Expectant mothers often experience discomforts like nausea, heartburn, or diarrhea. Many consider common over-the-counter remedies for relief. A frequent question is whether bismuth subsalicylate, found in products like Pepto-Bismol, is safe to use during pregnancy. This article explores why it is generally not recommended for pregnant individuals.
What Bismuth Subsalicylate Is
Bismuth subsalicylate is an over-the-counter medication widely used to alleviate common gastrointestinal symptoms. It provides relief from indigestion, heartburn, nausea, and diarrhea, including traveler’s diarrhea. This medication works through several mechanisms. It helps reduce inflammation in the stomach and intestinal lining, and possesses antisecretory properties, decreasing fluid loss associated with diarrhea. Furthermore, it has antimicrobial effects against certain bacteria and viruses that can cause diarrhea.
Why It’s Not Recommended During Pregnancy
Bismuth subsalicylate is generally not recommended during pregnancy due to risks from its salicylate component. Salicylates are absorbed into the bloodstream and can pose concerns for both the mother and the developing fetus. The FDA classifies it as a Category C medication, meaning animal studies have shown adverse effects on the fetus, and human studies are lacking. Some sources advise against its use in the second and third trimesters.
The primary concern stems from the salicylate component, which is chemically similar to aspirin. In the third trimester, salicylates can interfere with fetal physiological processes. One significant risk is the premature closure of the ductus arteriosus, a fetal blood vessel. Early closure can lead to serious heart and lung problems for the newborn.
Salicylates can also increase the risk of bleeding complications for both the mother and the fetus, especially around delivery. This increased risk is due to their antiplatelet effects, which impair blood clotting. Additionally, salicylate exposure in late pregnancy has been linked to prolonged gestation and labor. The presence of salicylate makes the medication generally unsuitable for use during pregnancy.
Addressing Pregnancy Symptoms Safely
Several safe alternatives exist for managing common pregnancy symptoms. For nausea and morning sickness, dietary adjustments are helpful. Eating small, frequent meals, choosing bland foods like the BRAT diet (bananas, rice, applesauce, toast), and staying hydrated can provide relief. Ginger, in tea or supplement form, reduces nausea. Vitamin B6 (pyridoxine), either alone or in combination with doxylamine, is also a recommended and safe option for relieving pregnancy-induced nausea and vomiting.
Heartburn and indigestion are also common during pregnancy. Dietary changes, such as avoiding spicy, fatty, or acidic foods and eating smaller meals, can help prevent symptoms. Over-the-counter antacids containing calcium carbonate, such as Tums, are generally considered safe and provide a beneficial calcium boost. Milk, yogurt, or sugar-free gum can also offer some heartburn relief.
For diarrhea during pregnancy, staying well-hydrated is paramount to prevent dehydration. Consuming a bland diet helps firm up stools. Probiotics may also be beneficial in restoring gut flora. For persistent or severe diarrhea, certain anti-diarrheal medications like loperamide may be considered safe, but only after consulting with a healthcare provider.
Consulting Your Healthcare Provider
Given the complexities of medication safety during pregnancy, always consult a healthcare provider before taking any medication. This includes over-the-counter remedies, herbal supplements, or vitamins. A doctor, obstetrician, or pharmacist can provide personalized guidance based on your health history and pregnancy stage. They can assess symptoms, rule out underlying conditions, and recommend the most appropriate and safest treatment options.