If I’m pregnant, can I use essential oils? Is it ok to take herbal products, like flaxseed and other herbal supplements during breastfeeding? MotherToBaby Podcast host Chris Stallman, a certified genetic counselor and mother of three, takes questions from other moms from around the country about the known safety of using essential oils and herbal products during pregnancy and breastfeeding. Alfred Romeo, RN, PhD from MotherToBaby’s Utah affiliate is her guest expert helping to provide evidence-based answers.

Are vaccines ok to get during pregnancy? Which vaccines should you get in pregnancy or before becoming pregnant? What about vaccine safety in breastfeeding? Sonja Rasmussen, MD, a world-renowned clinical geneticist, pediatrician and professor at the University of Florida and Kerri Bertrand, MPH of MotherToBaby California and the Mommy’s Milk research project join host Chris Stallman, a certified genetic counselor, live from MotherToBaby’s Annual Meeting in San Diego to answer the public’s questions.

When Your Bundle of Joy Comes with a Bundle of Questions – We’re Your Experts

MotherToBaby is the nation’s most trusted source of evidence-based information on medications and other exposures during pregnancy and while breastfeeding. MotherToBaby Fact Sheets summarize all the available scientific information to determine whether or not parents and their developing babies are at risk because of an exposure. We offer over 300 Fact Sheets on a wide variety of exposure topics that are available to the public 24/7 in English and Spanish. Our Fact Sheets cover many common pregnancy and breastfeeding exposures that a woman may experience, including prescription and over-the-counter medications, recreational substances, cosmetic treatments, maternal health conditions, infections, vaccines, chemicals, and workplace exposures.

Our Fact Sheets are not the only way that MotherToBaby provides information about the benefits or risks of exposures that a woman who is pregnant or breastfeeding may encounter. Our experts also provide personalized information by live chat, text, phone, and email at no-cost to to residents of the United States and its territories. If our database of Fact Sheets does not include the exposure that you are interested in or if you have additional questions about the exposure, please don’t hesitate to contact our information specialists.

Everyone should have access to accurate information to make the best health decisions for themselves and their family.

While our experts are steeped in scientific backgrounds, we focus on communicating information about pregnancy and breastfeeding exposures in an easy to read format through multiple channels, including The MotherToBaby Podcast and our Baby Blog. You can listen to The MotherToBaby Podcast to hear from host, MotherToBaby specialist, and mom-of-four, Chris Stallman, as she takes listeners’ questions on exposures and engages guest experts to address what’s okay and what’s not during pregnancy and breastfeeding. You can also read our Baby Blogs, which provide helpful information on some of today’s most pressing exposure topics.

Our team knows so much about pregnancy and breastfeeding exposures because we are also top researchers in the field of birth defects prevention and medication use in pregnancy and breastfeeding. Our MotherToBaby Pregnancy Studies are observational research studies that aim to answer questions about whether a person’s health conditions and treatments affect their pregnancy. Our research has been instrumental in identifying previously unrecognized exposures that can be harmful to pregnancy, as well as ruling out substantial risk for other medications and vaccines. MotherToBaby Pregnancy Studies provides study opportunities to residents of the United States and Canada. The information yielded by our research gets included on medication labels and can be used by the public and their health professionals to make treatment decisions during pregnancy.

Browse below to find our most popular exposure topics and to access related fact sheets, blogs, podcasts, ongoing observational MotherToBaby Pregnancy Studies, and more. Check back frequently as we are constantly adding new resources and updating existing information!

Explore Our Most Popular Topics

By Brittany Ajoku, MotherToBaby North Texas

Did you know that 1 of every 2 sexually active people will contract a sexually transmitted disease (STD) by age 25? That number is shocking, and highlights why it is so important to tackle this often-stigmatized topic head-on! So as we ease into National STD Awareness Month, it’s time to talk openly about STDs, pregnancy and breastfeeding. STDs can affect people from all walks of life, and do not discriminate against anyone, including pregnant and breastfeeding women.

I remember when a client recently called our office panicked about the result of an STD test after learning her husband was having an affair. She tested positive for a bacterial infection and her doctor prescribed an antibiotic for treatment. Because she was breastfeeding, she was hesitant to begin using the antibiotic and had many questions. Would the antibiotic hurt her baby? Could she have infected her baby before she knew she had the infection? With a Google search leaving her with more questions than answers, she turned to MotherToBaby. After listening to her concerns, I began to dig through the latest research to provide her with what we are known for: giving understandable and current, evidence-based information.

