How can I Treat a Cold During Pregnancy?

While the common cold is always annoying, it is even more of a bother to catch one while pregnant! Pregnant women are more susceptible to infections because of their decreased immune system, so this can make colds happen more often and last longer. Also, the nasal passages are already prone to be dilated and therefore stuffy in pregnancy, so a cold can only make this worse. Here are some things you can try to treat the common cold in pregnancy.

Many over-the-counter (OTC) medications can be used in pregnancy if they are used on a short-term basis. If you have the choice, avoid medications that are long-acting, extended-release, “maximum strength,” contain alcohol, or are a combination of multiple ingredients. As always, you should check with your provider first before starting any new medications.

To help combat fever and the aches associated with colds, acetaminophen (Tylenol) can be safely used. A recent study out of Norway associated Tylenol usage with poorer motor skills and some delayed milestones in children born to mothers who took this drug, but this was in women who used the medication for an extended period of time (as long as 28 days!). Therefore, use it when needed but avoid prolonged consumption.

The well-known antihistamine diphenhydramine (Benadryl) is considered safe in pregnancy. This can help with common cold symptoms such as watery eyes, runny nose, and sneezing. Doxylamine is another antihistamine considered safe; some women also use this for symptoms of nausea and vomiting in pregnancy.

There are many OTC cough medications on the market. The bad news is that none of them work better than the tincture of time, so in pregnancy it makes little sense to try these when there is no evidence that they will even help!

Decongestants such as pseudoephedrine and phenylephrine are both active ingredients in Sudafed. There have been some small studies showing a possible increased risk of certain malformations, especially when used early in pregnancy. They could also potentially decrease blood flow to the uterus and subsequently to a developing fetus. Therefore, these should be avoided in the first trimester and should be used with caution after that.

Echinacea has often been touted as a natural cold remedy. This is a non-FDA regulated supplement that contains multiple chemical components, and the quality of the supplement cannot be evaluated or guaranteed. Therefore, it would be ideal to avoid during pregnancy. Vitamin C has also been used to decrease the length of a cold. Pregnant women should not exceed doses of more than 1,800 mg/day. If you choose to try zinc, also be sure to stay under the recommended level of 34 mg/day.

There are many things you can try to relieve the symptoms of a cold that are safe in pregnancy. These include:

• Making sure you get adequate rest and nutrition
• Saline nasal sprays
• Using a humidifier
• Saltwater gargling
• Sore throat lozenges

You should check in with your provider if you have a fever, are having trouble breathing, or feel unwell enough to care for yourself. These may be signs of something more concerning and you will likely need to be seen by your doctor or midwife.

Reviewed by Dr. Jen Lincoln, November 2018

Sources:

• Treating the common cold during pregnancy Aida Erebara, Pina Bozzo, Adrienne Einarson, Gideon Koren Can Fam Physician
• 2008 May; 54(5): 687–689.
  The Pharmacist’s Letter: Cough and cold medications in pregnancy and lactation
• November 2013
• Document #291108.
  International Journal of Epidemiology
• Prenatal paracetamol exposure and child neurodevelopment: a sibling-controlled cohort study.

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