Prevention and Treatment of Malaria in Pregnant Women or Breastfeeding Mother

Malaria is a disease which has been considered one of the most fatal and lethal ones, as it is caused by parasite like mosquito, which tend to feed on human blood. Usually a person affected with malaria is struck with high fevers, flu-like symptoms and severe shaking chills.

Generally there are four types of malaria disease detected due to four kinds of parasites- P. vivax, Plasmodium falciparum, P. ovale. and P. malaria .

Under any circumstance, malaria if left untreated can be disastrous and life-taking, henceforth precaution is a necessity.

Now, pregnant and lactating women are to be extra-cautious, as they are now shouldering the responsibility of their little one too. Medically it has been analyzed and observed that pregnant women are much more prone to falling ill and sick, and eventually die, once affected by malaria than average adults.

Precautions While Visiting a Malaria-Risk Zone During Pregnancy:

Your work may require you to travel abroad or a certain need calls for an urgent visit to malaria-risk zone, the first thing to do would be to postpone the travels, post-delivery. The basic necessity for doing this would be to secure the health, both of the mother and the child.

Instances of severe malaria can highly aggravate the chances of premature birth, stillbirth and miscarriage too.

However, there might raise unavoidable situations where you must visit and in that case, consultation with a doctor is a must as it would help you to remain protected. The doctor might inject some anti-malaria drug or prescribe one for the pregnant lady’s consumption.

Mosquito-repellent creams or gels can also be slathered all over body to avoid mosquito-bites. Also, avoiding mosquito prone areas like water-logged zones, unclean or garbage area etc. would do the trick.

Detection of Malaria During Pregnancy and Lactation:

There might raise atypical manifestations of this disease and women during pregnancy and postpartum are to be kept under constant medical scrutiny and observation for restricting any suspicious growths of infection.

In malaria there may be fever but cases of an absence of fever is also not uncommon. In the second and third trimester, the woman must be properly diagnosed to avoid any unwanted consequences.

In case of a recent travel, the information is to be provided to the doctor with ample details. Symptoms like malaise, myalgia, cough and diarrhea must not be overlooked as it can be the prelude to the disease.

Medicines for Consumption:

​Antimalaria drug like Chloroquine is actually declared as a safe drug to be consumed during pregnancy. Although in zones where Chloroquine is not that effective due to formation of drug resistance, Mefloquine is often used as a supplement.

It is best to talk to the doctor before initiating a medication as he or she would fully grasp your situation and give you the drug that is best in that part of the world.

Along with that, the medical supervisor would also take care that the drug would never interfere with the pregnant mother or fetus’ health.

Taking the drugs as per schedule is highly recommended as otherwise it would fail to act promptly and would also reduce the chances of immunization. Overdose or skipping doses are not at all advisable in respect of the effectiveness of the medicine.

Lactating Mothers and Their Concerns Pertaining to Malaria:

Chloroquine treatment is usually safe but for lactating and nursing mothers, the drug does pass into the breast-milk a little and would eventually be transferred to the baby too.

But, there have been reported no cases of harm in this aspect. Though, it must be positively noted that the anti-malaria medicine consumed by the mother, would not protect the child from the disease.

So, in case of safeguarding the infant’s health, it is advisable to give separate anti-malaria drugs. Now, the dosage for the baby would entirely be decided as per the medication instructions and also the doctor’s observation.

Generally the medication for the child is variable upon the age and body weight. Also for the mother, the medicines are to be kept at a safe and secure place in order to reap benefits without tampering with its clinical goodness at all.

Prevention is the Best Possible Means:

Now, the first thing applicable for both lactating and pregnant women has got to be prevention. While leaving for malaria prone areas, see the doctor and he or she would definitely chart out the prescription to be followed, when away.

Usually the drugs are recommended around 7days before travel, and the medication duration is approximately till 7 to 30days after returning from the trip. This duration would be charted out by the doctor as per the health status.

  • Mosquitoes being the vector of malaria generally are active from dusk till the morning. If it is possible, then one must not step out during this time in malaria-prone zones.
  • It has been evidenced that wearing covered clothes like full-sleeved uppers and considerably long trousers can keep the mosquitoes at bay. Clothes in lighter colors are also useful in driving away mosquitoes.
  • Mosquito-repellents formulations are best in this case. Avoid applying it on your hands and consuming it or rubbing your eyes with the cream, as it can prove to be an irritant.
  • Some repellents consisting of DEET must always be applied while going outdoors and should be cleansed off immediately after coming back from the outside. The label directions are to be abided in order to reap the most out of it. DEET can be applied both on your skin and the clothes for a better protection all day long. Inhaling DEET is also hazardous and accidental consumption should immediately be reported to the doctor. Women prone to skin allergies or have broken and itchy skin should seek for medical alternatives as DEET might aggravate the problem. During pregnancy DEET must be used very cautiously for your own benefit.
  • The most practically utilitarian way to protect pregnant and lactating mothers from malaria is by putting up a mosquito-net. It does not yield any side-effects and is great for daily usage. One can even sprinkle permethrin, an insecticide, on the net for making oneself guarded.
  • Those lactating or pregnant mothers who are seeking for an all round solution can use sprays for killing insects and also can light up a mosquito coil for killing the parasite. Pyrethrum is very useful for killing mosquitoes.
  • In spite of observing these preventions, one might still get affected with malaria. If any pregnant lady notices chills, incessant tiredness, severe muscle aches accompanied with high-fever, one should immediately talk to the doctor and get malaria tests done.