STD Testing: Why Knowing Your Status Is Definitely Better For You & For Baby

In any woman, including those who are pregnant or breastfeeding, some STDs are asymptomatic (do not have symptoms or signs) even when infected. As a result, it can be difficult to know for sure whether a woman is infected or not without testing. Some STDs are automatically tested for over the course of a pregnancy (such as syphilis, HIV, hepatitis B, and chlamydia) while others are only tested if you are at an increased risk for the infection due to various risk factors. Even if you have already been tested earlier in pregnancy or you were tested in the past while breastfeeding, it is important to let your doctor know if you are having symptoms or suspect you have or may have been exposed to an STD. Earlier treatment of STDs allows for earlier detection of infections, which reduces the likelihood for you to transmit the infection to your baby during pregnancy or via breastmilk. Untreated STDs can not only lead to negative outcomes in moms but can also lead to negative outcomes in their babies.

Some of the negative outcomes from untreated STDs in pregnancy are:

• Preterm delivery
• Low birth weight
• Pregnancy loss
• Infections in the baby’s organs
• Premature rupture of membranes

Treating STDs in Nursing Moms and Moms-To-Be

Once detected and diagnosed, it’s best to begin to treat the STD as soon as possible. Antibiotics are commonly prescribed to treat and cure bacterial infections, while antiviral medications are prescribed to help treat the signs and symptoms of viral infections.  Many medications have not been shown to increase risks in pregnancy and breastfeeding. Our library of fact sheets has many of the antibiotics and antiviral medications used to treat STDs and can be viewed here.

While breastfeeding with an STD, there is an additional factor to keep in mind besides what medication is prescribed to treat the STD. There are some STDs (such as syphilis and herpes) that may produce sores on various areas of the body and it’s important to keep your baby and any pumping equipment from touching these sores to limit transmission of infections.

“An Ounce of Prevention Is Worth A Pound of Cure”

As important as it is to talk about treatment, prevention is also important to discuss. Here are a few things to keep in mind both during pregnancy and while breastfeeding.

• It is important to always have open and honest conversations with both your doctor and intimate partner(s) about your STD status.
• Abstaining from any type of sex (oral, vaginal, or anal) is the most reliable way to avoid infection. But if you want to be sexually active (and let’s face it, many do!), practice safe sex by consistently and correctly using condoms, especially if you and your partner are not mutually monogamous or have not recently been tested.
• Be sure to get tested as soon as possible whenever you notice symptoms and signs, or think you’ve been infected.
• If you and/or you partner(s) are currently receiving treatment for an STD, practice abstinence during treatment.

With this information in mind, I was able to counsel my client on the importance of treating her STD and that the antibiotic she was prescribed was not expected to have negative effects in her nursing infant. Many STDs that are bacterial (such as chlamydia and gonorrhea) have not been shown to be transmitted via breast milk so my client had not put her infant at risk prior to treatment.

Just as I was able to help my client, the experts at MotherToBaby are always available to discuss medications and exposures, like STDs, during pregnancy and breastfeeding – it’s confidential, no-cost, and judgment-free!

Brittany Ajoku is a Teratogen Information Specialist with MotherToBaby North Texas. She received her bachelor’s degree in biochemistry from the University of North Texas and is working towards a Master in Public Health in Maternal and Child Health. Along with providing counseling at the service, she also enjoys raising awareness of the organization through community presentations and events.

About MotherToBaby

MotherToBaby is a service of the Organization of Teratology Information Specialists (OTIS), and a suggested resource by many agencies including the Centers for Disease Control and Prevention (CDC). If you have questions about exposures during pregnancy and breastfeeding, please call MotherToBaby toll-FREE at 866-626-6847 or try out MotherToBaby’s new text information service by texting questions to (855) 999-3525. You can also visit MotherToBaby.org to browse a library of fact sheets about dozens of viruses, medications, vaccines, alcohol, diseases, or other exposures during pregnancy and breastfeeding or connect with all of our resources by downloading the new MotherToBaby free app, available on Android and iOS markets.

References:

Center for Disease Control and Prevention (CDC). 2017. STDs during Pregnancy. https://www.cdc.gov/STD/pregnancy/default.htm

The American College of Obstetricians and Gynecologists (ACOG). 2017. FAQs: Routine Tests During Pregnancy. https://www.acog.org/Patients/FAQs/Routine-Tests-During-Pregnancy

March of Dimes (MOD). 2018. Sexually Transmitted Infections. https://www.marchofdimes.org/complications/sexually-transmitted-infections.aspx

National Institute of Child Health and Development. 2017. How do sexually transmitted diseases and sexually transmitted infections (STDs/STDs) affect pregnancy? https://www.nichd.nih.gov/health/topics/STDs/conditioninfo/infant

Office on Women’s Health, U.S. Department of Health and Human Services. 2018. Sexually transmitted infections, pregnancy, and breastfeeding. https://www.womenshealth.gov/a-z-topics/STDs-pregnancy-and-breastfeeding

 

 

Being pregnant can be stressful enough without worrying all the time about things like “can I bake with poppy seeds?” Or “can I drink tea with peppermint?” Recently I had a caller tell me that “it seems like every time I turn around, there is something else that either I should not cook with or drink in a tea during pregnancy. What about when I am breastfeeding? Help!” As a specialist who answers questions about exposures during pregnancy and breastfeeding, I hear these kinds of questions all the time.

