Why sore throats are common in pregnancy
- The immune system adapts during pregnancy, which can make some infections more likely or longer lasting.
- Pregnancy hormones increase blood flow and swelling of the nasal lining, causing a blocked nose (pregnancy rhinitis).
- A blocked nose leads to mouth breathing, especially at night, drying the throat.
- Heartburn and reflux increase as the baby grows and pushes on the stomach.
- Contact with young children at home or work increases exposure to viruses.
Common causes
- Colds and viral infections: the most common cause, with runny nose, cough and mild fever.
- Postnasal drip: mucus dripping down the throat from a blocked nose; see postnasal drip.
- Acid reflux: a burning throat, sour taste and cough, often worse at night; see acid reflux sore throat.
- Dry air and mouth breathing: worse in the morning.
- Strep throat and tonsillitis: severe pain, fever and swollen tonsils; may need antibiotics.
Safe home remedies
- Rest and drink plenty of fluids.
- Gargle with warm salt water several times a day.
- Drink warm water with honey and lemon (honey is safe in pregnancy, but not for babies under 1).
- Suck ice chips, ice lollies or lozenges.
- Use a humidifier and keep bedrooms well ventilated.
- Use saline nose sprays or rinses for a blocked nose.
- Sleep with your head raised on extra pillows.
Which medicines are safe?
Paracetamol is the recommended painkiller in pregnancy for pain and fever, at the lowest effective dose for the shortest possible time. Ibuprofen and other anti-inflammatory painkillers are generally avoided, particularly from 20 weeks of pregnancy, unless a doctor advises them.
Many cold and flu remedies contain several ingredients, including decongestants, that are not recommended in pregnancy. Always check with a pharmacist, midwife or doctor before taking any medicine, throat spray or herbal remedy.
Managing reflux in pregnancy
- Eat smaller meals more often.
- Avoid eating within 3 hours of bedtime.
- Raise the head of the bed.
- Limit spicy, fatty foods, chocolate, caffeine and fizzy drinks.
- Ask a pharmacist about antacids suitable in pregnancy.
Why fever matters in pregnancy
A high temperature in pregnancy, especially in the first trimester, should be treated and checked. Paracetamol helps bring down a fever. If you have a temperature of 38°C or above, or feel very unwell, contact your midwife or doctor. Flu and COVID-19 can be more serious in pregnancy, which is why vaccination is recommended.
Strep throat and antibiotics in pregnancy
If a doctor suspects a bacterial infection such as strep throat, a swab or rapid test may be done. Several antibiotics, including penicillins, are commonly used in pregnancy when needed. Do not stop a course of antibiotics early without advice.
See strep throat.
Hoarseness and voice changes
Some people notice a deeper or hoarse voice in pregnancy, linked to fluid retention, reflux and nasal congestion. It usually resolves after birth. Hoarseness lasting more than 3 weeks should be checked by an ENT specialist.
Reducing the risk
- Wash hands frequently, especially if you have young children.
- Keep up to date with recommended vaccinations in pregnancy, such as flu.
- Stay hydrated and treat a blocked nose.
- Get enough rest and eat a balanced diet.
Pregnancy rhinitis and a blocked nose
Up to one in five pregnant people develop pregnancy rhinitis: a blocked, stuffy or runny nose without an infection, lasting six weeks or more and usually settling within two weeks after birth. It causes mouth breathing, snoring and a dry, sore throat in the morning.
Saline sprays and rinses, raising the head of the bed, a humidifier and nasal strips are safe options. Decongestant sprays and tablets should only be used if a doctor or pharmacist confirms they are suitable. See stuffy nose.
When to contact a doctor or midwife
- Temperature of 38°C or above, or shivering.
- Difficulty swallowing, breathing or opening the mouth.
- A rash, severe headache or stiff neck.
- A sore throat lasting more than a week or getting worse.
- Reduced baby movements or feeling very unwell.
Key points to remember
- Most sore throats in pregnancy are viral and settle on their own.
- Pregnancy rhinitis and reflux are common contributors.
- Fluids, salt-water gargles, honey and paracetamol are generally safe.
- Check with a pharmacist before any medicine, and seek help for fever.
Questions about sore throat during pregnancy
These answers are general information and do not replace an examination or individual medical advice.
Is a sore throat an early sign of pregnancy?
Not specifically, though pregnancy changes can make colds and nasal congestion more likely.
Can I take throat lozenges while pregnant?
Simple lozenges are generally fine; check medicated ones with a pharmacist.
Is honey safe during pregnancy?
Yes. Honey is safe for pregnant people, though not for babies under 1.
Can a sore throat harm my baby?
A common cold is unlikely to harm the baby, but a high fever should be treated and checked.
Can I take ibuprofen for a sore throat while pregnant?
It is generally not recommended, especially from 20 weeks, unless a doctor advises it.
Why is my throat sore every morning while pregnant?
Mouth breathing from a blocked nose and night-time reflux are common causes.
Can I use a throat spray in pregnancy?
Check with a pharmacist, as ingredients vary.
Can pregnancy cause a blocked nose and sore throat?
Yes. Pregnancy rhinitis can cause a blocked nose, mouth breathing and a dry, sore throat.
Sources
- NHS · Sore throat
- NHS · Paracetamol in pregnancy and breastfeeding
- NHS · Indigestion and heartburn in pregnancy
This guide is for general information and does not replace medical advice. How a problem is diagnosed and treated depends on your examination and medical history. If you think you have an emergency, contact your local emergency services.