Ever wonder if you’re getting the right amount of vitamins and minerals during pregnancy or breastfeeding? Like Goldilocks, you don’t want too little or too much — you want just right. Even though it took Goldilocks multiple tries to find the right size chair and the right bowl of porridge, it doesn’t have to take you that long to find the right amount of vitamins and minerals for you!

Everyone has a 3% chance of developing a birth defect during pregnancy. Getting the right amount of vitamins and minerals FOR YOU is not expected to increase the risk for issues during pregnancy and it is not expected to increase the risk for side effects during breastfeeding.

Most people in the United States get some vitamins and minerals in their diet. However, your healthcare provider might have specific goals for you to get certain amounts of a vitamin or mineral, particularly during pregnancy or breastfeeding. One way to get that extra support during pregnancy is to take a prenatal vitamin that has at least 600 mcg of folic acid (for more information on folic acid, check out our fact sheet: https://mothertobaby.org/fact-sheets/folic-acid/.

If you also take other supplements, or drink juices and shakes that list vitamins on the nutrition label, you could be getting more than you need. Reading nutrition labels help you track how many vitamins and minerals you are getting into your body.

DRIs: What Are They?

DRI stands for Dietary Reference Intake. DRIs are a list of nutritional values that are used to guide people to make sure they are getting a well-balanced diet that supports their health. There are a couple different DRIs, but the ones that are used in this blog are called RDA and UL.

• RDA (Recommended Dietary Allowance): The average daily amount of a vitamin or mineral that most people need.
• UL (Tolerable Upper Limit): The maximum safe amount you can take in a day without raising the risk of side effects.

Not every vitamin and mineral has an RDA or UL. For the vitamins and minerals that do have DRIs, it’s typically recommended to aim for the RDA every day, unless your healthcare provider tells you differently. For the ones that do have DRIs, they can change based on age or when pregnant or breastfeeding. You will also get many nutrients from your regular diet, so supplements are intended to help fill in gaps — not overload your system.

Why Supplement Safety Matters

Supplements are regulated differently than prescription drugs. Even though the United States Food and Drug Administration (FDA) regulates supplements, the FDA doesn’t check every product for safety or effectiveness before it goes on the shelf. This means labels may not always tell the whole story, and some products could include unknown or unlisted ingredients.

Talk to your healthcare provider before taking a supplement to make sure you are getting the right amount of vitamins and minerals to support your health. You can contact MotherToBaby to get more information on a supplement you are considering.

Have more questions about supplements or exposures during pregnancy or breastfeeding? You can reach a teratogen-information specialist at MotherToBaby.org.

DRIs for Vitamins and Minerals During Pregnancy and Breastfeeding:

