Sore Throats Suck, But Here’s How To Deal With One When Pregnant

Why it might be happening and what you can do.

Feeling under the weather when you’re pregnant sucks. 

Especially when it’s impossible to know what medicines and remedies are OK to take. Read on for more information about the causes of a sore throat during pregnancy and what you can safely do about it.

The Culprits

Viruses – The common cold (adenovirus) & Influenza. These are the most common causes of a sore throat, and both have the same symptoms: the sore throat along with a running nose, sneezing, a cough, sometimes a fever, aches, chills, and generally feeling lousy. 

With the flu, the symptoms will be more debilitating and can often be accompanied by diarrhea and/or vomiting. It’s important to be able to differentiate between the two when pregnant, as the flu can be much more serious. 

The CDC has this important information about the implications of flu when pregnant. According to Livestrong, anything higher than 100.4 is considered a fever and can be dangerous to your baby.

Safe treatment: If not accompanied by a fever then drink extra fluids, take Tylenol for the aches and pains, and use hot lemon tea to soothe the sore throat. It is important to call your doctor to arrange an appointment as soon as you develop any fever or suspect flu.  There are anti-viral drugs available that your doctor may want to prescribe.

Prevention: Getting a flu shot each year is the best way to protect yourself and is something to consider for both you and your partner before getting pregnant. The CDC has found it been shown to provide protection to both mother and baby for several months after birth.

Bacterial infection. Strep throat is the most common bacterial infection. Group A streptococcal bacteria infect the throat and tonsils and cause redness and inflammation, soreness, fever, chills, swollen neck glands, loss of appetite and sometimes nausea.  You might see small white or grey patches inside your throat – read here for more information.

Other bacterial infections can also cause a sore throat, such as gonorrhea, chlamydia and corynebacterium.  A visit to the doctor will usually result in a throat swab which will be tested in a lab to determine the type of bacteria present, and which antibiotics are needed to kill it.

Safe treatment: Antibiotics, usually amoxicillin or penicillin unless you are allergic to it. A doctor may also prescribe cephalexin if the infection is affecting the tonsils or sinuses. A bacterial infection will continue to grow unless treated with antibiotics so for this type of sore throat a visit to the doctor is needed.

At home you can also gargle with warm salt water to help heal a sore throat faster.

Oral Thrush. Caused by the fungus Candida albicans, which can grow abundantly during pregnancy because of the extra hormones and lack of immune system to fight the fungus.  More commonly seen as a vaginal infection, the symptoms can appear in the mouth and throat and usually present as white lesions, redness, soreness, sometimes slight bleeding, cracking at the corners of the mouth, a cottony feeling inside the mouth, and a loss of taste.  Many people describe this fungus growth as cottage cheese.

Safe treatment: Rinsing with salt water is a safe way to alleviate pain and the Mayo Clinic recommends using ½ teaspoon of salt in 1 cup of warm water.

Avoid using mouth wash during pregnancy as this can take away the natural flora inside the mouth and create a better environment for fungus to grow.

Often if the infection is established you will need help from a doctor to get rid of it using an antifungal medication. Be aware that a common one called fluconazole is potentially harmful to your developing baby and should not be prescribed.

Acid reflux. This one is more of a burning sensation in the throat, often after eating. During pregnancy stomach acid can escape upwards into the esophagus because those pesky pregnancy hormones make the muscle closing the top of the stomach less effective. Symptoms include a hot or burning type of pain, burping, regurgitation of acid, and sometimes nausea.

Safe treatment: Over the counter antacids such as TUMS are safe to take during pregnancy for on the spot relief of acid reflux. You could also take pills to decrease the amount of stomach acid being produced but you must check first with your doctor.

Side note: Peppermint tea will dilate the muscle that closes off your stomach and can make this condition worse!

Asthma. Inflammation of the lining of the lungs that causes spasms, resulting in shortness of breath. It is usually related to allergies or hypersensitivity to things like dust, pollen, etc.

