Pharmaceutical medicines for colds and coughs provide short-term symptom relief; therefore, a significant number of Australians use complementary medicines to strengthen their immune systems and reduce symptom severity and duration during the cold weather months. In pregnancy when the nutritional and immune health of the mother may be under stress, many of these effective formulations cannot be used. However, recent research shows the safety of Echinacea purpurea (echinacea), lactoferrin, vitamin D, vitamin C and zinc in pregnancy and their effectiveness in promoting immune health.
Echinacea is a traditionally used herb with evidence of antiviral, antioxidant and immunodulatory effects, due to its polysaccharides, glycoproteins and caffeic acid derivative content.[2,3] In the 2016 Norwegian Mother and Child Cohort Study, researchers analysed the association between echinacea intake in 363 pregnant women with adverse pregnancy outcomes. They reported no association with an increased risk of malformation or adverse pregnancy outcomes. This supports previous research suggesting this herb may be safely used in pregnancy, but like all supplements, intake should be co-ordinated by a trained health professional.
Lactoferrin is a protein found naturally high in colostrum, the first milk produced by mothers and cows, for immune development support in the newborn. Studies have shown the effectiveness of bovine lactoferrin supplements on the prevention and treatment of influenza and the common cold. It has anti-inflammatory and antimicrobial properties, and acts on viruses by inhibiting their attachment to target cells, and enhancing natural killer cell activity and Th1 cytokine responses. Studies have also shown the safety of bovine lactoferrin in pregnancy, with a recent trial showing it to be more effective, with less gastrointestinal complaints, than ferrous sulfate in iron deficiency anaemia during pregnancy.
Vitamin D deficiency is widespread in pregnancy. This important vitamin supports both adaptive and innate immune function to enhance immune activity and maintain antimicrobial defences. A recent randomised, controlled, double-blind trial found vitamin D supplementation in pregnancy increased regulatory T cell immunity. There were no adverse effects related to the supplementation at either 400IU or 200IU per daily doses.
Finally, vitamin C and zinc are known for their beneficial effect on immunity and ability to reduce the length and severity of a cold. Like vitamin D, they have also been found to be deficient in pregnancy.[7,8] With a high degree of safety, when taken at normal therapeutic doses, vitamin C and zinc are beneficial for nutritional and immune support in pregnancy.
- Blott L. Complementary medicines for coughs, colds and flu. inPHARMation.Pharmaceutical Society of Australia , July 2016. [Link]
- Ardjomand-Woelkart K, Bauer R. Review and assessment of medicinal safety data of orally used echinacea preparations. Planta Med 2016;82(1-2):17-31. [Full Text]
- Mousa HA. Prevention and treatment of influenza, influenza-like illness, and common cold by herbal, complementary, and natural therapies. J Evid Based Complementary Altern Med 2017;22(1):166-174. [Abstract]
- Heitmann K, Havnen GC, Holst L, et al. Pregnancy outcomes after prenatal exposure to echinacea: The Norwegian Mother and Child Cohort Study. Eur J Clin Pharmacol 2016;72(5):623-630. [Abstract]
- Rezk M, Dawood R, Abo-Elnasr M, et al. Lactoferrin versus ferrous sulphate for the treatment of iron deficiency anemia during pregnancy: a randomized clinical trial. J Matern Fetal Neonatal Med 2016;29(9):1387-1390. [Abstract]
- Zerofsky MS, Jacoby BN, Pedersen TL, et al. Daily cholecalciferol supplementation during pregnancy alters markers of regulatory immunity, inflammation, and clinical outcomes in a randomized controlled trial. J Nutr. 2016;146(11):2388-2397. [Full Text]
- Juhl B, Lauszus FF, Lykkesfeldt J. Poor vitamin C status late in pregnancy is associated with increased risk of complications in type 1 diabetic women: a cross-sectional study. Nutrients 2017;9(3):186. [Full Text]
- Moghimi M, Naseh A, Ashrafzadeh S, et al. Maternal zinc deficiency and congenital anomalies in newborns. Pediatr Int 2017;59(4):443-446. [Abstract]