It’s the third week of January and I feel like my entire world is covered in a fine layer of snot. My kiddos are sick, my friends are sneezing on me and half my staff is home with the flu. Luckily, so far I have managed to stay healthy, but I realize many of my pregnant patients are not so fortunate. The flu is miserable. Pregnancy can be miserable. Together they can be truly awful. This post is intended to give you solid advice on avoiding the flu and how to safely treat it if you do get it.
How do I stay healthy?
In addition to stretch marks, pregnancy also brings with it a lowered immune system. This makes you more susceptible to viruses. If you do get sick, your body also has a harder time fighting off disease, placing you at an increased risk for more serious complications including pneumonia, preterm labor and even death. While we can never fully prevent the flu, there are some steps that can help reduce your odds of transmission.
Get your flu shot. The flu shot is safe in all trimesters and is your best defense against the flu. It does not cause the flu, hurt your baby or cause autism. The preservatives in the flu shot are not harmful, but if you have lingering concerns, preservative free shots are available. The flu shot consists of the top three strains of the flu that the epidemiologists predict will be the most active, so some years the vaccine works better than other years.
Getting the flu shot can protect your baby, as a portion of your immunity can pass through the placenta in the third trimester, helping to protect your precious newborn from the virus. It is also recommend that all household contacts and close family get the flu shot to hopefully provide a cocoon effect for the baby, since the baby can’t get the flu shot until 6 months of age (his immune system is not strong enough for the vaccine to work properly).
Wash your hands. The flu virus travels through the air when an infected person sneezes and coughs. The infected droplets can travel up to 6 feet away and primarily infect your body as you inhale them through your mouth and nose. Less commonly, when you touch something with the virus on it, you can infect yourself by touching your mouth, eyes or nose. Make Lysol your friend, often wiping down commonly touched surfaces like doorknobs and telephones.
Take care of yourself. Attempt to get 8 hours of sleep, take your prenatal vitamin, and eat your fruits and veggies. Make sure to consume lots of fluids and protein (i.e. chicken soup). Avoid sick contacts if at all possible. If it is unavoidable to be near the sickies, then consider wearing a mask.
What should I do when I start feeling sick ?
Rest. If you are experiencing minor cold symptoms such as dry cough and runny nose, reduce your activity by about 50% if possible.
Treat symptoms. There are many cold medications that are considered safe in pregnancy. I’ve listed some at the bottom of this post.
Extended fever (>101) in pregnancy can lead to serious complications, especially in first trimester. If you do have fever, take acetaminophen (Tylenol) to help bring it down. It is safe to take the maximum dose (1000 mg every 6 hours, not to exceed 4000 mg in 24 hours) if needed. Aspirin and ibuprofen are not recommended in pregnancy.
When should I call the doctor?
Known exposure to the flu. If one of your kids or someone you have close contact with tests positive for the flu, you should notify your doctor. The CDC recommends to consider giving antiviral medication to pregnant women who are exposed to flu in order to help prevent them from getting sick. The sooner you can start the better, so call right away.
You have the flu. If you test positive for the flu or have classic flu symptoms (acute onset of fever >101, body aches, headaches or weakness) then notify your provider immediately. There are antiviral medications that can help you feel better more quickly when you have the flu, but they work best if taken within the first 48 hours of symptoms. The medications also can reduce your risk of pneumonia and other more severe complications.
You are not getting better.
- If you have been treated for the flu but continue to have severe symptoms or develop a productive (chunky) cough then you could be developing an additional infection such as pneumonia.
- If you tested negative for the flu, but have a fever (>101) despite Tylenol.
- If you have a sore throat and fever it could be strep throat, so a visit to the doctor is recommended.
- If you have nausea and vomiting lasting greater than 12 hours, dehydration could be eminent and you should call your doctor.
How do I know if I have the flu and not just a cold?
Flu season in the US usually runs from October to April. Most often, flu symptoms come on very suddenly. A woman may feel fine in the morning, but by the afternoon feels like she was hit with a load of bricks. Body aches, shaking chills and fever are usually the initial symptoms. Additional symptoms may include headache, nausea, vomiting and sore throat.
Cold symptoms are usually milder, with a more gradual onset. The common cold is characterized by runny nose and cough, rarely accompanied by high fevers.
If you are unsure, then talk to your provider to see if you need to get a flu test.
Medications I recommend to my patients for use in pregnancy :
- Acetaminophen (Tylenol)
- Zinc lozenges
- Chloraseptic spray
- Vitamin C
- Calcium (Tums)
- Dextromethorphan (Delsym & Robitussin)
- Guaifenesin (Mucinex)
- Cough drops and throat lozenges
- Oseltamivir (Tamiflu)
- loperamide (Imodium)
Medications NOT recommended in pregnancy:
- Aspirin (full strength)
Have you had the flu during pregnancy? What was your best method for feeling better?