What If You Catch a Cold or Flu Virus in Pregnancy?
Pregnancy is an exciting and scary time. What if you get sick with a cold or flu? Which treatments are safe and which can harm your baby? House Call Doctor explains.
Sanaz Majd, MD
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What If You Catch a Cold or Flu Virus in Pregnancy?
Coming down with the cold or flu is no fun. What could be worse than that? Well, actually, a lot of other medical conditions are worse. But being pregnant and catching a virus is pretty bad. When pregnant, you are likely living with daily nausea, an intense acid reflux, a myriad of musculoskeletal symptoms from an ever-expanding fetus pushing on your pelvic bones, and chronic insomnia. As if you weren’t uncomfortable enough, you’re suddenly smacked with a seemingly endless snot-producing virus on top of it all.
Well, unfortunately, pregnancy is considered an “immune compromised state” – this means that our immune system is working suboptimally since we are carrying and growing another human being that is yanking away at our energy stores and taking over our immune system. So women are definitely more susceptible to catching viruses when pregnant.
Now that we know how common it is to get sick in pregnancy, what can we do about it? It’s a challenge to figure out what is safe and what isn’t safe during these crucial 9 months. >
What Is the Cold and Flu Virus?
I’ve discussed in detail everything you’ve ever needed to know about the cold and the flu virus (and then some) in my prior episodes. Check out What Causes Colds?, What Is the Flu Virus?, and 5 Tips to Treat the Common Cold.
But just as a review, let’s group these viruses all together and list the most common ways they set up shop in our respiratory systems and wreak havoc on our bodies, in varying degrees:
Runny nose- Stuffy nose
- Sneezing
- Cough
- Sore throat
- Fever
- Malaise
- Body aches
- Headache
Runny noseNote: Nasal congestion can be a common and sometimes chronic pregnancy-related phenomenon in some patients and occurs secondary to hormonal changes. Therefore, a mild nasal congestion on its own isn’t necessarily a virus or a bacterial sinusitis when it occurs in pregnancy. It typically resolves after delivery.
Before You Run to Treatment, Consider…
Despite anything I discuss in this episode, I urge every pregnant woman to discuss any treatment options you consider (even if they’re over-the-counter) with your doctor before you proceed. And before starting on any treatment, there are a couple of things you should be aware of:
1. Cold/Flu viruses are self-resolving: The symptoms are typically mild and self-resolve without any treatment, just like in non-pregnant adults. The typical virus takes about 7-10 days to resolve, and does so on its own without any treatment. Unfortunately, there’s simply no cure for the common cold or flu virus (whoever invents that one may simply become the wealthiest person in the world). And unfortunately, treatment doesn’t shorten the duration of the illness. So you really don’t have to take anything as long as your symptoms are mild and you can bear through them. That being said, if you are truly miserable and absolutely must take something, the only remedies available are for symptomatic relief – that is, they relieve the symptoms but don’t cure the underlying condition.
2. Evidence is limited: In general, cold and flu medications haven’t been well-studied in pregnancy. Therefore, we don’t know how safe or unsafe they may be for your growing baby. Doctors categorize medications in various safety groups in pregnancy based on available research – these include Categories A through D (in order of increasing evidence for risk and harm to the fetus), in addition to Category X (which is an absolute contraindication for a drug to be taken in pregnancy). Most drugs used in pregnancy are Class A through C – we don’t like to prescribe anything past that. You must weigh the risks and benefits of any treatment, even if it’s a Class A drug.
See also: Can You Take Medication While Pregnant?
But despite knowing all of this, if you opt to take something, at least make sure it’s something that has been better studied and deemed safer in the womb. And use it for the shortest duration possible.
Here are some ideas to discuss with your doctor on how to treat your symptoms while carrying little Bambino…..
How to Treat Cold and Flu in Pregnancy
- Nasal congestion: Use a humidifier – this will return some moisture into the air, which will help open up your nasal passages and subsequently drain that mucus (similar to a soothing warm-shower effect).
- Runny nose: If the dripping is leaving your nose feeling like an over-flowing faucet, then one group of over-the-counter drugs you can ask your doctor about are antihistamines that work to “dry up” those tubes. The most well-studied in pregnancy are chlorpheniramine and diphenhydramine, typically our first-line choices for expecting mothers.
- Fever, sore throat, geadache, body aches: Please never use an anti-inflammatory drug while pregnant – this includes aspirin, ibuprofen, Aleve, Motrin, or Advil. The only over-the-counter pain aid or fever reducer deemed safe during pregnancy is acetaminophen (or Tylenol).
- Flu vaccine: Prior influenza pandemics were associated with more severe symptoms and risks (including death) in pregnant women. For that reason, we recommend the flu vaccine for every pregnant woman.
What Treatments to Avoid in Pregnancy
- Non-steroidal anti-inflammatories: Like I mentioned earlier, these are contraindicated in pregnancy. Drugs such as ibuprofen and aspirin have been associated with some fetal defects, such as heart anomalies, cleft palate, and gastrointestinal defects.
- Throat lozenges: Be careful when selecting a throat lozenge to treat your sore throat. Some ingredients, such as zinc, are controversial and have been associated with some possible fetal anomalies (such as brain defects). Opt for acetaminophen for your sore throat instead of a lozenge. Or better yet, drink some hot tea with lemon or honey.
- Vitamin C: Large doses of vitamin C can also be harmful in pregnancy and doctors don’t recommend supplementation for viral syndromes — there have been reports of it causing scurvy in infants born to moms who took high doses of vitamin C while pregnant.
- Cough medicines: Cough syrup ingredients, such as codeine, dextromethorphan, and guaifenisin, haven’t been well-studied in pregnant women. Because we are not sure of their effects on a growing fetus, they are to be avoided in pregnancy.
- Decongestants: Decongestants such as pseudoephedrine and phenylephrine are also not advised as they can increase blood pressure and have been associated with certain congenital fetal anomalies.
Quick and Dirty Tip: Antibiotics do not work on viruses. Antibiotics only work for bacterial illnesses – such as pneumonia, urinary tract infections, strep throat, ear infections, and bacterial sinusitis (nasal congestion is usually viral, however, especially the first 7-10 days of an illness). Contrary to popular myth, bronchitis is also typically viral (but may require other prescription treatments).
Red Flags
The common cold virus is, well, pretty common. And the flu virus runs rampant in the winter months. But if you experience any of the following symptoms, you should consult your doctor right away:
- Difficulty breathing or shortness of breath
- Increased heart rate
- Wheezing
- Chest pain
- High fevers
- Abdominal pain
- No improvement in symptoms after 7-10 days
- Severe symptoms or anything out of the ordinary
The truth is, pregnancy is truly a special time in our lives. For those women who have been given the gift of fertility, please treasure it and treat your body and baby with great care and love. When in doubt about anything, seek your doctor’s advise. If it doesn’t feel like the run of the mill cold, then it’s always better to be safe than sorry, especially when you are pregnant. And again, before you consider any treatment, you should always consult your obstetrician.
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Please note that all content here is strictly for informational purposes only. This content does not substitute any medical advice, and does not replace any medical judgment or reasoning by your own personal health provider. Please always seek a licensed physician in your area regarding all health related questions and issues.
Pregnant woman sneezing and pregnant woman with cold images courtesy of Shutterstock.