Name	RDA-pregnancy	UL-pregnancy	RDA-lactation	UL-lactation
Biotin	14+ years old: 30 mcg	Unknown	14+ years old: 35 mcg	Unknown
Boron	Unknown	14-18 years old: 17 mg 19+ years old: 20 mg	Unknown	14-18 years old: 17 mg 19+ years old: 20 mg
Calcium	14-18 years old: 1,300 mg 19+ years old: 1,000 mg	14-18 years old: 3,000 mg 19+ years old: 2,500 mg	14-18 years old: 1,300 mg 19+ years old: 1,000 mg	14-18 years old: 3,000 mg 19+ years old: 2,500 mg
Choline	14+ years old: 450 mg	14-18 years old: 3,000 mg 19+ years old: 3,500 mg	14+ years old: 550 mg	14-18 years old: 3,000 mg 19+ years old: 3,500 mg
Chromium	14-18 years old: 29 mcg 19+ years old:     30 mcg	Unknown	14-18 years old: 44 mcg 19+ years old: 45 mcg	Unknown
Copper	14+ years old: 1,000 mcg	14-18 years old: 8,000 mcg 19+ years old: 10,000 mcg	14+ years old: 1,300 mcg	14-18 years old: 8,000 mcg 19+ years old: 10,000 mcg
Folic Acid	14+ years old: 600 mcg DFE	14-18 years old: 800 mcg 19+ years old: 1,000 mcg	14+ years old: 500 mcg DFE	14-18 years old: 800 mcg 19+ years old: 1,000 mcg
Iodine	14+ years old: 220 mcg	14-18 years old: 900 mcg 19+ years old: 1,100 mcg	14+ years old: 290 mcg	14-18 years old: 900 mcg 19+ years old: 1,100 mcg
Iron	14+ years old: 27 mg	14+ years old: 45 mg	14-18 years old: 10 mg 19+ years old:  9 mg	14+ years old: 45 mg
Magnesium	14-18 years old: 400 mg 19-30 years old: 350 mg 30+ years old:  360 mg	9+ years old: 350 mg*	14-18 years old: 360 mg 19-30 years old: 310 mg 30+ years old:  320 mg	9+ years old: 350 mg*
Manganese	14+ years old: 2.0 mg	14-18 years old: 9 mg 19+ years old: 11 mg	14+ years old: 2.6 mg	14-18 years old: 9 mg 19+ years old: 11 mg
Molybdenum	14+ years old: 50 mcg	14-18 years old: 1,700 mcg 19+ years old: 2,000 mcg	14+ years old: 50 mcg	14-18 years old: 1,700 mcg 19+ years old: 2,000 mcg
Niacin	14+ years old: 18 mg NE	14-18 years old: 30 mg 19+ years old: 35 mg	14+ years old: 17 mg NE	14-18 years old: 30 mg 19+ years old: 35 mg
Omega-3 fatty acids	14+ years old: 1,400 mg	Unknown	14+ years old: 1,300 mg	Unknown
Pantothenic acid	14+ years old:   6 mg	Unknown	14+ years old: 7 mg	Unknown
Phosphorus	14-18 years old: 1,250 mg 19+ years old:  700 mg	14+ years old: 3,500 mg	14-18 years old: 1,250 mg 19+ years old:  700 mg	14+ years old: 4,000 mg
Potassium	14-18 years old: 2,600 mg 19+ years old: 2,900 mg	Unknown	14-18 years old: 2,500 mg 19+ years old: 2,800 mg	Unknown
Riboflavin	14+ years old: 1.4 mg	Unknown	14+ years old: 1.6 mg	Unknown
Selenium	14+ years old: 60 mcg	14+ years old: 400 mcg	14+ years old: 70 mcg	14+ years old: 400 mcg
Thiamin	14+ years old: 1.4 mg	Unknown	14+ years old: 1.4 mg	Unknown
Vitamin A	14-18 years old: 750 mcg RAE 19+ years old:  770 mcg RAE	14-18 years old: 2,800 mcg 19+ years old: 3,000 mcg	14-18 years old: 1,200 mcg RAE 19+ years old: 1,300 mcg RAE	14-18 years old: 2,800 mcg 19+ years old: 3,000 mcg
Vitamin B6	14+ years old: 1.9 mg	14-18 years old: 80 mg 19+ years old: 100 mg	14+ years old: 2.0 mg	14-18 years old: 80 mg 19+ years old: 100 mg
Vitamin B12	14+ years old: 2.6 mcg	Unknown	14+ years old: 2.8 mcg	Unknown
Vitamin C	14-18 years old: 80 mg 19+ years old:     85 mg	14-18 years old: 1,800 mg 19+ years old: 2,000 mg	14-18 years old: 115 mg 19+ years old: 120 mg	14-18 years old: 1,800 mg 19+ years old: 2,000 mg
Vitamin D	14+ years old: 15 mcg (600 IU)	14+ years old: 100 mcg (4,000 IU)	14+ years old: 15 mcg (600 IU)	14+ years old: 100 mcg (4,000 IU)
Vitamin E	14+ years old: 15 mg	14-18 years old: 800 mg 19+ years old: 1,000 mg	14+ years old: 19 mg	14-18 years old: 800 mg 19+ years old: 1,000 mg
Vitamin K	14-18 years old: 75 mcg 19+ years old:     90 mcg	Unknown	14-18 years old: 75 mcg 19+ years old:     90 mcg	Unknown
Zinc	14-18 years old: 12 mg 19+ years old:     11 mg	14-18 years old: 34 mg 19+ years old: 40 mg	14-18 years old: 13 mg 19+ years old:     12 mg	14-18 years old: 34 mg 19+ years old: 40 mg

(This chart has last been updated on 9/29/2025)

*Note: The UL for magnesium only applies to supplements. You can safely get more from food since the RDA includes dietary magnesium.

Where Can I Find More Information?

MotherToBaby has fact sheets on a couple of the common vitamins and minerals that might be found in a multivitamin or a prenatal vitamin. For more detailed information on a specific vitamin or mineral, check out our fact sheets below:

• Folic acid – https://mothertobaby.org/fact-sheets/folic-acid/

• Iodine – https://mothertobaby.org/fact-sheets/iodine-pregnancy/
• Iron – https://mothertobaby.org/fact-sheets/iron/
• Vitamin B12 – https://mothertobaby.org/fact-sheets/vitamin-b12/
• Vitamin C – https://mothertobaby.org/fact-sheets/vitamin-c/
• Vitamin D – https://mothertobaby.org/fact-sheets/vitamin-d/
• Vitamin E – https://mothertobaby.org/fact-sheets/vitamin-e/
• Vitamin K – https://mothertobaby.org/fact-sheets/vitamin-k/
• Zinc –   https://mothertobaby.org/fact-sheets/zinc/

References

National Academies of Sciences, Engineering, and Medicine. 1998. Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline. Washington, DC: The National Academies Press. https://doi.org/10.17226/6015.

National Institutes of Health Office of Dietary Supplements. 2025. Dietary Supplement Fact Sheets. U.S. Department of Human and Health Services. https://ods.od.nih.gov/factsheets/list-all/

Office of Disease Prevention and Health Promotion. 2023. Dietary Reference Intakes. U.S. Department of Human and Health Services. https://odphp.health.gov/our-work/nutrition-physical-activity/dietary-guidelines/dietary-reference-intakes

During my own three pregnancies, I learned how even the smallest skin discomforts can feel  like a lot. Pregnancy had a way of making me hyperaware of every sensation in my body. Most of the skin problems I had during pregnancy were minor irritations, like dry skin and acne, and they eventually went away. This was not the case with my hidradenitis suppurativa (HS). HS didn’t take a break just because I was pregnant. So, what happens when the discomfort is something more chronic, something that doesn’t come and go with a particular week or trimester, but shows up again and again, like HS?

