What to expect when you're expecting (193 page)

Is It the Flu or a Cold?

Here’s how to tell which bug has you down:

The cold.
A cold, even a bad one, is milder than the flu. It often starts with a sore or scratchy throat (which typically lasts only a day or two) followed by the gradual appearance of cold symptoms. These include a runny, and later stuffy, nose; lots of sneezing; and possibly slight achiness and mild fatigue. There is little or no fever (usually less than 100°F). Coughing may develop, particularly near the cold’s end, and may continue for a week or more after other symptoms have subsided.

The flu.
Influenza (or the flu) is more severe and comes on more suddenly. Symptoms include fever (usually 102°F to 104°F), headache, sore throat (which generally worsens by the second or third day), often intense muscle soreness, and general weakness and fatigue (which can last a couple of weeks or longer). There may also be occasional sneezing and often a cough that can become severe. In some cases, nausea or vomiting may occur, but don’t confuse this with what is often called the “stomach flu” (see
page 501
). You can easily avoid coming down with the flu by getting a flu shot.

If your cold is severe enough to interfere with eating or sleeping, if you’re coughing up greenish or yellowish mucus, if you have a cough with chest pain or wheezing, if your sinuses are throbbing (see the next question), or if symptoms last more than a week, call your doctor. It’s possible that your cold has settled into a secondary infection and prescribed medication may be needed for your safety and your baby’s.

“I’ve had a cold for about a week. Now my forehead and cheeks are starting to really hurt. What should I do?”

Sounds as though your cold has turned into sinusitis. Signs of sinusitis include pain and often tenderness in the forehead and/or one or both cheeks (beneath the eye), and possibly around the teeth (pain usually worsens when you bend over or shake your head), as well as thickened and darkened (greenish or yellowish) mucus.

Sinusitis following a cold is fairly common, but it is far more common among pregnant women. That’s because your hormones tend to swell mucous membranes (including those in and leading to the sinuses), causing blockages that allow germs to build up and multiply in the sinuses. These germs tend to linger longer there, because immune cells, which destroy invading germs, have difficulty reaching the sinuses’ deep recesses. As a result, sinus infections that aren’t treated can persist for weeks—or even become chronic. Treatment with antibiotics (your practitioner will be able to prescribe one that is safe during pregnancy) can bring relief quickly.

“It’s fall, and I’m wondering if I should get a flu shot. Is it safe during pregnancy?”

A flu shot is definitely your best line of defense during flu season. Not only is it safe to receive while you’re pregnant, it’s considered a good move. In fact, the Centers for Disease Control and Prevention (CDC) recommends that any woman who will be pregnant during flu season (generally October through March) be given the flu shot. And since the CDC puts pregnant women at the top of the priority list for getting vaccinated (along with the elderly and children between the ages of 6 months and 5 years), moms-to-be can waddle to the front of the flu-shot line, even if the vaccine is in short supply. Talk to your ob-gyn or midwife about getting a flu shot. If he or she doesn’t offer it, make an appointment with your general practitioner to get one. You can also look for flu-shot clinics that are sometimes set up at local drug and grocery stores during flu season.

The flu vaccine must be taken prior to each flu season—or at least early in the season—for best protection. It’s not 100 percent effective because it protects only against the flu viruses that are expected to cause the most problems in a particular year. Still, it greatly increases the chance that you will escape the season flu free. And even when it doesn’t prevent infection, it usually reduces the severity of symptoms. Side effects occur infrequently and are generally mild.

Flu Shot for Two

Getting a flu shot is good for you when you’re expecting, but did you know that its benefits carry over to your newborn as well? Researchers have found that babies born to mothers who were given the flu shot during the last trimester of pregnancy appear to be protected against the virus for the first six months of life. Which means that by getting a flu shot now, you’ll be keeping your baby protected until it’s time for his or her first flu shot.

When going for your flu shot, ask if you can receive thimerosal-free (or -reduced) vaccine. And stick with the needle, not the nasal spray vaccine (FluMist). That vaccine, unlike the flu shot, is made from live flu virus (which means it could actually give you a mild case of the flu) and is not recommended for pregnant women.

If you suspect you might have the flu (see symptoms in box, facing page), call your doctor so that you can be treated (and so that the flu doesn’t progress to pneumonia). Treatment is typically symptomatic—aimed at reducing fever (take steps right away to bring down any fever; see next question), aches and pains, and nasal stuffiness. Most important if you’ve got the flu (or any virus) when you’re expecting: Rest and drink plenty of fluids, essential for preventing dehydration.

