Cold During Pregnancy: How to Treat It Safely

A cold during pregnancy unsettles almost every mom-to-be. A runny nose, a scratchy throat and a cough may seem like nothing on their own, but an anxious thought quickly follows: could this harm my baby, and what is even safe to take? The good news is that most colds and respiratory viruses clear up on their own within a week or two, and you can ease the symptoms in safe ways. In this article we'll calmly walk through how a cold differs from the flu, how to treat a cold during pregnancy, which remedies are considered safe, when a fever becomes dangerous, and the warning signs that mean you should call your doctor right away.

Cold, respiratory virus or flu — what's the difference?

All three terms are often used interchangeably, but they aren't the same thing. Understanding the differences helps you judge how serious the situation is.

• A respiratory virus (an acute viral respiratory infection) is a catch-all name for a whole family of cold-causing viruses. The ordinary "common cold" is the most frequent and mildest version.
• A cold comes on gradually: first your throat tickles, then a runny or stuffy nose, sneezing and a mild cough appear. Your temperature is usually normal or only slightly raised, and you generally feel well enough to keep going.
• The flu hits suddenly and harder: a high fever (100.4 °F / 38 °C or above), body aches, deep fatigue, headache and sometimes a dry cough. It's the flu that deserves extra attention during pregnancy, because it tends to be more severe and more likely to lead to complications.

Put simply: if you feel run down but are still on your feet, it's most likely a cold. If a high fever and body aches hit you out of nowhere, it could be the flu — and it's worth telling your doctor as early as possible.

Why you catch colds more easily during pregnancy

Many moms-to-be notice they catch colds more easily while pregnant — and that's no coincidence. During pregnancy the immune system naturally shifts a little so that your body doesn't reject your baby. As a result, you may be slightly more susceptible to viruses, and a cold itself can sometimes drag on longer.

Add to that swollen nasal passages: hormones boost blood flow to the lining of your nose, and many women feel congested even without any infection — a condition known as pregnancy rhinitis. When a respiratory virus lands on top of that, the congestion feels even worse. All of this is a normal part of pregnancy, not a reason to blame yourself for "not being careful enough".

Which symptoms you can treat at home

Most cold symptoms are safe to ease at home while you keep an eye on how you feel. These usually include:

• a runny or stuffy nose;
• sneezing and a scratchy throat;
• a mild cough;
• a low-grade fever and general tiredness;
• a mild headache (for more on its causes and relief, see our guide to headaches during pregnancy).

The main "medicines" here are rest, warm fluids and time. But there are symptoms where waiting and treating yourself at home isn't the right call.

Warning signs — when to call your doctor right away

Contact your doctor or seek urgent care if any of the following appear:

• a fever of 100.4 °F (38 °C) or higher, or a fever that won't come down;
• trouble breathing, shortness of breath, or chest pain or pressure;
• a severe cough, or a cough that brings up unusually colored phlegm or blood;
• symptoms that last longer than 10 days, or that improve and then suddenly get worse;
• a severe headache, confusion or fainting;
• signs of dehydration: you're barely drinking, passing little urine, or feeling very dizzy;
• vomiting that keeps you from drinking and eating;
• any changes involving your baby: weaker or absent movements, cramping low in your belly, leaking fluid or bloody discharge.

These signs don't necessarily mean something is wrong, but they're for your doctor to assess. It's better to make one extra call than to worry on your own.

How to treat a cold during pregnancy: what's safe and what to avoid

The key rule: discuss any medication during pregnancy with your doctor or pharmacist, even one you used to buy over the counter without a second thought. Combination "cold and flu" sachets and "3-in-1" tablets deserve special caution: they often blend several active ingredients at once, including some that aren't recommended in pregnancy, plus caffeine. It's safer to treat each symptom separately.

Fever and pain: acetaminophen, and why ibuprofen and aspirin are avoided

Acetaminophen (known as paracetamol outside the US, and sold as Tylenol) is generally considered the go-to choice for lowering a fever and easing pain during pregnancy — taken at the lowest effective dose for the shortest time, with your doctor's okay. To the common question of whether you can take Tylenol during pregnancy, most reputable sources say it's suitable for most women, but you should still talk through the dose and how long to take it with a professional.

Ibuprofen and other NSAIDs (non-steroidal anti-inflammatory drugs), as well as aspirin at pain-relief doses, are usually avoided in pregnancy — especially in the second half — and used only if your doctor prescribes them. For the same reason, steer clear of combination painkillers that contain aspirin and caffeine. If you're not sure which pain relievers are right for you during pregnancy, ask your doctor rather than reaching for your usual go-to.

