Many women have allergies, either seasonal or year-round, before getting pregnant. Others develop a stuffy nose during pregnancy, even if they haven't had that problem before.

During pregnancy, elevated levels of estrogen appear to increase mucus production and swelling in the nose, causing congestion. In addition to a runny or stuffed nose, you may experience sneezing and itchy, watery eyes.

Many of the usual remedies for these signs and symptoms should be avoided in pregnancy:

• Antihistamines. Use caution when considering the use of antihista-mines, which are commonly used to relieve cold and allergy signs and symptoms such as itching, sneezing and a runny nose. Talk with your health care provider to see if antihistamines would help and for direction on which product to use.

• Decongestants. There is reason for concern regarding pregnant women's use of decongestants, which come in either nasal or oral form and work by shrinking blood vessels to relieve nasal congestion. Decongestants are sold under many brand names, including Afrin, Dristan, Drixoral, Naphcon Forte, Neo-Synephrine, Otrivin, Sudafed, and Vicks Sinex. Use decongestants only on a health care provider's advice.

• Combination antihistamines and decongestants. Many prescription and nonprescription products combine antihistamines and decongestants. Some over-the-counter medications of this type include Allerest, Benadryl Allergy & Sinus, Claritin-D, Contac Day & Night Allergy/Sinus, Sudafed Severe Cold Formula and Vicks DayQuil. Avoid all medications of this type while pregnant because combination drugs may have combined effects on the fetus.

Preferred medications for problems in pregnancy include:

• Nasal sprays. Steroid nasal sprays reduce inflammation and mucus production and may improve night sleep and daytime alertness. Nasal sprays include beclomethasone (Beconase, Vancenase), budes-onide (Rhinocort), flunisolide (Aerobid), fluticasone (Flonase), mometasone furoate (Nasonex) and triamcinolone (Nasacort). Steroid nasal sprays are thought to be safe during pregnancy, but discuss your options carefully with your health care provider before taking them.

• Cromolyn. Cromolyn (NasalCrom) also is a nasal spray that reduces inflammation, but it's not a steroid. It's not as effective as the steroid sprays, but it's effective for treating mild allergies. It's often a good treatment option for pregnant women with mild allergies.

• Allergy shots. Allergy shots (immunotherapy) are safe for pregnant women who are already receiving them. If you haven't been getting shots, don't start them during pregnancy unless you've talked about this option with your health care provider.

■ Prevention and self-care for allergies

As a first step, try to determine what you're allergic to. Try to avoid exposing yourself to those things. Common irritants or allergens include pollen, dust mites, animal dander and hair, molds, fungi and cockroaches. Keep in mind that smoking or being in a smoke-filled room can make your allergies worse. Air filters and air conditioning can help control pollen allergies.

Here are some other tips to help you deal with allergy signs and symptoms:

• Use a nasal wash to clear a congested nose. Dissolve 1/4 teaspoon of salt in 1 cup of warm water. Lean over the sink with your head down and to the side. Pour some of the saline solution into the palm of your hand and inhale it through a nostril while holding the other nostril closed with your finger. The solution will move through your nasal passages and into your mouth. Spit the remaining solution out, and gently blow your nose. Tilt your head to the other side and repeat with the other nostril. You can also administer the wash with a large rubber syringe, available at pharmacies. You can do nasal washes several times a day. Make a fresh solution each time.

• You may be able to clear a stuffy nose by breathing steam from a hot shower, a pot of boiling water taken off the stove, a cool mist humidifier or a vaporizer. Be sure to keep humidifiers and vaporizers clean because bacteria and mold can grow in them.

• Place warm, moist towels on your face to clear your nose and chest.

• Use your fingers to massage your sinuses — rub on the bony ridge above and under your eyebrows, under your eyes and down the sides of your nose.

■ When to seek medical help for allergies

If your signs and symptoms are severe or don't improve with self-care techniques, talk to your health care provider. He or she may suggest an appropriate medication. Don't take any medication for allergies without consulting your health care provider. Studies haven't found any benefit from most alternative therapies, including high-dose vitamins, homeopathic remedies and most herbal remedies. And they aren't any safer than medications.

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