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A cold during pregnancy


Pregnant with a cold: Treatments, risks, and prevention

Catching a cold during pregnancy will not harm the fetus, but it can be uncomfortable for the person who is pregnant, and they may also worry about which treatments and medications they can use safely.

Colds are very common. The Centers for Disease Control and Prevention (CDC) estimate that adults have an average of 2–3 colds per year.

The chances of catching a cold while pregnant are higher because the immune system is less robust during pregnancy.

According to March of Dimes, catching a cold will not harm a developing fetus, and the pregnant person will typically recover in a week or so.

People are also more likely to catch potentially more serious infections, such as the flu, during pregnancy. This means that taking steps to prevent illness is important during pregnancy.

This article looks at what to consider when treating the symptoms of a cold during pregnancy, how to prevent a cold, and when to see a doctor.

Treating a cold usually means using over-the-counter (OTC) medications. However, many pregnant people worry about whether drugs will affect the fetus.

The Food and Drug Administration (FDA) recommend always talking to a doctor before using any pain medication during pregnancy.

Most OTC drugs contain the same few ingredients to treat cold symptoms. The following sections look at the safety of different types of cold treatments.

Pain relievers

Pain relievers are a group of drugs that reduce pain. Some types also reduce inflammation and fever.

OTC pain medications include:

  • acetaminophen, under brand names such as Tylenol
  • nonsteroidal anti-inflammatory drugs (NSAIDs), including naproxen, ibuprofen, and aspirin

Research suggests that acetaminophen is the safest pain relief drug to use during pregnancy, with recommendations to use the lowest effective dosage for the shortest time.

An article published in American Family Physician (AFP) reports acetaminophen to be safe to use during all trimesters on its own, but not necessarily in combination with other cold remedies that contain a range of other ingredients.

However, the article states that NSAIDs may carry risks. They recommend avoiding aspirin during pregnancy except for specific uses and avoiding naproxen and ibuprofen during the third trimester.

Prescription drugs tend to be stronger than OTC drugs and are more likely to carry risks.

The FDA note that prescription NSAIDs may increase the risk of pregnancy loss during the first half of pregnancy and that prescription opioids may increase the risk of birth abnormalities when taken in the first trimester.

Severe and persistent pain can lead to serious effects, such as high blood pressure, depression, and anxiety. It is important to weigh the benefits of taking pain relief drugs during pregnancy against the potential risks.

Always talk to a healthcare professional before deciding to take any medication that relieves pain during pregnancy.

Cough suppressants

OTC cough suppressants often contain medications such as dextromethorphan and guaifenesin.

According to the AFP, these medications appear to be safe during pregnancy in the correct doses. However, it may be best to consider drug-free options as the first line of defense.

For example, before using a cough suppressant medication, people can try using herbal or mentholated throat lozenges to ease a cough or sore throat.

Read more about natural cough remedies here.

Antihistamines

Antihistamines are a popular allergy medication that may relieve a runny nose, watery eyes, or sneezing caused by a cold.

Up to 15% of people use antihistamines during pregnancy, and experts generally consider them safe.

According to the American College of Allergy, Asthma, and Immunology (ACCAI), people can use the following during pregnancy:

  • diphenhydramine (Benadryl)
  • chlorpheniramine (ChlorTrimeton)
  • loratadine (Claritin)
  • cetirizine (Zyrtec)

Most OTC antihistamines are safe to take in pregnancy as long as a doctor approves them.

Read about some natural antihistamines here.

Decongestants

According to one source, it is safe to take decongestants, such as pseudoephedrine, when directed by a healthcare provider.

However, research has not yet established that decongestants are safe during pregnancy. Some studies suggest that some decongestants, including pseudoephedrine and phenylephrine, may increase the risk of birth abnormalities.

The overall evidence suggests that people use decongestants sparingly during pregnancy, especially during the first trimester.

Saline nasal sprays and nasal strips are safe alternatives for nasal congestion.

Natural remedies

Resting while sick is important to give the body time to focus on recovery. Lying down with the head elevated may help with breathing and stuffiness.

Drinking plenty of water can help people recover from a cold. Juices and smoothies can also provide nutritional intake when people have no appetite.

Many people also use room humidifiers to help clear a stuffy nose and promote a productive cough.

Applying warm compresses to the head, sinuses, and shoulders may help reduce pain and congestion.

Read more about natural remedies for a cold or flu here.

People are also more likely to catch colds and the flu during pregnancy, so it is important to take steps to prevent illness.

To prevent the common cold, the CDC recommend:

  • washing the hands often with soap and water for 20 seconds, or using an alcohol-based hand sanitizer when this is not possible
  • avoiding touching the face with unwashed hands because viruses that cause colds can enter the body through the eyes, nose, and mouth
  • staying away from people who are sick as close contact with others can spread cold viruses.

Light to moderate pregnancy-safe exercises, such as swimming and indoor cycling, can boost the immune system and increase metabolism.

Healthful eating is another important factor in preventing a cold. Focusing on eating a variety of fresh foods can help ensure the body gets the nutrients it needs.

