If you’re planning to get pregnant or are pregnant, it’s important to talk to your OB-GYN about the medications and supplements you’re taking or are considering taking, as some can pose health risks to a developing baby.

Dr. Ankita Langan is wearing a white lab coat and is smiling into the camera
Dr. Ankita Langan

“I encourage all of my patients to have a preconception counseling visit or bring it up at their annual exam if they know they’re going to be considering pregnancy soon,” said Dr. Ankita Langan, OB-GYN at Novant Health Queen City OB/GYN. “At my practice, if you call with a positive pregnancy test, we do a virtual visit before your first ultrasound to go through any medications or supplements you’re taking, and any goals for controlling preexisting conditions.”

Whether you’re pregnant or you’re planning to get pregnant, here are five supplements and over-the-counter medications to know about that could be risky for a developing baby.

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Nonsteroidal anti-inflammatory drugs such as aspirin

Headaches during pregnancy can be caused by hormonal shifts. But don’t soothe them with nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ibuprofen. The Food and Drug Administration (FDA) specifically recommends pregnant women not use NSAIDS at 20 weeks or later due to the risk of low amniotic fluid, fetal kidney problems and other issues.

“I usually say Tylenol is the safest option for pain and headache management within pregnancy,” Langan said. “You can also take Excedrin Tension Headache.”

For a natural approach, pregnant women can try a small dose of natural caffeine, like chocolate or coffee for under 200 milligrams of caffeine.

Decongestant medications

A lot of women suffer from various nasal congestions during gestation, as well as nosebleeds. But during early pregnancy in particular, there’s an increased risk of birth defects with oral decongestants.

“I specifically don’t recommend those that contain pseudoephedrine,” Langan said. “Some options like plain Mucinex can be safe during pregnancy.”

There are natural ways to alleviate these issues as well, such as by using a neti pot or a gentle saline mist spray, and by setting up a humidifier at your bedside.

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Both CBD and THC are enjoyed for their calming effects. This may be especially appealing during the first trimester, when anxiety can spike due to hormonal changes.

But it’s best to avoid CBD and THC in any form during pregnancy. While research is insufficient regarding the use of CBD, the Centers for Disease Control and Prevention (CDC) attributes newborn health problems such as lower birth weight and abnormal neurological development to the use of THC during pregnancy.

Protein powders and plant powders with added vitamins and minerals

Protein powders have become a mainstream staple for pre- and post-workout nutrition, but it’s ideal to skip them during pregnancy. For one, Studies by the Clean Label Project revealed a variety of protein powders contain heavy metals, BPA, pesticides or contaminants that have been linked to health issues.

Langan points to the overall unpredictability of ingredients in different powders. “In general, I don’t encourage protein powders during pregnancy because there are so many additives, like extra vitamins and caffeine,” she said. “There are so many ingredients put together in these powders, so it’s hard to reliably know if different protein powder mixtures would be appropriate during pregnancy. It’s best to avoid these.”

Collagen, on the other hand, doesn’t carry the same concerns. “As long as you’re using plain collagen peptides, there’s no harm in taking this during pregnancy,” Langan said. “That also has some protein in it, so it’s probably a better source of protein than standard protein powder.”

Retinols and retinoids

Retinols have become popular in skincare routines to smooth and brighten skin, and minimize wrinkles, while retinoids are commonly used to treat acne. Studies show the use of retinoids, or synthetic vitamin A, during pregnancy can lead to miscarriage, premature delivery and certain birth defects. Meanwhile, retinol, which is derived from vitamin A, is also suspected to pose risks to developing babies during pregnancy.

“For hormonal acne caused by pregnancy, I usually recommend face washes that contain benzoyl peroxide,” Langan said. “I don’t recommend anti-aging or anti-wrinkle cream. Just use a plain facial cleanser and a nice moisturizer.”

Ultimately, when choosing supplements and medications before and during pregnancy, always talk to your doctor first.

Quick tips: What should women add to their dietary intake during pregnancy?

300-500 extra daily calories. The easiest way is to keep portions the same as pre-pregnancy, but add in a snack between meals.

A prenatal vitamin. Make sure it contains at least 400 micrograms of folic acid to decrease risks of neural tube defects, as well as DHA for baby’s brain health.

Additional micronutrients like iron and choline. You can get more iron by eating foods like leafy greens, beans and lentils. You can get more choline by eating foods like eggs, poultry, shiitake mushrooms and soybeans.