Malaria and pregnancy

If you are pregnant and planning to travel to a malaria-risk area, it would be best to postpone your travel plans. Malaria infection in pregnant women may be severe and may increase the risk of miscarriage, premature birth, or stillbirth. If you must travel in these areas, talk to your doctor beforehand about getting an antimalarial drug to take. You should also try to prevent mosquito bites to reduce the risk of contracting malaria.

Which drug should I take?

Chloroquine, a type of antimalarial drug, is generally considered safe to take during pregnancy. In some malaria-risk areas, chloroquine may be less effective due to resistance to this medicine, and mefloquine may be used as an alternative. Your doctor will prescribe an antimalarial that is best suited to the area of the world in which you are travelling and any other medical conditions you may have. You need to take antimalarials on schedule and be careful not to miss any doses.

Antimalarials and breastfeeding

If you are breastfeeding, a very small amount of the antimalarial drug you are taking will be passed into your breast milk. This very small amount of drug will be transferred to your baby, but this has been shown not to be harmful, in general.

However, this small amount of antimalarial does not protect the baby from malaria, so infants need to be given their own antimalarial medications.

• Recommended dosages for babies and children are usually listed on the medications and will vary with the age and weight of the child. Your doctor will advise you.
• All antimalarial medications should be taken on schedule, with no missed doses.
• Over-dosage of antimalarials can be fatal and these medications should be stored in childproof containers out of the reach of children.

Prevention

It is always best to take precautions to prevent being bitten by mosquitoes in high-risk areas.

• Before leaving, visit your doctor to see about any necessary vaccinations and to get a prescription for an antimalarial drug. It is recommended that you take these antimalarial medications at least one week before you travel and continue them for two to four weeks after you return - according to your doctor's intructions.
• The most active time for the malaria mosquito is from dusk till dawn, so you should try to avoid going outside during this time, if possible.
• Wear long-sleeved shirts and long pants in light colours when going outside after dusk. Also wear fully covered footwear and aim for clothing that protects ankles and wrists from bites. 
• Use mosquito repellents containing DEET (N,N-diethyl m-toluamide). However, do not apply these repellents on the hands of children who may wipe their hands on their eyes or put their hands in their mouths.
• When using repellents with DEET, always follow the label directions. Do not inhale or swallow the repellent, or allow it to get in the eyes. The repellent should also not be applied to wounds or broken skin.
• Sleep under a mosquito bed net that has been treated with permethrin insecticide if you are not staying in a screened or air-conditioned room.
• Use insect sprays containing pyrethrum in your living and sleeping areas. Lighting a ‘mosquito coil’ may also be effective.

It is still possible to get malaria even after using all the prevention measures, so if you experience any of the symptoms of malaria (fever and flu-like illness, including chills, muscle aches and tiredness), seek medical attention as soon as possible.

Related topics

See also Diseases spread by mosquitoes and Food and drink - safety tips for travellers

Original content from myDr. Edited by everybody, November 2011.