“I’m running a little fever. What should I do?”

During pregnancy, a low-grade fever (one that’s under 100.4°F) isn’t usually something to be concerned about. But it’s also not something to be ignored, which means you should take steps to bring any fever down promptly. Keep a close eye on your temperature, too, to make sure it doesn’t start rising.

Any fever over 100.4°F while you’re expecting is more of a concern and should be reported to your practitioner right away. That’s because the cause (such as an infection that should be treated with antibiotics) can pose a pregnancy problem even when the fever doesn’t. While you’re waiting to speak to your practitioner, take two acetaminophen (Tylenol) to start reducing the fever. Taking a tepid bath or shower, drinking cool beverages, and keeping clothing and covers light will also help bring your temperature down. Aspirin or ibuprofen (Advil or Motrin) should
not
be taken when you’re expecting unless they’ve been specifically recommended by your practitioner.

If you had a high fever earlier in pregnancy and did not report it to your practitioner, mention it now.

“My three-year-old came down with strep throat. If I catch it, is there a risk to the baby?”

If there’s one thing kids are good at sharing, it’s their germs. And the more kids you have at home (particularly of the child-care-attending or school-going variety), the greater your chances of coming down with colds and other infections while you’re expecting.

So step up preventive measures (don’t share drinks, resist the temptation to finish that peanut-butter-and-germ sandwich, wash your hands frequently) and boost your immune system—which is lowered during pregnancy anyway—by eating well and getting enough rest.

If you do suspect that you’ve succumbed to strep, go to your practitioner for a throat culture right away. The infection will not harm the baby, as long as it is treated promptly with the right type of antibiotic. Your practitioner will prescribe one that is effective against strep and perfectly safe for use during pregnancy. Don’t take medication prescribed for your children or someone else in the family.

“I’m afraid I have a urinary tract infection.”

Your poor battered bladder, which spends months on end being pummeled by your growing uterus and its adorable occupant, is the perfect breeding ground for less welcome visitors: bacteria. These little bugs multiply fast in areas where urine pools or is prevented from moving along, meaning anywhere along a urinary tract that’s being squished by the expanding uterus. (It’s that same compression that makes you unable to sleep through the night without getting up several times to pee.) That here- and-there compression, added to the muscle-relaxing properties of the hormones flooding your body, makes it much easier for the intestinal bacteria that live quietly on your skin and in your feces to enter your urinary tract and make you miserable. In fact, urinary tract infections (UTIs) are so common in pregnancy that at least 5 percent of pregnant women can expect to develop at least one, and those who have already had one have a 1 in 3 chance of an encore. In some women, a UTI is “silent” (without symptoms) and diagnosed only after a routine urine culture. In others, symptoms can range from mild to quite uncomfortable (an urge to urinate frequently, pain or a burning sensation when urine—sometimes only a drop or two—is passed, pressure or sharp pain in the lower abdominal area). The urine may also be foul smelling and cloudy.

Diagnosing a UTI is as simple as dipping an indicator stick into a urine sample at your practitioner’s office; the stick will react to red or white blood cells in the sample. Red blood cells indicate bleeding in the urinary tract; white cells indicate a likely infection. Treating a UTI is as simple as taking a full course of prescribed antibiotics specifically aimed at the type of bacteria found when a lab analyzed that urine sample. (Don’t hesitate to take them—your practitioner will prescribe one of the many antibiotics that are safe for use during pregnancy.)

Of course, your best bet is to prevent a UTI in the first place. There are a number of steps you can take to reduce your chances of developing one during your pregnancy (or, in conjunction with medical treatment, help speed recovery when infection occurs):

Drink plenty of fluids, especially water, which can help flush out any bacteria. Cranberry juice may also be beneficial, possibly because the tannins it contains keep bacteria from sticking to the walls of the urinary tract. Avoid coffee and tea (even decaffeinated varieties) and alcohol, which may increase risk of irritation.

Wash your vaginal area well and empty your bladder just before and after sex.

Every time you urinate, take the time to empty your bladder thoroughly. Leaning forward on the toilet will help accomplish this. It sometimes also helps to “double void”: After you pee, wait five minutes, then try to pee again. And don’t put off the urge when you have it; regularly “holding it in” increases susceptibility to infection.

To give your perineal area breathing room, wear cotton-crotch underwear and panty hose, avoid wearing tight pants, don’t wear panty hose under pants, and sleep without panties or pajama bottoms on if possible (and comfortable).