Morning Sickness - Prevention and Treatment

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General Information

Pregnancy sickness, better known as Morning Sickness, is a pregnancy-related condition of nausea and vomiting. According to current research, morning sickness in some form affects approximately fifty percent of all women during the first three months of pregnancy and usually disappears sometime during the fourth month. Morning sickness tends to be more severe during the morning hours but can occur anytime during the day or night.

According to many doctors, in most cases morning sickness will not affect the fetus and in fact is a good sign of fetal growth.

In some cases a pregnant woman will experience severe nausea and vomiting, known as hyperemesis gravidarum. A direct result of this condition is the inability to keep any foods or liquids down. If left untreated, hyperemesis gravidarum may lead to dehydration and malnutrition. The first course of action in these instances is to carefully monitor the mother's intake of liquids and soft foods and to encourage the mother to limit her activities. If this measure does not prove effective, then the mother may be hospitalized. Special IV fluids may be used to keep her hydrated and to combat the loss of important nutrients (see the Prevention and Treatment section).

The pregnant woman should seek medical attention under the following circumstances:

If the woman has been vomiting for more than 12 hours.
If blood has been seen in the vomit.
If signs of dehydration occur: dry mouth, little or no urine.
If there is a fever of over 102 degrees Fahrenheit.
If there is weight loss of more than a few pounds.
If the woman is feeling faint, lightheaded, or dizzy.
If the woman sees no improvement in a few days.

Causes

The exact causes for morning sickness are unknown. Research points to the following causes: the physiological changes which take place in early pregnancy, low blood sugar, the changes in the way the body metabolizes carbohydrates and hormonal changes. It is thought that these hormonal changes don't cause sickness directly but make some women more susceptible to the stimuli that cause sickness. Research is being conducted to determine whether morning sickness is actually involved in helping the pregnant woman to modify her diet in order to produce a healthier baby. In the first 12 to 14 weeks when the baby's organs are developing it is important that toxins do not enter the embryo and if they do, that they don't stay there for long. Morning sickness may be nature's way of protecting the embryo from naturally occurring plant and bacterial toxins in the mother's diet by causing her to become repulsed by smells and tastes that indicate toxicity.

It should be noted that an empty stomach can lead to nausea.

Prevention and Treatment

There are many treatments for morning sickness. It is important to know that not every treatment will work for every woman. In fact, sometimes nothing works. The best strategy is to try several until you hit upon one that works for you.

A word of caution is necessary before presenting the list of Prevention and Treatment. The general rule is that one should check with one's practitioner before starting any new treatment (herbal teas, extra vitamins, medications etc.) for morning sickness. Adverse side affects are possible with many of the treatments.

The following is a list of the more common methods for the prevention and treatment of morning sickness:

Prevention

Eat small, frequent snacks

Rice cakes or whole-wheat crackers can help counteract those pangs of nausea. Sometimes feeling sick may actually mean you are hungry and regular small snacks can help by boosting your energy levels. You may want to have these items next to your bed for first thing in the morning or in the middle of the night. Also, carry some with you in case you start to feel queasy while on the road. Consider having six smaller meals during the day instead of three larger ones. This will help keep your stomach full and your blood sugar steady throughout the day. Make sure you don't overeat.

Eat foods high in carbohydrates and protein

Foods high in carbohydrates and protein help fight nausea. Eat fresh fruits and vegetables and carbohydrate-rich foods like bread, plain baked potato, plain biscuits or crackers. Avoid hard-to-digest, high-fat foods that leave the stomach slower than carbohydrates and proteins, thereby aggravating the nausea.

Drink plenty of fluids

Drink plenty of fluids such as water, herb teas, diluted fruit juice, sparkling mineral water and/or other soft drinks in between meals to replace the fluids you're losing by vomiting and to help neutralize stomach acids. Drink in between meals, rather than with meals (about an hour after solids), which helps to prevent distention of the stomach that may trigger vomiting. Don't drink alcohol - you probably wouldn't want to anyway and it can be bad for your baby.

Eat when and what appeals to you

Trust your cravings providing they are healthy. You may fear that giving in to a craving will worsen your nausea, but usually the opposite is true. If you want brown rice with tofu for breakfast and multi-grain Cheerios for dinner, then by all means do so. As long as you are meeting your daily nutritional requirements, it doesn't matter when you eat particular foods. Also, missing an occasional meal is not going to harm the developing fetus. As long as you can maintain sufficient daily intakes of water and prenatal vitamins, you don't have to worry about the effects of morning sickness on your baby.

Avoid the particular odors that make you sick

Many pregnant women have hypersensitive noses, and odors can trigger nausea. Let someone else cook while you get out of the house, or use the microwave instead of the stove. Open the windows after meals to clear out cooking odors. If the sight or smell of cooking makes you feel worse, ask someone to help out in the kitchen or stick to foods that are relatively easy to prepare and cook. You might also try sucking on clear blue mints (sold in bags in the grocery store) to calm your stomach when food odors or smoke, etc. make you sick - it blocks out smells.

Make time to rest

Studies show that fatigue, worry and stress exacerbate morning sickness symptoms. You should give yourself some time to rest and relax. Learn how to pamper yourself and conduct your life at a slower pace. Nap whenever you get the chance. It's not always easy if you have other children to look after or go out to work, but having a break and putting your feet up for a while can help.

Exercise

Pregnant women who participate in a regular exercise program decrease their risk of morning sickness, without endangering their fetus, according to a study of almost 400 women. Women who exercised had lower rates of bloating and nausea than did non- exercisers. (Medical Tribune 33(12), June 25, 1992).

