5. Using Over-the-Counter (OTC) Medicines

Nearly 65% of all pregnant women use some sort of medicine during pregnancy, including nonprescription medicine, also called over-the-counter medication. Often, it is used to treat pain and discomfort.

Facts about OTC Medicines

Below are some interesting facts about over-the-counter medicines and how they can affect you. Be careful with any medications you take during pregnancy.

• Avoid sudafed during the first trimester.

• Avoid cold remedies that contain iodine. Iodine can cause problems in baby.

• Claritin and Zyrtec are believed to be safe during pregnancy.

• Primatene Mist is not recommended for use when you’re pregnant.

• If you regularly take Airborne to prevent colds when you aren’t pregnant, it may be a good idea to skip it during pregnancy. It hasn’t been tested on pregnant women.

• Be careful with antacid use—it can interfere with iron absorption.

• If you have a yeast infection, ask your healthcare provider about using an over-the-counter treatment, such as Terazol or Monistat.

Many people don’t think of OTC products as medications, and they take them willy nilly, pregnant or not. Some researchers believe over-the-counter medication use actually increases during pregnancy.

Some OTC products may not be safe during pregnancy. See the box above. Use them with as much caution as any other drug! Many products are combinations of medicines. For example, pain medicine can contain aspirin, caffeine and phenacetin. Cough syrups or sleep medications can contain alcohol.

Tip for Week 7

Don’t take any over-the-counter medicines for longer than 48 hours without talking to your healthcare provider. If a problem doesn’t get better, your healthcare provider may have another treatment plan for you.

Read package labels and package inserts about safety during pregnancy—nearly all medicines contain this information. For example, some antacids can cause constipation and gas.

Some OTC products can be used safely during pregnancy, if you use them wisely. Check the list below:

• analgesics and pain relievers—acetaminophen (Tylenol)

• decongestants—chlorpheniramine (Chlor-Trimeton)

• nasal spray decongestants—oxymetazoline (Afrin, Dristan Long-Lasting)

• cough medicine—dextromethorphan (Robitussin; Vicks Formula 44)

• stomach relief—antacids (Amphojel, Gelusil, Maalox, milk of magnesia)

• throat relief—throat lozenges (Sucrets)

• laxatives—bulk-fiber laxatives (Metamucil, Fiberall)

If you think your symptoms or discomfort are more severe than they should be, call your healthcare provider. Follow his or her advice, and take good care of yourself.

Using Acetaminophen

Most experts believe acetaminophen is OK to use during pregnancy—it’s hard to avoid because it’s in over 200 products! Studies show it’s easy to overdose on the medication because it is in so many preparations. You may not be aware it is contained in various products you may take to treat a single problem. Taking more than one product to treat a condition or illness could be dangerous. Always read labels! For example, take only one medication to treat a cold or flu symptoms, and always take the correct dose!

6. Your Nutrition

Dairy products can be very important during pregnancy. They contain calcium and vitamin D; both are important to you and baby. Calcium helps keep your bones healthy; baby needs it to develop strong bones and teeth.

A pregnant woman should take in 1200mg of calcium a day (1½ times the recommended amount for nonpregnant women). Your prenatal vitamin supplies about 300mg, so be sure you eat enough of the right foods to get the other 900mg.

Read food labels to find out how much calcium per serving is in a packaged food. Every day, write down the amount of calcium in each food you eat, and keep a running total to be sure you’re getting 1200mg. 

Some Good Sources of Calcium. Milk, cheese, yogurt and ice cream are good calcium sources. Other foods that contain calcium include broccoli, bok choy, collards, spinach, salmon, sardines, garbanzo beans (chickpeas), sesame seeds, almonds, cooked dried beans, tofu and trout. Some foods are fortified with calcium, such as some orange juice, breads, cereals and grains. Check your grocery shelves.

Some dairy foods you may choose, and their serving sizes, include the following:

• cottage cheese—¾ cup

• processed cheese (American)—2 ounces

• hard cheese (Parmesan or Romano)—1 ounce

• custard or pudding—1 cup

• milk (whole, 2%, 1%, skim)—8 ounces

• natural cheese (cheddar)—1½ ounces

• yogurt (plain or flavored)—1 cup

If you want to lower calories, choose low-fat dairy products. Calcium content is unaffected in low-fat dairy products. Good choices include skim milk, low-fat yogurt and low-fat cheese.

Increase the amount of calcium you get by adding powdered nonfat milk to recipes, such as mashed potatoes and meat loaf. Make fruit shakes with fresh fruit and milk; add a scoop of ice milk, frozen yogurt or ice cream. Cook rice and oatmeal in skim or low-fat milk. When you make canned soups, substitute milk for water. Have a smoothie instead of plain orange juice.

Some foods interfere with calcium absorption. Salt, tea, coffee, protein and unleavened bread lower the amount of calcium absorbed.

If you take antibiotics, read the label on your prescription. If it says not to take it with calcium-containing foods, take the antibiotic 1 hour before or 2 hours after meals.

If you’re having trouble getting enough calcium into your diet, ask your healthcare provider about taking a calcium supplement. He or she can advise you.

Lactose Intolerance. When lactose is not properly digested, it can cause gas, bloating, cramps and diarrhea; a person with this problem is referred to as lactose intolerant. If you’re lactose intolerant, there are many sources of calcium available to you. Look for calcium-fortified products. Try rice milk and soy milk fortified with calcium and vitamin D. You may be able to buy lactose-free milk at your grocery store. If you like cheese, there are lactose-free brands you can buy. Ask your grocer about them.

The OTC medicine Lactaid helps the body break down lactose. There are no warnings or precautions about it for use in pregnancy, but check with your healthcare provider before you use it.

How Much Calcium?

It may be a little difficult to determine how much calcium you’re getting in foods you eat. Package labeling usually lists the percentage of calcium in a food. This may be confusing because it’s hard to know how much that is.

The solution is to understand that labeling is based on the RDA recommendation for a nonpregnant woman, which is 800mg a day. If a package states “calcium 20%,” just multiply 800 times 0.2, which gives you the amount of 160mg. Keep a written record of how much calcium you take in every day. You need a total of about 1200mg of calcium a day.

7. Listeriosis

Every year about 1500 cases of listeriosis, a form of food poisoning, are reported in the United States. About 500 of these cases occur in pregnant women, who are more susceptible to infection. Babies born to moms who had listeriosis are at higher risk of developing problems.

Your body can’t absorb more than 500mg of calcium at a time, so spread your intake out every day. At breakfast, if you have calcium-fortified orange juice, calcium-fortified bread, cereal with milk and a carton of yogurt, you may be taking in a lot more than 500mg, but your body won’t be able to absorb it!

To prevent listeriosis, avoid unpasteurized milk and any foods made from unpasteurized milk. Avoid unpasteurized soft cheeses such as Camembert, Brie, feta, Gorgonzola, bleu cheese and Roquefort. If they have been made with pasteurized milk, soft cheeses are OK during pregnancy. Read labels very carefully.

You also need to be careful of other products that are not pasteurized, such as some juices. Use caution when buying fruit juice at a farmers’ market or a farm stand. It may not be pasteurized. Unpasteurized fresh juice can contain a lot of germs.

Undercooked poultry, red meat, seafood and hot dogs can also contain listeriosis. Cook all meat and seafood thoroughly. Be careful about cross-contamination of foods. If you put raw seafood or hot dogs on a counter or cutting board, thoroughly wash the area with soap and hot water or a disinfectant before you put other food on that surface.

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