Morning Sickness: What to Do When Your Body Says No to Food

Morning sickness is one of the most common side effects of pregnancy. “Most pregnant women experience it to some degree during the first few months, thanks to hormonal changes, and its symptoms can usually be eased with a few dietary changes,” says says Heather Hilkowitz, MD, Hilltop Obstetrics & Gynecology.

Dr. Hilkowitz talks about how common morning sickness is.

Click play to watch the video or read the transcript.

Is morning sickness normal? Video Transcript

Well over half of pregnancies deal with some morning sickness to some degree. It really runs a large spectrum. Some women are very lucky and just feel a little bit queasy here and there. Other women have the all-day sickness but most of the time it gets better shortly after that first trimester ends. There can actually be some validity to the old wives’ tale that morning sickness is a reassuring sign for a pregnancy. Typically part of what drives morning sickness are the chemicals associated with pregnancy and the hormone changes associated with pregnancy. If all is going well those pregnancy levels early on are driven higher and higher and lead to that sensation of morning sickness. So there really is some truth to that.

 

To combat regular morning sickness, try the following:

  • Eat small amounts frequently. This helps prevent the stomach from being empty, which can make nausea worse.
  • Choose dry foods, like crackers.
  • Sip cold, clear drinks.
  • Ask your doctor about taking vitamin B6 or ginger.
Morning Sickness - In Content

When Symptoms are Severe

Sometimes, morning sickness is so severe that it can cause dehydration, weight loss and metabolic changes, which are dangerous for you and your baby.

Hyperemesis gravidarum (HEG) is the medical term for severe nausea and vomiting during pregnancy. “It is not clear what causes HEG, but it could have something to do with hormones,” says Dr. Hilkowitz “We do find that it is more common in multiple pregnancies (twins or more) and in women with migraines. Women with a family history of HEG or who had the condition in a previous pregnancy are also more likely to have it again.”

Dr. Hilkowitz explains severe morning sickness.

Click play to watch the video or read the transcript.

Can morning sickness be severe, and can it be eased? Video Transcript

I suffered from morning sickness terribly. Only about 2 percent of the pregnant population will have it to the degree that I ended up with it and in that case there’s a medical term called hyperemesis gravidarum which describes that where as not only do you feel ill and have some morning sickness but it turns out to be an all day sickness that doesn’t go away not even later on in the pregnancy like it’s supposed to. So in these types of cases patients can drop large amounts of weight, their electrolytes can become unbalanced and you worry about not only the mom’s physical health but also the baby. Fortunately in my case it turned out well but it made me particularly cognizant to watch for this in my patients. For people who have really bad morning sickness, some of the foods that seem to be sought out more than others include cheeses; those seem to be tolerated relatively well, whereas a glass of milk or even a glass of water would be the last thing that would make someone comforted. Some string cheese or some strong citrus flavor . . . maybe a lime or a lemon . . . those kinds of thing that we typically would never think of taking a big bite out of a lime but if you’re pregnant and having a lot of trouble with morning sickness, that might be just the ticket to make you feel a little better. If you have really extreme nausea and vomiting, we want to know about that. So absolutely we want you to call us if it’s been even 12 hours of not being able to keep anything down. That’s an absolutely appropriate phone call to your doctor to help get some guidance of what to do next.

 

Call your doctor right away if you suspect that you have HEG. The symptoms include:

  • Inability to keep down liquids
  • Nausea that is severe and lasts beyond the first few months
  • Blood in your vomit
  • Inability to empty the bladder
  • Urine that is dark and concentrated, or very little urine
  • Dizziness or fainting spells
  • Extreme thirst
  • Dry, sticky mouth
  • Weight loss
  • Racing, pounding heart

Your doctor may recommend that you try a medication called doxylamineto relieve the nausea. In some cases, alternative treatments such as acupuncture are effective.

Sometimes, morning sickness is so severe that it can cause dehydration, weight loss and metabolic changes

If your situation is severe, your doctor may order tests to rule out other causes of nausea and vomiting, explains Dr. Hilkowitz. You may be admitted to the hospital, at least for a short time, to protect you and your baby. There, you will probably be given intravenous (IV) fluids for hydration, essential vitamins and nutrients and possibly medication to control the nausea. In severe cases, longer hospitalization may be needed.

With proper treatment, HEG can be managed, says Dr. Hilkowitz. The key is to communicate with your doctor if you have concerns, and follow up on your doctor’s advice.

Heather L. Hilkowitz, MD

Heather L. Hilkowitz, MD

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Small Steps: Friends and Family: Take Her Seriously
Listen without giving advice. Tell her she’s a good mom, that it’s not her fault, and that she will get better.