Taking a prenatal vitamin that includes zinc and vitamin C may also help support the immune system and prevent colds.

Many people experience pregnancy rhinitis, which has symptoms similar to a cold.

This occurs due to inflammation and swelling of the mucous membranes in the nose, extra fluid in the body, and changing hormone levels.

Pregnancy rhinitis occurs in around 20% of people. Some people may find it difficult to distinguish rhinitis from a common cold.

The symptoms of pregnancy rhinitis include:

  • a runny nose
  • congestion
  • sneezing
  • difficulty breathing
  • snoring

A cold during pregnancy is the same as any other cold. The common cold is not likely to not harm the mother or fetus.

People may catch a cold or flu from being around others who are sick. The CDC provide guidance on how to avoid catching the flu.

It is important to know the difference between a cold and the flu. The two have similar symptoms, but the flu tends to be more severe, and a person will usually have a fever.

Read more about pregnancy and the flu here.

If someone experiences a fever during pregnancy, they should contact their doctor to see what steps they can take to reduce the fever to safe levels as quickly as possible.

Having a cold during pregnancy will not usually affect the fetus. Colds are mild illnesses that a person’s immune system can handle relatively easily.

However, the person’s temperature and infections can affect the fetus. If a person is experiencing a fever or other signs of infection, it is essential to speak with a doctor immediately to find the best way to reduce these symptoms.

When a person is pregnant, their body deals with a cold in much the same way as it does at any other time. The symptoms are temporary, and in most cases, the cold will be gone in 7–10 days.

If someone experiences the following symptoms during pregnancy, they should talk to a doctor right away:

  • a fever of over 100.4° F
  • severe or unusual symptoms
  • symptoms that last more than 10 days
  • symptoms of the flu
  • violent coughing that makes it hard to breathe

Colds are very common during pregnancy, and they are unlikely to harm the pregnant person or fetus.

While there are some uncertainties over the safety of OTC cold remedies during pregnancy, most people can relieve their symptoms using gentle home remedies. Most people will feel better in around a week.

Cold and flu during pregnancy and breastfeeding

Cold and flu during pregnancy and breastfeeding | Pregnancy Birth and Baby beginning of content

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Key facts

  • A cold is an infection of the upper respiratory tract caused by a virus.
  • Colds usually get better on their own (without any taking specific treatment), but there are things you can do to help yourself feel better while you recover.
  • Influenza (‘the flu’) is a viral infection that can cause serious complications in pregnancy for both mum and baby.
  • The influenza vaccine is the best way to protect you and your baby from catching the flu.
  • Some medicines are not safe to use during pregnancy. If you are pregnant and not sure whether a medicine is safe to use, ask your doctor or pharmacist for advice.

Colds and flu symptoms can be very similar to the symptoms of COVID-19. Even if your symptoms are mild, get tested for COVID-19 immediately — use the colds and flu Symptom Checker if you're not sure what to do. You can also learn more here about COVID-19 during pregnancy.

How do I manage a cold when I’m pregnant or breastfeeding?

A cold is a viral infection of the upper respiratory tract. This means that a cold can affect your throat and airways and cause symptoms such as:

  • sore throat
  • headache
  • sneezing
  • blocked or runny nose
  • cough
  • mild fever

Colds can be very uncomfortable, but they are not dangerous to you or your baby.

Colds get better on their own without any specific treatment. Antibiotics will not help you recover from a cold any faster, because colds are caused by viruses and not bacteria.

There are things you can do to treat your symptoms and make you feel more comfortable while your body fights the virus:

  • Resting gives your body more energy to fight the infection.
  • Drink lots of fluids — this will help you feel better and is important for your milk supply when you are breastfeeding.
  • Avoid dehydration which can be dangerous in pregnancy — warm drinks with lemon and honey can be especially soothing.
  • Avoid exposure to cigarette smoke.
  • Use saline (salt water) nasal sprays or rinses to clear mucus from your nose and sinuses.
  • Inhale steam (using a bowl of hot water, or a warm shower) to help clear your nose and sinuses.

There are some medicines you need to avoid while you’re pregnant or breastfeeding. If you’re not sure whether a particular medicine is safe to use, ask your doctor or pharmacist.

You should continue to breastfeed your baby if you have a cold so that your baby gets antibodies from your breast milk, which may protect them from getting sick.

How do I manage the flu when I’m pregnant or breastfeeding?

Influenza, also known as the ‘flu’, is an infection caused by the influenza virus.

Most people who catch the flu start to notice symptoms about 1 to 3 days after being in contact with someone carrying the virus.

Symptoms of the flu include:

  • fever
  • sore throat
  • cough
  • severe tiredness
  • muscle aches
  • loss of appetite

If you are pregnant and think you might have the flu, you should see your doctor right away. If you are pregnant, especially if you are in your second or third trimester, you are more likely to become seriously unwell with the flu than people who are not pregnant.