Spices vs. Herbs

Let’s explore some of the spices and herbs that are not recommended for frequent use during pregnancy and breastfeeding. Many of these items can be used in different ways, such as in baking, to flavor candy, as spices in foods, toppings on salads, or as part of herbal teas. To clarify, the difference between a spice and an herb is that herbs have to have a green leafy part and are mainly used for flavoring. They are also used as a garnish in cooking or salads. Spices, on the other hand, come from a variety of things such as dried roots, nuts, dried fruits and vegetables, or even from bark. Some spices are used for flavoring, while others are used as food preservatives or to give food color. If you use these herbs and spices once in a while as flavoring in your food and drinks, that is OK. The concern is when you consume these items every day or most days.

Poppy Seeds

Poppy seeds come from the poppy plant and are often used in foods such as bagels, pastries, cakes, and salad dressings. The seeds are washed and processed before use and eating small amounts now and then as part of a food dish or baked item is not known to be a risk during pregnancy or breastfeeding. However, the outer surface of the poppy seed does contain small amounts of morphine and other opiates such as codeine. When poppy seeds are used to make tea, the drugs can seep into the water when the seeds are soaked. Poppy seed tea should be avoided during pregnancy and breastfeeding for this reason.

Nutmeg

Who hasn’t had nutmeg floating on top of a latte or a cup of hot apple cider on a cold day in the winter? Nutmeg is a ground spice that comes from the seed of a dark-leaved evergreen tree. Nutmeg is also used in many different baked goods and with vegetables, specifically going well with squash dishes. Eating a little nutmeg as a spice in food does not have a known increased risk during pregnancy or breastfeeding. But high levels of nutmeg can also be used as a recreational drug as it contains myristicin, which has mind altering hallucinogenic effects. The myristicin isolated from nutmeg oil can be used to produce synthetic amphetamines. Also, in the past, nutmeg was used in folk medicine to induce abortion. Because of this, high level exposure should be avoided in pregnancy and breastfeeding.

Peppermint

Peppermint use is a common question during pregnancy and breastfeeding. Peppermint is a popular herb used as flavoring in candy, chewing gum, desserts, and tea. Peppermint oil is also made from the leaves of the peppermint plant. The oil is widely used topically on the skin to treat headaches, muscle, and joint aches and pain, and in aromatherapy to treat coughs and colds. Peppermint oil can also be diluted with water and sprinkled around your house as an insect repellent too. So is this popular herbal product a risk during pregnancy? High levels of peppermint exposure during pregnancy can be a risk since it can relax the muscles of the uterus and increase the risk for miscarriage. For that reason, frequent use of peppermint oil on your skin (see our blog on essential oils) or drinking lots of peppermint tea is not advised during pregnancy.

Rosemary

One of my favorite herbs is rosemary! It is easy to grow and widely used as a seasoning in soups, salads, vegetable dishes, and with chicken and fish. Rosemary grows as a large evergreen shrub. The small evergreen “needles” are used in cooking, while the oil is used in folk medicine for digestive problems and to treat headaches. The concern comes when ingesting large amounts of rosemary, which can stimulate menstruation and increase the risk for miscarriage. Due to this reason, using rosemary for medicinal reasons or frequently on your skin is not advised during pregnancy. Rosemary also contains camphor. When taken orally in high amounts, camphor can act as a poison.

Garlic

Lastly, I want to talk about garlic, a favorite for many people. Is it an herb or a spice? Even though garlic is widely used as both an herb and a spice, it is really a root vegetable. I still want to include it in this blog due to its widespread use as a spice. Garlic is popular in pasta dishes, in garlic butter and on garlic toast, and in many dishes such as stews and soups! Additionally, garlic is high in vitamins B6 and C and is also high in calcium, so it’s often taken as an oral supplement. Yet taking high levels of garlic can increase the risk for bleeding as garlic contains alliin, which acts as a blood thinner in our bodies. During pregnancy, this can lead to an increased risk for miscarriage. Avoiding high levels of garlic during pregnancy is advised. Even topical use of garlic on your skin is not advised as it can cause dermatitis and burns. When breastfeeding, eating garlic can change the taste of the milk and babies may not like it. Garlic use can also increase the chance for gas and colic in some babies.

Hopefully this blog has helped you make heads and tails out of using/eating/drinking these spices and herbs during pregnancy and breastfeeding. In general, with many spices and herbs, using a little bit to flavor your food usually does not have any known increased risks during pregnancy or breastfeeding. However, using the product in a tea or as an oral supplement is often not advised. We have a helpful fact sheet on herbal supplements that explains how little pregnancy safety data there is on most herbal supplements. Plus, these products are not regulated by the Food and Drug Administration (FDA) for safe use during pregnancy and breastfeeding. Any time you have questions or concerns about using spices and herbs during pregnancy, please contact us! One of our specialists will be happy to help you.