This sheet is about exposure to tetracycline 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 providers.

What is tetracycline?

Tetracycline is an antibiotic that has been used to treat acne and infections.

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

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

Does taking tetracycline increase the chance of miscarriage?

Miscarriage is common and can occur in any pregnancy for many different reasons. It is not known if using tetracycline can increase the chance of miscarriage. One study looking at filled prescriptions of antibiotics (67 for tetracycline) reported an increased chance of miscarriage. Studies based on filled prescriptions cannot tell if a person took the medication. This makes it hard to know if the study outcomes are related to the medication or other factors.

Does taking tetracycline 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. Overall, the available information on tetracycline has not shown an increased chance of birth defects.

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

If tetracycline is taken after the 4th month of pregnancy, there is a chance for discoloration of the “baby” teeth (baby teeth might be gray or yellowish brown). Although this changes the look of the teeth, it does not seem to change the development of the outer covering, the enamel, or the chance of getting cavities. It is not clear how many babies who are exposed in pregnancy will go on to have tooth staining.

Tetracycline appears to affect the calcification (hardening) of the bones and teeth, and it might also reduce the growth of some bones while the fetus is exposed to the medication. Even though the tooth discoloration is permanent, the bone growth seems to return to usual after tetracycline is stopped.

It has been suggested that tetracycline be avoided after 4 months of pregnancy unless there is a reason for your healthcare provider to prescribe the medication.

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

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

Breastfeeding while taking tetracycline:

Tetracycline gets into breastmilk in small amounts. The bones and teeth in the baby continue to harden until one year of age. There is a theoretical concern (not proven) that if a baby is exposed to tetracycline in breast milk, it could cause tooth discoloration and delayed bone growth. However, both tetracycline levels in milk and absorption by a breastfeeding baby are low. Problems in infants are not expected when used for a short period of time.

The World Health Organization (WHO) Working Group on Human Lactation states that when tetracycline is used for 7-10 days while nursing, the risk to the infant appears to be low. Other antibiotics might be suggested for use while breastfeeding for long-term or repeated use. If you suspect the baby has any symptoms (diarrhea, thrush, or diaper rash), contact the child’s healthcare provider. Be sure to talk to your healthcare provider about all your breastfeeding questions.

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

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

Please click here for references.

This sheet is about exposure to clopidogrel 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 clopidogrel? 

Clopidogrel is an antiplatelet medication that helps prevent blood clots. It has been used to help prevent heart attacks and strokes. A brand name for clopidogrel is Plavix®.  

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

Studies have not been done to see if taking clopidogrel can make it harder to get pregnant. In animal studies, clopidogrel did not affect fertility (ability to get pregnant). 

Does taking clopidogrel 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 clopidogrel can increase the chance of miscarriage. Studies conducted on animals did not report an increase in miscarriages. 

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

Information on the use of clopidogrel in pregnancy is limited. In animal studies, clopidogrel did not increase the chance of birth defects. In 17 case reports of women taking clopidogrel during pregnancy, no birth defects were reported in 16 of the babies. A heart defect was reported in 1 baby. A single case report is not enough information to link an exposure to a birth defect. Also, in all of these reports, other medications were also taken during pregnancy. This makes it hard to know if clopidogrel, the combination of medications, or other factors are related to the reported heart defect.  

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

Studies have not been done to see if clopidogrel can increase the 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). 

Taking clopidogrel during labor or delivery may increase the chance of bleeding and hemorrhaging (too much blood loss) in the woman giving birth. There is also an increased chance of spinal hematoma (when blood collects in the spine) when women who take clopidogrel get an epidural (injection of medication into the space around your spinal nerves to provide pain relief (analgesia) or numbness in one area of the body). The product label and professional medical societies, including the American Society of Regional Anesthesia and Pain Medicine and the American Academy of Pain Medicine, have recommended that anyone taking clopidogrel stop taking it 5-7 days before labor, delivery, or getting an epidural. 

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

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

Breastfeeding while taking clopidogrel: 

In two women taking clopidogrel, it was found that clopidogrel and its metabolites appeared in breast milk in minimal quantities, below the limit of detection. No side effects have been reported in a small number of infants exposed to clopidogrel through breast milk. If you suspect the baby has any symptoms (such as bruising or bleeding), contact the child’s healthcare provider.  

