You've decorated the nursery, stockpiled diapers and finally found the perfect chair to rock your little bundle to sleep. Now here's another thing to add to your baby's-on-the-way checklist: preparing for and protecting yourself from the flu.

That's because when you’re expecting, normal changes to your heart, lungs and immune system leave you more susceptible than usual to viruses than you were before. So even if you’re one of those people who usually sails through winter without so much as a sniffle, you may be likely to get sick with a cold, flu or other illness this season.

The flu, which most often announces itself with body aches, fever and chills, among other symptoms, can be problematic for pregnant women, potentially leading to complications requiring hospitalization.[1] That’s why it’s so important that all expectant moms get the flu shot well before flu season hits, preferably in the fall.

Whether you’ve already caught the flu or just want to know what to look out for and how to prevent it, here’s what you need to know to protect yourself and your baby. Most importantly, if you suspect that you do have the flu, call your doctor right away to get a firm diagnosis and the treatment you need (which may involve pregnancy-safe antiviral prescription medications for the flu) as soon as possible.

What are symptoms of the flu in pregnancy?

Influenza (aka the flu) is more severe and comes on more suddenly than a cold. Symptoms include:[2]

  • Fever (usually 101 degrees Fahrenheit to 104 degrees F or higher; call your doctor if it climbs above 101 degrees F)
  • Intense muscle aches
  • Chills
  • A sore throat that generally worsens by the second or third day
  • Headache
  • General weakness and fatigue
  • Occasional sneezing
  • Cough that can become severe
  • Occasionally nausea, vomiting and/or diarrhea

However, some people who have the flu have respiratory symptoms without a fever.

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Symptoms of the flu typically last two weeks, though they can go on for longer.

What causes the flu during pregnancy?

Cases of the flu are caused by an array of influenza viruses. Because the influenza virus is constantly mutating, there are an unlimited number of flu viruses — which also explains why the flu vaccine is different each year (and why even if you’ve had the shot in the past, you need to get a new one each flu season).

Can I get the flu shot during pregnancy?

Yes, it's safe to get the flu shot during pregnancy. In fact, you definitely should get it: The Centers for Disease Control and Prevention (CDC) recommends that all moms-to-be get the flu shot to keep safe during flu season. You can get the flu shot at any time during your pregnancy, and there is plenty of evidence that the vaccine is safe for you and your baby. 

As an added bonus, if you get immunized during the last trimester of pregnancy, you also help protect your baby from the flu for several months after he's born.

The flu vaccine offers the most protection if it’s given before flu season or early on during it (preferably by the end of October). It’s never 100 percent effective because it protects only against the influenza viruses that are expected to cause the most problems in a particular year. Still, it greatly increases the chance that you’ll escape the season flu-free.

Keep in mind that the nasal spray vaccine (FluMist, which is made from live "weakened" flu virus), should not be given while you are pregnant or nursing. Check with your doctor to learn more.

If you're still not convinced about getting vaccinated against influenza — or COVID-19, for that matter — while you're pregnant, make no mistake about it: Both shots have been shown to be safe for moms (and growing babies) at every stage of pregnancy. You can even get them at the same time. Still concerned? Talk to your practitioner, who will assure you that it's not only fine for you and your little one, but a necessary preventative measure.

What happens if I get the flu while pregnant?

If you have flu symptoms, it's important to call your practitioner immediately. Often your primary care doctor or local urgent care will offer you a rapid flu test. Getting tested early on helps ensure you’re treated as early as possible and that your close contacts can receive preventative (prophylactic) treatment to stay healthy.[3]

Because the flu can be serious in pregnant women, your doctor may want to treat you with an antiviral mediation like Tamiflu. Antiviral medications work best if you take them within two days of getting sick. The sooner you’re treated, the safer you and your baby will be.

