Sore Throat During Pregnancy: Should You See Your Doctor?

Are you pregnant and experiencing a sore throat?

Pregnancy can make the treatment of common ailments infinitely more complex. Because your baby’s health is of utmost importance, there are many things you can’t ingest while pregnant.

But your health and comfort are important, too, so it’s necessary to appropriately diagnose and treat any potentially serious illnesses you may develop during pregnancy.

A sore throat is rarely an indicator of serious illness, but it can cause severe discomfort. Here’s everything you need to know about treating a sore throat during pregnancy.

What Causes a Sore Throat?

A sore throat is a feeling of irritation in the back of the throat. It can vary from mild to severe, and may feel like:

• Minor itching.
• Rawness.
• Burning pain.
• Rough, sandpaper-like scratching.
• Sharp pains, like swallowing glass.

A sore throat can be caused by a multitude of things, from environmental irritants to viruses to pregnancy hormones.

Here are some of the most common causes of a sore throat during pregnancy:

• Viruses: The vast majority of sore throats are caused by viruses, which are also the culprits responsible for the common cold and seasonal flu. Antibiotics are ineffective against viral infections, which usually just have to run their course over five to seven days.

  Some viruses are more severe than others. One way to minimize your chances of getting the flu is to get your annual flu shot at the beginning of your pregnancy, which will protect you and your baby. Pregnant women are more severely affected by the flu, and this can cause complications during pregnancy. The flu can even cause preterm delivery and low birth weight in some instances ⁽¹⁾.

  

  Editor's Note:

  Dr. Njoud Jweihan, MD
• Bacteria: Bacterial infections can also cause a sore throat, and these can be treated with prescription antibiotics. Strep throat is one of the most common types of bacterial infections accompanied by a sore throat. One of the hallmarks of strep throat is a white coating or white spots on the back of the throat along with a high fever. Keep in mind that it is extremely important to finish your course of antibiotics — even if you are starting to feel better. Antibiotic resistance caused by insufficient treatment can lead to more infections with even stronger bacteria ⁽²⁾.
• Environmental irritants: There are many things that can irritate your throat and nasal passages, causing discomfort. These include dry air, dust, pollen or other allergens, smoke, and chemicals. If an environmental irritant causes your sore throat, the best way to treat it is to avoid the source of your irritation. If your home is dry, try running a humidifier to moisten the air.
• Postnasal drip: As your sinuses drain, the mucus drips down the back of your throat, which can be extremely irritating and can cause a chronic cough. This is often a secondary symptom after dealing with a bacterial or viral infection of the sinuses ⁽³⁾.
• A weaker immune system: During pregnancy, your immune system lowers its strength to protect your baby from any attack by your body. This causes your body to be more susceptible to all sorts of infections.
• Pregnancy hormones: Thanks to fluctuating hormones, your body can experience several oral symptoms, including dry mouth, excessive thirst, and sore throat. If this is the cause of your sore throat, there are few medical options available, and you can instead focus on measures to increase your comfort with safe warm beverages and lozenges.
• Acid Reflux: Acid reflux occurs when the contents of the stomach, including stomach acids, back up into the esophagus. Acid reflux causes a number of symptoms, one of the secondary symptoms being a sore throat. It is common during pregnancy, thanks to both a slower digestive process and a compressed digestive system ⁽⁴⁾. It is primarily due to one of the main pregnancy hormones, progesterone. This hormone has been shown to relax the muscles in your esophagus — the track the food travels down to the stomach. In turn, it is easier for food to be brought back up causing the symptoms of acid reflux that resemble the irritation and burning of a sore throat.

Is a Sore Throat Dangerous During Pregnancy?

A sore throat alone is not dangerous during pregnancy. While it is a common symptom of many uncomfortable ailments, serious complications are rare. Always check with your doctor for reassurance and precaution.

When Should I See a Doctor for My Sore Throat?

While a sore throat is not dangerous, there are some occasions when you should check in with your doctor.