What is hidradenitis suppurativa (HS)?

HS is a long-term skin condition that causes repeated painful lumps, areas that drain (abscesses), or pits and tunnels under the skin. These areas tend to show up where skin folds and rubs together, such as the armpits, groin, inner thighs, under the breasts, or along the buttocks. Over time, HS may also cause ropelike scars to develop, which can limit movement in some areas. For example, scarring in the armpits may make it difficult to fully lift the arms. HS can also cause pain, which  can make daily activities, work, and intimate relationships hard for people with HS.

Symptoms of HS can include ingrown hairs, infections, or cysts, which is why diagnosis by a healthcare provider familiar with HS, like a dermatologist, is important. HS is considered an inflammatory condition because the same spots can get inflamed over and over again, often described as “flares.” HS is not caused by infection, poor hygiene, diet, or anything you did or didn’t do. HS is not contagious (it does not spread from person to person). Instead, HS is “multifactorial,” meaning it is influenced by several things at once, including the immune system, genetics, hormones, and more.

How do pregnancy and HS interact with each other?

Everyone’s experience with HS in pregnancy is different. Some people notice that their symptoms get better in pregnancy, others notice little change, and some find that their symptoms worsen and flares increase. Experiences can also be different between pregnancies. For two of my pregnancies, my symptoms stayed the same, but in the third, the number of my flares increased, and I had  much more pain.

Can HS affect pregnancy outcomes?

Pregnancy hormones, increased body heat, and sweating can sometimes make areas with HS feel more inflamed or tender. And as your body grows and shifts during pregnancy, areas that weren’t rubbing before may suddenly start rubbing now. Occasionally, an area of the skin may become more irritated or develop signs of infection. Because HS can get better or worse during pregnancy, it is helpful to check in with your healthcare provider whenever you notice new symptoms or changes in how HS feels in your body.

Pregnancy complications, like miscarriage, are common and can occur in any pregnancy for many different reasons. Birth defects can also happen in any pregnancy for different reasons. Out of all babies born each year, about 3 out of 100 (3%) will have a birth defect.
Many people with HS have no complications during pregnancy. At the same time, recent research has suggested that HS may increase the chance for certain pregnancy-related problems, not because HS directly causes them, but because the underlying inflammation in HS may play a role.

Several studies looking at more than 5,000 pregnant women with HS found that pregnant women with HS had a higher chance of miscarriage and of developing high blood pressure and/or diabetes in pregnancy when compared with pregnant women without HS. And when looking at babies, these studies found that babies born to moms with HS had a slightly higher chance of being born preterm (birth before week 37). One study did show a slightly higher chance of birth defects, which was not seen in other studies. Learning that for the first time can feel scary, and I remember feeling that way too. However, while having HS may increase the chance for certain pregnancy related problems, it does not mean that if you have HS something will happen. We are still learning a lot about HS and pregnancy.

What do we know about HS medications in pregnancy?

Some people may not need any treatment during pregnancy or may be able to pause certain medications. Others may need ongoing therapy to  manage and treat their HS symptoms. For some people, the potential benefits of treatment may outweigh the risks of using medication. In addition to  reduce inflammation, treating HS in pregnancy may help improve comfort for some people and might reduce pain or lower the chance of infections.

Thinking about treatments during pregnancy can feel confusing, especially when your symptoms change. For me, because I had no flares in my first two pregnancies and required no treatment, I felt very nervous when my breakouts increased during my third pregnancy. Yes, I was in pain and uncomfortable every time I walked, but that wasn’t what was worrying me most. I was anxious about the stress HS was placing on my body and how constant inflammation might affect my baby. It was the first time pregnancy made me feel unsure about what my own body might do next. I needed to make decisions about the best course of treatment, and that felt overwhelming at first. The good news is that I didn’t have to make those decisions alone. With the help of my healthcare providers, and resources available at MotherToBaby, we talked through what was known about my treatment options and what made the most sense for my HS and made me more confident in my pregnancy.

Some of the treatments options we discussed included topical antibiotics, such as clindamycin, and antiseptic washes, such as chlorhexidine or diluted bleach baths. Based on available data, using washes and antibiotics on the skin is not known to increase risks to a pregnancy because most of the medication is not well absorbed into the bloodstream, where it could reach the baby. Small amounts of corticosteroids may be injected directly into inflamed bumps to help calm down painful flares. When a corticosteroid is injected into the skin, it primarily stays in that area, and very little of the medication enters the bloodstream.

Antibiotics taken by mouth (oral antibiotics) are sometimes used to help manage HS symptoms or treat suspected infections. The antibiotics most often used to manage HS symptoms, cephalexin (Keflex) and clindamycin, are not expected to increase the chance for pregnancy complications or birth defects when they are used as prescribed. Some other antibiotics, however, have been associated with certain pregnancy-related complications.

