What to take - or not - for colds during pregnancy

Which cold medications do you recommend during pregnancy?

In general, acetaminophen (Tylenol and generic versions) may be safely used during pregnancy. This drug is effective in treating the fever, aches and pains that can accompany colds. You should limit the amount of acetaminophen in a 24-hour period to 3,000 milligrams.

Women with liver problems should not use acetaminophen until they have checked with their doctors.

Pregnant women should avoid ibuprofen (Motrin, Advil and generic versions), naproxen (Aleve, Naprosyn and generic versions) and other nonsteroidal anti-inflammatory drugs, unless specifically instructed to take them by their obstetrician. They may have an effect on the fetal heart and kidneys. These effects are most concerning late in pregnancy. Brief use of ibuprofen early in pregnancy probably has very low risk.

Diphenhydramine (Benadryl and generic versions) can be useful in treating some of the congestion that comes along with a cold. It is considered safe to take during pregnancy.

Pseudoephedrine (Sudafed and generic versions) is a common decongestant, but recent information shows it should be avoided, especially in the first trimester. It may affect maternal and fetal blood vessels. Perhaps because of this, it has been associated with an increased risk of certain birth defects.

Later in pregnancy - after organs are more fully formed - there is probably much lower risk from pseudoephedrine as long as a mother's blood pressure is normal (pseudoephedrine can cause a rise in blood pressure).

The absolute risk of problems from medications, even those not recommended, is low, however. If you have taken things without knowing of risks or before recognizing you were pregnant, you should not panic. Probably all is well.

And, of course, the very safest remedies are the ones many grandmothers recommend - chicken soup and rest.