Lauren stood in the pharmacy aisle at 11 PM, seven months pregnant and desperate for relief. Her head throbbed, her nose was completely blocked, and she’d been awake for three nights straight. She reached for the Zicam she’d always used before pregnancy, then pulled out her phone to search “can I take Zicam while pregnant?” The results were confusing and contradictory. Exhausted and frustrated, she left empty-handed, still suffering.
If you’re pregnant and fighting a winter cold, you’re probably discovering that your usual go-to remedies are suddenly off-limits or questionable. With your immune system naturally suppressed to protect your growing baby, you’re more vulnerable to catching every bug that goes around. Understanding which medications are safe can help you find relief without the worry.Is Zicam Safe During Pregnancy?
The short answer is: it depends on which Zicam product you’re considering.
Zicam products contain zinc, an essential mineral that’s generally considered safe during pregnancy in appropriate amounts. According to the American College of Obstetricians and Gynecologists (ACOG), zinc is important for fetal development, and many prenatal vitamins include it.
However, not all Zicam formulations are created equal:
- Zicam Nasal Spray and Swabs: These intranasal zinc products have been associated with loss of smell (anosmia) in some users. While the FDA withdrew an advisory after reformulation, many healthcare providers recommend pregnant women avoid nasal zinc products due to lingering concerns. Loss of smell can be permanent, and the risk-benefit analysis during pregnancy doesn’t favor these products.
- Zicam Oral Products (Lozenges, Rapidmelts, Gummies): These are generally considered safer options. The oral zinc formulations don’t carry the same anosmia risk as nasal products. However, you should still consult your provider before use, especially regarding dosage and duration.
- Key Consideration: The total amount of zinc matters. If you’re already taking a prenatal vitamin with zinc, adding Zicam could push you over recommended daily limits. The upper limit for zinc during pregnancy is 40 mg per day. Excessive zinc can interfere with copper absorption and cause other complications.
Understanding Cold Remedies by Trimester
Your provider’s recommendations may vary depending on how far along you are:
- First Trimester (Weeks 1-12): This is when your baby’s major organs are forming. Most healthcare providers recommend avoiding all medications unless absolutely necessary. Focus on non-pharmaceutical approaches like hydration, rest, and saline rinses.
- Second Trimester (Weeks 13-27): More options become available. Certain decongestants and cough suppressants may be approved by your provider. This is often when zinc lozenges get the green light.
- Third Trimester (Weeks 28-40): While more medications are considered safe, some carry new risks. For example, NSAIDs that were avoided in the first trimester are now restricted again due to potential effects on the baby’s heart and kidneys.
Safe Cold Relief Options for Pregnancy
Here are evidence-based remedies that most providers consider safe:
For Congestion:
- Saline nasal spray or rinses (safe throughout pregnancy)
- Neti pot with sterile or distilled water
- Cool-mist humidifier in your bedroom
- Steam inhalation with a bowl of hot water
- Nasal strips to open airways at night
- Pseudoephedrine (Sudafed) after the first trimester, with provider approval
For Cough:
- Dextromethorphan (Robitussin DM) after the first trimester
- Honey (one tablespoon) in warm water or tea
- Throat lozenges without excessive menthol or eucalyptus
- Propping yourself up while sleeping
For Fever and Body Aches:
- Acetaminophen (Tylenol) is the preferred pain reliever and fever reducer during pregnancy
- Cool compress on forehead
- Lukewarm bath (not cold)
- Stay hydrated to help regulate body temperature
For Sore Throat:
- Gargling with warm salt water
- Warm tea with honey
- Cold popsicles or ice chips
- Throat lozenges (check ingredients)
What to Avoid During Pregnancy
These common cold remedies should be avoided:
NSAIDs:
Ibuprofen (Advil, Motrin) and naproxen (Aleve) can cause complications, especially after 20 weeks of pregnancy. They’ve been linked to low amniotic fluid and potential heart problems in the baby.
Aspirin:
Regular use of aspirin should be avoided unless specifically prescribed by your provider for certain pregnancy complications.
Multi-Symptom Formulations:
Products like NyQuil or Theraflu often contain multiple active ingredients, including ones to avoid during pregnancy. They may also contain alcohol. Stick to single-ingredient products approved by your provider.
Herbal Supplements:
“Natural” doesn’t mean safe during pregnancy. Many herbs can trigger contractions or cause other complications. Avoid echinacea, goldenseal, and other immune-boosting herbs without medical approval.
