What Allergies to Expect When You’re Expecting

“They may worsen, they may improve, or they might not change at all, and it really is patient-dependent.” —Dr. Lana RosenfieldOn this episode of The Allergist, Dr. Mariam Hanna welcomes Dr. Lana Rosenfield to unpack the complexities of managing allergic conditions during pregnancy and postpartum. With hormones shifting, the immune system recalibrating, and anxiety about medication safety running high, allergic disease can be especially tricky to manage during this time. Dr. Rosenfield offers practical insights for clinicians supporting pregnant patients with conditions like asthma, rhinitis, chronic urticaria, and food allergy, while navigating a landscape of limited data and heightened patient concerns.On this episode:How the maternal immune system changes during pregnancy—and why it may exacerbate allergic conditionsSafe options for managing allergic rhinitis, including which medications to avoidAsthma in pregnancy: monitoring frequency, preferred inhalers, and why under-treatment is riskier than treatmentAtopic dermatitis: mimics to watch for, which topicals are safe, and what we know (or don’t) about dupilumabManaging chronic urticaria with second-generation antihistamines and omalizumabFood allergy and anaphylaxis: fetal risks, symptom variations, and why epinephrine remains essentialWhat to do with patients already on immunotherapy, and why it should never be initiated during pregnancyBiologics and breastfeeding: limited evidence, but emerging reassurancePreconception counselling and postpartum care: optimizing control while minimizing riskDr. Rosenfield emphasizes shared decision-making, lowest effective dosing, and the clinical resources she trusts when evidence is limited. It’s a thoughtful and clinically grounded conversation to support allergists managing allergic conditions through pregnancy and beyond.Have an idea for the show or a comment, send us a text!Visit the Canadian Society of Allergy and Clinical ImmunologyFind an allergist using our helpful toolFind Dr. Hanna on X, previously Twitter, @PedsAllergyDoc or CSACI @CSACI_caThe Allergist is produced for CSACI by PodCraft Productions