Pregnancy, Breastfeeding and the Common Cold

The common cold does not feel so common if you are pregnant or breastfeeding. We often get calls from patients of the Teen and Pregnant Program (TaP) regarding which medications are safe to take for cold symptoms. Here are some things you need to know:

What Causes the Common Cold?

Though there are more than 100 viruses that can cause the common cold, the rhinovirus is the most common cause, and it’s highly contagious. The virus enters your body through your mouth, eyes or nose and can spread through droplets in the air when someone who is sick coughs, sneezes or talks. It also spreads by contact with someone who has a cold or by sharing contaminated objects, like utensils, towels, toys or telephones.

Handwashing is important in the prevention of spreading a cold. If you have not washed your hands after you touch a contaminated object and you then touch your eyes, nose or mouth, you will be likely to catch a cold.

Symptoms of a common cold usually appear about 1-3 days after exposure and may include:

• Runny or stuffy nose
• Itchy or sore throat
• Cough
• Congestion
• Slight body aches or a mild headache
• Sneezing
• Watery eyes
• Low-grade fever
• Mild fatigue

Complications of the Common Cold

Ear pain could signal an ear infection and an evaluation by a provider is recommended. The common cold can also exacerbate asthma symptoms with wheezing and difficulty breathing, which should prompt a call and/or visit to your provider. Also, if you have a fever along with sinus pain, difficulty breathing or discomfort when taking a deep breath, this could signal a secondary infection like sinusitis or pneumonia. Throat pain with white patches can be a sign of strep throat and will require a visit to your provider. If you have a high fever of more than 103 degrees, dehydration, severe fatigue and/or body aches, see a doctor immediately, especially if you are pregnant.

There is no cure for the common cold, but there are some things that you can do to feel better. We recommend:

• Getting plenty of rest
• Drinking plenty of fluids (especially water)
• Take a hot bath or shower and breathe in the steam
• Use nasal saline sprays or washes
• Use a cool mist humidifier in your bedroom when sleeping
• Gargling with warm salt water
• Using cough drops, lozenges or throat sprays

In addition, here are some safe over-the-counter cold medications that can help.

• Acetaminophen: Take for body aches and headaches, mild pain, and fever. If you are pregnant then you CANNOT take ibuprofen or naproxen, but these medications are safe if you are breastfeeding.
• Pseudoephedrine or phenylephrine: Use for congestion and runny nose. Medications that contain pseudoephedrine are kept behind the pharmacy counter and have restrictions on the quantity that you can purchase. You must show ID to prove you are older than 18. You should NOT take these if you are breastfeeding or pumping as they are known to decrease your milk supply.
• Guaifenesin or dextromethorphan: This medicine suppresses coughing and thins mucus so that coughs are more productive.  You should NOT take these medications while breastfeeding or pumping.
• Diphenhydramine or Loratidine: Can relieve watery eyes and itchy throat. These can also make you sleepy, so it may be better to take at night to aid with rest.  You should NOT take these medications while breastfeeding or pumping.
• Fluticasone: can decrease inflammation in your nose and help with nasal congestion.

It is always best to check with your or your baby’s doctor prior to starting any new medications.

When you have a cold, it is recommended you continue feeding your baby as you normally would, including breastfeeding or pumping. Your baby has already been exposed to the cold virus before you started to develop symptoms. Your body is working hard to produce specific antibodies to protect your baby from the cold virus. By continuing to breastfeed or pump, your baby receives these antibodies through your milk. In addition, suddenly stopping breastfeeding or pumping causes your breasts to hurt and can possibly lead to mastitis, which is an infection of the breast tissue.

To protect your baby, it is important to perform good hand hygiene. Wash your hands or use hand sanitizer frequently, especially before touching your baby, and cover all coughs and sneezes. As always, if there are any concerns, please contact your or your baby’s doctor.

If you are pregnant or breastfeeding and have questions about your health and/or what is safe to take, call your provider’s office and they will be more than happy to assist you and answer questions. The Teen and Pregnant Program at Nationwide Children’s Hospital has a provider on call 24/7 to answer questions for our patients.