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Pregnant woman in bed with a cold

How to treat a cold or the flu when pregnant

Obstetricians Dr Margie Harpham and Dr Kathryn Austin from North Shore Private hospital talk about what you should know about cold and flu during pregnancy.

With winter upon us we are entering the peak season for colds and flu. These viruses are common, and many women will face these illnesses during their pregnancy. We give you the run down on prevention and safe treatment options.

A cold is a very common infection of the nose, throat and airways. It can cause a blocked or runny nose, sneezing, a sore throat and a cough. Whilst very annoying, it is usually short lived and often will only last a few days or up to a week.

However the flu is a highly infectious illness caused by the influenza virus. Symptoms are often similar to a cold however they can be much more severe with a temperature (fever) and occasionally breathing troubles, and can last longer.

It is important to remember that any cold and flu symptoms can be similar to COVID -19 and anyone with these symptoms should get tested immediately.

Safe treatments

With any early cold or flu symptoms it is important to stay home from work, get lots of rest and drink plenty of fluid. A sore throat or cough may be helped by drinking warm drinks (including the old remedy of honey and lemon), gargling with warm salty water or using throat lozenges. Salt water nasal sprays, drops or nasal flushes can help with congestion and are very safe to use in pregnancy. Sometimes steam inhalations or deep breathing in a warm shower can assist with congestion and clearing your nose.

Paracetamol is safe to use in pregnancy, however if you have a persistent high fever or continue to feel very unwell then you should see a doctor.

Can I take cold and flu tablets when pregnant?

There are many cold and flu tablets on the market and unfortunately a large number of them contain medications that are not suitable for pregnancy. Some cold and flu medicines contain multiple ingredients so it is best to check with your doctor or pharmacist about their safety in pregnancy before taking anything.

But topical nasal decongestants (sprays or drops) such as oxymetazoline and xylometazoline can be used to help a runny or blocked nose to ease congestion. They should only be used for short periods (less than 3-5 days). Importantly, if you have an underlying medical condition or pregnancy complications, you should check with a doctor or pharmacist prior to using these medications.

Drugs like ibuprofen (Nurofen, Advil etc. in the class known as Non-steroidal anti-inflammatories or NSAIDs) should not be used in pregnancy unless discussed with your doctor.

Complimentary or herbal medicines are popular remedies for treatment, as well as prevention, of cold and flu. There is variable evidence on the effectiveness of many of these preparations and even less information about their safety in pregnancy or breastfeeding.  Check with your doctor or pharmacist before you take these to make sure they are suitable.

Unfortunately, women who get the flu in pregnancy are at higher risk of hospitalisation, as well as some of the rare complications of pregnancy. Very severe illness during pregnancy can be dangerous to a mother and the developing baby because, although rare, it increases the risk of problems, such as going into labour early and/or having a baby prematurely (before the due date).

Prevention is the best strategy

Try and avoid contact with sick people, wash your hands well and stay away from others if you are sick. The flu vaccination is strongly recommended for all pregnant women. The flu vaccination is free for any pregnant woman and is recommended at any stage of pregnancy.

Having the flu vaccination when you are pregnant protects not only you but can also protect your baby from getting the flu in their first few months of life.

Treating a cold or flu while breastfeeding

If you are breastfeeding and have a cold or the flu, it is recommended to continue to breastfeed your baby. Baby will have some protection from the cold or flu from antibodies in your breast milk.

As a general rule, it is best to breastfeed your baby first and then take medication. In general, if you are breastfeeding, the advice is similar to during pregnancy – stay home, get plenty of rest and drink plenty of fluid.

Some cold and flu medications can be used safely when breastfeeding such as paracetamol and ibuprofen. Other medications can reduce breast milk supply (such as decongestants like phenylephrine or pseudoephedrine) and should only be used after checking with a doctor or pharmacist.

Most colds and even the flu are bothersome during pregnancy and breastfeeding however will resolve quickly with rest and simple treatments. If you continue to be unwell, symptoms are severe or you are worried, then contact your doctor or midwife.


Dr Kathryn Austin is an obstetrician, gynaecologist and maternal fetal medicine qualified subspecialist. She has special interests in high and low risk pregnancies, maternal medical conditions in pregnancy and preconception counselling.

Dr Margie Harpham is an obstetrician and maternal fetal medicine specialist. Margie is able to look after healthy ‘low risk’ pregnancies, as well as pregnancies where women are experiencing medical complications.

This content was supplied by North Shore Private Hospital

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