A cough during pregnancy is a common and often uncomfortable experience. Since medications can cross the placenta, the primary concern is ensuring that any treatment, even an over-the-counter remedy, poses no risk to the developing baby. Before starting any new medication or supplement, it is always recommended to consult with a healthcare provider to ensure the treatment plan is appropriate for your specific health situation.
Non-Medication Relief Strategies
The safest first-line approach to managing a cough during pregnancy involves non-pharmaceutical methods. Staying well-hydrated is highly effective, as drinking plenty of water, juice, or clear broth helps to thin the mucus, making it easier to expel. Warm liquids, such as decaffeinated tea with lemon, can also provide temporary relief for a scratchy throat.
The use of honey, a natural demulcent, is a highly recommended strategy for cough relief. Honey works by coating the throat, which helps to calm irritation and suppress the cough reflex, making it a safe alternative to many cough syrups. A spoonful of honey, or mixing one to two teaspoons into warm water or tea, can be taken as needed, but it should be avoided if you have gestational diabetes or only used after consulting your provider.
Environmental controls are beneficial for reducing cough frequency, especially at night. Using a clean humidifier in the bedroom adds moisture to the air, which soothes irritated airways and helps reduce the severity of coughing fits. Inhaling steam from a hot shower or using a saline nasal spray or rinse can help address postnasal drip, a frequent cause of cough, by loosening mucus in the nasal passages.
Over-the-Counter Medications Generally Considered Safe
When non-medication methods are insufficient, certain over-the-counter (OTC) medications are generally considered acceptable for short-term use, typically after the first trimester. Dextromethorphan (DM) is a cough suppressant that targets the cough reflex in the brain, making it useful for managing a dry, non-productive cough. It is considered safe for use during pregnancy when taken at the recommended dose for a short duration.
Guaifenesin acts as an expectorant, helping to thin and loosen mucus in the chest. This action allows for a more productive cough that clears the airways, and it is considered safe, especially when used after the first trimester. When selecting a product containing either DM or Guaifenesin, choose single-ingredient formulations to avoid inadvertently taking unnecessary or restricted medications.
For managing accompanying symptoms like fever, headache, or body aches, acetaminophen is widely recommended as the preferred pain reliever throughout pregnancy. It should be used sparingly, at the lowest effective dose, and for the shortest time needed to manage discomfort. Always check the label of any cough product to ensure it does not include acetaminophen if you are already taking it separately for pain or fever, to prevent accidental overdose.
Ingredients and Medications to Strictly Avoid
A number of common cough and cold ingredients are restricted during pregnancy due to potential risks to the fetus. Oral decongestants, such as pseudoephedrine and phenylephrine, are a concern, particularly during the first trimester. These medications work by constricting blood vessels, which carries a risk of reducing blood flow to the placenta and potentially affecting the developing fetus.
Nonsteroidal anti-inflammatory drugs (NSAIDs), including ibuprofen and naproxen, must be avoided as the pregnancy progresses. NSAIDs are contraindicated from about 20 weeks of gestation onward due to the risk of causing fetal kidney problems and the premature closure of the fetal ductus arteriosus. This risk is especially pronounced in the third trimester, where even short-term use is linked to serious cardiac complications.
Alcohol Content
It is crucial to check the labels of liquid cough and cold preparations for alcohol content, as many syrups use alcohol as a solvent. Alcohol should be avoided entirely during pregnancy, and choosing alcohol-free formulations is necessary to eliminate this risk.
Multi-Symptom Remedies
Multi-symptom cold remedies that combine several active ingredients, such as a cough suppressant, decongestant, and pain reliever, should also be avoided. These products often contain restricted substances and may result in taking medication for symptoms you do not have.
Knowing When to Contact a Doctor
While most coughs are caused by common, self-limiting viruses, a persistent or severe cough during pregnancy requires medical evaluation to rule out more serious conditions. A high or persistent fever, specifically a temperature of 100.4°F (38°C) or greater that does not respond to acetaminophen, is a significant red flag. Contact a healthcare provider immediately if you experience this symptom.
Other symptoms that require prompt medical attention include signs of respiratory distress, such as shortness of breath, difficulty breathing, wheezing, or chest pain. These symptoms could indicate a complication like pneumonia or bronchitis that requires specific treatment. Seek immediate consultation if the cough is accompanied by severe vomiting that prevents you from keeping down fluids or food, coughing up blood, or thick, discolored phlegm.