"Morning sickness" is the term commonly used to describe the nausea and vomiting that often occurs in early pregnancy. It is somewhat of a misnomer, as most women who suffer from this disorder experience these symptoms throughout the day. In most cases, the occurrence of nausea and vomiting is not a dangerous or threatening situation. In fact, people who experience morning sickness generally have better pregnancy outcomes than those who do not.
Evolutionary, the nausea and vomiting of early pregnancy probably developed as a means of protecting the unborn fetus. During the first 12 weeks of pregnancy, the fetus completely forms all of its major organ systems. By the 12th week of pregnancy, the unborn baby is virtually completely developed. It is during this time that potential toxins may cause birth defects. For this reason, the nausea and vomiting actually provides a protective benefit to the unborn baby. It is a defense mechanism for the baby passed down through the ages that prevents mothers from ingesting toxins that may cause birth defects. Seen in this light, morning sickness is a normal phenomenon that helps protect the unborn baby and helps prevent birth defects.
While morning sickness may be protective for the baby, it is obviously very uncomfortable for the mother. For this reason, appropriate measures can and should be taken to minimize maternal discomfort. One of the triggering events for vomiting is often abnormal smells. Pregnant women are hypersensitive to many smells. Even common and every day foods such as cheese, coffee, or citrus fruits may be extremely nauseating to a woman during her pregnancy. If one finds that this is the case, then these foods should be avoided. Eat what you can tolerate and avoid foods that you cannot tolerate.
It is also much more important to maintain fluid intake than it is to maintain an intake of solid foods. Pregnant women can go for a fairly prolonged period without taking in solid foods as long as they maintain their fluid intake. In addition, even minimal dehydration, can exacerbate symptoms of nausea. As such, it is important to make a conscious effort to increase your fluid intake. It is also a good idea to avoid foods (such as sodas) that contain caffeine. Caffeine is a mild diuretic and ultimately only results in further dehydration. A pregnant woman should aim to consume 12-18 tall glasses of fluid a day. However, a pregnant woman will often feel nauseated after drinking a single glass of fluid at one time. As a result, we recommend that a regimen of virtually constant sipping be employed. Rather than drinking a tall glass of fluid at once, it is better to consume that quantity over a course of an hour. Drinking small amounts constantly will minimize the distention of the stomach and prevent nausea. In addition, it is probably best to drink from a covered container through a straw. Drinking in this manner also minimizes any smell that may be associated with the fluid consumed. A pregnant woman who vomits three times a day, but constantly drinks throughout the day, will more than make up for the fluid loss suffered during the episodes of vomiting. She will prevent herself from becoming dehydrated, and she will be able to maintain her normal blood volume.
For those who truly do experience more nausea and vomiting when they first wake up in the morning, there are a couple of measures that can be taken to help alleviate this. Sleeping with the upper body propped up on several pillows will minimize any gastric reflux or esophagitis that may be contributing to the nausea. In addition, taking Mylanta or Tums to minimize the normal acidity in the stomach at bedtime will also help reduce irritation. In addition, keep some soda crackers or saltine crackers at the bedside and eat them immediately upon waking. An over-the-counter medication called Emetrol can also be used for the treatment of nausea in pregnancy. Emetrol can be used in the morning and throughout the day, as needed, to help alleviate these symptoms.
There is also a helpful product called "Sea-Bands" which is available in many marine supply stores. These are wrist bands containing a small marble-like structures on one side. They are designed to be worn on both wrists with the marble facing toward the skin. They work by applying pressure to the acupuncture site for nausea and vomiting. These bands are marketed as a treatment for motion sickness and therefore they are most commonly found in marine supply stores. However, occasionally they can be found in general drug stores. These products have been tested in doubled-blinded, randomized studies and found to be very successful in controlling the nausea and vomiting associated with early pregnancy.
In summary, the nausea and vomiting experienced during early pregnancy is very normal. It can usually be controlled with the very simple measures described above. If, however, daily episodes of vomiting, exceed 3-4 times, then we would recommend that you contact the office for further advice.
Combating Morning Sickness
Eat crackers before getting out of bed.
Eat frequent small meals, as nausea usually sets in when your stomach gets empty
Eat low-fat, bland foods such as unbuttered rice, potatoes, noodles, crackers, toast, cereal, soft fruits (especially bananas), poached or boiled eggs and most soups.
Ginger helps curb nausea, so ginger ale, ginger tea, or eat ginger snaps. Also ginger extract 250 mg every 6 hours.
Pyridoxine (Vitamin B6) 25 mg every 6 – 8 hours
Suck on hard candy or mints
Eat tart and salty foods together, such as lemonade and saltines
Chew mint gum
Eat lemon Italian ice
Do not gulp fluids; it is better to sip fluids slowly
Try using wristbands made for motion sickness
Prescription medication (Diclegis)