Stuffy nose, sore throat, and a general feeling of exhaustion? Getting a cold is common during pregnancy, and it's natural to wonder what you can safely do.
The good news: a regular cold is not dangerous for you or your baby. But there are a few things you should know about medications, the flu specifically, and when to call your doctor.
Is a Cold Dangerous When You're Pregnant?
No. A typical common cold poses no danger to you or your baby. Your body handles the virus on its own, just as it always does.
What you may notice is that the cold feels heavier than usual. This is because the immune system adjusts during pregnancy to protect the baby — a natural downregulation that can mean you catch colds more easily or take a little longer to recover.
Typical cold symptoms:
- Stuffy or runny nose
- Sore throat and cough
- Mild headache
- Fatigue and tiredness
- Low-grade fever (under 100.4°F / 38°C)
Colds are common in pregnancy. Good hand hygiene is the single most effective step you can take to avoid them. Wash your hands frequently and thoroughly.
Safe Home Treatment for a Cold During Pregnancy
You can do a great deal to relieve symptoms without medication. Rest and fluids are still the best advice.
Home Remedies That Help
- Drink plenty of fluids — water, warm broth, herbal tea with honey and lemon
- Rest as much as you can — your body is already working hard growing a baby
- Saline nasal drops — safe and effective for a blocked nose
- Elevate the head of your bed — helps you breathe more easily at night
- Throat lozenges without active medications — can soothe a sore throat
- Steam inhalation over a bowl of hot water — opens the airways
Medications That Are Safe During Pregnancy
Sometimes you need a little help from the pharmacy. Knowing what to choose is important.
Acetaminophen (paracetamol) is safe: Acetaminophen is the first-choice pain reliever and fever reducer during pregnancy. Short-term use is considered safe throughout all trimesters at the recommended dose. Always follow the dosing instructions on the packaging.
Nasal decongestant spray: Short-acting nasal decongestant sprays can be used for congestion caused by a cold. Use for a maximum of 7–10 days.
A stuffy nose during pregnancy can also be caused by pregnancy rhinitis — a condition affecting up to 30% of pregnant women that is unrelated to infection. Nasal decongestant sprays should NOT be used for pregnancy rhinitis. If you're not sure what's causing your congestion, ask your pharmacist or healthcare provider before using one.
Throat lozenges: Plain throat lozenges without active medicinal ingredients are safe. Medicated lozenges (especially those with antiseptics or topical anesthetics) are generally best avoided. Ask your pharmacist if you're unsure.
Cold sore cream: Topical aciclovir cream (for cold sores/herpes labialis) is safe to use during pregnancy.
Medications to Avoid When Pregnant
Not all pain relievers and cold remedies are safe in pregnancy. Some can affect the baby, especially in the third trimester.
NSAIDs (anti-inflammatory medications) should be avoided during pregnancy:
- Ibuprofen (Advil, Motrin)
- Naproxen (Aleve)
- Diclofenac (Voltaren)
These can affect fetal development, particularly in the third trimester. Use acetaminophen instead.
Also avoid combination cold and flu remedies (such as DayQuil, NyQuil, Theraflu, or similar products) without first checking with your doctor or pharmacist. These often contain ingredients that are not recommended during pregnancy, including decongestants like pseudoephedrine.
If you're unsure whether a medication is safe, call your pharmacy, doctor, or midwife before taking it.
The Flu During Pregnancy: Higher Risk
The flu is different from a common cold, and during pregnancy you should be more alert.
Pregnant women are at higher risk of developing severe influenza compared to non-pregnant women. The risk increases as pregnancy progresses and is greatest in the second and third trimesters.
WHO and CDC data: Pregnant women are significantly more likely to be hospitalized with serious flu complications. This is why health authorities worldwide recommend the flu vaccine for pregnant women.
How to Tell the Difference Between a Cold and the Flu
| Cold | Flu | |
|---|---|---|
| Onset | Gradual, over days | Sudden, within hours |
| Fever | Mild or none | High fever (100.4–104°F / 38–40°C) |
| Body aches | Mild | Severe muscle aches |
| Energy | Tired but functional | Completely knocked out |
| Duration | 7–10 days | 1–2 weeks |
Not sure if it's a cold or flu? If you developed high fever and severe body aches suddenly, it's more likely the flu. Contact your doctor for assessment.
