Pregnancy is undoubtedly one of the most magical times in a woman’s life, but it also comes with many new concerns and questions. One of the most common concerns we get asked about as physicians is about the safety of various products during pregnancy. Pregnancy is a time when extra caution is necessary, as certain products can negatively affect the health of the mother and her developing baby.
Products to be Avoided During Pregnancy
Prescription Medications
Always consult with your doctor before going off any prescribed medications. However, certain prescribed medications may not be recommended, these include, but are not limited to:
- Accutane (Isotretinoin): Used for severe acne and should be as it can cause serious birth defects.
- Tetracycline: Antibiotics that can affect bone growth and teeth coloring in the fetus.
- Warfarin: A blood thinner that can cause birth defects.
- Angiotensin-Converting Enzyme (ACE) Inhibitors: Drugs like enalapril and lisinopril, used for high blood pressure, can cause serious fetal harm, particularly in the second and third trimesters.
- Angiotensin II Receptor Blockers (ARBs): Similar to ACE inhibitors, ARBs like losartan and valsartan are contraindicated in pregnancy due to the risk of adverse fetal outcomes.
- Valproate (Depakote): Used in the treatment of epilepsy and bipolar disorder, valproate can lead to neural tube defects and other birth defects.
- Lithium: Used to treat bipolar disorder, lithium has been associated with a risk of heart defects in infants.
- Methotrexate: Used for cancer, rheumatoid arthritis, and psoriasis, this medication can cause miscarriage and severe birth defects.
- Thalidomide: Known for causing severe birth defects, it is not used during pregnancy.
- Certain Anticonvulsants: Some medications used for seizures, other than valproate, can also pose risks and should be used under strict medical supervision.
- Hormones: Certain hormone treatments, like some forms of progesterone or androgen therapy, can be harmful during pregnancy.
Over-the-Counter Medications
Certain over-the-counter medications should be avoided, these may include:
- NSAIDs
- Aspirin
- Cold and flu meditations
- Pepto-Bismol
- Laxatives and some stool softeners.
However, it’s important to always consult your doctor as some over-the-counter medications may be perfectly safe to take when pregnant. Ask your doctor for a personalized recommendation that is right for you.
Supplements
When pregnant, it's crucial to be cautious about the supplements you take, as some can be harmful to the developing fetus. Supplements to potentially avoid include:
- Vitamin A (Retinol) in High Doses: Excessive intake of vitamin A can lead to birth defects and liver toxicity. Pregnant women should avoid supplements that contain high doses of preformed vitamin A (retinol), including some types of fish liver oil and high-potency multivitamins. Topical Retinol should also be avoided.
- High-Dose Vitamin E: While Vitamin E is important, high doses can increase the risk of abdominal pain and premature rupture of the amniotic sac.
- High-Dose Vitamin C: Excessive Vitamin C, especially in supplement form, may not be safe. The body's requirement for Vitamin C can be met with a balanced diet or a prenatal vitamin.
- Certain Herbal Supplements: Some herbs can be harmful during pregnancy, potentially causing preterm birth, miscarriage, or developmental problems. Because of this, certain types of herbal tea should also be avoided. These herbal supplement include, but are not limited to:
- Dong Quai
- Ephedra (Ma Huang)
- Yohimbe
- Goldenseal
- Saw Palmetto
- Blue Cohosh
- Black Cohosh (except possibly under midwife or doctor supervision)
- Pennyroyal
- And many more; check with your doctor if you’re unsure
- Weight Loss Supplements: Supplements marketed for weight loss are typically not recommended during pregnancy. They can contain a range of potentially harmful substances, including stimulants, which aren’t safe for the developing fetus.
- Omega-3 Supplements Containing Vitamin A: Some omega-3 supplements, especially those made from fish liver, such as cod liver oil, can contain high levels of vitamin A.
- Certain Mineral Supplements: Excessive intake of minerals like iron or selenium can be harmful. While iron is crucial during pregnancy, too much can be toxic. Selenium in high doses can also be dangerous.
Alcohol
Avoid all forms of alcohol, no amount of alcohol is recommended during pregnancy. Alcohol consumption during pregnancy can lead to Fetal Alcohol Spectrum Disorders (FASDs), which encompass a range of physical, behavioral, and learning problems.
