FOR COLD:

Nasal Congestion

Getting enough rest is important when you are pregnant but a cold can cause a runny nose and nasal congestion. There are a few safe things you can do to help relieve nasal congestion during a cold.
Saline solution is great for breaking up mucus and soothing inflammation in the nasal passages. You can purchase saline in the form of a nasal spray or drops, but be sure to check the ingredient list.
Salt and water should be the only main ingredients listed on the label. You can also make your own by adding 1/4 tsp. of salt per cup of water.
Sleeping slightly propped up can help you get some relief during the night by making it easier for mucus to drain naturally. Another option is to purchase nasal strips to put on your nose and help open up nasal pathways, making it easier to breathe. If you are suffering from sinus congestion, try alternating hot and cold compresses over the sinuses.

Cough and Chest Congestion

If you have cough or chest congestion, try breathing in some steam. You can use a facial steamer or vaporizer or just boil a pot of water and lean over it to breathe in the steam.
A chest or nasal rub containing menthol will also work to relieve congestion and cough.
If your cough is severe, it is safe to take Robitussin D.M. during pregnancy.

Other Remedies Include:

Nettie pot
A humidifier may help relieve nasal congestion
Benadryl 25mg or 50mg as directed or Claritin (over the counter)
Afrin nasal spray- should not be used for more than 3 days!

If the above does not relieve your symptoms, call your primary care doctor.

For Headaches/Fever

Tylenol (acetaminophen) regular or extra strength only. DO NOT take Advil, Ibuprofen, or Motrin without consulting Dr. Kahen first.

For Nausea and Vomiting

The treatment of pregnancy-related nausea and vomiting aims to help you feel better and allow you to eat and drink enough so that you do not lose weight.

Dietary changes — Try eating before or as soon as you feel hungry to avoid an empty stomach, which may aggravate nausea. Eat snacks frequently and have small meals (e.g., six small meals a day) that are high in protein or carbohydrates and low in fat. Drink cold, clear, and carbonated or sour fluids (eg, ginger ale, lemonade) and drink these in small amounts between meals. Smelling fresh lemon, mint, or orange or using an oil diffuser with these scents may also be useful.

Avoid triggers — One of the most important treatments for pregnancy-related nausea and vomiting is to avoid odors, tastes, and other activities that trigger nausea. Eliminating spicy foods helps some women. Other examples of triggers include:

Stuffy rooms
Odors (eg, perfume, chemicals, coffee, food, smoke)
Heat and humidity
Noise
Visual or physical motion (eg, flickering lights, driving)
Excessive exercise
Being tired
Consuming large amounts of high-sugar foods/snacks

Brushing teeth after eating may help prevent symptoms. Avoid lying down immediately after eating and avoid quickly changing positions.

If you take a prenatal vitamin with iron and this worsens your symptoms, try taking them at bedtime. If symptoms persist, stop the vitamins temporarily. If you stop taking your prenatal vitamin, take a supplement that contains at least 400 micrograms of folic acid until you are at least 14 weeks pregnant to reduce the risk of birth defects.

Medications — Medications that reduce nausea and vomiting are effective in some women and are safe to take during pregnancy. None of the medications discussed below are known to be harmful.

Vitamin B6 and doxylamine — Vitamin B6 supplements (10 to 25 mg three times per day) can reduce symptoms of mild to moderate nausea, but do not usually help with vomiting. Doxylamine is a medication that can reduce vomiting, and may be combined with vitamin B6. Doxylamine is available in the United States in some non-prescription sleep aids (e.g., Unisom®, Good Sense Sleep Aid®) and as a prescription antihistamine chewable tablet (Aldex AN).

In the United States, one-half of a 25 mg doxylamine tablet or two of the chewable 5 mg tablets can be used to reduce vomiting, although doxylamine is not “officially” approved for this purpose. Some healthcare providers also prescribe vitamin B6 supplements (10 to 25 mg three times per day) to take with it. Outside the United States, combinations of vitamin B6 and doxylamine are available (eg, Diclectin® in Canada).

Combinations of vitamin B6 and doxylamine were previously available in the United States in a prescription medication called Bendectin®. Bendectin® was voluntarily withdrawn from the market in 1983 due to lawsuits claiming that the medication caused birth defects. However, subsequent studies confirmed that the medication is safe, effective, and does not increase the risk of birth defects [2].

Antihistamines and other anti-nausea medications — Antihistamines and other anti-nausea medications are safe and effective treatments for pregnancy-related nausea and vomiting. The following medications may be recommended:
Diphenhydramine (25 to 50 mg) orally every four to six hours, as needed, but this drug causes drowsiness
Meclizine 25 mg orally every four to six hours, as needed, but this drug causes drowsiness

Other anti-nausea medications that are available by prescription include:

Promethazine (Phenergan®) — Promethazine is available in pill, injectable solution, or rectal suppository form. It is usually taken every four hours, and may cause drowsiness and dry mouth. Rare side effects include muscle contractions that cause twisting or jerking movements.
Metoclopramide (Reglan®) — Metoclopramide speeds emptying of the stomach and may help to reduce nausea and vomiting. It is usually taken by mouth or injection every six hours (four times per day, 30 minutes before eating and at bedtime).
Ondansetron (Zofran®) — Ondansetron is an anti-nausea medication that is usually taken by mouth or injection every eight to 12 hours. Ondansetron is one of the most expensive anti-nausea medications (approximately $500 for 30 pills in the United States) and it may not be covered by some insurance plans.

Fluids and nutrition — If you are unable to hold down food or liquids, you may be treated with intravenous (IV) fluids. This may be done in your doctor or nurse’s office or in the hospital, depending upon the severity of your vomiting. For a short time, you may be advised not to eat or drink anything, to allow the gut to rest. You can slowly begin to eat and drink again as you begin to feel better, usually within 24 to 48 hours.

If you continue to lose weight despite treatment, your doctor may consider other forms of feeding, such as the use of a nasogastric tube (a tube that is inserted through your nose into the stomach) or supplemental nutrition through an IV line.

Remember to consult with Dr. Kahen first before using any medication or therapy not listed or if these do not work. Follow the directions for use on the bottles of medicines listed. If your symptoms worsen or are not improved with the following recommendations please call us at 818-344-8822.