The vast majority of pregnant women have some form of nausea and or vomiting in pregnancy, also known as morning sickness. If you have a mild case of nausea and vomiting, some relatively simple changes to your diet may be enough to help. In some cases the symptoms are so severe that you need to see your obstetrician.
What is morning sickness?
“Morning sickness” is the term often used to describe mild nausea and vomiting in pregnancy, while “hyperemesis gravidarum” is the term used to describe a more severe condition. Hyperemesis may cause you to vomit multiple times throughout the day, lose weight, and usually requires treatment in the hospital.
Morning sickness (nausea and vomiting) often develop by five to six weeks of pregnancy. The term morning sickness is misleading as symptoms can occur at other times of the day. The symptoms are worst around nine weeks, and typically improve by 16 to 18 weeks of pregnancy. In some patients symptoms can continue until the third trimester in 15 to 20 percent of women, and until delivery in 5 percent of women.
What causes morning sickness?
The cause of pregnancy-related nausea and vomiting is not clear. Several theories has been proposed, although none have been definitively proven. Increased hormone levels, slowed movement of the stomach’s contents, and psychological factors are among the more common theories. Interestingly, women with mild nausea and vomiting during pregnancy experience fewer miscarriages and stillbirths than women without these symptoms.
What can you do about morning sickness?
There are many things a pregnant woman can do if she has morning sickness. The following might prove helpful:
Eat small, frequent meals
Eat small, frequent meals and snacks throughout the day so that your stomach is never empty. Some women find that carbohydrates are most appealing when they feel nauseated, but high-protein foods are more likely to help ease nausea, so add something like chicken breast to your diet.
Use snacks
Keep simple snacks such as crackers on hand, by your bed, or ask your husband to get some for you. When you first wake up, nibble a few crackers and then rest for 20 minutes before getting up. Snacking on crackers may also help you feel better if you wake up nauseated in the middle of the night.
Decrease the use of fatty foods
Fatty foods take longer for your system to digest, and are therefore more likely to irritate your digestive system. The same applies to rich, spicy and acidic foods. So avoid these foods as much as possible.
Use more bland foods
Try to avoid foods and smells that trigger your nausea. If that seems like almost everything, it is okay to eat the few things that do appeal to you for this part of your pregnancy, even if they do not add up to a perfectly balanced diet. Cravings are common at this time. Most men who have children know about this.
Try some ginger tea
I am sure your grandmother told you that ginger will help your nausea, and she was right. Grate some root ginger into hot water and sip it slowly to help ease the nausea. Do not use it too strong, and avoid excessive use of ginger as well.
Decrease the use of iron tablets in the first few weeks of pregnancy
You might want to ask your doctor if he/she can suggest prenatal vitamins with a lower dose of iron for your first trimester, as this mineral can be hard on your digestive system, and can make the nausea worse. In fact some obstetricians avoid all prenatal tablets and iron tablets in the first twelve weeks of pregnancy especially if the woman is healthy and not anaemic.
Avoid using fluids with meals
Do not use fluids with your meals. Instead use fluids between meals. Be sure to keep your intake of fluids up, and do not drink too much at one time, that your stomach feels full, as that will make you less hungry for food. A good strategy is to sip fluids frequently throughout the day.
When to see your doctor?
All pregnant women should see their health care provider ideally in the first trimester (twelve weeks of pregnancy) or before if they have a medical disorder.
Some women, especially those with mild to moderate nausea and/or vomiting, do not need to see a healthcare provider for treatment. If your symptoms cause dehydration then you should see your doctor as soon as possible. The suggestions above may help to reduce symptoms and prevent dehydration.
Women with more severe nausea and vomiting sometimes need to be evaluated by their obstetrical doctor or nurse. I encourage all pregnant women to seek help if they have one or more of the following:
? Signs of dehydration, including infrequent urination, dark-coloured urine, or dizziness while standing
? Vomiting repeatedly throughout the day, especially if you see blood in the vomit
? Abdominal or pelvic pain or cramping
? If you are unable to keep down any food or drinks for more than 12 hours
? You lose more than 5 pounds (2.3 kg)
Treatment
Treatment of morning sickness will depend on its severity. Your obstetrician might prescribe certain medications if symptoms are very severe. Medications that reduce nausea and vomiting are effective in some women and are safe to take during pregnancy. Make sure you talk with your healthcare provider before taking any new over the counter or prescription medications, including nutritional and herbal supplements for the treatment of morning sickness.
If you are unable to hold down food or liquids, you may be treated with intravenous (IV) fluids. This may be done in your doctor’s office or in the hospital, depending upon the severity of your vomiting.
Most women with pregnancy-related nausea and vomiting recover completely without any complications. Women with mild to moderate vomiting often gain less weight during early pregnancy. This is rarely a concern for the baby unless the mother was very underweight before pregnancy (at least 10 percent under the ideal body weight).
Conclusion
Many women have morning sickness (nausea and sometimes vomiting) during the first twelve weeks of pregnancy. In fact this might be the first sign of pregnancy for many women. The term “morning sickness” can be misleading because symptoms can occur at any time of the day. The causes of morning sickness are not fully understood, but hormone changes that occur during pregnancy may play a role.Morning sickness usually goes away as a pregnancy progresses. In some women the symptoms might persist for many more weeks, and in others the symptoms might become more severe. You may be able to gain some relief from morning sickness using home treatment. Talk to your doctor about safe medicines to treat your nausea and vomiting in pregnancy.
Ask Your Doctor is a health education column and is not a substitute for medical advice from your physician. Dr Brett Hodge is an Obstetrician/Gynaecologist and Family Doctor who has over thirty years in clinical practice. Dr Hodge has a medical practice in the Johnson Building in The Valley.