• Fever: You should contact your doctor if your sore throat is accompanied by a fever of 100 degrees or higher — especially if the fever sets in after you’ve already had a sore throat for a few days. A high temperature can indicate a condition that may need medical treatment, and a prolonged elevated temperature can be harmful to your baby ⁽⁵⁾.
• Suspected flu: If your sore throat is accompanied by fever, chills, and a severe sense of malaise that came on rather quickly, it could be the flu. The flu presents a particular danger to pregnant women, but the good news is there are antiviral drugs available for some types of influenza. Tamiflu is recommended by the Centers for Disease Control and Prevention for use during pregnancy, but it is most effective if started within the first 48 hours of illness onset ⁽⁶⁾. So, if you suspect the flu, don’t wait — head to your doctor right away for testing.
• Rash: If a skin rash accompanies your sore throat, contact your doctor. It could indicate a more severe illness that needs appropriate medical treatment.
• Strep Throat: If your sore throat comes on suddenly and severely, you may have strep throat. Strep throat is frequently accompanied by white or red spots in the back of the throat, but a culture at your doctor’s office can confirm.

Many patients think that the bacteria that causes strep throat is the same bacteria that the doctor checks for around week 36 of pregnancy, or Group B Strep bacteria, which can spread to your baby from the vaginal or rectal area. However, they are not the same bacteria, and there is no need to worry. In fact, the bacteria from strep throat will not spread to your baby.

Editor's Note:

Dr. Njoud Jweihan, MD

Strep throat is easily treated with antibiotics, and your doctor will likely give you a prescription if you’re diagnosed with it. The antibiotic is a good idea to help prevent some of the complications of strep throat that can crop up, such as kidney issues and rheumatic fever.

What Types of Remedies Should I Avoid While Pregnant?

Several common remedies should be strictly avoided while pregnant, including:

• Aspirin.
• Ibuprofen.
• Caffeinated teas.
• Vitamin C supplements: Vitamin C supplements marketed to boost immunity (like the brand name “Emergen-C”) are typically safe for consumption. While it may be tempting to use these products to ward off a larger cold at the first sign of a sore throat, it’s best to check with your doctor first — especially since your prenatal vitamin should already contain Vitamin C.
• Zinc lozenges: As is the case with Vitamin C, your prenatal vitamins give you all the vitamins and minerals you need during pregnancy, so taking more can cause you to take too much. Check with your doctor about whether you can take zinc lozenges to stave off a cold — and if there’s any question, skip it.

What Medications Can I Take While Pregnant?

Some medicines are safe for use during pregnancy, as long as you follow proper dosing instructions. Always check with your doctor prior to taking medications to make sure they agree the medication you choose will complement your obstetric care:

• Antibiotics: Since a doctor must prescribe these, your doctor will choose one that is safe for use during pregnancy. Antibiotics that can be used are cephalexin, amoxicillin, and penicillin.
• Acetaminophen (the active ingredient in Tylenol): Use Tylenol sparingly. While it has been determined to be safe for pregnancy, overuse has been linked to liver damage ⁽⁷⁾.
• Cough drops.
• Throat sprays.
• Antacids: If your sore throat is caused by acid reflux, antacids such as Tums or Rolaids are safe to use. However, choose ones that contain calcium carbonate over sodium bicarbonate as they can cause water retention ⁽⁸⁾.

How Can I Treat a Sore Throat While Pregnant?

If you’re experiencing a sore throat while pregnant, there are several things you can do.

1. Take Your Temperature.

Before treating your sore throat, make sure you are not running a fever. A fever is any temperature above 100 degrees, which can indicate there is an infection in your body that needs to be treated.

A high fever during pregnancy can be dangerous for your baby, particularly in the first trimester, and should be monitored by a physician ⁽⁹⁾.

2. Take Tylenol.

Tylenol is generally considered safe for use during pregnancy. If your sore throat is severe, you may take Tylenol, or generic acetaminophen, for pain relief.

3. Gargle with Salt Water.

Gargling with warm salt water can help clear your throat of irritants and loosen the mucus. The salt is also soothing and helps to draw out excess moisture.

