How to Manage Excessive Coughing During Pregnancy

Along with that radiant pregnancy glow, pregnancy brings on a plethora of new symptoms, from nausea and fatigue to mood swings and food cravings. Hormonal changes during pregnancy can also weaken your immune system, increasing your risk of getting a cough from the common cold, flu, or other viral infections.¹ This leads many people to wonder if it’s safe to take cough medicine during pregnancy, or if home remedies can provide relief.   

Causes of Excessive Coughing During Pregnancy

A bad cough during pregnancy can be caused by allergic rhinitis, gastroesophageal reflux disease, asthma, viral infections, or bronchitis.² 

• Allergic rhinitis, also known as hay fever, is your body’s response to an allergen, like pollen, pet dander, dust mites, or mold. Impacting up to 40% of the population, allergies are very common and can cause various symptoms, including a dry cough.³ When allergies occur in pregnancy, it’s particularly important to avoid your allergy triggers to prevent uncomfortable symptoms. 

• Gastroesophageal reflux disease (GERD) is prevalent during pregnancy, affecting an estimated nine out of 10 pregnant women by their third trimester. Heightened hormone levels and increased pressure on the stomach both increase the likelihood of GERD during pregnancy. Although heartburn is usually the main symptom, coughing, sore throat, difficulty swallowing, and a bitter taste in the mouth are also possible.⁴ 

• Asthma during pregnancy needs to be properly managed to prevent complications. While around one-third of women experience improved asthma symptoms during pregnancy, one-third of women have worsened symptoms, and the remaining third notice no change. Coughing, chest tightness, chest pain, shortness of breath, wheezing, and tiredness are all possible asthma symptoms.⁵ 

• Viral infections like the flu, common cold, and COVID-19 can cause a wet or dry cough during pregnancy. Pregnancy triggers various changes to your immune system, some of which can weaken your defenses against contagious pathogens.⁶ Coughing is a common symptom of respiratory infections, along with sore throat, fatigue, body aches, and congestion. 

• Bronchitis occurs when the bronchial tubes, which carry air in and out of the lungs, become inflamed. It often develops from a viral infection, like a cold, and causes a wet cough, chest pain, wheezing, fatigue, low fever, and shortness of breath.⁷ 

Safe Remedies for Cough Relief

As you consider how to get rid of a cough during pregnancy, it’s important to choose remedies that are both safe and effective. So, what cough medicine is safe during pregnancy? Options include dextromethorphan, oral antihistamines, acetaminophen, and benzocaine cough drops. 

• Dextromethorphan, the active ingredient in Delsym^®, is a cough suppressant that helps temporarily relieve coughing from the common cold, flu, allergic rhinitis, and bronchitis, among other conditions. The maximum dose is 120 mg of dextromethorphan in 24 hours for pregnant women.⁸ If pregnant or breastfeeding, ask a health professional before use. However, always check with your doctor prior to taking any medicines during pregnancy.

• Oral antihistamines including hydroxyzine, dexchlorpheniramine, and chlorpheniramine are considered safe to use during pregnancy.⁹ However, check with your doctor to ensure the particular antihistamine you’re considering taking is safe. 

• Acetaminophen is one of the only painkillers that’s generally considered safe during pregnancy. The maximum dose is 325 to 650 mg every four to six hours, and don’t take more than 3,000 mg in a 24-hour period.¹⁰ 

• Benzocaine cough drops are generally considered safe in pregnancy, although they should only be used when needed, and you should talk to your doctor about the potential risks. Benzocaine has a numbing effect that can help with minor throat irritation.¹¹ 

Guaifenesin, a common over-the-counter decongestant, may also be safe to take in the second and third trimesters of pregnancy. However, talk to your doctor before taking it.¹² 

Deciding what to take for a cough during pregnancy is an important choice. Don’t hesitate to talk to a physician for professional medical guidance to prevent side effects and complications. Your doctor can also help you better understand the difference between coughs and help you find the right remedy for your needs. 

Home Remedies for Cough During Pregnancy

Many cough remedies during pregnancy can be done at home for your comfort and convenience, including:

• Warm salt water gargles help reduce inflammation and eradicate bacteria in the mouth and throat. This can help you recover faster from a viral infection that triggers coughing. Dissolve ¼ to ½ teaspoon salt in an eight-ounce glass of warm water before gargling and spitting it out. 

• Staying hydrated by drinking plenty of fluids can help soothe your throat to prevent coughing. Hydration also supports immunity, which can help your body overcome infections that cause coughing.¹³ 

• Steam inhalation moisturizes your airway, helping to calm a dry cough during pregnancy. Take a warm shower or bath, or boil water and stand above the pot to inhale the steam. 

