Use of Over-the-Counter Herbal Preparations & Consumption of Fish During Pregnancy
Herbal Medications
A common misconception is that herbal preparations are safe because they are "natural", leading some patients to use such products without first consulting health care providers. Herbals are not always safe and some are actually contraindicated in pregnancy. Below is documented information on five herbal preparations that are commonly used. A good source of information about specific herbal preparations is the web site: www.motherisk.org.
ECHINACEA – Information to date is reassuring that Echinacea, as available in the United States and Canadian markets and does not cause birth defects. However there is still not enough data to definitively rule out any risk associated with Echinacea use in pregnancy.
GINGER – Ginger is frequently used for morning sickness and other forms of nausea and vomiting. At least two good studies fail to show that ginger had an effect on nausea and vomiting of pregnancy, although the studies did not show an increased rate of malformations or pregnancy complications in these women. While these results are reassuring, the varying doses provided in different preparations remain a concern.
GOLDEN SEAL – should not be used in pregnancy as it may have a role in development of hypertension and may cause uterine contractions.
BLACK COHOSH – should not be used in pregnancy or for stimulation of labor as there are several cases of women treated who collapsed during labor and had severe complications including loss of baby.
EPHEDRA – should not be used in pregnancy as it can increase blood pressure, impair circulation of the brain, cause anxiety, cause glaucoma, and cause uterine contractions.
In addition to the direct effects as noted above, there is concern for herbal preparations in pregnancy in general as some herbals may interact with drugs resulting in adverse reactions or may increase bleeding tendencies.
Consumption of Fish Products
Fish can be an important source of nutrition for you, your developing baby, and your young child. However, some fish contain harmful levels of mercury which, if consumed by a pregnant or nursing woman or by a young child, can harm the developing brain and nervous system. The Food & Drug Administration (FDA) has specific advice regarding consumption of fish for the pregnant or nursing mother and for young children: www.epa.gov/waterscience/fish
If you are pregnant or could become pregnant, are nursing a baby, or if you are feeding a young child, limit consumption of freshwater fish caught by family and friends to one meal per week. For adults this means 6 oz. of cooked fish or 8oz of uncooked fish per week; for a young child, one meal is 2oz of cooked fish or 3oz of uncooked fish.
Women who attempt to become pregnant, who are pregnant, who are nursing, and young children should not eat shark, swordfish, king mackerel, or tile fish. The FDA further advises that women attempting to become pregnant and pregnant women should limit consumption of fish bought in stores or obtained in restaurants to 12oz of fish each week.