Otherwise, the same tips that can help keep you comfortable when you’ve got a cold can also be used when you’re down with a bout of the flu. They include:

  • Keeping in close contact with your practitioner.
  • Resting a lot.
  • Drinking plenty of fluids to soothe your sore throat and replace what’s lost by fever.
  • Taking the antiviral medication your doctor may prescribe according to his or her instructions.
  • Eating well as much as you're able to. If you can stomach them, focus on eating lots of immune-boosting vitamin C foods (oranges, grapefruit, kiwis, pineapple, blackberries, raspberries, tomatoes, kale, broccoli and spinach) and foods that are high in zinc (lean red meat, chicken breast, fortified cereal, eggs, chickpeas, spinach, broccoli, kale and pumpkin seeds).
  • Taking your prenatal vitamin, which offers a pregnancy-safe dose of vitamin C and zinc in addition to the folate, calcium and other nutrients you and your baby need.
  • Having a couple spoonfuls of honey, which can be soothing and actually help suppress a cough as well as an OTC cough suppressant.

Since a high fever can be potentially harmful, you’ll need to take steps to reduce it, including.

  • Take a fever-reducing medication (acetaminophen — aka Tylenol — is the safest bet; see below for the medications you should avoid).
  • Try a tepid bath or shower.
  • Drink plenty of cool beverages.
  • Keep clothing and bed covers light.

Safe medications for the flu during pregnancy

While many of the medications you used to reach for before you became pregnant are off-limits now, there are still some meds that are safe to take to relieve symptoms of the flu during pregnancy:

  • Antivirals. Tamiflu and other antivirals are safe (and important to take) if prescribed by a practitioner who has diagnosed you with the flu.[4]
  • Acetaminophen. If you're running a fever or suffering from nasty body aches or headaches, it's generally considered safe to take products containing acetaminophen, such as Tylenol. Just talk to your doctor about the proper dosing.
  • Cough remedies. Expectorants (like Mucinex) as well as cough suppressants (such as Robitussin or Vicks 44) as well as most cough drops are considered safe during pregnancy, but ask your practitioner about whether they're okay for you and about dosing.
  • Some nasal sprays. Most steroid-containing nasal sprays are fine to use during pregnancy, but check with your doctor about brands and dosing. Plain saline drops and sprays are always safe to take when you're expecting and can help clear and moisturize a stuffy nose.
  • Some antihistamines. Benadryl and Claritin often get the green light during pregnancy, but be sure to check with your practitioner before taking them. Some doctors will advise staying away from those medications in the first trimester.

Remember: Never take any medication (prescription, over the counter or homeopathic) without consulting with a doctor who knows you’re expecting.

Some of the medications that could help with flu symptoms when you’re not pregnant are off the table for moms-to-be because they may cause harm to the unborn baby. These include:

  • Some pain relievers. Aspirin, ibuprofen (Motrin or Advil) and naproxen (Aleve) aren't safe during pregnancy because they can be harmful to you and your baby.
  • Most decongestants. Decongestants like Claritin-D, Sudafed and DayQuil should be avoided when you’re expecting (though those featuring phenylephrine and pseudoephedrine may be okay to take during pregnancy with your doctor’s approval). Even those experts who say it’s okay to take certain decongestants will caution that it’s only safe to use them after the first trimester and only as long as it’s used in a limited amount.
  • Some nasal sprays. Steer clear of nonsteroidal nasal decongestant sprays containing oxymetazoline (like Afrin) unless given the green light by your practitioner. Many will tell you to avoid these sprays completely while you're expecting, while others will advise only limited use (one or two days at a time) after the first trimester.
  • Homeopathic remedies. Never take echinacea or other supplements (like zinc and vitamin C) without medical approval.

However, don’t put off calling your practitioner or refuse to take a medication he or she prescribes because you think all drugs are harmful in pregnancy. When it comes to the flu, the sooner you’re treated, the safer you and your baby will be.

Can the flu be dangerous during pregnancy?

Being pregnant definitely puts you at greater risk for the flu's more serious complications, like pneumonia. In fact, pregnant women are more likely to be hospitalized from complications of the flu than non-pregnant women of the same age (which is why getting the flu shot as a preventative measure is such a good idea).

But what happens if you didn’t get the flu shot for some reason and then you do end up getting the flu? Your best bet is to see your practitioner right away to talk it all through and get the treatment you need so that you can be on the road to recovery as soon as possible.