Pregnant Women are on Higher Risks of Contracting the Malaria Infection:

In the continent of Africa, several studies and researches have extensively proven that pregnant women are more prone to be affected with malaria than average women. They run higher risks of acquiring the disease from mosquito- bites.

The WHO has taken extra measures to safeguard the health of these susceptible women and has intensively done awareness campaigns to spread out recommendations.

Mosquito repellents are to be applied and insecticide-sprayed nets are to be used in order to avoid contraction. Any overdose is to be shunned at any cost, so that no drug abuse is done.

There are arrays of theories that clarify why women who are pregnant or nursing are more susceptible to malaria; some of them are as follows-

  • During pregnancy women experience an increase in blood flow. This blood also is circulated to the skin, thus emitting certain odors that attract mosquitoes.
  • Pregnancy also escalates the urge of micturition, which is another causative factor for making a woman prone to insect bites, as they get out of the mosquito-nets to go to the toilet.
  • Another prime factor that controls our safety against malaria is immunity. During pregnancy the immunity can become strikingly low and this becomes as if a golden opportunity for mosquitoes to spread malaria quickly.
  • At time medicines taken for malaria are not entirely suitable for pregnant and lactating women and this can further accelerate the disease.

The precautions must be positively taken as they are the best means to secure the health of both the mother and the child. Propensity of contracting malaria thus should be controlled in a stern way.

Propensity of Malaria Causing Harm to the Pregnancy and the Fetus:

Several medical studies have shown that a woman contracting malaria during pregnancy or while nursing have greater risks of certain complications, which can perturb the child’s growth and harm the mother too. As the immunity level lowers rapidly, malaria can also affect the health in more than one ways-

  • It can make the affected woman anemic. This is the most fatal thing that can occur to a mum to be. The enormous deficiency of red-cells in the blood can harm the mother and also lead to a pre-term delivery. The delivered child may be underweight too. The mother even might notice post-partum depression, clogging of milk ducts or slow healing of sores in nipple area. The baby might also be left starving for insufficiency of iron and nutrition leading to lesser volume of milk secretion.
  • Malaria often leads to jaundice and this can be really life-taking for the mother. Intrahepatic cholestasis is also a dangerous thing.
  • A drastic fall in the blood sugar levels can occur due to malaria in pregnancy.
  • The blood pressure level might drop and this can make the mother to be, feel dizzy and lightheaded. It can even cause accidents, which might damage the fetus.
  • Malaria has the capability to cause pulmonary edema, which is basically an inability to breathe properly, making one choke. It is a sort of collection of fluids in the in the lungs, containing air sacs.
  • Renal failure is one of the most disastrous effects of malaria.
  • The liver can badly be damaged by malaria and this can cause cholestasis and severe itching, especially in the later part of pregnancy.
  • It can cause stillbirth, miscarriage, fetal distress or premature birth.
  • The malaria parasite affects the placenta, which hampers the nutrient flow to the baby. Even the fetal growth can become hampered due to malaria.
  • The new born might even run the risk of being susceptible to malaria. There remains a little risk even, that the baby may be born having this disease.
  • Neonatal death, implying that the baby dies within 28 days of birth, can also be triggered by malaria.

Therefore, it is a necessity to diagnose and treat malaria, before the situation goes out of hand.

Can Malaria be Transmitted from the Mother to the Child?

This is a vital question asked by most women and the answer is yes! It can get transmitted, though it is very rare. Malaria if treated properly and on time would not transmit the disease at all, once transmitted it can cause fetal distress too.

The baby can even acquire the disease through the placenta and eventually die due to this. If a mum to be has malaria during the time phase of labor, then it is advisable to perform a placenta check for detecting any unnaturalness in it.

Sometimes despite sufficient treatment, the baby can have serious health complications. Malaria during labor can also cause the baby to have high fever.

​Factors that Pose Risks:

It has been clinically observed that primigravidae run higher risk rates or malaria infection, thus complicating the pregnancy. Even, pregnant women already having one child are more prone to such issues.

HIV infection concurrently can negate the gravida-status on risks. Younger females, especially adolescents have extremely high chances of getting infected and can pose impediments on the path of a safe pregnancy.

Women in the second trimester have also the elevated risks of catching the infection. Scientific studies have definitely shown that post-delivery the risks of infection are lesser, yet it is not totally vanquished. The initial 2 months postpartum still does have the tendency to catch malaria more.

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