• Warm herbal tea with honey helps keep you hydrated while soothing your throat. Honey, in particular, has natural cough-suppressing properties to calm your cough reflex.¹⁴

• A humidifier adds moisture to the air in your home, helping to moisturize your dry airway and curb irritation, particularly from allergy-related coughing.

• Use saline sprays or drops to calm a cough from post-nasal drip. Saline is just a combination of salt and water, and it’s safe to use as directed during pregnancy. 

• Avoid spicy and acidic foods that can trigger coughing from GERD. Additionally, try to avoid lying down right after a meal. 

When to See a Doctor

If you experience a dry cough during pregnancy in the third trimester, or at any time during your pregnancy, it’s not necessarily cause for alarm. However, contact your doctor if you experience:¹⁵

• A cough that lasts longer than seven days

• A wet cough that produces green-tinged phlegm

• A fever that reaches 100.4°F or higher

• Wheezing or difficulty breathing

Additionally, if you think your coughing is from COVID-19 or the flu during pregnancy, contact your doctor and ask about getting tested. Your doctor may want to take steps to prevent serious complications from these viral infections. 

Overall, coughing during pregnancy is normal and typically goes away within a week of at-home care. But, if your cough becomes persistent or worrisome, reach out to your doctor to discuss your symptoms and treatment options.

Resources

1. Admin APA. Cough and Cold During Pregnancy. American Pregnancy Association. Published July 9, 2014. https://americanpregnancy.org/healthy-pregnancy/pregnancy-complications/cough-cold-during-pregnancy/
2. Ryabova MA, Shumilova NA, Lavrova OV, Pestakova LV, Fedotova YS. [Differential diagnostics of the causes responsible for a cough in the pregnant women]. Vestnik Otorinolaringologii. 2016;81(4):50-53. doi:https://doi.org/10.17116/otorino201681450-53
3. Small P, Keith PK, Kim H. Allergic rhinitis. Allergy, Asthma & Clinical Immunology. 2018;14(S2). doi:https://doi.org/10.1186/s13223-018-0280-7
4. GERD and Pregnancy. UChicago Medicine. https://www.uchicagomedicine.org/conditions-services/esophageal-diseases/gastroesophageal-reflux-disease/gerd-and-pregnancy
5. Pregnancy and Asthma. ACAAI Public Website. https://acaai.org/asthma/asthma-101/who-gets-asthma/pregnancy-and-asthma/
6. Immune system changes during pregnancy are precisely timed. Stanford Medicine. Published 2017. https://med.stanford.edu/news/all-news/2017/09/immune-system-changes-during-pregnancy-are-precisely-timed.html
7. Bronchitis | NHLBI, NIH. National Heart, Lung, and Blood Institute. Published December 2, 2022. https://www.nhlbi.nih.gov/health/bronchitis
8. Which over-the-counter cold medications are safe during pregnancy? | Your Pregnancy Matters. UT Southwestern Medical Center. https://utswmed.org/medblog/otc-cold-medication-safe-pregnancy/
9. Kar S, Krishnan A, Preetha K, Mohankar A. A review of antihistamines used during pregnancy. Journal of Pharmacology & Pharmacotherapeutics. 2012;3(2):105-108. doi:https://doi.org/10.4103/0976-500X.95503
10. Taking Medicine While Pregnant. The University of New Mexico. https://hsc.unm.edu/health/patient-care/womens-health/taking-medicine-while-pregnant_7-28-20_eng_2017-472.pdf
11. ‌Benzocaine. PubMed. Published 1994. https://www.ncbi.nlm.nih.gov/books/NBK582601/
12. Guaifenesin. PubMed. Published 1994. https://www.ncbi.nlm.nih.gov/books/NBK582733/
13. Moeller KT, Butler MW, DeNardo DF. The effect of hydration state and energy balance on innate immunity of a desert reptile. Frontiers in Zoology. 2013;10(1):23. doi:https://doi.org/10.1186/1742-9994-10-23
14. Abuelgasim H, Albury C, Lee J. Effectiveness of honey for symptomatic relief in upper respiratory tract infections: A systematic review and meta-analysis. BMJ Evidence-Based Medicine. 2020;26(2). doi:https://doi.org/10.1136/bmjebm-2020-111336
15. Coughs and Colds in Pregnancy. North York General Hospital. Published 2024. https://www.nygh.on.ca/areas-care/maternal-newborn-and-paediatric-care/pregnancy-and-birth/guide-to-pregnancy-and-birth/during-pregnancy/coughs-and-colds-in-pregnancy/