What to Know About Flu and Pregnancy

Having the flu is like having a pretty miserable cold in most cases. But for some, such as pregnant people, the flu can become much more serious. It may also affect the baby. The best way to avoid severe complications is to get the flu shot.

A pregnant woman with the flu

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Flu and Fertility

Generally speaking, any illness or threat to the immune system can affect your fertility. If you are actively sick, your immune system and stress levels can work against your efforts to conceive.

However, there isn’t evidence to show that the influenza virus itself harms fertility, but certain things that come with a typical flu presentation like high fevers may. High fevers have been linked to at least short-term infertility in males, with drops in sperm concentrations from fever resolving within about a month.

Some may worry that the flu shot could harm fertility or make it more difficult to become pregnant. According to the Centers for Disease Control and Prevention (CDC), numerous studies have demonstrated the safety of the flu vaccine in pregnant women. The CDC continuously collects data on adverse effects after all types of vaccinations to identify trends like vaccine reactions as early as possible.

Pregnant people should get a flu shot and not the live attenuated vaccine or nasal spray. The flu shot does not contain a live virus, and is therefore safer for the mother and baby.

Flu and Gestation

Any infection can cause problems in your pregnancy. Pregnant women are more prone to develop severe complications due to the flu than people who aren’t pregnant.

Risks

Your immune system changes throughout pregnancy, according to new research. This allows the immune system to adapt to prevent your body from rejecting your fetus and protect the mother and baby from illness. While these changes are generally protective of mother and baby, they can also set them up for flu complications.

Pregnant women who become sick with the flu have a higher risk of complications like preterm labor and birth, which take place before 37 weeks of pregnancy. They also have an increased risk of hospitalization and death.

Fever from the flu may be linked to birth defects, like neural tube defects, and other problems in your baby. Birth defects change the shape or function of one or more parts of the body and cause problems in overall health, how the body develops, or in how the body works. Neural tube defects are birth defects of the brain and spinal cord.

The flu in pregnant people has also been linked to:

  • A five-fold increase in mortality, miscarriage, and stillbirth
  • A three-fold increase in preterm and complicated births
  • Increased risk of low birth weight
  • A nearly doubled risk of Cesarean delivery due to severe illness in the mother

It may be difficult to tell if you have a cold, the flu, or another respiratory infection like COVID-19. Your healthcare provider can perform a flu test to tell for sure. Your provider will swipe the inside of your nose or the back of your throat with a swab and test the swab for the influenza virus.

Symptoms of the flu include:

  • Fever
  • Chills
  • Body aches
  • Headache
  • Tiredness and fatigue
  • Cough
  • Sore throat
  • Stuffy nose

Vaccination Is the Best Prevention

It’s not always possible to avoid flu exposure, so vaccination with the seasonal flu shot is recommended for all pregnant people or those who are trying to get pregnant. According to the CDC, vaccination against the flu can reduce a pregnant mother’s chances of being hospitalized by 40%. Flu shots are safe to use in pregnancy, and can help pass the protection on to your baby before and after birth too.

Treatment

Antiviral medications are used to treat influenza, and they can help reduce the severity and length of your illness. Guidelines for treating the flu in pregnant people include:

  • Begin treatment with antiviral medicines as soon as possible, ideally within 48 hours of the start of symptoms.
  • See your healthcare provider for a prescription for an antiviral medication.
  • Treat fever with acetaminophen.

For other symptoms, like a cough or stuffy nose, talk to your doctor about what medications are safe to use during pregnancy. Not many cold medications have been studied in pregnant women, and most healthcare providers use them with caution.

Flu Doctor Discussion Guide

Doctor Discussion Guide Old Man

Some medications that can be used include those that contain:

Dextromethorphan hasn’t been proven unsafe in pregnancy, but there are some concerns about this medication causing birth defects. Doctors therefore tend to shy away from using it.

For nasal congestion, more holistic treatments like saline sprays or even nasal strips may provide some relief.

Concerning Symptoms

It can be difficult to decide when you are sick enough to seek medical care. Whether you’ve been officially diagnosed with the flu or not, you should call 911 or seek medical care immediately if you are pregnant and have any of the following symptoms:

  • Difficulty breathing
  • Shortness of breath
  • Pain or pressure in the chest or abdomen
  • Dizziness
  • Confusion
  • Seizures
  • Inability to urinate
  • Severe muscle pain
  • Severe weakness
  • Fever or cough that gets better but then returns and worsens
  • High fever that is not responding to acetaminophen

Flu and Postpartum

Mothers who were sick with the flu during their pregnancy and at the time of delivery may need additional care during the postpartum period.

Impact on Recovery

Your body is healing from pregnancy and delivery, so you may need extra care to help fight the flu. You may remain at the hospital for longer than normal after delivery if you had the flu during childbirth.

Once you go home, you should take precautions for you and your baby, especially if it is during flu season. While it is nice to have visitors and support after delivery, you may want to limit visitors and contact, especially with people who are sick.

Breastfeeding

The flu cannot be passed on to your baby through breastmilk. In fact, breastmilk can help protect your baby from the flu by passing antibodies from the mother to the baby, especially if you got the flu vaccine.

The flu is spread by respiratory droplets, so be sure to keep your hands and breastfeeding supplies clean. You should also cover your nose and mouth when coughing or sneezing.

Summary

There is some evidence that the high fever as a result of the flu causes short-term infertility in males. The flu shot does not cause infertility. In fact, it protects pregnant people and their babies from serious complications from the flu, birth defects, and other health issues. Your recovery postpartum may take longer if you have the flu, but it does not have an impact on breastfeeding.

A Word From Verywell

The flu can cause additional complications for both the mother and baby during pregnancy. If you think you have the flu, see your doctor quickly. Early treatment with antiviral medications can help keep you from getting sicker and prevent complications of the flu.

Talk to your doctor about what cold and flu medications are safe for you to take, and call for help immediately if you experience problems like shortness of breath or chest pain.

Frequently Asked Questions

What cold and flu medicine can be taken during pregnancy?

Some over-the-counter cold and flu medications may be used in pregnancy, but you should talk to your doctor first. Acetaminophen is commonly used in pregnancy to treat fevers. Be careful when buying cold and flu medications during pregnancy since many of them contain a combination of several medications.

When do flu-like symptoms stop during pregnancy?

Flu symptoms will continue as long as you are sick. Seek treatment from your doctor as soon as your symptoms appear. Treatment is most effective within 48 hours of the beginning of symptoms.

What flu vaccine is given during pregnancy?

There are several options for flu vaccination, and all of them are safe to use in pregnancy except for the live-attenuated vaccine that is offered as a nasal spray. Use of this vaccine should be reserved for after delivery. It is safe to use while breastfeeding.

Can having the flu when pregnant harm the baby?

High fevers can be dangerous in the mother, and the flu has been associated with higher rates of preterm labor and birth, as well as Cesarean section. The flu has also been linked to birth defects affecting the brain and spinal cord.

What can you take for the stomach flu when pregnant?

The stomach flu is not the same as influenza. Stomach flu is usually caused by norovirus or rotavirus and can affect up to a third of women during their pregnancy. Staying hydrated with fluids and electrolyte drinks is key to treating “stomach flu,” or gastroenteritis, during pregnancy.

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