Caffeine
Limit caffeine intake. High caffeine consumption is associated with an increased risk of miscarriage and low birth weight. A safe limit is generally considered to be about 200 mg per day (about one 12-ounce cup of coffee).
Certain Foods
During pregnancy, it's crucial to be mindful of your diet, as certain foods can pose risks to both you and your developing baby. Here is a list of foods that are generally should be avoided during pregnancy:
- Raw or Undercooked Meat, Eggs, and Seafood due to increased risk of contamination with harmful bacteria and parasites like Toxoplasma, E. coli, Listeria, and Salmonella.
- Unpasteurized Dairy and Juices may contain a harmful bacteria called Listeria.
- High-Mercury Fish such as shark, swordfish, king mackerel, and tilefish. Mercury can affect the baby's nervous system.
- Deli Meats and Hot Dogs, unless they are heated until steaming hot, carry a risk of Listeria.
Read more on the best foods to choose while pregnant and those to avoid in our article, “What to Eat & Avoid While Pregnant”.
Recreational Drugs
All recreational drugs are to be avoided, there is absolutely no safe amount. They can have devastating effects on fetal development and can lead to birth defects, low birth weight, premature birth, and other severe complications.
Chemicals and Toxins
Remember, what you take into your body is what your baby is exposed to as well. Be mindful of your surroundings and aim to avoid exposure to certain chemicals and toxins like:
- Lead: Found in some paints, especially in older homes.
- Pesticides: Exposure to certain pesticides should be minimized.
- Solvents: Like paint thinners and nail polish removers can be harmful.
- Certain Cleaning Products: Avoid cleaning products with harmful chemicals, such as ammonia, chlorine bleach, and oven cleaners. Opt for natural or less toxic alternatives and ensure good ventilation when using any cleaning products.
- Cigarette Smoke: Secondhand smoke contains harmful chemicals and is associated with increased risks of miscarriage, low birth weight, and other complications.
- Heavy Metals Other Than Mercury: Like cadmium and arsenic, found in some contaminated water sources and certain foods, can be harmful to fetal development.
- Air Pollutants: Exposure to high levels of air pollution can affect fetal development and may lead to complications like preterm birth.
- Art Supplies: Some art materials can contain toxic substances. Pregnant women should use non-toxic, water-based paints and materials and avoid inhaling fumes from art supplies.
Certain Personal Care Products
Just like we can inhale chemicals and toxins we can also absorb them through our skin through personal care products. Not all personal care products are safe for your developing baby and you should avoid certain products like:
- Retinoids: Found in some anti-aging skincare products, high doses of Vitamin A can be harmful.
- Phthalates: Often found in scented products like perfumes and certain plastics.
- Salicylic Acid: High doses of salicylic acid, particularly in oral form or strong topical peels, are not recommended during pregnancy. Small, topical applications, like those in acne treatment products, are generally considered safer, but it's best to consult with a healthcare provider.
- Formaldehyde and Formaldehyde-Releasing Preservatives: These can be found in nail polishes, hair straightening products, and certain shampoos. Prolonged exposure to formaldehyde has been linked to fertility issues and miscarriage.
- Ammonia: Commonly found in hair dyes, ammonia fumes can be irritating and are best avoided during pregnancy. If hair dying is necessary, consider ammonia-free products and ensure a well-ventilated area.
- Dihydroxyacetone (DHA): Used in self-tanners, DHA is not believed to be harmful to the fetus when applied topically and in limited amounts, but inhaling it during spray tanning should be avoided.
- Chemical Sunscreens: Ingredients like oxybenzone and avobenzone can be absorbed into the skin and might affect the fetus. Mineral sunscreens containing zinc oxide or titanium dioxide are considered safer alternatives.
Being Mindful While Pregnant
During pregnancy, it's crucial to be mindful of the products you use and the substances you are exposed to. Always consult with your doctor before starting or continuing any medication or supplement. Remember that this list is not exhaustive, and when in doubt, it's always better to err on the side of caution for the health and well-being of both you and your baby.