A cold during pregnancy can bring uncomfortable symptoms like congestion, sore throat, and body aches. While seeking relief is natural, medication decisions require careful consideration. Always consult a healthcare provider before taking any medication, including over-the-counter remedies, to ensure safety for both the pregnant individual and the baby.
Medications to Avoid
Several common cold medications are not recommended during pregnancy due to potential risks. Oral decongestants like pseudoephedrine (Sudafed) and phenylephrine (Sudafed PE, DayQuil) should be avoided.
Pseudoephedrine is not recommended in the first trimester and should be used with caution in the second and third trimesters, especially for those with high blood pressure or preeclampsia, as it can elevate blood pressure and reduce placental blood flow. Phenylephrine constricts blood vessels, potentially reducing placental blood flow and increasing blood pressure. Some studies link first-trimester exposure to these decongestants with a small increased chance of certain birth defects, such as heart defects. The FDA has even proposed removing oral phenylephrine due to questionable effectiveness.
Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), including ibuprofen (Advil, Motrin) and naproxen (Aleve), are not safe during pregnancy, especially after 20 weeks. These medications can cause serious complications for the baby, such as low amniotic fluid (oligohydramnios) and premature closure of the ductus arteriosus, a vital heart vessel. While first-trimester risks like miscarriage or birth defects have been explored, the primary concern is their use in the second and third trimesters.
Many multi-symptom cold remedies contain multiple ingredients. Always choose single-ingredient medications to target specific symptoms and carefully check labels for hidden ingredients and alcohol, which should also be avoided.
Medications Generally Considered Safe
When selecting cold medications, single-ingredient options are preferred and should be discussed with a healthcare provider. Acetaminophen (Tylenol) is widely considered a safe option for pain relief and fever reduction throughout pregnancy, and it is often recommended as a first choice. While some studies link long-term acetaminophen use to mild developmental delays or ADHD, current guidelines from organizations like ACOG support its short-term use, noting that untreated fever can pose a greater risk.
For nasal congestion, saline nasal sprays are safe and effective, helping to moisten passages and loosen mucus. Antihistamines can be considered for runny nose and congestion, including chlorpheniramine, loratadine (Claritin), cetirizine (Zyrtec), and fexofenadine (Allegra). For cough relief, dextromethorphan (Delsym, Robitussin) and guaifenesin (Mucinex) are generally safe after the first trimester, though some studies suggest avoiding them earlier due to small risks. Cough drops with menthol or benzocaine are typically safe within recommended dosages. Topical mentholated chest rubs, like Vicks VapoRub, are generally safe when applied externally as directed.
Non-Pharmacological Relief
Many effective strategies for managing cold symptoms during pregnancy do not involve medication and can provide significant comfort. Getting ample rest is important, as it supports the body’s immune system in fighting off the virus. Staying well-hydrated is essential; drinking fluids like water, clear broths, and herbal teas helps thin mucus and prevent dehydration, especially with a fever.
Using a humidifier adds moisture to the air, soothing irritated nasal passages and easing congestion. Gargling with warm salt water can alleviate a sore throat and help clear post-nasal drip. Nasal irrigation using a neti pot with distilled or sterile water helps flush out nasal passages; proper hygiene is crucial to prevent germ spread.
Warm baths or showers provide steam that helps loosen congestion. Honey, taken directly or mixed with warm water and lemon, can soothe a cough and sore throat.
When to Seek Medical Advice
While most colds during pregnancy are mild and resolve on their own, certain symptoms warrant medical attention for the well-being of both the pregnant individual and the baby. Contact a healthcare provider if a high or persistent fever develops (101 degrees Fahrenheit / 38.3 degrees Celsius or higher), or if a fever does not respond to acetaminophen.
Other concerning symptoms include severe sore throat, chest pain, difficulty breathing, or persistent coughing that is worsening or accompanied by wheezing. If cold symptoms do not improve after a few days, worsen, or persist for more than 10 to 14 days, seek medical advice. Any new or concerning symptoms should also prompt a call to a healthcare provider.