To treat a cold or flu safely while pregnant, focus on rest, plenty of fluids, steam inhalation and other gentle self-care first. Paracetamol is generally considered the preferred option for pain or fever, used at the lowest effective dose for the shortest time, but always check with your doctor or pharmacist before taking anything. Avoid ibuprofen and other anti-inflammatory painkillers, and avoid decongestants and combination cold and flu remedies unless a pharmacist confirms they are suitable. Because flu can be serious in pregnancy, see your doctor or midwife promptly if you think you have it, and get your annual flu vaccine, which is recommended and free for pregnant women in South Africa.
Falling ill is never welcome, but it can feel especially worrying when you are pregnant. The good news is that a common cold rarely causes serious problems, and most symptoms can be eased safely at home. Flu is more serious in pregnancy and needs prompt medical attention. Below, Bloom explains the difference between the two, which treatments are considered safe, what to avoid, and when to see a doctor. If you are looking for affordable cover, you can explore health insurance options tailored to your needs.
Key takeaways
| • A cold is usually mild, but flu can be serious in pregnancy and needs prompt medical attention. |
| • Rest, fluids and steam inhalation are safe first steps, and paracetamol is generally the preferred option for pain or fever on your doctor or pharmacist’s advice. |
| • Avoid ibuprofen and other anti-inflammatory painkillers, and check with a pharmacist before using any decongestant or combination cold and flu remedy. |
| • The flu vaccine is recommended in pregnancy and protects both mother and baby. It is free for pregnant women through the public health system. |
Why a cold or flu matters more in pregnancy
During pregnancy, your immune system naturally adapts, which can leave you a little more vulnerable to infections and can make symptoms feel more intense. Telling a cold and flu apart helps you decide how to respond, because they need very different levels of care.
A cold is a viral infection of the upper respiratory tract. It is uncomfortable but rarely dangerous, and symptoms tend to come on gradually. They may include:
| Sore throat, sneezing, a blocked or runny nose, a mild cough, a headache and sometimes a mild fever. |
Flu (influenza) is also viral but tends to come on faster and hit harder. Symptoms may include:
| A sudden high fever, body and muscle aches, fatigue, a sore throat and a cough. |
Flu in pregnancy carries a higher risk of complications such as a chest infection or pneumonia, and has been linked to premature labour, particularly later in pregnancy. The National Institute for Communicable Diseases (NICD) lists pregnant women among the groups at highest risk of severe influenza. If you think you have flu, contact your doctor or midwife promptly, as they may be able to offer antiviral treatment that works best when started early.
Medication and pregnancy: what to know
Not every medicine is safe in pregnancy, and safety can depend on the specific ingredient, the dose and how far along you are. As a rule, it is best to be especially cautious in the first 12 weeks, and to speak to your doctor, midwife or pharmacist before taking anything, including remedies you would normally reach for without a second thought.
Generally considered safer, with professional advice
Paracetamol is widely regarded as the first-choice option for pain or fever in pregnancy, used at the lowest effective dose for the shortest time. Saline nasal drops or sprays and simple salt-water gargles can ease congestion and a sore throat without medication. Your pharmacist can confirm what is right for you.
Best avoided in pregnancy
Ibuprofen and other anti-inflammatory painkillers (NSAIDs) are generally not recommended, and international regulators advise avoiding them from around 20 weeks onwards. Decongestant tablets, sprays and drops are also best avoided, and many all-in-one cold and flu sachets contain a decongestant, so check the label with a pharmacist first. Aspirin should not be used for cold or flu symptoms unless a doctor has specifically prescribed it. When in doubt, leave it out and ask a professional.
Safe home remedies to ease symptoms
These gentle measures will not cure a cold or flu, but they can make you more comfortable while your body recovers:
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Rest. Giving your body time to recover helps it fight the infection. |
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Stay hydrated. Water, clear broth and warm herbal drinks help thin mucus and keep you comfortable. |
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Try steam. A warm shower, or breathing in steam from a bowl of hot water with a towel over your head, can ease congestion. |
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Soothe your throat. A little honey in warm water or herbal tea, or a salt-water gargle, can calm a sore throat. |
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Eat well and keep warm. A warm, nourishing meal such as chicken soup provides fluids and comfort while you rest. |
Be cautious with herbal and “natural” remedies, as not all are safe in pregnancy. Tell your midwife, doctor or pharmacist about anything you are using. If your symptoms persist or get worse, see a doctor.
How to lower your risk
Prevention really is better than cure. A few simple habits go a long way:
| • Get the flu vaccine. It is safe and recommended in pregnancy, and protects both you and your baby. |
| • Wash your hands often with soap and water, and use a sanitiser when you are out. |
| • Keep your distance from crowds and unwell people during flu season, which in South Africa typically runs from around autumn into winter. |
| • Support your immune system with a balanced diet, gentle exercise, good hydration and plenty of sleep. |
The NICD recommends annual flu vaccination for pregnant women as one of the most effective ways to prevent severe illness, and the vaccine is provided free of charge to pregnant women through the public health system. It takes about two weeks to build protection, so earlier is better.
When to seek medical help
Contact your doctor or midwife promptly if you think you have flu, or if you experience difficulty breathing or shortness of breath, chest pain, a high fever that will not come down, a cough that is getting worse, signs of dehydration, or reduced movement from your baby. Trust your instincts. If something does not feel right, it is always worth getting checked.
Cover for a healthy pregnancyBloom’s Health4Me cover includes access to a doctor, a maternity benefit and everyday care to help you through pregnancy with confidence. Fill in your details and we will call you back. |
Frequently asked questions
Looking after you and your baby
Most colds pass with rest and gentle care, and flu is very manageable when you act early and stay in touch with your healthcare provider. The most important things you can do are to get your flu vaccine, check with a professional before taking any medicine, and seek help promptly if you feel unwell.
Make sure you are covered with affordable health insurance from Bloom and Health4Me, including a maternity benefit to support you through pregnancy. Compare Health4Me options, explore the full range of benefits, or speak to a medical professional through our Hello Doctor service. To get started, get in touch and we will call you back.
