Expectorants are cough preparations which are marketed with the claim that they promote the expulsion of the sputum and secretions produced in the respiratory tract. They are supposed to relieve the symptoms by making one cough less and breathe easier. The reality is that they make little or no difference, and scientific evidence of their effectiveness is lacking. Simple linctus (the most common type) is a citric acid solution (i.e. orange or lemon!).

Some of them are marketed in combination with painkillers (such as paracetamol) and- decongestants (see below). Their value, over and above the placebo effect, is dubious.
All these preparations have no direct adverse effect on the pregnancy. Any preparation containing iodine should be avoided. Always read the label.

What about medicines for colds?
The nasal decongestants on the market are mostly made of an active ingredient in the form of pseudoephedrine or similar. Many also contain an antihistamine. Their effectiveness is really unproven and this is probably the biggest gravy-train in the retail trade today. The benefit from most is largely through the placebo effect: You believe it will do something, your mind and body responds to the expectation and you feel better.

Those preparations containing pseudoephedrine and similar drugs need to be used with caution if the mother is hypertensive or has a heart disease. They may also interfere with diabetes control. There is, however, no direct adverse effect on the pregnancy itself.

Preparations containing antihistamines such as chlor­pheniramine  (Piriton®) will tend to make the mother drowsy.

Nasal allergies of all types are mostly treated with antihistamines. Some of these, especially the newer 'non­-sedating' ones, are clearly considered unsafe to use in pregnancy. It is therefore important for a pregnant woman intending to use any of these preparations to check with her doctor and the enclosed literature about their status vis-a-vis pregnancy.

Some of the antihistamines contra-indicated for use in pregnancy include Fexofenadine (Telfast®), Loratadine (Clarityn®), Mizolastine (Mizollen®) and Astemizole (Hismanal®). The contra-indication is based on inavailability of proof of safety in pregnancy rather than any documented adverse effect.

The older generation antihistamine chlorpheniramine (Piriton®) is considered safe.

Steroidal preparations are also used in allergic rhinitis. These include beclomethasone (Beconase®, Qvar®), budesonide (Rhinocort Aqua®, Pulmicort®), fluticasone (Seretide®) etc. These are safe to use.

Eczema in Pregnancy

What about eczema and its treatment?
This fairly common condition can continue after conception. Treatments to control the lesions commonly consist of an emmolient, a steroidal skin preparation, occasionally oral medication or a combination of any of these.