There is a theoretical (not proven) concern that if a baby is exposed to clopidogrel through breast milk, the baby’s platelets may not work correctly. This has not been noted in the reports on infants exposed to clopidogrel through breastmilk. 

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

Studies have not been done in humans to see if clopidogrel could affect male fertility (ability to make healthy sperm) or increase the chance of birth defects. In animal studies, there were no reported effects on fertility. 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 pesticides 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 pesticides?  

Pesticides are substances used to prevent or destroy “pests” such as weeds, insects, animals (rodents and other), fungus and parasites that can harm crops or people. For example, pesticides are used to lower the number of mosquitoes which may carry the Zika virus or parasites that cause diseases (like malaria) that can be spread to people. Pesticides used to kill weeds are called herbicides. Pesticides used to kill or prevent the growth of fungi and their spores are called fungicides.  

Pesticides sprayed outside with ground equipment or by aircraft are called outdoor pesticides. There are many household products that are also considered pesticides, such as cockroach spray, rat poison, or flea collars for pets. These products are known as indoor pesticides.  

This sheet talks in general about pesticides. Please contact MotherToBaby to see if there is more information on a specific product or ingredient that you have questions about. When calling, have a copy of the label nearby so that you can list the ingredients. 

How can pesticides get into my body?  

Pesticides can get into the body in several ways, such as breathing them in (inhalation), eating foods that were sprayed with pesticides (ingestion), or absorbing them through your skin. When outdoor pesticides are being sprayed, wind can carry some of the pesticide to other areas. Small amounts of outdoor pesticides can also be found in the food and water supply.  

What are some commonly used pesticides?  

There are many different kinds of pesticides used in the United States. Some commonly used pesticides are glyphosate (Round Up®), organochlorines pesticides (DDT, dieldrin, lindane), organophosphate pesticides (examples are malathion and naled) and pyrethrin and pyrethroid pesticides (example: Anvil®, Raid®).  

Can exposure to pesticides make it harder for me to get pregnant?  

Some studies have suggested that pesticides and herbicides might increase the chance for fertility problems while other studies have not. Contact a MotherToBaby specialist to see if there is information on the specific product that you have questions about. 

Will exposure to pesticides increase the chance of miscarriage?  

Miscarriage is common and can occur in any pregnancy for many different reasons. In 2 human studies, there were no reported effects on miscarriage from spraying several different pesticides. Some other studies have suggested that pesticides might increase the chance for miscarriage and stillbirth while others have not. As there can be many causes of miscarriage, it is hard to know if an exposure or other factors (age, health, medications used, medical conditions) are the cause of a miscarriage. Contact a MotherToBaby specialist to see if there is information on the specific product that you have questions about. 

Will exposure to pesticides 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 pesticides, might increase the chance of birth defects in a pregnancy. Most animal studies with glyphosate, organophosphates, organochlorines, pyrethrins, or pyrethroid exposure have not shown an increased chance for birth defects above the background risk.  

Two human studies looked at pregnancy outcomes following the repeated spraying of malathion, and another study looked at several different pesticides. These studies did not find a consistent increase in birth defects above the background risk. A study of 113 women who used a pyrethroid cream to treat head lice during pregnancy did not show an increased chance for birth defects or pregnancy complications. Some studies have suggested that pesticides might increase the chance of neural tube (spinal cord), heart, and hypospadias (opening of the urethra under the penis instead of at the tip) defects while other studies have not. One study suggested that atrazine, an herbicide, might increase the chance of gastroschisis (an opening in the baby’s abdominal wall). Contact a MotherToBaby specialist to see if there is more information on the specific product that you have questions about. 

Will exposure to pesticides increase the chance of other pregnancy-related problems?  

In animal studies, low birth weight and higher rates of fetal loss were seen at doses that were poisonous to the pregnant animal. In human studies, there were mixed reports on the effects on birth weight and the rates of gestational diabetes. One study found a higher chance for preterm delivery (birth before week 37) in counties of California that used higher levels of pesticides when compared to counties with lower pesticide use. Some studies have suggested that pesticides may increase the chances of asthma and cancers later in life. These studies are limited because although pesticides were used in the community, it does not mean the women in the study were actually exposed. Contact a MotherToBaby specialist to see if there is more information on the specific product that you have questions about. 

