Morning Sickness

I had terrible nausea during the early part of my last pregnancy. Why does that happen? Is there anything I can do to make it better

Nausea and vomiting complicate over 70 percent of pregnancies--a finding common enough to sometimes serve as the first marker of pregnancy. Though often called "morning sickness", it can occur at any time during the day or night. We still have no good explanation for why this occurs, though pregnancies complicated by nausea and vomiting do seem to have a decreased miscarriage rate. For many women, particular foods or odors serve as triggers - and these can differ among pregnancies; for others, episodes occur without warning.

Typical duration is from 7-12 weeks of gestation. Though it can be unpleasant and sometimes miserable, most women are able to keep enough food and liquids down to avoid medications or hospitalization. Rarely, the condition is so severe that it requires intravenous nutrition.

What can be done? First, avoid any foods or odors that worsen the nausea. Greasy or spicy foods are common triggers. Second, use frequent small meals to keep some food on the stomach at all times. Having starchy foods like crackers or bread at the bedside to eat before arising in the morning can be helpful. I have had a few patients report that sniffing lemons or ginger, or eating salty potato chips helped with their symptoms.

Although avoiding any medications during the first trimester (when fetal organs are being formed) would be ideal, sometimes nausea in pregnancy requires additional therapy-and this should always be directed by a health care provider. Medications proven effective in randomized studies with modest risk include Vitamin B6 (25 mg three times a day), and doxylamine, the active ingredient in Unasom. Though there is not as much supporting evidence, ginger (250 mg capsules four times a day) also appears to be effective. Directed acupressure has shown promise in small studies. There are also additional prescription medications that can be used.

Let us know if you are experiencing nausea that is troublesome, as there are many treatment options.

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