If you have a cold or sore throat while you're expecting, it's natural to want to relieve your discomfort with cough drops. Many healthcare providers and clinics include cough drops on their list of safe over-the-counter medications for treating cold symptoms during pregnancy. The key, however, is moderation. You'll also want to choose your ingredients wisely and check with your healthcare provider before you take cough drops or any other medication.
Are Cough Drops Safe During Pregnancy?
You should always confirm the safety of any medication with your doctor or midwife. However, many health clinics include cough drops on a list of safe medications for expectant moms to use if they have a cold. Before you speak with your healthcare provider, it might be helpful to check the ingredients list of the brand that you plan to use. Different ingredients have varying effects.
The active ingredients in most cough drops suppress coughing, or slightly numb the throat. Some active ingredients in cough drops can have unknown or adverse effects and should be used in moderation.
Menthol is in most cough drops and gives you that cooling feeling that can comfort a sore throat and stuffy nose. "Menthol is a chemical compound found naturally in plants like peppermint or other mint plants. It can also be made synthetically. In very high concentrations, menthol can be toxic but it would require eating many bags of cough drops at one time to approach toxic levels," says Dr. Julia Arnold VanRooyen, a gynecological surgeon based in Boston, Massachusetts.
The amount of menthol in cough drops is very low and is generally considered to be safe. If you are concerned, compare the amount of menthol on the brands you are considering and choose one with a lower concentration or a brand without menthol.
To fight against the bitterness of menthol or herbs, many cough drop makers will add a lot of sugar to their recipes. While this makes them a lot nicer to take, too much sugar can increase your blood sugar levels. If you have gestational diabetes, your healthcare provider will probably suggest sugar-free cough drops.
Doctors usually recommend that you limit your use of cough drops containing the numbing agent benzocaine to two days. Benzocaine lozenges can help with sore or irritated throats, but they should be used as little as possible during pregnancy. Although there haven't been human studies, and animal studies have been limited, there is some evidence that benzocaine could increase the chance of stillbirth.
Dextromethorphan, a cough suppressant in some cough drops, crosses the placenta but appears to be safe. Research on this subject is getting old, but a 2001 study examined the use of this medication during pregnancy and found it did not appear to increase birth defects or negative outcomes.
Some cough drops include echinacea, which has been a controversial herbal treatment for colds. A study review from 2014 found inconclusive evidence on the effect of echinacea on a growing fetus. However, a large study published in 2016 reported no effects on babies after taking this herb.
Some claim zinc shortens the duration of colds. Zinc is already included in many prenatal vitamins, and has been shown to slightly decrease preterm births. The National Institutes of Health (NIH) recommends that expectant mothers should take 11 mg of zinc daily. Most prenatal vitamins already have the required daily amount, so if your cough drops also contain zinc, check with your healthcare provider before taking them.
Alternatives to Medicated Cough Drops During Pregnancy
Some cough drops are not medicated. Instead, they work by keeping your throat from feeling dry, often using an active ingredient of pectin, the same natural substance that helps solidify jams and jellies. Several unmedicated brands like Ludens are available over the counter at most drugstores.
"Alternatives to using cough drops during pregnancy include sipping hot water or tea with honey and lemon or gargling with warm salt water. It is important to drink plenty of water during pregnancy to stay well-hydrated," says Dr. VanRooyen. To gargle saltwater, you should mix half a teaspoon of salt in eight ounces of warm water and gargle for 15-30 seconds two or three times.
When to Call Your Doctor
If you have a sore throat while you are pregnant, The American Pregnancy Association (APA) says to make sure you get plenty of extra rest and stay hydrated. Sometimes a sore throat can make you avoid drinking, but baby needs those fluids.
If your sore throat just won't quit, or you get other symptoms, give your healthcare provider a call. The APA suggests that you call about these symptoms:
- Coughing up yellow or green mucus
- Fever (102 degrees F or higher)
- You can't eat or drink very much
Because of concern about Covid-19, your provider may be extra vigilant about a sore throat. Be sure to stay in close communication about your symptoms.
Using any medication during pregnancy is a decision you should make with your healthcare provider. For expectant moms, most providers suggest cough drops for sore or irritated throats, but they also emphasize moderation. Take some time to read the ingredients on the package and compare your options before you choose the one that's best for you.