Updated November 16, 2018.
For some, it’s merely a food aversion — a strong reaction to certain smells or tastes. For others, it’s periodic queasiness, often peaking in the morning and dissipating after lunch. For an unfortunate few, it’s an overwhelming feeling that lasts all day, their waking (and sometimes sleeping) hours punctuated by repeated heaving over the toilet.
Nausea during early pregnancy, sometimes called by the misnomer “morning sickness,” is very common and completely normal. More than half of women experience some degree of nausea and/or vomiting during their pregnancy. Even in severe cases that result in hospitalization, studies indicate that women who brought their weight up later in the pregnancy had the same birth outcomes as women who didn’t have morning sickness at all.
Why do women experience nausea during pregnancy?
No one knows for sure, but changes in your body, particularly the surge of pregnancy hormones, a heightened sense of smell, and a temporarily more sensitive digestive system likely play a role.
How long does it last?
Nausea usually starts by the fifth or sixth week of pregnancy and may be the worst towards the beginning of the third month. Symptoms usually disappear around the start of the second trimester, but in 15 to 20 percent of women, they may last longer.
Luckily, these sensations can usually be managed without a visit to your provider or prescription drugs. Here are some helpful home remedies from One Medical providers to get you through morning sickness.
1. Eat smaller, more frequent meals.
Not eating can make nausea worse. To avoid having an empty stomach, try smaller, more frequent meals instead of three large meals each day. To mitigate nausea in the morning, try placing some plain crackers, dry bread, or cereal next to your bed so you can eat a small amount as soon as you wake up.
2. Soothe your stomach with ginger.
Research suggests that ginger may help settle an upset stomach. Try ginger tea, ginger chews, ginger preserves, or ginger ale made with real ginger. Taking capsules containing 250 mg of ginger four times a day can also help.
3. Skip certain foods.
Try to steer clear of fatty and greasy foods, very sweet foods, spicy foods, and gas-producing foods. This is not the time to try out that new Indian restaurant! Women have reported that high protein, carbohydrate-heavy, salty, low-fat, bland, and/or dry foods (i.e. nuts, crackers, toast, and cereal) are less likely to cause nausea. You can also combat nausea at meals by keeping foods and beverages separate (avoid drinking beverages while you’re eating).
4. Avoid strong smells.
One of the best things you can do is avoid environmental triggers, especially strong smells. Keep your distance from cigarette smoke, perfumes, and anything else that seems to affect you. When it comes to cooking, see if someone else can do the food preparation. If you do cook, open the windows to minimize cooking odors.
5. Try aromatherapy.
On the flipside, smelling mint, lemon, or orange may help alleviate nausea. Try placing a cotton ball or tissue infused with scented oil under your nose. (Many prefer the cotton ball approach to spraying an aroma into the air because you can quickly discard the cotton — and its smell — if it does nauseate you.)
6. Time your prenatal vitamins right.
The iron found in many prenatal vitamins can exacerbate nausea. Try taking your prenatal vitamins before bedtime, instead of in the morning on an empty stomach. If that doesn’t help, talk to your provider about trying a prenatal vitamin without iron. Your need for iron is greater later in pregnancy so it may be okay to skip the iron as you get through this hump, but make sure to tell your provider so he or she can keep an eye on your iron levels.
7. Go alternative.
Many women report help from sea-band wristbands, sold to treat motion sickness in many drugstores, and which aim to decrease nausea by pressing against an acupressure point on your inner wrist. Although it’s unclear whether this is the result of the wristband or a placebo effect, this economical option may still be well-worth exploring. Some women have also found relief from acupuncture, and studies have found that hypnosis may lessen symptoms of nausea.
8. Get on your feet.
Some women find that exercise helps their symptoms. Try taking an extra walk during the day, going for a swim, or joining a prenatal yoga class. Keep in mind: exercise is strongly encouraged during pregnancy, but always consult with your provider before embarking on a new exercise routine—or dramatically increasing your fitness level.
When all else fails…
Most nausea and vomiting in pregnancy can be managed using the above recommendations, but if you’re not finding relief, here are some safe over-the-counter medications to consider:
- For reasons not entirely understood, vitamin B6 supplementation can reduce nausea. Take one 25 mg tablet three times a day, taking caution not to exceed 200 mg a day. Note that prenatal vitamins contain B6, so factor that into your daily allotment.
- Doxylamine, an antihistamine, is sold under the brand name Unisom as a sleep aid and is safe to take during pregnancy to help reduce vomiting. Take half a tablet in the morning and one whole tablet before bed, but be careful not to take before driving as it can cause drowsiness. Research indicates that vitamin B6 and doxylamine are most effective when taken together, so we recommend a combination of the two for maximum symptom reduction.
- Benadryl, another antihistamine, is safe for reducing nausea and vomiting. Take one 25 mg tablet orally four times a day. This may also make your sleepy.
When to See Your Doctor
A small number of pregnant women experience a condition known as hyperemesis gravidarum, in which continuous vomiting leads to severe dehydration requiring medical attention. In the hospital, women receive intravenous fluids and medication.
The following are concerning symptoms:
- The inability to keep down any food or drinks for more than 12 hours
- Signs of dehydration, such as infrequent urination, dark urine, and dizziness when standing
- Vomiting many times in one day, especially if there’s blood in the vomit
- Abdominal or pelvic pain or cramping
- Weight loss of more than 5 pounds
If you experience any of the above symptoms, call your prenatal provider or go to the emergency room. If you’re a One Medical patient, you can reach us 24 hours a day for medical advice.
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