If your doctor suspects that you have the flu, they may take a swab from the inside of your nose and throat to confirm the diagnosis. They may also prescribe you an antiviral medicine if they are concerned about the effects of the flu on your health. This medicine is more effective the earlier you take it, so it’s important to see your doctor when you first notice flu symptoms.

There are also strategies you can use to relieve your symptoms while you recover. These strategies are similar to those used to treat cold symptoms.

Is the flu dangerous during pregnancy?

If you are pregnant, the flu can be dangerous for you and for your baby.

If you are pregnant, you are more likely to catch the flu, and you are more likely to experience severe symptoms and complications. Even if you are healthy and your pregnancy is normal, catching the flu can cause life-threatening complications.

Complications of the flu in pregnancy include:

  • pneumonia
  • damage to your heart or other organs
  • premature labour
  • stillbirth

Can I get the flu vaccine during pregnancy or while breastfeeding?

Yes. The flu vaccine is the best way to protect both you and your baby from catching the flu. The flu vaccination is recommended at any stage of pregnancy, anyone planning a pregnancy, or anyone who is breastfeeding.

It is safe to have the flu vaccine in pregnancy and while breastfeeding. It is free at any trimester during pregnancy through the National Immunisation Program.

You should get vaccinated against the flu even if you were already vaccinated last year. This is because the flu vaccine is updated every year to give you the most protection from the type of influenza that is expected to be common that year.

What medicines can I take during pregnancy?

During pregnancy, you may have conditions that need treatment with medicines. Some medicines are not safe to use during pregnancy. If you are pregnant, it’s important to speak to your doctor or pharmacist before starting, stopping or changing any prescription or over-the-counter medicines.

Here are some common medicines and information about their use, during pregnancy.

  • Paracetamol is considered safe at all stages of pregnancy.
  • Ibuprofen and other non-steroidal anti-inflammatory drugs (NSAIDs) should not be used during pregnancy unless your doctor has prescribed them.
  • Some cough medicines are safe during pregnancy, but not all types. If you are pregnant and feel very unwell with cold symptoms, ask your doctor or pharmacist for advice.
  • Saline nasal sprays are safe to use during pregnancy. Decongestant nasal sprays (used to relieve a blocked nose) are generally safe to use during pregnancy.
  • Oral decongestant medicines, such as pseudoephedrine and phenylephrine are not recommended during pregnancy.

There is limited scientific information about many herbal or complementary products or medicines and their safety during pregnancy. If you are thinking about using herbal medicines during pregnancy, it’s a good idea to check with your doctor or pharmacist about their safety and effectiveness.

What medicines can I take while I’m breastfeeding?

If you need to take medicines while you are breastfeeding, check with your doctor or pharmacist that they are safe for you and your baby. Even when your medicine is considered safe during breastfeeding, it is best to breastfeed your baby before you take your medicine.

While you are breastfeeding, it’s especially important to maintain good hygiene to reduce the chance of spreading the infection to your baby and other members of your household.

Here are some common medicines and some information about their use while you’re breastfeeding.

  • Ibuprofen is generally safe to use in breastfeeding. If you are taking other medicines or have other health conditions, speak with your doctor about using ibuprofen in your circumstance.
  • Aspirin is not to be used for pain or fever if you are breastfeeding.
  • Codeine may make your baby drowsy, especially in young or small babies, and if you have a family history of codeine sensitivity. Codeine is found in many cold and flu tablets. If your baby becomes more drowsy than usual after you have taken codeine, stop using it and speak to your doctor.
  • Pseudoephedrine is a decongestant found in some cold and flu tablets. It doesn’t transfer easily into breastmilk, but it is associated with reducing milk supply and may cause your baby to be irritable. Pseudoephedrine is not generally recommended if you are breastfeeding.
  • Phenylephrine is another decongestant sometimes used in cold and flu tablets. It has not been well studied, but it seems to transfer poorly into breast milk. It is used for children and babies.
  • Saline nasal sprays are safe to use while you are breastfeeding.
  • Decongestant nasal sprays (medicines that relieve a blocked nose) with the active ingredients oxymetazoline and xylometazoline can be used while you’re breastfeeding because they transfer poorly into breast milk, and work in the nose.

There is limited scientific information about many herbal or complementary products or medicines and their safety while breastfeeding. If you are breastfeeding and want to use a herbal medicine, check with your doctor or pharmacist about their safety and effectiveness before you do.

Speak to a maternal child health nurse

Call Pregnancy, Birth and Baby to speak to a maternal child health nurse on 1800 882 436 or video call. Available 7am to midnight (AET), 7 days a week.

Sources:
The Royal Women's Hospital (Herbal medicines in pregnancy and breastfeeding), The Royal Hospital for Women (Medicines in pregnancy), Department of Health (Protecting your baby against influenza starts when you’re pregnant), The Royal Hospital for Women (Pregnancy and flu), NSW Health (Common cold in pregnancy and breastfeeding), Department of Health (Influenza (flu) vaccine), Department of Health (National Immunisation Program Schedule)

Learn more here about the development and quality assurance of healthdirect content.

Last reviewed: June 2022


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