Harmful chemicals to avoid during pregnancy and breastfeeding

The list of things worth changing in pregnancy is shorter than the internet suggests. Retinoids, unregulated whitening creams, mothballs, renovation fumes, high-mercury fish and smoke cover most of it. ACOG's guidance on environmental exposures in pregnancy focuses on avoidable, repeated contact, not on a single ingredient in a face cream.

Skin whitening and slimming products from unknown sellers

NPRA regularly warns the public about cosmetics found to contain mercury, hydroquinone or tretinoin, which are not allowed in cosmetics. Mercury crosses the placenta and can harm a developing nervous system. These products usually come from social media sellers, overseas websites or friends of friends, often with big promises of whiter skin in days.

In pregnancy, stop buying from sources you cannot check. Cosmetics sold in Malaysia must be notified to NPRA, and you can search a product on the NPRA website. Notification is not an approval. It does mean a local company is responsible for the product.

Retinoids and high-dose vitamin A

Oral retinoids, such as isotretinoin for acne, can cause serious birth defects and must not be used in pregnancy. High-dose vitamin A supplements and liver carry a similar concern, and the NHS advises avoiding them.

Retinol and other retinoid creams are absorbed through the skin in small amounts, but dermatologists still advise pausing them until after pregnancy. Waiting a few months costs little.

The replacement routine can be simple: a mild cleanser, a moisturiser and daily sun protection. Our Gentle Face Wash cleans without sulfates or fragrance, and our Daily Protection Face Moisturizer moisturises and gives SPF 20 PA++ from mineral filters. Both are formulated for pregnancy and breastfeeding and halal certified by BPJPH, Indonesia. If acne or dark patches bother you, see your doctor about options that suit pregnancy.

Mothballs and newborns

Malaysia screens newborns for G6PD deficiency, an inherited condition that is fairly common here. In a baby with G6PD deficiency, naphthalene from traditional mothballs can trigger a sudden breakdown of red blood cells and severe jaundice. The vapour settles into fabric, so the baby does not need to touch a mothball to be affected.

Before your baby arrives, clear mothballs from any cupboard holding her clothes, cloth diapers and bedding, and wash and air anything stored with them. If your baby's screening shows G6PD deficiency, your doctor will give you the full list of things to avoid, which includes some medicines and certain traditional remedies.

Renovation and painting

Many families renovate to get the house ready for a baby. That can make it the time of greatest chemical exposure in the whole pregnancy. Paint solvents, varnish, tile adhesive and dust from hacking are all avoidable. Older homes may also have lead paint under newer layers, and the WHO says no level of lead exposure is safe.

• Stay away while painting, sanding, hacking or tiling is going on.
• Keep windows open and fans running for several days afterwards.
• Ask for low-VOC paint.
• Wash new curtains and soft furnishings before they go in the baby's room.
• Let someone else do the heavy clean-up.

Strong fragrance and household cleaners

Fragrance in soaps and cosmetics is rarely dangerous, but a sharper sense of smell can make strong scents unbearable in pregnancy. Air fresheners, aerosol sprays and heavily scented cleaners are easy to drop.

Use cleaners with the windows open. Never mix bleach with anything containing ammonia or acid, which makes a toxic gas. Nail salons with strong solvent fumes and poor ventilation are best avoided, especially in the first trimester.

Mercury in fish

Fish is good for you in pregnancy, so the aim is to choose well, not to stop eating it. The US FDA advises avoiding shark, swordfish, king mackerel, marlin, tilefish, orange roughy and bigeye tuna, and eating 2 to 3 servings a week of lower-mercury fish. Salmon, sardines, ikan bilis, prawns, squid and tilapia are all on the FDA's best-choices list. See our list of foods to avoid during pregnancy.

Plastics and BPA

Bottles and cups for babies are now commonly BPA-free. For your own food, heat is what increases how much passes from plastic into food. Use glass or stainless steel for hot drinks, avoid microwaving food in takeaway containers, and replace scratched plastic.

Haze and smoke

During haze season, check the Air Pollutant Index (API) from the Department of Environment. When readings are unhealthy, stay indoors, keep windows closed, and move your walk inside. An N95 mask helps if you have to be outdoors for long.

Cigarette smoke, including secondhand smoke at home or in the car, is worse than haze. Ask family members not to smoke near you or the baby.

Medicines and supplements

Some medicines, herbal remedies and traditional preparations are not suitable in pregnancy or while breastfeeding. Check everything, including over-the-counter medicines and jamu or herbal products, with your doctor or pharmacist before you take it. Bring the box with you.

Once you are breastfeeding

Much of this list relaxes after birth. A few things still matter: mercury creams and high-mercury fish, because mercury reaches breast milk; oral retinoids; and medicines, which should be checked against breastfeeding advice by a pharmacist. Our guide to things to avoid during pregnancy has more.