Navigating Cold and Flu Medicines During Pregnancy

Catching a cold or the flu while pregnant can feel overwhelming. Not only are you dealing with uncomfortable symptoms, but you also want to make sure anything you take is safe for your growing baby. Here's what you need to know about managing cold and flu symptoms during pregnancy.

During the first trimester, your baby's development is most vulnerable, so it's important to limit any unnecessary medications. Sometimes the best medicine is no medicine at all.

These comfort measures can go a long way:

• Get plenty of rest and fluids.
• Use a humidifier or breathe in steam.
• Eat nutrient-rich fruits and vegetables.
• Try tea with honey or warm saltwater gargles.
• Apply warm compresses to the sinuses.

Remember, you're not alone. Many pregnant women face colds and flu, and safe options do exist to help you feel better.

If your symptoms don't improve with comfort measures alone, certain medications may be safe depending on your stage of pregnancy. Most medications approved during pregnancy are the safest to take during your second and third trimester.

It's important to note that anytime you have a fever above 101°F, regardless of what trimester you are in, promptly take Tylenol, fluids and cooling measures (lukewarm bath, cold compresses, fans) to reduce fevers.

What's considered safe?

While many medications should be avoided, some options are considered safe during pregnancy (second and third trimester) when taken as directed.

• Congestion relief: Saline nasal drops/spray, Flonase
• Allergies or runny nose: Benadryl (diphenhydramine), chlorpheniramine, Zyrtec (cetirizine), Claritin (loratadine)
• Sore throat: Chloraseptic spray, throat lozenges
• Pain, fever or body aches: Tylenol (acetaminophen)

What's NOT safe?

Certain medications may pose risks to your pregnancy or your baby's development. These include:

• Decongestants: Pseudoephedrine, phenylephrine
• NSAIDs: Ibuprofen, naproxen, Motrin, Aleve, aspirin
• Combination cold medicines: Such as DayQuil/NyQuil (many contain unsafe ingredients or alcohol)
• Guaifenesin (Mucinex): Avoid in the first trimester, otherwise ok to use

It's safest to treat only the symptom that bothers you most. Combination medicines often contain at least one ingredient that isn't recommended in pregnancy.

Many herbal and natural options can help ease symptoms, but remember these aren't regulated by the Food and Drug Administration.

Safe herbal/natural options in moderation include:

• Ginger or chamomile tea
• Honey with warm water or lemon
• Saltwater gargles
• Humidified air
• Vitamin C (up to 1,800 mg daily), vitamin D (up to 4,000 IU daily unless monitored), zinc (up to 15 mg daily)

Because the immune system works differently during pregnancy, women may be more prone to illness. Certain vaccines not only protect you but also pass some protection to your baby:

• Tdap: Prevents whooping cough (pertussis)
• RSV vaccine: Protects against respiratory syncytial virus
• Flu vaccine: Covers influenza A and B
• COVID-19 vaccine: Protects against multiple strains

It might be time to see your health care provider if you experience symptoms lasting longer than 14 days, high or persistent fever, shortness of breath, dehydration, or suspected flu, COVID-19 or RSV.

Always check with your OB provider before starting any new medication or supplement, and remember, sometimes rest, hydration and some TLC are the best remedies of all.