Coughs and colds in pregnancy

What causes a cold?

There are more than 200 viruses that cause symptoms of the common cold (Harding 2016). The symptoms last about a week, although a cough can last up to three weeks (NICE 2016).

Because colds are caused by a virus and not by bacteria, antibiotics won't help you get better.

Sometimes a viral or bacterial infection of your throat, sinuses, ears or chest can follow a cold (Harding 2016, NICE 2016). Some bacterial infections may need an antibiotic, so see your GP if your symptoms keep getting worse (NICE 2016).

Always see your doctor if you get a high fever or severe breathlessness while you're pregnant (West 2017).

Will it harm my baby if I have a cold?

Having an ordinary cold, though miserable for you, shouldn't be harmful to your health or your baby's.

You're very likely to pick up a cold at some time during your pregnancy because it's normal to catch two or three colds a year (NICE 2016). Young children get colds even more often, and if you're around them you may catch colds more frequently (NICE 2016).

How can I tell if it's a cold and not flu?

It's not always easy to tell the difference between a cold and flu. Colds can make you feel rotten, so it's easy to feel as if you're coming down with the flu.

With a cold, you may have the following symptoms:

• sore throat
• blocked or runny nose
• sneezing
• cough
  (NHS 2017a, NICE 2016)

Although not as common, you may also get other symptoms including a mild fever and headache (NHS 2017a, NICE 2016).

Generally, flu comes on faster, causes a higher fever, headache, muscle aches and sweating, and can make you feel exhausted (NHS 2017c, NICE 2015a). If you're not sure, see your doctor quickly, because flu in pregnancy can be harmful for you and your baby (NICE 2015a).

Find out what to do if you're pregnant and you think you may have coronavirus.

How can I avoid catching a cold?

You're most likely to pick up the virus when you touch someone who has a cold, or an object they've recently handled, such as a phone or a door handle, then touch your nose or eyes (NICE 2016).

So following good hygiene rules really can help prevent colds from spreading.

You can't always avoid a cold virus, but to give yourself the best chance, try to:

• Wash your hands often with warm soapy water, especially after you've been around someone who has a cold.
• Avoid touching your nose or eyes, especially while out and about.
• Stay away from anyone who has a cold, if possible. It's hard to avoid colds completely, though, as people are contagious a few days before their symptoms begin.
• Ask those around you to practise the "catch it, bin it, kill it" routine. People with a cold should catch coughs and sneezes in a tissue, throw it away, and wash their hands. Coughs and sneezes spread germs that can linger in the air.
• Wash your hands if you've picked up a dirty tissue.
• Clean surfaces in your home and your office space often.
• Avoid sharing cutlery, cups or plates with someone who has a cold.
• Avoid sharing towels – use your own, or use paper towels to dry your hands.
  (NHS 2017a, NICE 2016)

Taking a daily vitamin C supplement won't prevent you from getting a cold, but it may make it less severe and last a shorter time (Hemilä and Chalker 2013). Taking a zinc supplement as soon as a cold starts may also cut the time the virus lasts (Hemilä 2011).

A healthy lifestyle with a good diet and regular exercise will give you the best possible protection against catching a cold.

As long as you're eating well and taking a folic acid and iodine supplement, you should be getting all the vitamins and minerals you need. But if you're not sure you're getting enough, ask your doctor or midwife about taking a pregnancy multivitamin.

Herbal remedies, such as echinacea (Karsch-Völk et al 2014), are popular with many people who want to prevent colds and boost their immunity. But there's very little evidence that they work and some of them can be unsafe for you or your baby. You can read more in our article about herbal remedies in pregnancy.

How can I treat a cold during pregnancy?

Antibiotics won't help if you have a cold. Take it easy, rest when you feel tired, eat well and drink plenty of water to keep you hydrated (NHS 2017a, NICE 2016).

A stuffy nose is a nuisance. Try inhaling steam or use a salt water nasal spray (NICE 2016). Taking paracetamol may also help to relieve a runny or blocked nose (Li et al 2013).

Eucalyptus oil and menthol are traditionally used to help with congestion, though you should check with your pharmacist before using them while you're pregnant (UKTIS 2014a). You could also ask your pharmacist to recommend a vapour rub that's safe to use in pregnancy.

If you want to take any decongestant medicines while you're pregnant, always ask your pharmacist or doctor first because they're often not recommended for pregnancy (BNF 2017, TGA 2014).

Decongestants work by causing the blood vessels to narrow, which helps to relieve a blocked or runny nose, but they could also narrow the blood vessels of your placenta (UKTIS 2014b). Certain decongestants have also been linked to heart, ear or stomach defects in babies (Mosley and Witte 2013, OTIS 2016, Yau et al 2013).

Many all-in-one cold remedies you buy over the counter contain a combination of ingredients, including a decongestant, so always ask for professional advice before taking them while you're pregnant (NICE 2016).

To soothe a sore throat or cough, you could try remedies recommended for children, such as honey and lemon mixed in hot water (NHS 2017b, NICE 2016), or a teaspoon of honey half an hour before bed (Oduwole et al 2018, RCHM 2018). It may also help to gargle with salt water (NHS 2017a, NICE 2016).

Although it's unclear how effective cough medicines are (NICE 2016, Smith et al 2014), you could try a simple one that's based on glycerine. If you want to use a cough syrup or throat lozenge, ask your pharmacist to recommend one that's safe in pregnancy.

For fever or pain, you may want to take paracetamol, as this is safe to use in pregnancy (NHS 2015). Follow the dosage instructions on the packet and, as with all medicines when you're pregnant, take it for the shortest amount of time possible.

Although paracetamol is often recommended for relieving pain, this isn't necessarily based on good evidence (Moore et al 2015, Moore 2016, NICE 2015b). When you have a cold, paracetamol is more likely to help relieve a blocked or runny nose than a headache (Li et al 2013). If you do have a sore head, drink plenty of fluids and get lots of rest to help it pass.

Ibuprofen isn't usually recommended in pregnancy because it may be unsafe for your baby (BNF 2017).

You should also avoid aspirin as it can affect your baby's development in early pregnancy, and affect the onset and length of your labour if you take it in late pregnancy. And avoid codeine and painkillers that contain a combination of drugs, unless your doctor recommends them.

If you took any of these medicines before you knew you were pregnant, try not to worry. The risks are very small (OTIS 2016) and it's most unlikely your baby will be affected. Mention it to your doctor or midwife, and he'll be able to advise and reassure you.

If you need more information about any medications or what's safe for use in pregnancy, contact MothersafeOpens a new window in New South Wales on 02 9382 6539 or 1800 647 848. In all other states, you can call the NPS Medicinewise Medicines LineOpens a new window on 1300 633 424.

Find out which over-the-counter medicines are safe to use during pregnancy.