Why pregnancy changes the plan
Changes in the immune system, heart, and lungs during pregnancy make severe flu more likely, even in people who are otherwise healthy.[1] CDC counts people who are pregnant or within 2 weeks after the end of a pregnancy as a higher-risk group.[2]
Treatment
- Call early. CDC recommends that pregnant people be treated quickly with an antiviral if they get flu symptoms, even if they had a flu shot.[1] Treatment is recommended as soon as possible for higher-risk groups, even after the first 48 hours.[3]
- Oseltamivir is preferred, at the same dose as for anyone else.[3]
- Baloxavir (Xofluza) is not recommended during pregnancy or while breastfeeding.[3]
- No test needed first. Treatment should not wait for a test result.[3]
Fever
Fever early in pregnancy raises the chance of birth defects and other problems. Acetaminophen (Tylenol) can bring a fever down, but call your clinician too.[1]
In September 2025 FDA began a label change about a possible link between acetaminophen in pregnancy and autism or ADHD, while noting that a causal relationship has not been established.[8] ACOG responded that untreated fever and pain can be harmful in pregnancy and that acetaminophen remains an important and safe option.[7] Talk with your prenatal care team about any questions.
Avoid ibuprofen at 20 weeks or later unless a doctor specifically tells you to take it.[9] More on symptom relief.
Breastfeeding
- You can keep breastfeeding with flu. Breast milk remains the recommended food for your baby.[4]
- Wash your hands before touching the baby or anything the baby will touch, and wear a mask to reduce spread. If you express milk, have a healthy caregiver feed it if possible.[4]
- Oral oseltamivir is the preferred antiviral while breastfeeding. Very little passes into breast milk, and side effects in the baby are unlikely.[4][5]
Vaccination
- Get a flu shot in any trimester. Use the injectable vaccine, not the nasal spray.[6][1]
- Flu shots have been given to millions of pregnant people over more than 50 years with an excellent safety record.[6]
- Vaccination in pregnancy helps protect your baby from flu for the first several months after birth, when the baby is too young to be vaccinated. Antibodies also pass through breast milk.[6]
- If your baby arrives before you are vaccinated, you still need the vaccine, and so does everyone who cares for the baby.[1]