Phenylephrine:
This decongestant found in many cold medicines has questionable effectiveness and safety data during pregnancy.
Natural Immunity Boosters That Actually Work
Prevention is always better than treatment:
Hydration:
Drink eight to ten glasses of water daily. Proper hydration helps thin mucus, supports immune function, and keeps your respiratory system functioning optimally. Add lemon or cucumber for flavor if plain water is unappealing.
Quality Sleep:
Aim for eight to ten hours nightly. Your immune system does much of its repair work during sleep. If nighttime sleep is disrupted, take short naps during the day.
Vitamin C:
Get it from food sources like oranges, strawberries, bell peppers, and broccoli. While vitamin C won’t prevent colds, it may reduce duration and severity.
Vitamin D:
Many pregnant women are deficient in vitamin D, which plays a crucial role in immune function. Ask your provider about testing and supplementation.
Prenatal Vitamins:
Take them consistently. They provide immune-supporting nutrients like zinc, vitamin C, iron, and folate.
Hand Hygiene:
Wash hands frequently for at least 20 seconds with soap and water, especially after being in public spaces. Use hand sanitizer when soap isn’t available.
Avoid Sick People:
This sounds obvious, but don’t feel guilty about skipping gatherings or asking sick visitors to reschedule. Your health and your baby’s wellbeing come first.
When to Call Your Healthcare Provider
Most colds resolve on their own within seven to ten days, but contact your provider if you experience:
- Fever of 100.4°F or higher
- Difficulty breathing or shortness of breath
- Chest pain or pressure
- Severe or persistent vomiting
- Decreased fetal movement
- Symptoms lasting more than ten days without improvement
- Severe sinus pain or headache
- Coughing up colored or bloody mucus
- Signs of dehydration (dark urine, dizziness, decreased urination)
These symptoms could indicate flu, strep throat, pneumonia, sinus infection, or other conditions requiring prescription treatment.
The Importance of Flu and COVID-19 Vaccination
The single most effective way to prevent serious illness during pregnancy is vaccination:
Flu Shot:
Safe during any trimester, the flu vaccine protects both you and your baby. Pregnant women who get the flu are at higher risk for hospitalization and complications. Antibodies you develop are passed to your baby, providing protection for their first several months of life.
COVID-19 Vaccine:
Current CDC recommendations support COVID-19 vaccination during pregnancy. Pregnant women who contract COVID-19 are at increased risk for severe illness, preterm birth, and other complications.
Tdap Vaccine:
Given between 27 and 36 weeks, this vaccine protects your baby from whooping cough, which can be deadly for newborns.
Creating Your Cold-Season Action Plan
Start the new year with a prevention strategy:
- Schedule Your January Checkup: Discuss your specific medication concerns with your provider and get personalized recommendations based on your health history.
- Stock Your Medicine Cabinet: With provider approval, keep safe options on hand: acetaminophen, saline spray, throat lozenges, and a thermometer.
- Get Vaccinated: If you haven’t received your flu shot or updated COVID-19 vaccine, make it a January priority.
- Boost Your Immunity: Focus on sleep, nutrition, hydration, and stress management.
- Know Your Emergency Plan: Have your provider’s after-hours number saved and know when to seek immediate care.
Get Personalized Guidance
Every pregnancy is unique, and your health history may affect which cold remedies are safe for you. Conditions like high blood pressure, gestational diabetes, or a history of preterm labor can influence your provider’s recommendations.
Don’t suffer through a cold in silence or second-guess yourself in the pharmacy aisle. At Women’s Integrated Healthcare, we’re here to answer your medication safety questions and provide clear, evidence-based guidance tailored to your pregnancy.
Whether you’re dealing with a winter cold right now or want to discuss prevention strategies, our team is ready to support you through every season of your pregnancy journey.
Schedule a consultation today and start the new year with a clear plan for staying healthy and safe.
References:
American College of Obstetricians and Gynecologists. (n.d.). Over-the-Counter Medications and Pregnancy. Retrieved from https://www.acog.org
Centers for Disease Control and Prevention. (n.d.). Medications and Pregnancy. Retrieved from https://www.cdc.gov
National Institutes of Health. (n.d.). Zinc Supplementation During Pregnancy. Retrieved from https://www.nih.gov