People with HS may also use medications called biologics, which target the inflammation caused by HS. These may include medications such as adalimumab (Humira), secukinumab (Cosentyx), and bimekizumab (Bimzelx). Some biologics, like adalimumab, have been used to treat other inflammatory or autoimmune conditions in pregnancy and have been very reassuring. For newer biologics such as secukinumab and bimekizumab, we don’t have as much information yet. Because antibiotic or biologic choices can vary based on your HS symptoms, you can always contact MotherToBaby to talk through what is known about a specific medication.

Other things that can also make a big difference for some pregnant women, especially as your body changes, include wearing loose, breathable clothing, minimizing friction in skin folds, using gentle non‑scrubbing body soaps, changing out of damp or sweaty clothing as soon as possible, and trimming (not shaving) in areas that are more sensitive to HS. Some healthcare providers may also recommend taking an extra zinc supplement.

Even if you take medication and follow all these steps, you may still experience HS flares in pregnancy. That is not your fault. HS is a long-term condition, and pregnancy can add new layers to how it feels day to day. But you don’t have to navigate it alone. I didn’t either. Understanding how HS and pregnancy interact, along with having reliable resources like MotherToBaby, may give you comfort and confidence throughout your pregnancy. Your experience matters, and so does feeling supported during it.

What can you do to help us understand more about HS and pregnancy?

We continue to learn about the relationship between HS and pregnancy to better support pregnant women and their babies. If you are pregnant and living with HS, your experience matters. MotherToBaby is currently enrolling participants in a study on HS in pregnancy, and your story could help us learn more. Participation is simple, completely confidential, and can be done from home. You can learn more at:
https://mothertobaby.org/ongoing-study/hidradenitis-suppurativa/

HS Resources:

1. HS Connect at https://hsconnect.org/
2. HS Foundation at https://www.hs-foundation.org/

References:

1. Chen YN, Shen CH, Tai CC, Wang TY, Chi CC. Adverse pregnancy outcomes among pregnant women with hidradenitis suppurativa: a systematic review and meta-analysis. Clin Exp Dermatol. 2026 Mar 26;51(4):578-586. doi: 10.1093/ced/llaf515. PMID: 41268934.
2. Ghanshani R, Lee K, Crew AB, Shi VY, Hsiao JL. A Guide to the Management of Hidradenitis Suppurativa in Pregnancy and Lactation. Am J Clin Dermatol. 2025 May;26(3):345-360. doi: 10.1007/s40257-025-00935-x. PMID: 40131719;
3. Rivin GM, Fleischer AB Jr. Women of Childbearing Age With Hidradenitis Suppurativa Frequently Prescribed Medications With Pregnancy Risk. J Drugs Dermatol. 2023 Jul 1;22(7):706-709. doi: 10.36849/JDD.6818. PMID: 37410037.

Disclaimer from the author: Artificial intelligence tools were used for proofreading, grammar refinement, and development of the title

The runs, the trots, the green apple quickstep. You have heard all the nicknames for it, but even hearing something as cute as “bubble guts” does not make diarrhea any better, especially during pregnancy or breastfeeding.

Just last week, I got a call from someone in a panic: “Leah, it is really bad. I am so uncomfortable. I thought you were supposed to get constipated during pregnancy.”

That caller was not wrong – constipation can be common during pregnancy. Hormones like prostaglandins – which help signal to your intestines that it is time to move things along – tend to slow down during pregnancy. Even still, constipation does not always happen.

Food poisoning, viral illnesses (like COVID-19), and chronic conditions (like IBS or Crohn’s disease) can all cause diarrhea, even during pregnancy or breastfeeding. No matter where it comes from, everyone asks the same question, “How do I make this stop?” Before we answer that question, let us talk about what is really going on when you have diarrhea.

Diarrhea: What is Actually Going On?

What makes diarrhea different from your regular poops? Diarrhea is when you have loose or watery stools (poops). Diarrhea can look brown, but it can sometimes look yellow, mucous-y, or mostly clear. Some other symptoms of diarrhea can include abdominal cramping, feeling the urge “to go,” or gas. Diarrhea can be caused by lots of different things. Sometimes, diarrhea can be caused by food or drinks (such as food poisoning, contaminated water, or allergies to food products like lactose). Diarrhea can also be caused by other conditions (such as viral infections, conditions that affect the GI system, or medications). When you have diarrhea, your body gets rid of water and electrolytes much faster than usual. It is always important (but especially when you have diarrhea) to wash your hands for at least 20 seconds with soap and water after going to the bathroom. This helps prevent the spread of infections.

What Does That Mean if I am Pregnant or Breastfeeding?

One of the main concerns with diarrhea is the risk of dehydration. If you are severely dehydrated during pregnancy, this can increase the risk of some pregnancy-related issues, like oligohydramnios (not enough amniotic fluid). If you are severely dehydrated while breastfeeding, this can lower the amount of breastmilk that you produce. Yellow or dark urine, being unable to urinate, feeling dizzy or faint, and feeling thirsty are some signs of dehydration. Typically, rehydration includes giving yourself more water and more electrolytes to replace the water and electrolytes that you lost from the diarrhea. If you are experiencing dehydration, you should check with your healthcare team about what you can do to rehydrate yourself.

