Morning Sickness

Morning sickness is the nauseated feeling that many women get during the first trimester of pregnancy.  Morning sickness can be, but is not always, accompanied with vomiting.  It usually starts out in the morning and wears off as you become active throughout your day, but it can actually occur at any time of the day.

Many health care providers believe morning sickness is a good sign because it means the placenta is developing well.

Incidence; Causes and Development

More than half of all pregnant women experience morning sickness.  Most pregnant women have at least some nausea, and about a third have vomiting.

The nausea is often a result of the increased hormone levels that result from pregnancy.  The exact cause of morning sickness is not known; it may be caused by hormonal changes or lower blood sugar during early pregnancy.  Emotional stress, traveling, or some foods can aggravate the problem.

Signs and Symptoms

Nausea and vomiting can be one of the first signs of pregnancy and usually begins around the 6th week of pregnancy.  It can occur at any time of the day, and for most women it seems to stop around the 12th week of pregnancy although it can last until the 14th or 16th week.

Diagnosis and Tests

Diagnostic tests that may be performed include blood tests (including CBC and blood chemistry) and urine analysis for ketones and to determine severity of dehydration.

Treatment and Prevention

Recommendations:

• In the Morning

  • Allow yourself plenty of time to get out of bed – set your alarm an hour early
  • Put something in your stomach as soon as you wake up, such as crackers, dry toast or dry cereal
  • Get out of bed slowly

• During the Day

  • Eat small meals throughout the day to avoid getting too full or too hungry
  • Drink small amounts of fluids during the day to avoid dehydration
  • Nap during the day

• Eating and Drinking

  • Eat small meals often
  • Drink fluids ¹⁄₂ hour before or after a meal, but not with meals
  • Eat whatever you feel like eating, whenever you feel you can.  Trust your cravings!
  • Ask someone else to cook for you and open the windows or turn on fans if the odor bothers you
  • Sniff lemons or ginger, drink lemonade, or eat watermelon to relieve nausea
  • Eat salty potato chips (they have been found to settle stomachs enough to eat a meal)
  • Try cold foods, bland foods and anything that sounds good to you
  • Eat foods high in protein and complex carbohydrates, such as peanut butter on apple slices or celery; nuts; cheese; crackers; milk; cottage cheese; or yoghurt
  • For snacks, try lemons (eat, suck or sniff), anything made with ginger (soda, candy, tea, jam, etc.), peppermint tea, crackers, flavored popsicles, pretzels.
  • Avoid foods high in fat and salt, but low in nutrition
  • Do not lie down after eating
  • Do not skip meals
  • Do not cook or eat spicy or greasy food
  • Do not take a nap right after a meal.  This can cause nausea to be worse.

• Evening and Nighttime

  • Go to bed early!  You need your rest.
  • Have a small snack at bedtime
  • Take your prenatal vitamins at night
  • If you wake up in the middle of the night, try to eat something

• In General

  • Get plenty of rest
  • Avoid warm places (feeling hot adds to nausea)
  • Exercise
  • Keep rooms well-ventilated to reduce odors
  • Avoid smoking and second-hand smoke
  • Avoid taking medications for morning sickness.  If you do, consult a doctor first.

Hyperemesis gravidarum is a condition characterized by severe nausea, vomiting, weight loss, and sometimes electrolyte disturbance.  Mild cases are often treated with dietary measures, rest and antacids.  Severe cases often require a stay in the hospital so that the mother can receive fluid and nutrition through an intravenous line.  DO NOT take any medications to solve this problem without consulting your health care provider first.

Prognosis; Complications; Seek medical attention if...

Morning sickness is not harmful to you or your baby, but if you experience excessive vomiting and cannot keep your food down, you may have hyperemesis gravidarum.  Hyperemesis gravidarum can be harmful to you and your baby if severe and left untreated, due to the possible lack of nutrients and electrolyte imbalance.  The degree of morning sickness during one pregnancy does not predict how you will feel in future pregnancies.

Morning sickness does not hurt the baby in any way unless persistent weight loss occurs, such as with the severe vomiting of hyperemesis gravidarum.

Inform your health care provider if symptoms of Hyperemesis gravidarum appear and discuss possible options for treatment.  Specifically:

• If you are experiencing excessive nausea and vomiting that prevents you from keeping any food down
• If you vomit more than 3 times per day
• If vomiting is accompanied by pain or fever
• If nausea and vomiting persists well into the second trimester (after 16th week.)  This happens to some women and is usually normal, but have it checked out.
• If you vomit blood or material that looks like coffee grounds.  (Call IMMEDIATELY)
• You lose more than 2 pounds in weight