What are the safe treatment options for cough in pregnancy, specifically is honey a safe alternative?

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Last updated: March 10, 2025View editorial policy

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From the Guidelines

Honey is a safe and effective alternative for treating cough in pregnancy, and it is recommended to try 1-2 teaspoons of honey in warm water or tea, or take it straight from the spoon as needed. For pregnant women with a cough, other safe options include staying hydrated, using a humidifier, gargling with salt water (1/4 teaspoon salt in 8 ounces of warm water), and trying saline nasal sprays for postnasal drip 1.

Key Considerations

  • For medication, acetaminophen (Tylenol) is considered safe for fever or pain at regular doses.
  • Avoid most over-the-counter cough and cold medications, particularly in the first trimester.
  • Dextromethorphan (for dry cough) and guaifenesin (for productive cough) may be used after the first trimester if necessary, but always consult your healthcare provider first.

Mechanism of Action

Honey works by coating the throat and has antimicrobial properties, providing natural relief 1.

When to Seek Medical Attention

If your cough is severe, persists longer than a week, is accompanied by high fever, difficulty breathing, or colored sputum, seek medical attention promptly as these could indicate a more serious condition requiring specific treatment. The evidence from 1 supports the use of honey as a safe and effective treatment for cough in adults, and by extension, in pregnant women, and this approach prioritizes minimizing risk and maximizing quality of life.

From the FDA Drug Label

If pregnant or breast-feeding, ask a health professional before use. There is no mention of honey as a treatment option in the provided drug labels.

  • The labels for guaifenesin (PO) 2 and dextromethorphan (PO) 3 do not provide information on honey as a safe alternative for cough treatment in pregnancy. The FDA drug label does not answer the question.

From the Research

Safe Treatment Options for Cough in Pregnancy

  • The safety of over-the-counter cold medications during pregnancy is a concern, and pregnant women should read labels carefully and consult with pharmacists to ensure they are not taking unnecessary medicine 4.
  • There is no direct evidence in the provided studies regarding the safety of honey as a treatment option for cough in pregnancy.

Honey as a Treatment Option for Cough

  • Honey has been used to alleviate cough symptoms in children, and studies have shown that it may be effective in reducing cough frequency and severity 5, 6.
  • Honey may be better than no treatment, diphenhydramine, and placebo for the symptomatic relief of cough, but it is not better than dextromethorphan 5, 6.
  • Adverse events associated with honey use include mild reactions such as nervousness, insomnia, and hyperactivity, as well as gastrointestinal symptoms 5, 6.

Pregnancy-Specific Considerations

  • Pregnant women are at high risk of serious complications from influenza infection, and antiviral treatment is necessary for all pregnant women with suspected or confirmed influenza 7.
  • The Centers for Disease Control and Prevention advises that postexposure antiviral chemoprophylaxis can be considered for pregnant women who have had close contact with infectious individuals 7.
  • Pertussis immunization recommendations include administering Tdap to all pregnant patients between 27 and 36 weeks' gestation with each pregnancy to convey immunity to the newborn 8.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Treating the common cold during pregnancy.

Canadian family physician Medecin de famille canadien, 2008

Research

Honey for acute cough in children.

The Cochrane database of systematic reviews, 2018

Research

Honey for acute cough in children.

The Cochrane database of systematic reviews, 2014

Research

Pertussis: Common Questions and Answers.

American family physician, 2021

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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