A common cold or cough during pregnancy raises questions about the safety of over-the-counter (OTC) remedies like cough drops. While lozenges offer soothing relief for a sore throat or dry cough, their active ingredients require careful consideration. Many medications, even seemingly benign cough drops, have not been extensively studied in pregnant populations. Before taking any new product, consult with a healthcare provider to ensure safety for both mother and baby.
The Safety of Common Cough Drop Ingredients
The active ingredients in cough drops fall into different categories of safety for pregnant individuals, based on available medical data. Menthol, the most frequent ingredient derived from mint plants, is generally considered safe for short-term use in the small doses found in lozenges. Although comprehensive safety studies are limited, typical consumption of menthol cough drops has no reported negative effects.
Dextromethorphan (DM), a common cough suppressant, is often considered low-risk for use during pregnancy, especially after the first trimester. Studies on DM exposure in the first trimester have not demonstrated an increased risk of major congenital malformations. Benzocaine, a topical anesthetic that temporarily numbs the throat, has similarly not been linked to birth defects in human data. Its use can be considered if the benefit of symptom relief is significant.
Conversely, ingredients that affect the circulatory system, such as the decongestants pseudoephedrine and phenylephrine, should be avoided. These agents cause vasoconstriction, potentially reducing blood flow to the placenta. They are often found in multi-symptom cold-and-flu lozenges and should be avoided, particularly in the first trimester. Zinc is an essential mineral, but pregnant individuals must monitor their total intake from lozenges and supplements to not exceed the adult upper limit of 40 milligrams per day.
Guidelines for Selecting Safe Lozenges and Monitoring
When selecting a cough drop, choose single-ingredient products that address only the immediate symptom, such as a sore throat or a dry cough. Multi-symptom drops should be avoided because they often contain unnecessary active ingredients, like decongestants, that may not be safe during pregnancy. Always check the inactive ingredients list for high concentrations of alcohol, which should be avoided entirely.
Individuals with gestational diabetes must be cautious with cough drops containing large amounts of corn syrup or cane sugar, as these can affect blood glucose control. Sugar-free varieties often contain sugar alcohols like xylitol or sorbitol. While generally safe in moderation, excessive consumption can cause gastrointestinal distress, such as diarrhea. Adhering strictly to the recommended dosage on the packaging prevents overconsumption of any ingredient.
Be mindful of lozenges that contain a long list of herbal extracts, as many botanicals lack sufficient safety data for use during pregnancy. Licorice root, for instance, has been associated with potential risks and is often advised against. If symptoms are not resolving with the recommended use of lozenges, or if they worsen, discontinue use and consult a medical professional immediately.
Non-Lozenges Home Remedies and Hydration
Symptom management through non-medicinal approaches offers effective alternatives for pregnant individuals. Maintaining excellent hydration is a primary defense, as increased fluid intake helps thin mucus, making it easier to clear from the airways and soothing throat irritation. Warm liquids, such as caffeine-free herbal tea or broth, provide direct comfort to the throat.
A simple mixture of warm water with honey and lemon juice can be very soothing. Honey coats the throat to suppress the cough reflex, while the lemon helps to thin mucus. Using a clean cool-mist humidifier or inhaling steam from a hot shower can effectively moisturize the respiratory passages and relieve congestion. Gargling with warm salt water can also help reduce inflammation and temporarily relieve a sore throat.
When a Cough Requires Professional Medical Attention
While most coughs during pregnancy are due to a common cold and resolve on their own, certain warning signs indicate a need for immediate medical evaluation. A cough that persists for longer than seven to ten days, or one accompanied by a high fever, is a cause for concern. A fever of 100.4°F (38°C) or higher requires prompt attention, as it can pose a risk during pregnancy.
Other urgent symptoms include shortness of breath, chest pain, or difficulty breathing, which may suggest a serious lower respiratory infection. Coughing up thick, discolored mucus—such as green, yellow, or blood-tinged phlegm—warrants a consultation, as it may signal a bacterial infection, bronchitis, or pneumonia. Untreated serious respiratory conditions carry risks, including potential complications for the mother and the possibility of premature birth or low birth weight.