Does exposure to pesticides affect future behavior or learning for the child?  

Some studies have suggested that some pesticides might increase the chance for learning and behavior problems, including executive functioning, language, motor skills, attention deficit hyperactivity disorder (ADHD), and autism while other studies found no differences. Contact a MotherToBaby specialist to see if there is more information on the specific product that you have questions about. 

How can I minimize my exposure to pesticides?  

For all pesticides, it is important to carefully follow the recommendations on the label and safety data sheet. The labels should cover how to handle, store, and clean up spills. It should also outline if protective gear, such as gloves, is recommended. If possible, avoid mixing and applying pesticides yourself if you are pregnant. If that is not possible, exposure can be minimized by working in a well-ventilated area and using protective equipment such as a respirator, long sleeves, long pants, and gloves. It is unlikely that having your home or workplace treated by a professional exterminator will result in a high enough exposure to increase risks to a pregnancy. To reduce exposure to pesticides found on food, wash produce and your hands well before eating. 

Breastfeeding:  

Studies have not been done to look at the effects of pesticides while breastfeeding. The benefits of breastfeeding may outweigh the risk of exposure from pesticides sprayed in your home, workplace, or community. Be sure to talk to your healthcare provider about all your breastfeeding questions. 

If a man is exposed to pesticides at home or at work, can it affect fertility or increase the chance of birth defects? 

There are adult safety levels for pesticide exposure that should be followed in the workplace. In animal studies, high doses of malathion affected male fertility (ability to get a woman pregnant). A study of 152 farmers found that 62 males who had been exposed to either paraquat or malathion or both in various amounts had lower sperm count and motility than those not exposed. However, another human study compared men with high and low sperm counts and did not find a difference in the amounts of a malathion breakdown product in their bodies. In studies of other pesticides and herbicides, some studies suggested male fertility problems from exposure to pesticides and herbicides but other studies did not. Contact a MotherToBaby specialist to see if there is more information on the specific product that you have questions about. 

In general, exposures that males have are unlikely to increase the 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 the hepatitis A vaccine 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 hepatitis A? 

Hepatitis A is an infection caused by the hepatitis A virus (HAV). Hepatitis A spreads among people very easily. The virus infects the liver. Hepatitis A is the most common cause of jaundice (yellowing of the skin and eyes) in women who are pregnant. Unlike other forms of hepatitis, hepatitis A does not cause chronic (long-term) liver problems. For more information on hepatitis A, please see the MotherToBaby fact sheet at: https://mothertobaby.org/fact-sheets/hepatitis-a/.  

What is the hepatitis A vaccine? 

The hepatitis A vaccine contains an inactivated (not live) hepatitis A virus. The vaccine causes a person to develop antibodies to the virus and protects them against hepatitis A infection in the future. The vaccine does not cause hepatitis A. The hepatitis A vaccine is recommended for all children at 1 year of age, and for individuals, including pregnant women, that are traveling to countries where hepatitis A is common. It has also been recommended for some individuals working in professions with a high chance of exposure to the virus, and people who have other risk factors such as clotting disorders, chronic liver disease, or those who use certain drugs. 

How can I lower the chance of getting hepatitis A? 

The hepatitis A vaccine provides the best protection against the virus. The vaccine is thought to be effective for up to 20 years. A blood test is available to find out if a person has hepatitis A antibodies. If they do not, they can talk with their healthcare provider about their risk factors for hepatitis A and decide if vaccination is right for them.  

In addition, practicing good hygiene can lower the chance of infection. This includes washing hands with soap and water after using the bathroom, after changing a diaper, and before preparing and eating food. Boiling contaminated food or water for one minute can kill the virus.  

Does receiving the hepatitis A vaccine make it harder to get pregnant?  

It is not known if receiving the hepatitis A vaccine can make it harder to get pregnant. 

Does receiving the hepatitis A vaccination increase the chance of miscarriage? 

