Cold medications for pregnancy and breastfeeding

By Jeffrey Henderson, PharmD May 21, 2024 • 6 min


Selecting a cold medication while pregnant or breastfeeding that is going to be safe for both you and your baby can be stressful and overwhelming. However, there are some common ingredients found in cold medicines that are considered safe for you and your baby.

Can I take cold medicine while pregnant or breastfeeding?

There are certain cold medicines that are considered safe to take while you are pregnant or breastfeeding. The safety of using over-the-counter cold medication while pregnant or breastfeeding depends on the specific medicines within the products, how far along you are in your pregnancy, and any other medical conditions you may have. You should only use cold medicines for the shortest time possible to help with your symptoms. Always be sure to check with your healthcare provider or pharmacist before taking any over-the-counter cold medicines during pregnancy or while breastfeeding.

The American Pregnancy Association recommends limiting the amount of over-the-counter cold medicines you take and trying certain home remedies to alleviate symptoms. They promote washing your hands regularly, drinking plenty of fluids, getting ample amounts of rest, eating well and only using medications to treat the symptoms you are experiencing. As a home remedy for sinus congestion, they recommend using a humidifier, keeping your head elevated on a pillow while resting and/or using adhesive nasal strips. For a sore throat, they recommend sucking on ice chips, drinking warm herbal tea (non-caffeinated) or gargling warm salt water.

What cold medicine is safe for pregnancy and breastfeeding?

The common cold can cause a variety of symptoms, such as runny nose, fever, headache, body aches, cough, sore throat and congestion. Many over-the-counter cold medicines combine multiple medications that treat these symptoms into a single tablet or liquid. It's important to review the active ingredients in these products when you're pregnant or breastfeeding to ensure they are safe for both you and your child. In most cases, it's best to avoid combination products and instead use single-ingredient products to help relieve the symptoms you are experiencing.

Pain relievers and fever reducers

Acetaminophen (Tylenol) is considered the preferred medication during all trimesters of pregnancy to treat fever, aches and pains and is safe to use while breastfeeding. NSAIDs, such as ibuprofen (Advil, Motrin) and naproxen (Aleve), are less preferred in pregnancy but can still be used in the first and second trimesters. You should avoid all NSAIDs in the third trimester of pregnancy. According to the American College of Obstetricians and Gynecologists, ibuprofen is considered the preferred medication for pain while breastfeeding. Pregnant and breastfeeding women should avoid any products that contain aspirin.

Antihistamines

Chlorpheniramine (Chlor-Trimeton) is recommended as the antihistamine of choice to treat runny nose and sneezing in all trimesters of pregnancy. Doxylamine (Unisom) and diphenhydramine (Benadryl) are also considered safe to use in all trimesters. These medications can cause drowsiness and shouldn't be taken if you need to be awake and alert. Cetirizine (Zyrtec) and loratadine (Claritin) are both considered safe alternatives for pregnant women and cause less drowsiness. Loratadine is considered to be the preferred antihistamine to use while breastfeeding.

Cough suppressants

Dextromethorphan (Delsym) appears to be safe to use during all trimesters of pregnancy and while breastfeeding. However, more studies are needed to determine all the potential effects that cough suppressants like dextromethorphan may have on pregnant and breastfeeding women and their babies.  You should limit the use of these products to the lowest strength and for the shortest time possible.

Nasal decongestants

Nasal decongestant sprays, such as oxymetazoline (Afrin) and phenylephrine (Neo-Synephrine), are the preferred decongestants for pregnant and breastfeeding women for temporary relief from sinus congestion. The use of these products should be limited to three days, as they can cause worsening of your original congestion if used longer. If you develop severe nasal congestion during your second or third trimester and aren't able to use a nasal decongestant spray, you can use an oral decongestant such as pseudoephedrine (Sudafed). It's recommended to only use oral decongestants on a limited basis. You should avoid using oral decongestants during your first trimester, while breastfeeding or if you have high blood pressure. Nasal saline sprays are considered a safe alternative for treating nasal congestion while pregnant or breastfeeding.

Expectorants

Guaifenesin (Mucinex) is used to thin out and loosen chest congestion and requires drinking plenty of fluids to be effective. It's considered to be safe to use in the second and third trimester of pregnancy and likely to be safe while breastfeeding. You should avoid using products containing guaifenesin during your first trimester.

The American Pregnancy Association recommends that you contact your physician's office if you have a fever that is 102°F or higher, are coughing up thick, yellow-green mucus, are experiencing a cough with chest pain and/or wheezing, or have symptoms that last more than a couple of days without improving. These are signs that you may have a more severe infection and need to be seen by your physician.

Many cold medicines have not been thoroughly studied for safety during pregnancy, so it’s always recommended to speak with your healthcare provider before taking any over-the-counter medication during pregnancy and breastfeeding. 

Clinically reviewed and updated May 2024.