Morning sickness

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Morning sickness

For many women, the toughest part of early pregnancy is morning sickness. Morning sickness can range from mild, occasional nausea to severe, ongoing, disabling nausea with bouts of vomiting. Symptoms may be worse in the morning, but they can strike at any time of the day or night.

The first signs of morning sickness usually develop during the month following the first missed menstrual period, when pregnancy hormone levels rise. Women carrying twins or more have greater hormone increases, which tends to cause more severe morning sickness.

There is no way to predict how long your morning sickness will last, even if you have suffered through it before. Nausea and vomiting usually go away by 12 to 14 weeks of pregnancy. But in some cases, it can last well into a pregnancy.

If you have severe, persistent nausea and vomiting or are unable to take in fluids, see your doctor or nurse-midwife right away. This pregnancy problem can lead to dehydration and malnutrition. For this, you need intravenous (IV) fluids and/or prescribed medication. In some cases, you may need to stay in the hospital.

Lifestyle guidelines for curbing morning sickness

• Keep food in your stomach, but not too much at once. An empty stomach can make nausea worse. Eat several small meals every day instead of three large meals.
• For morning nausea, eat a small snack (like crackers) before rising. Allow a few minutes for the snack to digest, then get out of bed slowly.
• Stay hydrated. Drink a lot of fluids. Try a sports hydration drink, as well as water, broth, or juice.
• Eat more protein, and cut your fatty food intake.
• Avoid smells and foods that make you feel nauseated. Citrus juice, milk, coffee, and caffeinated tea commonly make nausea worse.
• Avoid iron supplements, which can make nausea worse. These aren't necessary during the first trimester.
• Get lots of rest. Stress and fatigue can make morning sickness worse.

Treatment for morning sickness

The following are safe, proven treatments for morning sickness. You may not gain complete relief from morning sickness treatment. Taking ginger or doxylamine is most likely to effectively curb nausea and vomiting.

• Ginger taken regularly can significantly relieve morning sickness after a few days of treatment.¹ Ginger can be taken as a powder in a capsule, grated fresh into hot water for a tea, or used in syrup or crystallized form.
• Doxylamine and vitamin B6 is taken according to your health professional's recommendation. Doxylamine is a nonprescription antihistamine that is marketed as Unisom Night-Time Sleep-Aid Tablets. Doxylamine is the most proven, safe, and effective medicine available for reducing nausea and vomiting during pregnancy.^{1, 2}Note: Do not confuse Unisom Tablets with Unisom SleepGels, which contain a different medication.
• Vitamins B6 and B12, taken regularly according to your health professional's recommendation, can reduce nausea and vomiting. Vitamin B₆ seems to be more effective for nausea, and vitamin B₁₂ for vomiting.³
• Acupressure relieves nausea for some women. Firmly press on the P6 point, the inner side of your arm, in line with your middle finger and one-sixth of the way between your wrist and elbow. Several studies suggest that acupressure shortens bouts of nausea and vomiting, though the symptoms may still be as severe.³

References

Citations

1. Niebyl JR, Goodwin TM (2002). Overview of nausea and vomiting of pregnancy with an emphasis on vitamins and ginger. American Journal of Obstetrics and Gynecology, 186(5, Suppl): S253–S255.

2. McKeigue PM, et al. (1994). Bendectin and birth defects: 1. A meta-analysis of the epidemiologic studies. Teratology, 50(1): 27–37.

3. Oates-Whitehead R (2005). Nausea and vomiting in pregnancy. Clinical Evidence (13): 1769–1779.

Credits

Last updated:	November 30, 2006
Author:	Shannon Erstad, MBA/MPH
Reviewed By:	Renée M. Crichlow, MD - Family Medicine, Kirtly Jones, MD - Obstetrics and Gynecology
Editors:	Kathleen M. Ariss, MS, Pat Truman