To gargle, add 1/2 teaspoon of salt to a cup of warm — not hot — water, and mix it until dissolved. Take a sip, tip your head back, and gargle so the mixture reaches as far back in your throat as possible.

Gargle for about a minute, then spit out the salt water.

4. Drink Tea with Lemon.

It can be difficult to drink adequate liquids when you have a sore throat. Choosing hot, soothing drinks will not only keep you hydrated but can help to thin and loosen irritating mucus in the back of the throat.

Herbal teas are a popular choice during pregnancy because they are naturally decaffeinated. However, it’s important to note that many herbs also have medicinal properties and, in certain quantities, may be harmful.

Because these herbs are not regulated by the FDA and are not widely studied, there is little agreement in the medical community about what is safe and what is not. Check with your doctor about any herbal teas you plan to consume. Avoid teas that contain cinnamon, licorice, chamomile and red raspberry leaf specially in the first trimester.

5. Use Throat Lozenges or Throat Sprays.

Throat lozenges and throat sprays are generally safe for use during pregnancy, so feel free to use them to coat your throat. Some also have menthol to help relieve other cold symptoms, and most throat sprays have antiseptic in them to help numb your throat from the pain.

If choosing a multi-symptom throat lozenge, make sure you need all the treatments listed; if not, opt for a single-use lozenge, such as one that only soothes the throat. Choosing a multi-symptom lozenge when you don’t have a cold that needs treating can cause you to over-medicate.

Avoid zinc lozenges that are designed to fight a cold rather than just soothe symptoms.

Always check with your doctor before taking any medication — even if it is over the counter.

6. Rest.

When you’re pregnant, your immunity is not up to par.

Rather than being suppressed, your immune system is weaker — meaning your body has to work harder to fight off bacteria and viruses. One of best things you can do to help your immune system function properly is to get adequate rest, allowing your body to use its energy to fight off the bug.

Editor's Note:

Dr. Njoud Jweihan, MD

FAQs

What Can I Take If I Have a Sore Throat and Cough While Pregnant?

Cough drops are safe to take while you’re pregnant. Another great option is Robitussin DM. If you want to do things the old-fashioned way, gargling salt water can also help soothe a sore throat.

Always double-check a medicine bottle’s warning label while pregnant to ensure it’s safe for you and the baby.

How Long Does a Sore Throat Last?

That depends on what’s causing your sore throat. A sore throat caused by something minor will heal itself within a week.

If your symptoms last longer than that, don’t wait to see the doctor. Your doctor will know what to do if it’s something more serious than allergies or the common cold.

Why Is Sore Throat Worse at Night?

The culprit behind sore throats worsening at night is postnasal drip. Laying down increases postnasal drip, which irritates your throat. The good news is that postnasal drip is a sign that your body is fighting off sickness (even though it’s doing it in a super annoying way.)

Should I Take a Covid Test If I Have a Sore Throat?

Generally, the answer would be no if you don’t have any other symptoms. However, we understand moms-to-be want to ensure they’re in the best health for their baby.

If you have reason to believe you have COVID-19 or just want to make sure you don’t, go ahead and take a COVID test. Hopefully, a negative result will put your mind at ease if nothing else.

How Do You Know If You Have Strep Throat or Just a Sore Throat?

Strep throat usually feels a lot worse than a regular sore throat. With strep throat, you can expect to have a high fever and for every swallow to feel pretty painful. Not to mention, strep throat makes you contend with all the other usual side effects of sickness:

• Runny nose
• Sneezing
• Coughing
• Occasionally a headache

Can Sore Throat Spread to Baby?

Your sore throat can’t spread to your baby if they’re still in the womb. Outside of the womb, they are vulnerable to contracting any sickness you might have. Luckily, babies usually don’t contract strep throat; if they do, the symptoms are very mild.

The Bottom Line

A sore throat can be incredibly uncomfortable during pregnancy, but the good news is it’s rarely serious. More often than not — as long as it’s not accompanied by fever — a sore throat is simply the result of a cold virus or environmental irritants.

However, always check with your doctor before taking any medication — even if it is over the counter.