Over-The-Counter Options

Over-the-counter medications might be a helpful way to treat diarrhea, depending on the situation. Let us explore what we know about the common over-the-counter antidiarrheal medications: loperamide (Imodium) and bismuth subsalicylate (Pepto-Bismol). For more information on these types of medications, or any others, contact a specialist at MotherToBaby.

Loperamide

Loperamide is a common over-the-counter antidiarrheal. Loperamide works by attaching to certain receptors in your intestines to say, “please don’t move things along so much.” Taking loperamide slows the movement in your intestines, which slows down how often you have a bowel movement.

When you take loperamide as directed, most of the medication stays in your intestines and it is not expected that you would absorb a lot of the loperamide into your bloodstream where it can then reach the baby. Loperamide, however, is not well-studied in pregnancy and it is not known if taking loperamide as directed during pregnancy changes the chance of miscarriage or pregnancy-related issues, like preterm delivery (birth before week 37) or low birth weight (weighing less than 5 pounds, 8 ounces at birth). One study showed that taking loperamide during the first trimester of pregnancy might increase the chance of birth defects and another study did not find an increased chance.

Because there is not a lot of information about using loperamide during pregnancy, you and your healthcare provider may need to decide what’s best for you. Treating diarrhea is important especially to prevent dehydration, but it is also important to consider the limited information we have about this medication in pregnancy.

Loperamide does pass into breastmilk. If you decide to take loperamide while breastfeeding, your infant will get a very small exposure. It is not expected that exposure to loperamide through breastmilk will lead to side effects in the infant.

Bismuth Subsalicylate

Bismuth subsalicylate is another over-the-counter medication that is commonly used for diarrhea.  Some common names for bismuth subsalicylate are Pepto-Bismol, Kaopectate, and BisBacter. Bismuth subsalicylate works by slowing prostaglandins down (which helps to lower inflammation and slow intestinal movements) and encouraging your body to reabsorb water from the intestines (which helps make bowel movements less watery). Bismuth subsalicylate turns into two components in the body: bismuth and salicylate.

Most of the bismuth stays in your intestines and it is not expected that you would absorb a lot of the bismuth into your bloodstream where it can reach the baby.

However, salicylate can be absorbed into your bloodstream. Taking something that has salicylate in it during pregnancy (like bismuth subsalicylate or NSAIDS, like aspirin or ibuprofen), can cause problems with how the baby’s heart works or how baby’s kidneys work which may cause oligohydramnios (not enough amniotic fluid around the baby) and poor lung development. It may also cause bleeding concerns for you.  Because of this, it is generally recommended to avoid any medications that have salicylate in them, especially in the second and third trimester of your pregnancy.

If you take something that has salicylate in it while breastfeeding (like bismuth subsalicylate or NSAIDS, like aspirin or ibuprofen), some salicylate will most likely be present in your breastmilk. There is concern about giving salicylate directly to an infant. Infants tend to metabolize (or process) salicylate slower than adults do. Reye’s syndrome, a rare condition involving brain swelling and liver damage, can happen if an infant is recovering from a viral infection and is exposed directly to salicylate.

For more information on bismuth subsalicylate, check out our “Managing Tummy Troubles During Pregnancy” blog.

The Bottom Line – No Pun Intended

Diarrhea is uncomfortable, exhausting, and when you are pregnant or breastfeeding, often stressful on a whole new level. You should not have to choose between feeling better and worrying about your baby.

Staying hydrated is always a priority, but when symptoms don’t improve, medications might be helpful, depending on your situation. As always, if you notice any changes in your body during pregnancy or in your infant during breastfeeding (like an increase in stools, or a change in color or consistency of stools), you can reach out to a healthcare provider for guidance on what to do next.

And remember, if you ever feel unsure about an exposure, medication, or symptom during pregnancy or breastfeeding, you don’t have to figure it out alone. Evidence-based guidance can bring peace of mind — even on the days your stomach has other plans. Contact a MotherToBaby specialist to talk to someone about your concerns.

Good luck and I hope your tummy feels better soon!

References

https://www.acog.org/womens-health/faqs/problems-of-the-digestive-system

https://www.acog.org/womens-health/faqs/morning-sickness-nausea-and-vomiting-of-pregnancy

By MotherToBaby and experts from the Centers for Disease Control and Prevention (CDC)

At 16 weeks pregnant, Maria is busy planning a summer trip for her family. But lately, every time she opens her phone, she sees another headline about measles outbreaks.

It makes her pause and wonder: What does this mean for me and my baby?

What is measles, and why are people worried about it?

Measles is a highly contagious virus that spreads through the air when someone who is sick with measles coughs or sneezes. Since measles spreads so easily, up to nine out of 10 unvaccinated people who come into close contact with someone who has measles will become infected.

Symptoms often include high fever, cough, runny nose, red eyes, and rash. Measles can lead to serious health complications and severe illness. During 2025, about 1 in 10 people with measles were hospitalized.

In recent years, the United States has seen a rise in measles cases. In the past, measles has mostly affected children, but there are also recent increases among people of reproductive age. In 2025, nearly a third of measles cases (1 out of 3) were in adults 20 years of age or older. So far in 2026, nearly a quarter of measles cases (1 out of 4) have occurred in adults. This trend is one reason Maria may feel especially worried.

