. Your healthcare provider can test your levels of prolactin if there is concern.

Does taking fluphenazine increase the chance of miscarriage?

Miscarriage is common and can occur in any pregnancy for many different reasons. One study did not find an increased chance of miscarriage in 244 pregnancies exposed to fluphenazine in first trimester of pregnancy.

Does taking fluphenazine 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. It is not known if fluphenazine can increase the chance of birth defects. Animal studies have raised some concern about a higher chance for birth defects. However, animal studies cannot always predict if or how a medication would affect a human pregnancy. One study in humans included 244 women exposed to fluphenazine; no increased chance of birth defects was reported.

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

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

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

The use of fluphenazine during pregnancy can cause temporary symptoms in newborns soon after birth. These symptoms are sometimes referred to as withdrawal. Symptoms can include unusual muscle movements, stiff or floppy muscle tone, being sleepier than expected, agitation, tremors, trouble breathing, and problems with feeding. Not all babies exposed to fluphenazine will have these symptoms. It is important that your healthcare providers know you are taking fluphenazine so that if symptoms occur your baby can get the care that is best for them.

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

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

Breastfeeding while taking fluphenazine:

There is no published information on the use of fluphenazine in breastfeeding. Use of other medications like fluphenazine have not shown negative effects on infant development. If you suspect the baby has any symptoms (sleepiness or developmental problems), contact the child’s healthcare provider. Be sure to talk to your healthcare provider about all your breastfeeding questions.

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

Studies have not been done in men to see if fluphenazine could increase the chance of birth defects. Using fluphenazine may raise a person’s levels of the hormone prolactin, which might affect a man’s fertility (ability to get a woman pregnant). Animal studies have noted some changes in sperm shape and reduced number of offspring with exposure to fluphenazine. However, it is not clear if fluphenazine would cause similar changes in humans. In general, exposures that men have are unlikely to increase risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/.

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

What is propranolol? 

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

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

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

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

Does taking propranolol increase the chance of miscarriage?  

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

Does taking propranolol increase the chance of birth defects?  

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

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

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

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

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

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

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

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

Breastfeeding while taking propranolol: 

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

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

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

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

What is phenylephrine?

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

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

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

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

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

Does taking phenylephrine increase the chance of miscarriage?

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

Does taking phenylephrine increase the chance of birth defects?

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

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

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

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

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

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

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

Breastfeeding while taking phenylephrine:

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

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

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

Please click here for references.

This sheet is about exposure to natural disasters 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 a natural disaster?

Natural disasters are events that result from natural processes of the Earth. They can greatly affect a person’s health and safety. Some examples of natural disasters include heat waves, hurricanes, earthquakes, floods, and wildfires.

How can I prepare for a natural disaster?

Preparation is key for people who are pregnant because they are considered a vulnerable population during these times. The CDC (Centers for Disease Control and Prevention) and the U.S. government have helpful information to get you through a disaster:

• Natural Disaster Safety for Expecting and New Parents: https://www.samhsa.gov/resource/dbhis/disaster-safety-expecting-new-parents
• Safety Messages for Pregnant, Postpartum, and Breastfeeding People During Natural Disasters and Severe Weather: https://www.cdc.gov/reproductive-health/emergency-preparation-response/safety-messages.html?CDC_AAref_Val=https://www.cdc.gov/reproductivehealth/emergency/safety-messages.htm
• Information to prepare for natural disasters such as floods, hurricanes, earthquakes: https://www.ready.gov/

I am pregnant. What are some exposures that could happen during or after a natural disaster?

Vaccinations

Vaccinations are given to protect people from serious diseases. Some vaccinations that might be recommended following a natural disaster are hepatitis A, hepatitis B, and/or tetanus. If you are up to date on these vaccinations, you may not need to get them again. Keep your vaccination record in a safe place and take it with you when you see your healthcare provider, especially if you need to move to a new area. Your healthcare providers or health authorities may recommend additional vaccinations. MotherToBaby has a fact sheet on vaccines at https://mothertobaby.org/fact-sheets/vaccines-pregnancy/.

Infections

There can be risks for infections after a natural disaster. Drinking polluted food or water, physical injury, and/or crowding in shelters can increase the chance of infection. Follow the recommendations from health authorities to lower your chances of getting an infection. If you think you already have an infection, talk to your healthcare provider right away. Be sure to follow their advice on treating your infection.

