Better Me

How to Treat a Cold or Flu When You’re Pregnant

While catching a cold or the flu (influenza) can be a pain, becoming unwell during pregnancy can be a little more worrisome. 

When you’re pregnant, your immune system changes to make way for your growing baby. As a result, it makes it harder for your immune system to fight pesky infections. 

If you’re pregnant, you need to take special steps to stay healthy during cold and flu season

Here is a guide to understanding how a cold or flu virus can affect you during pregnancy and how to safely manage illness. 

Understanding the risks during pregnancy

Catching the common cold will not harm your baby, but the flu might lead to more serious complications for you and the baby.

“The flu during pregnancy can lead to preterm birth and low birth weight, and it can also put your newborn at higher risk of catching the infection after birth,” said Devin Minior, MD, with Banner Health. “A high fever from the flu has been linked to birth defects.”

According to the American College of Obstetricians and Gynecologists (ACOG), if you are pregnant – especially in the second or third trimester – you are more likely to become seriously ill with the flu than people who aren’t pregnant.

When should you see your health care provider?

Cold viruses can be uncomfortable, but they are not usually dangerous for you and the baby. “Generally, if you are feeling well, you can treat colds at home and don’t need to see your provider,” said Dr. Minior. “But if you think you have the flu, you should see your provider immediately.”

Your provider might swab the inside your nose and throat to confirm you have the flu. They may also prescribe an antiviral medicine to treat the flu.

The ACOG and the Centers for Disease Control and Prevention (CDC) recommend that pregnant women who get the flu should be treated with antiviral medications. These medicines work best when started within 48 hours of the start of symptoms.

“Antiviral drugs don’t cure the flu, but they can shorten how long the flu lasts, as well as its severity,” said Dr. Minior.

Flu symptoms might include:
  • High fever
  • Sore throat
  • Dry cough
  • Chills and sweats
  • Intense muscle and body aches
  • Feeling very tired or worn out
Cold symptoms might include:
  • Runny or stuffy nose (nasal congestion)
  • Headache
  • Sore throat
  • Cough
  • Slight body aches
  • Feeling tired

[Also read Do I Have a Cold or the Flu? How to Tell the Difference.]

Tips for treating symptoms at home

During pregnancy you should be cautious about taking over-the-counter (OTC) medicine —and only take those approved by your health care provider. If you need some symptom relief, the following methods are safe during pregnancy:

Natural, pregnancy-safe home remedies
  • Stay home and rest: Elevating your head while sleeping can help with symptoms.
  • Gargle with warm salt water to help with throat pain: Dissolve half a teaspoon of salt in a cup of warm water and gargle several times a day.
  • Stay hydrated: Drink plenty of water, herbal teas with honey and lemon and clear broths like chicken. Humidifiers and nasal rinses can also help clear mucus from your nose and sinuses. 
  • Mind the herbs: Not all herbs and supplements are safe in pregnancy. You might be able to safely take vitamin C, zinc and elderberry, but check with your provider first.
Pregnancy-safe OTC cold and flu medication

Check with your provider before taking any OTC medications. Many cold and flu medications treat many symptoms so they may include several ingredients.

  • For fevers and pain relief:
    • Acetaminophen (Tylenol) can help with fevers, sore throat, aches and pains. It is not safe if you are allergic to it or have liver problems. Limit to 3,000 mg in 24 hours.
    • Menthol throat lozenges
  • For coughs and chest congestion: 
    • Delsym and Robitussin (dextromethorphan) may help with coughs. Limit the use of these products to the lowest strength and for the shortest time possible.
    • Mucinex (guaifenesin) is safe to use in the second and third trimester of pregnancy.
  • For stuffy noses:
    • Saline nasal drops or sprays
    • Sudafed (pseudoephedrine) is safe in the second and third trimesters. Check with your provider if you have high blood pressure or a history of heart disease.
    • Triaminic (chlorpheniramine), Unisom (doxylamine) and Benadryl (diphenhydramine) are considered safe throughout pregnancy.
    • Zyrtec (cetirizine) and Claritin (loratadine) are safe for use during all trimesters.

If these aren’t helping treat your symptoms or your symptoms have worsened, talk to your health care provider. You may have developed a secondary infection and need to be treated with an antibiotic. However, antibiotics won’t cure your cold.

“There are times when an antibiotic may be appropriate, such as a strep throat or sinus infection caused by bacteria, but antibiotics simply won’t work against viruses,” said Dr. Minior. “Overprescribing antibiotics can lead to antibiotic resistance and side effects that can make you sicker.”  

Ways you can prevent a cold and flu

The key actions you can take to prevent cold and flu during pregnancy include:

  1. Get a flu shot: The flu vaccination is safe, prevents the common flu, reduces the severity of symptoms and lowers the ability to spread it to others. The flu shot can’t cause the flu.
  2. Practice good hand hygiene: Wash your hands regularly with warm water and soap.
  3. Avoid close contact with people who are sick: If someone you live with becomes sick, try to limit time with them. Have someone else look after them if possible.
  4. Maintain a healthy lifestyle with a balanced diet: Check out our list of what to eat and what to avoid during pregnancy.
  5. Get regular exercise: Try to get 30 minutes of moderate aerobic activity each day.

Bottom line

While catching a cold or flu during pregnancy can be worrisome, the good news is that most pregnant people recover with proper care.

Remember to get your flu shot and give yourself some extra TLC during the cold and flu season. Talk to your health care provider or a Banner Health specialist if you have questions or concerns.

For more cold and flu-related content:

Pregnancy Cold and Flu Women's Health