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The Japan Drug Information Institute in Pregnancy

Medications during Pregnancy and Breastfeeding Q&A

Answers to questions and concerns about
Common questions regarding medications during Pregnancy and Breastfeeding

  • Can I get vaccinated during pregnancy?
    • Japanese obstetrics and gynecology societies recommend pregnant mothers to get vaccinated against influenza. Inactivated vaccines such as the influenza vaccine are considered safe for pregnant mothers to use. Pregnant mothers are not expected to be vaccinated with live vaccines such as measles, rubella, varicella, and polio (a live vaccine may be necessary depending on the incidence and prevalence of these diseases).
  • Is it necessary to be careful of everyday medicines and treatments such as medicated poultices?
    • Even medicated poultices, when used in large quantities, may increase the concentration of the medication in the blood. Depending on the ingredients of anti-inflammatory medications, there may be a risk of premature closure of the ductus arteriosus when used during term pregnancy. Please consult with your physician or pharmacist regarding the use of anti-inflammatory medications.
  • I frequently become constipated when I am pregnant, but is it safe to use natural remedies and herbal medicine such as rhubarb?
    • Natural remedies and herbal medicine are not necessarily safe. Laxatives such as magnesium oxide, senna, senocide, and picosulfate may be used for constipations during pregnancy, so please consult with your physician.
  • Is it necessary to use supplements such as vitamins and minerals during pregnancy?
    • Folic acid, a type of B vitamin, is recommended before and during pregnancy, as it has promising effects of reducing the risks of developing neural tube defects, if 0.4mg of supplement is taken along with your diet daily.
      Other supplements are not particularly recommended unless there is a deficiency of certain nutrients.
      The use of vitamin A supplements requires special attention because it may cause congenital abnormalities when taken in excess amounts, especially during the first trimester of pregnancy.
  • Are there other consumable items I should be aware of?
    • It is known that consumption of alcohol and smoking during pregnancy may cause congenital abnormalities and fetal growth retardation. We recommend abstaining from alcohol and cigarettes throughout the pregnancy, as there is no known "okay" amount.
      High intake of caffeine may lead to miscarriages and low birth weight infants, so overconsumption of caffeinated beverages such as coffee requires precaution.
  • Why is folic acid supplement so important?
    • Although a requirement for almost all vitamins increases during pregnancy, folic acid, a type of B vitamin, is especially important. This is because it was reported that consumption of folic acid between before pregnancy and the first trimester decreases the risks of developing neural tube defects such as spina bifida.
  • How much folic acid should I take? Also, what food products are high in folic acid?
    • The Ministry of Health, Labor and Welfare recommends to consume 0.4mg (400μg) daily from both diet and supplements between a month before pregnancy and until three months into pregnancy with management under a physician, especially if the mother has been pregnant with an infant with neural tube defects. Folic acid intake under a physician will also be recommended if antiepileptic drugs are being taken as folic acid becomes deficient when using the medication. Folic acid is high in green and yellow vegetables such as spinach and broccoli, but the use of supplements are recommended because folic acid is water-soluble and weak to heat, resulting in a loss of folic acid during cooking.
      Note: Not all neural tube defects occur due to a lack of consumption of folic acid.

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