Cough and sore throat

A scratchy, sore throat responds well to simple home measures: warm drinks, gargling with warm salt water, and sucking on lozenges. A warm drink with a spoonful of honey gently soothes both your throat and a dry cough. Many throat and cough lozenges and syrups are allowed in pregnancy too, but it's best to check the ingredients with a pharmacist — some contain alcohol, large doses of herbs or other ingredients you'd rather avoid.

Runny and stuffy nose

The safest way to manage a runny nose during pregnancy is saline: sprays and drops with sea water or saline solution, and nasal rinses. They aren't absorbed into your bloodstream and gently help clear your nose. Decongestant drops and tablets (for example, those with pseudoephedrine) should be used with caution and only after talking to your doctor. Simple steps help too: humidified air in the room, a warm shower, and raising the head of your bed while you sleep.

Home remedies: rest, fluids and honey

When you have no appetite for medicines, the most underrated remedy comes to the rescue — rest. Give yourself permission to slow down and sleep more; if congestion or coughing makes it hard to get comfortable, take a look at our guide on how to sleep during pregnancy and which positions are easier. Drink plenty of fluids — warm water, fruit drinks, broth and herbal teas help thin mucus and prevent dehydration, especially with a fever.

Food can support your body too: warm soups, vegetables and vitamin C-rich fruit are a gentle way to look after your immune system (we've gathered what to eat and what to skip in our article on nutrition during pregnancy). Be careful, though, with pharmacy "hot drink" cold remedies and coffee: many cold products contain caffeine, and it's easy to overdo — we covered how much is okay per day in our piece on coffee and caffeine during pregnancy.

When a fever really is dangerous

A low-grade fever (up to about 99.5–100.4 °F / 37.5–38 °C) with a cold usually isn't dangerous and often passes on its own. But a higher fever during pregnancy is a reason to act rather than wait. A high fever, especially in the first trimester, is best avoided, so it's important to bring it down gently (usually with acetaminophen) and let your doctor know.

Get in touch with your provider if your temperature climbs to 100.4 °F (38 °C) or higher, lasts more than a day, or doesn't come down after a fever reducer. While you wait for advice, help yourself with simple measures: light clothing, cool air in the room and plenty of fluids. Don't rub yourself down with cold water or alcohol — it can trigger shivering and actually raise your temperature.

Can a cold harm my baby?

This is probably the biggest fear for moms-to-be — and here you can breathe out. An ordinary cold on its own usually doesn't harm your baby: the virus stays in your airways rather than passing to your child. The placenta and amniotic fluid protect your baby, so a runny nose and mild cough are nothing for them to fear.

The flu is more serious: in pregnant women it more often runs a severe course and raises the risk of complications for both mom and pregnancy, especially with a high fever. So if you suspect the flu, it's important not to self-treat but to contact your doctor quickly. In some cases your doctor may prescribe antiviral medication (such as oseltamivir, known as Tamiflu) — it works better when started in the first days of illness. Only a professional makes the decision about this treatment.

Prevention: the flu shot and good hygiene

You can't avoid every virus, but you can lower your risk. The main tool for protecting against the flu during pregnancy is the flu shot. Leading medical organizations, including ACOG and the CDC, recommend vaccination for pregnant women in any trimester: it's considered safe and also passes some protection to your baby for the first months of life. Talk to your doctor about timing and whether the shot is right for you.

Simple everyday habits help too:

• wash your hands often and thoroughly, especially after being in public places;
• try not to touch your face with unwashed hands;
• keep your distance from people who are clearly sick and from crowds during cold-and-flu season;
• get enough sleep, eat well and drink plenty of water — a rested body handles viruses more easily;
• air out your rooms often and keep the humidity comfortable.

Key takeaways

• Most colds and respiratory viruses in pregnancy clear up on their own, and an ordinary cold usually doesn't harm your baby.
• Acetaminophen is generally the go-to choice for fever and pain, while ibuprofen, other NSAIDs and aspirin are avoided — clear any medication with your doctor.
• Treat a runny nose with saline, and a sore throat and cough with warm drinks, honey and gargling.
• Rest, sleep, plenty of fluids and warm food are the foundation of recovery; avoid combination remedies that contain caffeine.
• Call your doctor right away with a fever of 100.4 °F (38 °C) or higher, shortness of breath, chest pain, dehydration, or any worsening or change in your baby's movements.
• The flu is more dangerous than a cold: the best protection is the flu shot, which is allowed in any trimester.

This article is for general information only and is not a substitute for personalized medical advice. For any symptoms, medications or vaccines during pregnancy, please consult your own healthcare provider.