Morning Sickness

What is morning sickness?

Morning Sickness is the name given to nausea and vomiting during pregnancy, particularly in the first 3 months. Approximately 70 to 90% of all pregnant women experience nausea and 50% have at least one episode of vomiting or retching.

Morning Sickness occurs frequently in the morning, though some women may complain of nausea throughout the whole day. It generally resolves by 16 weeks of pregnancy, but may last for a longer period in some expectant mothers. It does not appear to affect the foetus.

What causes morning sickness?

The cause is still unknown. Around 1% of women get a severe form of morning sickness called hyperemesis gravidarum. This occurs when vomiting leads to dehydration, hyponatraemia (low salt levels in the blood) and the presence of ketones in the urine (an indication of malnutrition). It is more common in first pregnancies and multiple births due to increased levels of the beta-HCG hormone. Hospitalisation is often required for IV fluid and vitamin therapy. Hyperemesis gravidarum has been known to be fatal if untreated.

Health care for morning sickness

As with all conditions, your doctor should be consulted to diagnose and treat morning sickness. Some women can manage symptoms by avoiding certain foods and eating when symptoms have eased.

As a general rule, any medication during pregnancy should be avoided except under strict medical guidance. Severe nausea and vomiting that cannot be controlled by dietary and lifestyle changes may require drug therapy.

Diet tips to manage morning sickness

Avoid hunger by eating and drinking frequently in small amounts only. Include bland foods in the diet such as rice, pasta and soup and avoid spicy foods. Avoid soft cheeses.

Always eat food that is fresh and restrict your intake of fat. Lean meat, skinless chicken and fish are good examples of low fat protein sources.

Certain types of fish are especially good (e.g. mackerel, tuna and mullet). These are high in Omega 3 fatty acids which are thought to help reduce the risk of high blood pressure during pregnancy.

Keep sugar and refined carbohydrates to a minimum. These foods are usually high in calories and low in nutritional value.

Make sure that there are plenty of green leafy vegetables in the diet. Eat raw if possible, and if cooked, steam lightly to help retain vitamin and fibre content. Include other fibre-rich foods to help ensure that the bowels work properly. These include beans, peas, oats, barley and rice.

Restrict your intake of table salt and salty foods to help prevent the risk of high blood pressure and fluid retention during pregnancy.

Try dry toast with tea or a few dry, cracker biscuits whenever the nausea occurs. Eat small meals regularly throughout the day, including some foods from all food groups.

Ginger has a long history of use in helping to relieve the nausea associated with morning sickness. Moderate amounts of ginger root are safe to eat during pregnancy.

Some women find it beneficial to eat before rising. Eating a dry biscuit before getting out of bed in the mornings may help to reduce the nausea.

Cravings for strange foods during pregnancy may indicate a lack of minerals, such as iron, zinc or chromium.

Limit your intake of caffeine containing drinks such as cola, tea and coffee.

It is best to avoid alcohol altogether, as the effects of even a small amount of alcohol may adversely affect the growth and development of the foetus. All social drugs affect the supply of breast milk and are passed through the breast milk to the baby.

Rinsing the mouth with bicarbonate of soda and water or another alkalising agent after vomiting can help to alkalise the mouth to prevent the erosion of the tooth enamel.

Iron supplements should be temporarily stopped.

Vitamins, minerals and herbs

Nutritional supplements are only to be used if the dietary vitamin intake is inadequate.

Ginger is well known for its anti-nausea action. Ginger may stop nausea and vomiting and also cramps.

Chamomile may reduce nausea, vomiting and cramps associated with motion sickness.

Peppermint is believed to have a strong anti-nausea action and also acts as an anti-spasmodic herb (reduces cramps).

Vitamin B6 and magnesium may help to prevent nausea during pregnancy. Vitamin C and vitamin K may also be useful.

Acidophilus supplementation may reduce nausea.

Thiamine supplements (vitamin B1) are recommended for severe vomiting to prevent Wernicke-Korsakoff syndrome, a life-threatening disease caused by thiamine deficiency.

Notes
Excessive vomiting is serious and must be treated by a doctor. For some women, morning sickness can continue for the full nine months.