Asthma Pregnancy And Breastfeeding

Overview

Asthma is a common long-term condition that affects the small tubes in your lungs. It can make it harder to breathe, especially when it flares up. If you have asthma and are pregnant or breastfeeding, it is important to keep your asthma well managed. This helps keep you and your baby healthy.

Yes, asthma is one of the most common health conditions in pregnancy. Around 1 in 10 pregnant women has asthma.

It affects women of all ages who have asthma. You may already know you have asthma, or you may notice symptoms for the first time during pregnancy.

Symptoms

Common symptoms

• Wheeze (a whistling sound when you breathe)
• Cough, especially at night or early morning
• Shortness of breath
• Tightness in the chest
• Feeling tired because you are not getting enough air

Symptoms in children

• This article focuses on adults who are pregnant or breastfeeding. Asthma can also affect children, but the signs are similar: cough, wheeze, and trouble breathing during play or exercise.

Symptoms in older adults

• Older adults who become pregnant are rare, but asthma symptoms can be similar. If you are older and pregnant, your healthcare team will watch your asthma closely.

Causes

Main causes

• Asthma is a condition where your airways are inflamed (swollen) and narrow, making it hard to breathe.
• During pregnancy, hormone changes can affect your asthma. Some women get better, some stay the same, and some get worse.
• Things that trigger asthma (such as colds, allergens, smoke, or pollution) can still cause symptoms while pregnant.

Risk factors

• Having a history of asthma or allergies (such as eczema or hay fever)
• Not taking your asthma medicines as prescribed
• Smoking or being around second-hand smoke
• Poorly controlled asthma before pregnancy
• Having a viral infection during pregnancy

When to see a doctor

See a doctor urgently if:

• If you have a severe asthma attack, call your local emergency number right away.
• If your symptoms are not improving with your usual medicine, seek urgent medical help the same day.

Book a routine appointment if:

• As soon as you know you are pregnant, tell your GP or asthma nurse so they can review your treatment plan.
• Schedule regular asthma reviews during pregnancy.
• Talk to your midwife about your asthma and how to manage it during labour and birth.

Diagnosis

Asthma is usually diagnosed by asking about your symptoms, listening to your chest, and doing breathing tests. If you are already diagnosed, the main focus is checking how well controlled your asthma is during pregnancy.

Tests that may be done

• A spirometry test (you blow into a machine to measure how well your lungs work)
• Peak flow test (a small handheld device that measures how fast you blow out air)
• Your doctor may ask you to keep a symptom diary

What to expect at your appointment

Your GP or asthma nurse will ask you about your symptoms, how often you use your inhaler, and any triggers. They will also check your baby's wellbeing during pregnancy and help you plan for labour and breastfeeding.

Treatment

The goal is to keep your airways open and your asthma under control so you and your baby get enough oxygen. Most asthma treatments are safe during pregnancy and breastfeeding. You should never stop your asthma medicines without talking to your doctor.

Self-care at home

• Take your asthma medicines exactly as prescribed — do not skip doses.
• Learn and avoid your triggers (such as dust, pollen, smoke, or strong smells).
• Get the flu vaccine and whooping cough vaccine if offered — you can have these during pregnancy.
• Keep your home smoke-free.
• Monitor your peak flow regularly and follow a written asthma action plan.

Medical treatments

Asthma is usually treated with inhalers. A preventer inhaler (taken every day) reduces swelling in your airways. A reliever inhaler (used when you have symptoms) opens your airways quickly. During pregnancy and breastfeeding, your doctor may adjust your inhaler type or dose to keep your asthma well controlled. Always talk to your healthcare provider before changing any treatment.

When is surgery considered?

Surgery is not a usual treatment for asthma. However, if you are pregnant and need a caesarean section, your healthcare team will make sure your asthma is well managed before, during, and after the procedure.

Living with this condition

Keep taking your regular preventer inhaler even if you feel well. Carry your reliever inhaler with you. Make sure your midwife and GP know about your asthma so they can include it in your birth plan.

Lifestyle tips

• Do not smoke, and avoid being around others who smoke.
• Stay active with walking, swimming, or prenatal exercise, as long as your symptoms are controlled.
• Get enough rest — tiredness can make symptoms harder to manage.
• Join a supportive community or ask your asthma nurse for advice.

Diet and exercise

There is no special diet proven to treat asthma during pregnancy, but eating a healthy balanced diet is good for you and your baby. Ask your healthcare team about safe exercise — gentle activity is usually fine and may improve your breathing control.

Mental health and emotional wellbeing

Worrying about your asthma and your baby is common. Stress and anxiety can make asthma symptoms feel worse. Talk to your midwife or doctor about how you are feeling — they can offer support. If you are struggling, remember that asking for help is a sign of strength.

Prevention

Asthma itself cannot be prevented, but you can prevent most asthma attacks by taking your medicines regularly, avoiding triggers, and following your action plan. Good control is the best prevention.

Vaccines

You can safely have the flu vaccine and whooping cough vaccine during pregnancy. Ask your doctor or midwife which vaccines they recommend.

Screening programmes

If you have asthma, you will have regular check-ups during pregnancy to monitor your lung function and your baby's wellbeing.

Complications

If left untreated

• Uncontrolled asthma can reduce the oxygen supply to your baby.
• It can increase the risk of pre-eclampsia (high blood pressure in pregnancy).
• It may lead to your baby being born early or with a low birth weight.
• Severe asthma attacks can be dangerous for both mother and baby.

Long-term outlook

The good news is that with proper management, the vast majority of women with asthma have a healthy pregnancy and a healthy baby. Taking your medicines, staying in contact with your healthcare team, and managing your triggers can give you and your baby the best chance.

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