Most allergy medications are considered safe during pregnancy and breastfeeding, including certain antihistamines (like cetirizine and loratadine) and nasal steroids (like budesonide). But some medicines should be avoided or used only with medical guidance. If symptoms remain uncontrolled, pregnancy-safe allergy treatments like SLIT allergy drops may be an option. Always speak with a board-certified allergist to personalize what's safe for you and your baby.

Pregnancy, breastfeeding & allergies: the quick answer

Pregnancy and breastfeeding can change how your body reacts to allergens. Hormones increase congestion, sensitivity, and mucus production—making even mild allergies feel worse.

The good news:
Most first-line allergy treatments are safe for both pregnancy and breastfeeding.
But choosing the right option matters, especially if you also have asthma.

Below is your quick, scannable guide.

Safe allergy medications during pregnancy (Quick Guide)

Safe antihistamines

Commonly used and preferred by allergists (AAAAI/NIH supported):

• Cetirizine (Zyrtec) – safe
• Loratadine (Claritin) – safe
• Fexofenadine (Allegra) – generally considered safe
• Diphenhydramine (Benadryl) – safe but causes drowsiness

These help with sneezing, itching, hives, and runny nose.

Safe nasal sprays

Top recommended options:

• Budesonide (Rhinocort) — pregnancy Category B; most studied
• Fluticasone (Flonase) — widely used; good safety data
• Mometasone (Nasonex)

These are first-line for congestion and inflammation.

Asthma medications

According to NIH and AAAAI, keeping asthma controlled is safer than stopping medications.
Safe options include:

• Albuterol (rescue inhaler)
• Budesonide inhaled steroid
• Combination inhalers when needed

What’s not recommended (or needs special caution)

Pseudoephedrine (Sudafed)

Avoid during first trimester; use later only if your clinician approves.

Phenylephrine

Avoid — limited safety data plus low effectiveness for congestion.

Allergy Shots (SCIT)

If you are already on allergy shots and tolerate them well, you can continue.
But you typically should not start allergy shots during pregnancy, according to AAAAI guidelines.

SLIT Allergy Drops (Sublingual Immunotherapy)

Evidence-based guidance (AAAAI/ACAAI):

• Safe to continue if you started before pregnancy
• Not started during pregnancy as a new treatment due to possible local reactions
• Excellent option to continue during breastfeeding

Learn more about customized allergy drops (SLIT):
➡️ HeyPak® Allergy Drops

Safe allergy treatments while breastfeeding

Breastfeeding mothers can safely use many of the same medications.

Safe antihistamines

• Cetirizine
• Loratadine
• Fexofenadine

These pass into breastmilk in very small amounts and are considered safe.

Benadryl may decrease milk supply if used frequently.

Safe nasal sprays

• Budesonide
• Fluticasone
• Mometasone

These have minimal systemic absorption.

Asthma medications

Inhalers used for asthma are safe while breastfeeding, including rescue and maintenance inhalers.

Non-medication allergy relief that’s always safe

These options are safe during pregnancy and breastfeeding:

• Saline nasal rinses
• HEPA air purifiers
• Showering after outdoor exposure
• Changing clothes after pollen exposure
• Keeping windows closed during high-pollen days
• Using mattress/pillow allergy covers

These add symptom relief without medication risks.

What about allergy testing during pregnancy?

Good news: Allergy skin testing is generally considered safe but often avoided unless urgently needed, because a rare systemic reaction is theoretically possible.

Blood testing (IgE testing) is safe and commonly used.

Book a convenient online allergy evaluation:
➡️ Allergy Testing Options

SLIT allergy drops (HeyPak®): can you use them while pregnant or breastfeeding?

Sublingual immunotherapy (SLIT) is a long-term allergy treatment that retrains your immune system. At HeyAllergy, our HeyPak® drop program is physician-designed and customized to your allergens.

During Pregnancy

• Safe to continue if you already started
• Not recommended to start new SLIT while pregnant
  This is based on AAAAI/ACAAI practice parameters.

During Breastfeeding

• Safe to continue
• Safe to start as a new patient postpartum
• No evidence of harm to baby or milk supply

Explore SLIT and see if you qualify:
➡️ Allergy Drops (SLIT) Guide

Quick Comparison Table: What’s Truly Safe?

When to see an allergist

You should schedule an allergy appointment if:

• Symptoms are daily or more than 3 days/week
• You have nighttime congestion affecting sleep
• You wheeze or have shortness of breath
• You’re using rescue medications often
• You’re unsure which allergy meds are safe during pregnancy or breastfeeding
• Allergies worsen asthma symptoms
• You want long-term treatment like SLIT drops

Get expert guidance from board-certified allergists through secure telehealth:
➡️ Schedule Your Online Allergy Visit
➡️ How Telemedicine Works

What to Do Next (Action Plan)

✔ Step 1: Confirm which medications you’re using now
Check your antihistamine, nasal spray, and asthma meds.

✔ Step 2: Identify gaps in control
If you’re still congested, waking up at night, or avoiding activities, you may need a safer alternative.

✔ Step 3: Meet with a board-certified allergist
We help ensure every treatment is pregnancy-safe and breastfeeding-safe.

✔ Step 4: Explore long-term treatment
If you want to reduce your reliance on medications, SLIT allergy drops may be the right path, especially postpartum.

FAQs

1. Can I take Zyrtec or Claritin while pregnant?
‍Yes. Cetirizine (Zyrtec) and loratadine (Claritin) are two of the safest, most recommended antihistamines during pregnancy and breastfeeding.

2. Are nasal steroid sprays safe in pregnancy?
‍Yes. Budesonide, fluticasone, and mometasone are safe and preferred for congestion and inflammation.

3. Can I start allergy drops during pregnancy?
‍No. You can continue if you started before pregnancy, but new SLIT treatment is usually started after delivery.

4. Is Benadryl safe while breastfeeding?
‍It’s generally safe, but frequent use may lower milk supply and cause drowsiness.

5. Are decongestants safe in pregnancy?
‍Avoid pseudoephedrine during the first trimester and use only with clinician approval later in pregnancy.

6. Can allergies worsen during pregnancy?
‍Yes. About one-third of people notice worse allergies due to hormonal congestion and immune changes.

If you want safe, expert-guided allergy care during pregnancy or breastfeeding, HeyAllergy’s board-certified team is here for you.

📅 Book your online allergy appointment today: https://www.heyallergy.com/book-appointment
💧 Explore personalized allergy drops (SLIT): https://www.heyallergy.com/heypak

Author, Review & Disclaimer

Author: Krikor Manoukian, MD, FAAAI, FACAAI — Board-Certified Allergist/Immunologist
Bio: Dr. Manoukian is a board-certified allergist/immunologist specializing in telemedicine-enabled allergy care and personalized SLIT programs. He leads HeyAllergy’s clinical team and trains providers in safe immunotherapy.
Medical Review: HeyAllergy Clinical Team (Board-Certified Allergists/Immunologists)
Disclaimer: This article is educational and not a substitute for personalized medical advice. Always consult your clinician about your medications and treatment options.

References

• AAAAI. “Medication Safety in Pregnancy & Lactation.”
• AAAAI/ACAAI. Sublingual Immunotherapy Practice Parameter Update (2017).
• NIH/NHLBI Asthma Guidelines.
• CDC: Pregnancy & Medication Safety.