Why is measles infection concerning during pregnancy?

When you are pregnant, your body changes in many ways. These changes can increase your chances of getting sick from infections during pregnancy.

For example, if you are pregnant and get measles, you have a higher chance of:

• Being hospitalized
• Developing pneumonia
• Rarely, death

Measles during pregnancy can also increase the chance of health problems for the baby, such as:

• Pregnancy loss (including miscarriage or stillbirth)
• Preterm birth
• Low birthweight

Measles can also pass from mother to baby if an infection happens during pregnancy. This can cause serious illness in newborns, hearing loss, and—very rarely—a fatal brain condition called subacute sclerosing panencephalitis, or SSPE, years later.

Even after birth, measles can be dangerous for babies who are too young to get vaccinated against measles.

How can I protect myself and my baby from measles?

This was Maria’s main question as she started planning her trip. When she talked with her healthcare team, she learned that the MMR (measles-mumps-rubella) vaccine is the best protection against measles. Luckily, Maria had received this vaccine when she was younger. 

If you are not up to date with vaccinations, the ideal time to get the MMR vaccine is at least one month before becoming pregnant. The MMR vaccine is not recommended during pregnancy. However, it can be given after delivery, even while breastfeeding.

If you are not sure whether you have immunity against measles, talk with your healthcare provider. MotherToBaby has a tool to help you start the conversation.  While it is important to weigh the risks and benefits of any vaccine with your healthcare provider, serious reactions from MMR vaccination are rare.

After delivery, when you start taking your baby to their well-child visits, talk with your baby’s healthcare provider about the MMR vaccine and ask any questions you may have. Starting conversations early can help you feel confident when it is time for your baby to get vaccinated.

What should I do if I am planning to travel soon or live in an area with a current measles outbreak?

This was also a key question on Maria’s mind. She brought it up with her healthcare provider, and together they talked about her vaccination status as well the status of others in her household. They also looked up the measles activity at her summer trip location and talked about watching for symptoms of measles for 21 days after travel. If you are pregnant, these are helpful steps to take.

If a measles outbreak is happening near where you live, follow local recommendations. Consider avoiding crowded public settings and avoid contact with people who are sick. Encourage people around you (partners, family members, caregivers) to be up to date on MMR vaccination to help protect you and your baby.

What should I do if I am exposed to measles while pregnant?

If Maria is exposed to measles during her trip, her first step would be to call her healthcare provider’s office right away. They can tell her what to do next and how to get into the office safely, if needed, to avoid exposing others.

For pregnant patients who are not immune to measles or do not know if they are immune, they could be given antibodies called immune globulin (IG) after a measles exposure. If you have measles during pregnancy, talk to your baby’s healthcare provider about IG, which might also be recommended for your newborn.

What if I develop symptoms of measles while pregnant?

If you develop a fever and rash, especially if you live in an area with measles or have recently traveled, call your healthcare provider right away, and they can provide further instructions. Be sure to tell them if you have received the MMR vaccine before and where you have traveled.

A few key points:

• Fever in early pregnancy can pose risks, especially if it lasts for a long period of time. Talk with your healthcare provider about how best to treat your fever with fever-reducing medications.
• Taking extra Vitamin A is not recommended during pregnancy because high doses can increase the chance of certain birth defects.

What should I know if I am breastfeeding?

Measles is not spread through breast milk, and infants can receive breast milk from a mother with measles infection. Follow guidance from your healthcare team on precautions, which may include staying away from nonvaccinated people, expressing breast milk, and having a person who is not sick feed your infant your breast milk. Or, they may recommend you wear a mask and practice careful hygiene when breastfeeding and caring for your newborn.

If you are pregnant or breastfeeding and unsure about your immunity to measles or worried about exposure, you are not the only one with these questions. As with Maria, your healthcare provider and MotherToBaby are here to help answer any questions you may have.

References

1. Joseph, NT. Measles in Pregnancy: Clinical Considerations and Challenges. Obstetrics & Gynecology 147(1):p 44-53, January 2026. | DOI: 10.1097/AOG.0000000000006126:
2. Rasmussen, SA; Jamieson, DJ. What Obstetric Health Care Providers Need to Know About Measles and Pregnancy. Obstetrics & Gynecology 126(1):p 163-170, July 2015. | DOI: 10.1097/AOG.0000000000000903
3. Congera P et al. Measles in pregnant women: A systematic review of clinical outcomes and a meta-analysis of antibodies seroprevalence. Journal of Infection 80(2):p152-160, February 2020. | DOI: 10.1016/j.jinf.2019.12.012

Disclaimer: The contents of this post are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention. Reference to any third party, company, or product is intended for factual information only and does not indicate any form of endorsement or approval from CDC, or the U.S. Department of Health and Human Services.

Is it a cold? The flu? Or is it COVID-19? Either way, it is miserable.