The Flu Vaccine During Pregnancy
The WHO and CDC recommend the influenza vaccine for all pregnant women, ideally in the second or third trimester (from week 13). The vaccine is safe and protects both you and your baby.
What you should know:
- The flu vaccine is well-documented and safe during pregnancy
- It causes no harmful effects on the fetus
- Your baby receives protective antibodies that last for the first months after birth
- In many countries, the vaccine is provided free to pregnant women during flu season
- Talk to your doctor or midwife about vaccination
Whooping Cough Vaccine
In addition to the flu vaccine, the whooping cough (pertussis) vaccine is recommended during pregnancy — typically around weeks 27–36 in many countries. This protects your newborn from whooping cough in the first months of life, before they are old enough to be fully vaccinated themselves.
When Should You Call Your Doctor?
Most colds pass on their own. But as a pregnant woman, keep your threshold for calling low.
Contact your doctor or midwife if:
- Fever above 100.4°F (38°C) lasting more than two days
- Symptoms are getting worse instead of better after a week
- Difficulty breathing or chest pain
- Thick green or yellow discharge from your nose for an extended period (may indicate sinusitis)
- You suspect the flu (high fever and severe aches)
- You are in your third trimester and have any fever
For difficulty breathing, chest pain, or very high fever — call your healthcare provider immediately or go to urgent care. In an emergency, call 911.
Prevention: How to Reduce Your Risk
You can't completely guard against colds, but these simple steps reduce the risk:
- Wash your hands often — with soap for at least 20 seconds
- Avoid touching your face — viruses spread via the eyes, nose, and mouth
- Keep distance from people who are sick
- Sleep enough — sleep strengthens the immune system
- Eat well — a varied diet supports your immune system
- Stay active — moderate exercise during pregnancy supports immunity
- Get vaccinated — flu vaccine in season
Other Pregnancy-Related Symptoms That Resemble a Cold
Many pregnant women experience symptoms that mimic a cold but are actually caused by pregnancy itself. A blocked nose without other cold symptoms may be pregnancy rhinitis. Headaches and fatigue are also common in pregnancy independent of illness. Track your symptoms week by week to understand what's normal at your stage of pregnancy.
Summary
- A typical common cold is not dangerous for you or your baby
- Acetaminophen is safe — avoid ibuprofen and other NSAIDs
- Short-acting nasal sprays can be used briefly for cold-related congestion
- The flu is more serious in pregnancy — consider the flu vaccine
- Rest and fluids remain the best treatment
- Call your doctor for high fever, breathing difficulty, or symptoms lasting over a week
Frequently Asked Questions
Can I take ibuprofen when pregnant?
No. Ibuprofen and other NSAIDs (naproxen, diclofenac) should be avoided during pregnancy. These can affect fetal development, especially in the third trimester. Use acetaminophen (paracetamol) instead — it is safe throughout pregnancy at the recommended dose.
Is the flu vaccine safe during pregnancy?
Yes. The WHO, CDC, and major health agencies worldwide recommend the flu vaccine for pregnant women from the second trimester onward. It is well-documented and causes no harmful effects on the fetus. The baby receives protective antibodies that last for the first months after birth. The vaccine is often provided free of charge during flu season.
How do I tell a cold apart from the flu?
A cold comes on gradually over a few days with a runny nose, sore throat, and mild fatigue. The flu comes on suddenly — within hours — with high fever (100.4–104°F), severe muscle aches, and complete exhaustion. If you had a sudden onset of high fever and severe body pain, it's likely the flu, and you should contact your doctor.
Can I use nasal spray while pregnant?
Short-acting nasal decongestant sprays can be used briefly (up to 7–10 days) for congestion caused by a cold. Be aware that congestion during pregnancy can also be caused by pregnancy rhinitis — in which case decongestant spray should not be used long-term. Ask your pharmacist if you're uncertain about the cause.
When should pregnant women call a doctor for a cold?
Call your doctor if you have a fever over 100.4°F (38°C) lasting more than two days, if symptoms are worsening after a week, if you have breathing difficulty or chest pain, or if you suspect flu. In the third trimester, have an especially low threshold for calling with any fever.