Treatments

Ginger

Ginger, the spicy root that is used to flavor some of our most beloved exotic dishes, is also praised for its many medicinal properties. Ginger is a time-proven remedy for cramps, indigestion and upset stomach. It has also been used for stimulating the circulatory system, easing cold symptoms and sore throats, and helping to cleanse the kidneys and bowels. Ginger is also effective for motion sickness and morning sickness. In the early 1980's a double-blind study found that 75 percent of expectant mothers who took ginger for morning sickness experienced complete relief (LANCET, March 20, 1982). The mothers were given three capsules, or about 94 mg., of dried ginger, the equivalent of about a teaspoon of grated fresh ginger; they reported that the ginger worked best if taken at the onset of nausea. A word of caution though, another traditional use for ginger has been to promote delayed menstruation, and some scientists have expressed that this could cause miscarriage. However, Chinese doctors recommend that at least 5 grams be used to induce menstruation, which is several times more than the amount needed to treat morning sickness. Additionally, there has never been a reported incident of a ginger induced miscarriage. In many of the Eastern medical traditions ginger is valued as a woman's root. Its antispasmodic properties relax menstrual cramps, PMS, and menopause-related indigestion.

Ways to take ginger: Take it in capsule form (available from health food shops) or make ginger tea by infusing root ginger in boiling water. You can also try eating foods like ginger biscuits, crystallized ginger or ginger ale.

Herbal teas

Some people have found herbal teas to be helpful. However, like drugs, most herbal teas are made from plants and some caution is necessary. The following list of herbal teas are not known to cause birth defects: peppermint, red and black raspberry, spearmint, slippery elm, dandelion, ginger. Chamomile has also been suggested but must be taken with caution because of possible allergic reactions.

Acupressure

A non-drug treatment that involves pressing on acupuncture points rather than using needles is an increasingly popular way of relieving nausea. Contact a qualified therapist or alternatively try the special elasticized wrist bands sold for travel sickness which work on the same principle. You can buy the bands at chemists, boating stores or travel agencies. The ancient Chinese practice of acupuncture rests on the premise that needles inserted into the skin can affect the body's "energy flow," thereby restoring our natural balance and promoting health. Variations of the technique often use pressure or electrical stimulation in place of needles.

Several studies document the success of acupuncture, acupressure, and electrical stimulation in treating nausea. In a 1991 study the late J.W. Dundee, M.D., Ph.D. of Queens University in Belfast found that 75 out of 100 chemotherapy patients who received electrical stimulation along an acupuncture point felt relief from nausea. And in an earlier study Dr. Dundee found that acupressure was successful in reducing the severity and frequency of morning sickness.

Medications

Drugs used to be widely prescribed for morning sickness but doctors are now reluctant to prescribe them except in very severe cases. If you find the sickness hard to cope with, or become so sick that you are unable to keep down even fluids, ask your doctor for advice. Never be tempted to dose yourself with travel sickness tablets or other over-the-counter remedies. Speak with your practitioner first before taking any medications during your pregnancy.

Vitamin B-6

Vitamin B-6 has successfully been given to relieve nausea and in moderate dosages (50 - 100 mg per day) has been found to be non-toxic. One woman who received a vitamin B-6 shot found that it "took the edge off for 2 days." Again, like with all medications, first speak with your practitioner before taking vitamin B-6.

Wild Yam

Traditionally, Wild Yam has been used for cramps and the relief of morning sickness from pregnancy. It is relaxing and soothing in neuralgia, is said to help expel gas from the system, and is also used for pain in the urinary tract. It has been used to prevent miscarriage.

Rehydration

The best way to break the ravages of morning sickness is to correct the dehydration that results from it. When you get dehydrated, your body accumulates chemicals called ketones, which make you feel even worse and further accentuate the vomiting. To break the vicious cycle, we suggest you call your doctor and ask to go into your local emergency room for two hours of intravenous therapy, even if you have to do that once a week. Simply rehydrating yourself and flushing out the chemicals that have accumulated from dehydration will make you feel a lot better.

Miscellaneous Treatments

• Eat lightly seasoned foods.
• Sit upright after meals to reduce the frequency of stomach upset (gastric reflux).
• A snack such as yogurt, milk, juice, bread or a small sandwich before going to bed or during the night may help to reduce nausea in the morning. However, you may need to sit upright for 10-20 minutes following eating to prevent gastric reflux.
• Get out of bed slowly. Avoid sudden movements.
• Avoid brushing your teeth immediately after eating.
• Slowly sip a carbonated beverage or carbonated water when feeling nauseated.
• Fresh air may help. Take a short walk, or try sleeping with the window open.
• Eat or drink something sour like lemon or a sour pickle.
• Try sucking on peppermints. It really helps temporarily. Drink something called "Essence of Peppermint Oil" mixed with a half cup of water.
• Try gelatin desserts, flavored frozen desserts, broth, non-diet ginger ale, sugared decaffeinated teas, and pretzels.
• Changing the type of vitamins you're taking may help. The iron in prenatal vitamins can bother some women. If you think your morning sickness is related to your vitamins, talk with your doctor.

Support and sympathy from family and friends can help you cope with the ups and downs of pregnancy, including sickness. It's more difficult in the early months if you haven't told other people that you're pregnant and are trying to work or carry on as normal, but you can talk to your midwife or doctor who will be able to offer advice and support.

Related books in the Pregnancy Place Bookstore

Morning Sickness Books

Pregnancy Books (General)