It is Friday afternoon. You are pregnant, or actively planning, and you wake up with a scratchy throat, pressure in your nose and forehead, and runny nose. You think you have a cold… or is it the flu or COVID-19? You have left a message with your healthcare provider to ask them about what to do and what medication you can take. You are worried about taking the wrong medication. As the hours pass, you think it is unlikely that you will be able to get in touch with them before the end of the workday. Now, you are worried about going into the weekend without medication.

What to do? First, try to figure out if it is a cold, flu, or COVID-19. Some healthcare providers may share instructions for this situation and/or give their pregnant patients a list of medications that they approve for common medical conditions. When this list is not provided, many pregnant women contact MotherToBaby specialists for help. Although MotherToBaby specialists cannot make specific medication recommendations, we can provide information on most medications based on the studies and how the drugs work.

Is It a Cold?

A cold is caused by one of more than 200 viruses. Colds can spread easily from person to person. Symptoms can include sore throat, runny or stuffy nose, sneezing and coughing, headache, and muscle aches. For healthy pregnant women, an infection with a cold is not associated with a higher risk to her or her developing baby. There is no testing for a cold. Generally, colds are treated with over-the-counter medications.

Is it the Flu?

Influenza, often called “the flu,” is an illness caused by a virus. Flu symptoms include fever (typically between 100°F to 104°F), chills, cough, sore throat, body aches, and tiredness. Pregnant women and their pregnancy are at higher risk from flu. Testing for flu is available in the doctor’s office and at some pharmacies. Antiviral medications are recommended for pregnant women even if the testing has not been completed due to the risks from flu.

Is it COVID-19?

COVID-19 is caused by the SARS-CoV-2 (virus). The symptoms of flu and COVID-19 are similar. Symptoms include fever, cough, shortness of breath, sore throat, body aches, headache and change of taste or smell. Some people may have symptoms that last a short time and others may get very sick. Pregnant women and their pregnancy are at higher risk from COVID-19 infection. Testing for COVID-19 is available over the counter. Medication is recommended by health organizations for pregnant women with COVID-19.

Fever

In adults, a fever is a temperature of 100.4°F (38°C) or higher. Most healthcare providers recommend acetaminophen to treat fever, headache, and body pain in pregnancy. Studies on acetaminophen use during pregnancy have not shown a higher risk to the developing baby when it is used as directed for a short time.

A high fever that is untreated in pregnancy increases the chance of birth defects. A temperature of 101°F that lasts for over 24 hours early in pregnancy may increase the risk for a birth defect of the spine. You can read more about fever at https://mothertobaby.org/fact-sheets/hyperthermia-pregnancy/.

Over the Counter and Self-care Treatments

Pharmacies have rows of cough and cold products. In pregnancy, it is best to take an alcohol-free medication that contains only those ingredients that address the specific symptoms. For example, if the only symptom is body aches, taking a multi-symptom medication for congestion, cough and body aches would mean unnecessarily exposing yourself and the developing baby to medications.

Below we review some over-the-counter cold treatments and self-care treatments. The options below do not cover all treatments and should not be considered a recommendation. Ideally, it is best to always discuss your symptoms with your healthcare provider, because they know you best and can take into account any unique health issues that you may have.

Medication for Cough

Because many cough syrups can contain up to 10% alcohol, it is important to select an alcohol-free cough syrup. Cough syrups may also contain ingredients for stuffy nose or pain. If the only issue is a cough, taking the medication with the least ingredients is preferred to minimize the exposure to the pregnancy.

Cough drops and throat lozenges can contain flavorings such as honey, menthol, or anesthetics to numb the throat. There is no warning about using these during pregnancy for cough or a sore throat.

Vitamin C and other vitamins are taken during a cold or for cold prevention. During pregnancy, it is recommended to limit vitamins to those in the prenatal category unless recommended by the healthcare provider. Vitamins, like medications, cross the placenta and expose the developing baby which does not have a need for higher doses and in some cases, could be harmful.

Tea and Honey

Honey and warm tea may be helpful in relieving a sore throat caused by coughing and may thin mucus so that the cough is more productive. There is no warning about eating honey in tea, toast, or any other food during pregnancy. Herbal tea does not have caffeine and if taken as a beverage, there is no warning. Black tea, green tea, and white tea may have caffeine. If taking tea with caffeine, it is important to read the label to learn about the amount of caffeine per cup. Pregnant women can have up to 200 mg of caffeine per day from all sources combined. If drinking decaf tea, there is no warning to pregnant women.

Medications for Nasal Congestion

A stuffy nose can cause painful sinuses and make it less enjoyable to eat and hard to sleep. Over-the-counter nasal decongestant choices fall into two categories: oral (pills by mouth) or nasal spray. Some oral decongestants are pseudoephedrine and phenylephrine. Nasal sprays may contain phenylephrine, oxymetazoline, or steroid medications. Taking an oral decongestant means that your developing baby will be exposed to the medication. Nasal sprays reduce the chance of exposure to your baby, depending on the frequency of use and dose. Always read the labels and take them as directed.

Nasal Congestion: Non-medication Options

Nasal irrigation (bulb syringe, squeeze bottle, or neti pot): Studies of nasal irrigation have not shown a proven benefit on the duration or severity of colds. However, some people who have used nasal irrigation have reported feeling better. For pregnant women, the most reassuring part is that it uses only water and saline, so there is no medication involved and no exposure to the pregnancy. It is important to use only previously boiled, distilled, or sterile water to irrigate; and to keep nasal irrigation equipment clean and sterilized to avoid the risk of infection.