Miscarriage is common and can occur in any pregnancy for many different reasons. Receiving the hepatitis A vaccination is not expected to increase the chance of miscarriage. 

Does receiving the hepatitis A vaccine in 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 hepatitis A vaccine, might increase the chance of birth defects in a pregnancy. Inactivated vaccines, like the hepatitis A vaccine are not thought to pose a risk to a fetus.

Does receiving the hepatitis A vaccine during pregnancy increase the chance of other pregnancy-related problems?  

One study suggested a possible increased chance for babies to be small for gestational age. Other studies have suggested that the hepatitis A vaccine would not cause pregnancy-related problems, such as preterm delivery (birth before week 37) or low birth weight (weighing less than 5 pounds, 8 ounces [2500 grams] at birth).  

Does receiving the hepatitis A vaccine in pregnancy affect future behavior or learning for the child? 

Several studies have not found that receiving hepatitis A vaccine in pregnancy increase the chance for behavior or learning issues for the child.  

Breastfeeding if I receive the hepatitis A vaccine: 

The Centers for Disease Control and Prevention (CDC) state that getting the hepatitis A vaccine is not a reason to stop breastfeeding. Breastfeeding also does not affect how well the vaccine works.  Be sure to talk to your healthcare provider about all your breastfeeding questions. 

If a man receives the hepatitis A vaccine, could it affect his fertility or increase the chance of birth defects? 

Studies have not been done to see if the hepatitis A vaccine 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 calcium carbonate in pregnancy and while breastfeeding. This information is based on published research. It should not take the place of medical care and advice from your healthcare provider. 

What is calcium carbonate? 

Calcium carbonate is a dietary supplement that has been used as an antacid to help symptoms of heartburn, acid indigestion, and upset stomach. Some examples of over-the-counter antacids with calcium carbonate are Tums®, Rolaids®, Maalox®, and Mylanta®.  

The supplement label should list both the calcium carbonate dose along with the actual calcium dose, which is often listed as ‘elemental calcium’. There are Recommended Daily Allowance (RDA) guidelines and upper limit amounts for calcium (elemental calcium). If you are pregnant and/or breastfeeding and age 19 or older, the RDA is 1,000 mg a day, and the upper limit is 2,500 mg. If you are pregnant and/or breastfeeding and are ages 14 to 18 years old, the RDA of calcium is 1,300 mg a day and the upper limit is 3,000 mg. People can reach their RDA of calcium from the foods and beverages they consume as well as the calcium found in supplements and vitamins. If you have a medical condition that might change your calcium levels, talk with your healthcare providers about the amount of calcium that is right for you.  

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

When used as directed and within the recommended amounts, taking calcium carbonate is not expected to make it harder to get pregnant. 

Does taking calcium carbonate increase the chance of miscarriage? 

Miscarriage is common and can occur in any pregnancy for many different reasons. When used as directed and within the recommended amounts, taking calcium carbonate is not expected to increase the chance of miscarriage. 

Does taking calcium carbonate 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 calcium carbonate, might increase the chance of birth defects in a pregnancy. When used as directed and within the recommended amounts, calcium carbonate is not expected to increase the chance of birth defects above the background risk. 

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

When used as directed and within the recommended amounts, taking calcium carbonate is not expected to 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). 

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

Studies have not been done to see if calcium carbonate can cause behavior or learning issues for the child.  

What if I take more than the recommended amounts of calcium carbonate? 

The use of calcium carbonate in more than recommended amounts might increase the chance of low birth weight (weighing less than 5 pounds, 8 ounces [2500 grams] at birth). There have been a few case reports of newborns with seizures when high doses of calcium carbonate were used near the end of pregnancy. Also, taking more calcium carbonate than recommended can cause milk-alkali syndrome, a condition in which there is a high level of calcium in the body (hypercalcemia) and could lead to kidney failure or inflammation of the pancreas in the woman who is pregnant.  

Breastfeeding while taking calcium carbonate: 

Calcium is found in breastmilk. When used as directed and within the recommended amounts, calcium carbonate is unlikely to be harmful to a nursing baby. Be sure to talk to your healthcare provider about all your breastfeeding questions.  

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

Studies have not been done to see if calcium carbonate 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/.  

Please click here for references.