Medication

If you take medication, keep it in a safe place and continue to take it as directed. If you have a condition that needs monitoring and you cannot reach your healthcare provider, let authorities know as soon as it is safe to do so. You may need to take other medication if you have an infection or other illness. Contact MotherToBaby (https://mothertobaby.org/contact-expert/ or 866.626.6847) if you have questions about specific medication(s).

Mosquito-Borne Illness

During or after a natural disaster, there may be more mosquitoes around. Using insect repellent correctly is important to help protect against infections spread by mosquitoes, such as

• Zika: https://mothertobaby.org/fact-sheets/zika-virus-pregnancy/
• West Nile Virus: https://mothertobaby.org/fact-sheets/west-nile-virus-infection-pregnancy/
• Malaria: https://mothertobaby.org/fact-sheets/malaria/
• Dengue: https://mothertobaby.org/fact-sheets/dengue/

Insect Repellent

Insect repellent is recommended for people who are pregnant or breastfeeding. Use as directed on the label. The most common active ingredient in insect repellent is DEET. Please see our fact sheets for more information:

• DEET: https://mothertobaby.org/fact-sheets/deet-nn-ethyl-m-toluamide-pregnancy/
• General insect repellents: https://mothertobaby.org/fact-sheets/insect-repellents/.

Other ways to lower your chance of being bitten by a mosquito include wearing long pants, long sleeved shirts, a hat, and shoes.

Cleaning Products

When used as directed on the label, common household cleaning products are not expected to increase the risks to your pregnancy. To help reduce skin exposure, wear the type of gloves recommended on the product label. Wash your hands well after using cleaning products.

Chemicals/Pollutants

If you think that you may have been exposed to harmful chemicals or pollutants and you have symptoms or concerns, contact your healthcare provider and Poison Control as soon as possible. Poison Control can be reached online at https://www.poison.org/ or by calling 1-800-222-1222.

Lead

If you have been exposed to lead, talk to your healthcare provider. MotherToBaby has a fact sheet on lead at https://mothertobaby.org/fact-sheets/lead-pregnancy/

Water

The water supply may not be safe to use after a natural disaster. Local authorities will tell you if your water supply is safe to drink, to use for cooking, or to use for bathing. It may be recommended to drink bottled water. If bottled water is not available, use boiled water if the local public health department says this is okay. Bringing water to a rolling boil for 1 minute will kill most disease-causing organisms, but it will not remove chemicals. Do not use water that has been treated with iodine unless you do not have bottled water and cannot boil your water. If you do not have clean water for washing hands, use alcohol-based hand sanitizers.

Stress

Stress is the way your body reacts to something that is unusual, dangerous, unknown, or disturbing. Feeling stress is very common during natural disasters. When under stress, your body goes through physical and chemical changes. Some of the symptoms of stress can include chest pain, fast heart rate, breathing problems, headaches, vision problems, confusion, anxiety, grief, denial, fear, or worry. Please see our fact sheet on stress at https://mothertobaby.org/fact-sheets/stress-pregnancy/. Also, the Disaster Distress Helpline, (phone: 1-800-985-5990), is a 24/7, 365-day-a-year, national hotline dedicated to providing immediate crisis counseling for people who are experiencing emotional distress related to any natural or human-caused disaster.

Mold

Molds are fungi that can be found both indoors and outdoors. They grow best in warm, damp, and humid places. Some molds can produce substances called toxins. In some people, exposure to mold toxins can cause symptoms such as stuffy nose, eye irritation, rashes, wheezing, fever, or shortness of breath. For more information on mold see our fact sheet at https://mothertobaby.org/fact-sheets/mold-pregnancy/.

Breastfeeding after a natural disaster:

If possible, keep breastfeeding even after a natural disaster. Breast milk can help protect babies from infections. For more information, see our sheet Breastfeeding Following a Natural Disaster at https://mothertobaby.org/fact-sheets/breastfeeding-natural-disaster/. If you have a question about a specific medication, infection, or other exposure while breastfeeding, contact a MotherToBaby specialist. Be sure to talk to your healthcare provider about all of your breastfeeding questions.

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