Shower tablets/vaporizers: Shower vapor tablets have become popular because they might help clear stuffy noses for a short time. These tablets are placed on the shower floor and as the warm water reaches the tablet, it dissolves and makes a steam with a vaporizer-like effect. Most shower tablets ingredients include sodium carbonate, sodium bicarbonate (baking soda), and essential oils (such as peppermint, rosemary, eucalyptus, and lavender). There are no studies on the use of shower tablets during pregnancy, but essential oils are used in many candles, lotions, and other home products, so exposure to these oils is common. With use as directed, it is not expected that the ingredients in shower tablets would increase the chance for problems during pregnancy.

Humidifiers: Humidifiers are used to add moisture to the air and provide relief from sinus pressure, dry skin, and throat. They use only water so there is no medication exposure. It is important to keep humidifiers clean to avoid the risk of putting mold and bacteria into the air, which could then cause allergies.

Nasal strips: Nasal strips are marketed to people who have a hard time sleeping due to snoring, but they also claim to help with congestion from colds. Although there are no studies that show these products help with colds, there is some evidence that they may help with snoring by spreading the nose and widening the air passage. Nasal strips do not contain medication, so there is no concern about their use during pregnancy.

Electric Blankets and Heating Pads: Electric blankets are sometimes used by people with body chills from having the flu or a cold. Electric blankets produce heat that varies from 86°F (30°C) to 122°F (50°C), which can be comforting. However, there is some concern about the heat from use of electric blankets in early pregnancy, raising body temperature and increasing the risk of birth defects of the spine. However, the studies on electric blanket use during pregnancy have some problems and not all have shown problems in pregnancy. As the studies are unclear, pregnant women may want to avoid the higher heat for peace of mind.

Remedies to Avoid

Vitamin C and zinc: When you feel a cold coming on, you could be tempted to reach for vitamin C and zinc. This is not recommended during pregnancy. First, there is not enough evidence that vitamin C or zinc help in preventing or treating colds. Second, the doses of vitamin C and zinc in supplements for colds are higher than recommended doses for pregnant women. The recommended vitamin C dose is 80 mg for pregnant teens and 85 mg per day for pregnant adults. The recommended dose for zinc is 12 mg for pregnant teens and 11 mg per day for pregnant adults. If you are taking prenatal vitamins, it is likely that they contain the vitamin C and zinc that you need for the day.

Non-steroidal anti-inflammatory drugs (NSAIDs): For most healthy pregnant women, over-the-counter pain relievers such as ibuprofen, naproxen, and aspirin are generally not recommended during pregnancy. NSAIDs are associated with a risk for premature closure of the ductus arteriosus (a heart and lung condition) in the baby if the medication is used at higher doses in the second half of pregnancy. Although low dose aspirin is sometimes recommended in pregnancy under a doctor’s supervision to treat or prevent specific medical conditions, regular strength aspirin and other NSAIDs are not typically recommended for treating pain or fever in pregnancy.

Herbal products: Many herbal supplements marketed for treating colds and flu have not been studied in pregnancy, so the possible risks are not known. In addition, the benefits of using herbal supplements are not always proven. For example, echinacea has been promoted as a cold remedy, but a review of over 24 studies with over 4,000 participants did not find that it shortened the number of days for a cold compared to people who did not take echinacea.

Prevention

Vaccination is key and the best tool that we have for preventing flu and COVID-19 or reducing the severity of the symptoms if you do get infected. Studies involving many thousands of pregnant women have not shown a higher risk of birth defects or complications. MotherToBaby has fact sheets with information on both the flu vaccine and COVID-19 vaccine.

References:

Botto LD, Lynberg MC, Erickson JD. (2001). Congenital heart defects, maternal febrile illness, and multivitamin use: A population-based study. Epidemiology. 12:485-90.

Centers for Disease Control and Prevention. (2025). Treating Flu with Antiviral Drugs. Retrieved from https://www.cdc.gov/flu/treatment/antiviral-drugs.html

Centers for Disease Control and Prevention, NIOSH Science Blog, April 9, 2020. Respiratory Protection During Outbreaks. Retrieved from https://blogs.cdc.gov/niosh-science-blog/2020/04/09/masks-v-respirators/

Chambers CD, Johnson KA, Felix RJ, Dick LM, Jones KL. (1997). Hyperthermia in pregnancy: a prospective cohort study. Teratology. 55:45.

Hubner, N-O., Hubner C., Wodny M., Kampf G., Kramer A. (2010). Effectiveness of alcohol-based hand disinfectants in a public administration: Impact on health and work performance related to acute respiratory symptoms and diarrhea. BMC Infectious Diseases. Retrieved from http://www.biomedcentral.com/1471-2334/10/250

Karsch-Völk, M., Barrett B., Kiefer D., et al. (2014). Echinacea for preventing and treating the common cold. The Cochrane Database of Systematic Reviews. 2014(2):CD000530.