Managing morning sickness

For many women, the toughest part of early pregnancy is morning sickness. If you are suffering from nausea, vomiting, or both, you need safe measures that will bring you some relief. Your best course of action for managing morning sickness is home treatment. By following a few proven guidelines, you are likely to gain significant relief from nausea and vomiting. Home treatment measures for morning sickness include:

• Changing what, when, and how much you eat.
• Taking ginger, vitamin B₆, or vitamin B₁₂, which are known to reduce nausea and/or vomiting during pregnancy.
• Avoiding foods and smells that make you feel sick.
• Trying acupressure, which seems to work for some women.
• Taking doxylamine with vitamin B₆, which you can buy without a prescription. Talk to your health professional before taking this remedy.

If you have severe, persistent nausea and vomiting, see your doctor or nurse-midwife immediately. This uncommon complication of pregnancy can lead to dehydration and malnutrition, sometimes requiring prescribed medication or hospitalization.

 What is morning sickness?
 Why use home treatment for morning sickness?
 How can I manage morning sickness at home?
 Where to go from here

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Morning sickness can range from mild, occasional nausea to severe, continuous, disabling nausea with bouts of vomiting. Symptoms may be worse in the morning, though they can strike at any time of the day or night.

Although its cause is poorly understood, morning sickness has been linked to increasing estrogen levels, along with other hormone changes during early pregnancy.¹

• The first signs of morning sickness usually develop during the month following the first missed menstrual period, when hormone levels increase.
• Women carrying twins or more have more pronounced hormone increases and tend to have more severe morning sickness.

There is no way of predicting how long your morning sickness will last, even if you have suffered through it before. Nausea and vomiting usually go away by 12 to 14 weeks of pregnancy. But in some cases, morning sickness can last well into a pregnancy.

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Morning sickness begins during the first trimester, when the fetus is vulnerable to developing birth defects. Therefore, during the first-trimester use home treatment to treat nausea and vomiting, unless your health professional recommends medicine to treat your symptoms.

If you have severe, persistent nausea and vomiting that is causing dehydration or weight loss, your health professional can prescribe a medication for you that is not known to cause fetal problems.

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The following are safe, proven treatments for morning sickness. However, few women gain complete relief from morning sickness treatment. Taking ginger or doxylamine is most likely to effectively curb nausea and vomiting.

• Doxylamine and vitamin B₆ (formerly Bendectin), taken according to your health professional's recommendation, is a safe and proven treatment for morning sickness.^{2, 3}
• Ginger, taken regularly as a powder in a capsule, grated fresh into hot water for a tea, or in syrup or crystallized form, can significantly relieve morning sickness after a few days of treatment.²
• Vitamin B₆ and B₁₂, taken regularly according to your health professional's recommendation, can reduce nausea and vomiting.
• Acupressure, firmly placed on the P6 point (the inner side of your arm, in line with your middle finger and one-sixth of the way between your wrist and elbow), relieves nausea for some women.

Follow these guidelines for minimizing nausea and vomiting during pregnancy.

• Keep food in your stomach, but not too much at once. An empty stomach can make nausea worse. Eat several small meals every day instead of three large meals.
• For morning nausea, eat a small snack (like crackers) before rising. Allow a few minutes for the snack to digest, then get out of bed slowly.
• Stay hydrated. Drink a lot of fluids. Try a sports hydration drink, as well as water, broth, or juice.
• Eat more protein, and cut your fatty food intake.
• Avoid smells and foods that make you feel nauseated. Citrus juice, milk, coffee, and caffeinated tea commonly make nausea worse.
• Avoid iron supplements, which can make nausea worse. These aren't necessary during the first trimester.
• Get lots of rest. Stress and fatigue can make morning sickness worse.

Contact your health professional immediately if you vomit more than 3 times a day or are unable to take fluids, especially if you also have pain, fever, or both.

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Now that you have read this information about morning sickness, you can take action toward curbing your symptoms. If you have any questions about home treatment or are considering using doxylamine, talk to your doctor or nurse-midwife.

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Citations

1. Cunningham FG, et al. (2005). Prenatal care. In Williams Obstetrics, 22nd ed., pp. 201–229. New York: McGraw-Hill.

2. Niebyl JR, Goodwin TM (2002). Overview of nausea and vomiting of pregnancy with an emphasis on vitamins and ginger. American Journal of Obstetrics and Gynecology, 186(5, Suppl): S253–S255.

3. McKeigue PM, et al. (1994). Bendectin and birth defects: 1. A meta-analysis of the epidemiologic studies. Teratology, 50(1): 27–37.