Symptoms could be a scratching, irritated feeling, or tightness of the throat, rather than soreness.  This could be a warning sign of an oncoming asthma attack.

Safe treatment: Inhaled corticosteroids are the usual treatment for nasal and throat symptoms, and to ease breathing.  Studies have shown that treatment during pregnancy is much safer than leaving it, as there are risks to both mother and baby if left untreated. According to WebMD problems with blood pressure, pre-eclampsia, low oxygen levels to the fetus causing slow growth or pre term birth, are just a few.

Having an asthma action plan to control the inflammation and be ready for potential asthma attacks is crucial and monthly check-ins with your doctor and/or OB are recommended. Your lung function will be monitored, and you will be asked to count fetal kicks and movements, especially during an attack.  Later in pregnancy you will likely need more ultrasounds and other forms of monitoring.

Sinus infection/congestion. Pressure in the sinuses, coupled with a blocked nose and a sore throat, could be due to sinusitis.  It is caused by infection in the lining of the nasal cavities which stops mucus from draining and causes it to pool. The symptoms will include tenderness or pressure around your cheeks, eyes, and forehead, and may also cause a headache.

Safe treatment: There are a number of causes for a sinus infection – bacteria, virus, fungus, so treatment may depend on that.  But in most cases the inflammation is caused by a common cold or generally by your increased pregnancy hormones.

Tylenol (acetaminophen) is OK to relieve the headache, but not aspirin or ibuprofen. Home remedies such as irrigating the nose with saline, and using a humidifier or sitting over a steaming bowl of water, will help to loosen the passages and clear the mucus. Drinking plenty of fluids including broth, chicken soup, and citrus juice is also recommended. Hot and cold packs can relieve pain in the sinuses –

Postnasal drip. This happens when glands in your nose, throat, and airways produce too much mucus, or the mucus is not easily cleared.

The excess drips from the nose down the back of the throat.

Symptoms include a feeling of not being able to clear your throat, a runny nose, sometimes a cough that is worse at night, and a scratchy sore throat.  Postnasal drip can happen at the same time as GERD (see above)

If accompanied by ear ache then it is possible that mucus has blocked the Eustachian tube between your throat and ear and caused an infection. This would require a visit to the doctor.

Safe treatment: A simple way to thin out the mucus to allow it to clear, is to drink more water. Saline sprays and irrigation, and using a humidifier will also help to clear the airways, as with any kind of congestion. Over the counter antihistamines may help but a visit to the doctor is needed before taking any kind of medication, as the doctor should be able to determine the cause of the excess mucus – infection with bacteria or a virus, allergies or irritants, or GERD.

When to be concerned.

It can be hard to determine the true cause of your sore throat without the help of a medical professional.  Many women prefer to tough it out for the first little while, using self treatment and home remedies to alleviate the symptoms.  This is fine providing that you call your doctor and/or go to your ER if any of the following occur:

  • Vomiting or diarrhea
  • Difficulty breathing, or you are short of breath
  • Faintness/dizzy spells
  • Asthma attack – if you don’t have medication at hand
  • Inability to swallow food and water due to swelling/pain
  • A fever of more than 100.4
  • Decreased fetal movement

Medicines to avoid.

According to University of Michigan Health System it is better to avoid taking any medication during the first trimester of pregnancy, as this is the crucial time when the fetus is developing and is at it’s most vulnerable –

Healthline says that after the first trimester, it is recommended to avoid taking “all-in-one” type medications that combine several ingredients. Having a high dose of multiple medicines in one go is not safe when your body is already under extra strain, and your baby does not have any capability to filter out what is passed to him or her through your blood.

Avoid these medications:

  • Ibuprofen
  • Codeine
  • Bactrim
  • Naproxen
  • Aspirin
  • Herbs, minerals, or vitamins (other than prenatal vitamins)
  • Fluconazole – for fungal infection

The bottom line is you should always check with your doctor before taking any medications when pregnant, whether over the counter or something you have at home.

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