If you are pregnant, one the first tell tale signs is usually morning sickness. Although the name is “morning” sickness, it refers to nausea that a lady may experience anytime during the day when she is pregnant. It is usually worse in the mornings and during the first three months. However, the feeling may linger in the later months as well.
What is morning sickness?
Morning sickness is the nausea and sensation of wanting to vomit that a woman experiences in early pregnancy. Usually it starts by 9 weeks and lasts upto 14- 16 weeks. However, sometimes it may continue through-out the pregnancy. In most women the nauseous feeling comes and goes and may be associated with strong aversion to certain foods and or smells. Simple daily activities like brushing or cooking can bring on waves of nausea. The symptom can affect your nutrition and daily activities but usually does not harm the baby.
Why does it happen?
The exact cause of the sickness is not clear yet. However, it seems to be a response of certain areas of the brain to the pregnancy hormone – hcg. this is the reason why women with multiple pregnancies have more nausea ( as they have more hcg).
Certain factors in your pregnancy may make it worse –
- If it’s your first pregnancy or you are carrying a female baby/ multiples.
- If you/ your mother/ your sister have had nausea and vomiting in previous pregnancies.
- If you have a history of motion sickness or migraine or have had
nausea with combined oral contraceptive pill.
- Whenever you are stressed/ anxious/ overworked/ not rested
- If you are obese.
What problems can I or my baby have due to the morning sickness?
The nausea and vomiting in early pregnancy can affect your nutrition if you are unable to eat well due to it. You may even lose some weight in the first three months. Not being able to drink can make you dehydrated and give you a feeling of tiredness.
However, the baby is usually not affected by this condition. The baby is able to procure all its nutritional requirements from your body’s reserves, even if you are not eating well. More severe form of this condition is called hyperemesis gravidarum and that can sometimes affect the growth of the baby. In fact, the nausea is usually a good sign and indicates a growing pregnancy.
What is the treatment?
For mild nausea slight modifications in diet and lifestyle may be all that you need.
- Have small frequent meals during the day. Eat a little something every 1.5- 2 hours. This will keep your energy levels high and not allow the stomach to be empty for too long.
- Avoid spicy and fried foods. They feel good at the time but cause heartburn and nausea later.
- Chew on something sweet early in the morning, even before getting out of bed. Allow the sugar level to rise and you will not feel giddy or nauseated early in the morning.
- Get you sleep. You will find you do better on days you are less tired.
- Keep hydrating yourself. If you are unable to drink water, substitute it with coconut water, milk, yoghurt, fruits with high water content, ice. Anything that can keep you hydrated. For the same reason, avoid tea, coffee, fizzy drinks and packaged juices.
- Avoid things that trigger off the nausea. Very soon you will know what smells/ foods increase your sense of nausea. It is best to avoid these stimuli.
If it is still bothering you and affecting your daily life you can take some medicines which are safe for you and the baby. I will discuss them later.
What is hyperemesis gravidarum?
Hyperemesis gravidarum is the more severe form of nausea and vomiting in pregnancy. It can happen to upto 3 out of 100 pregnant women. It is diagnosed if you have excessive vomiting along with the nausea and are unable to keep anything down. If you have lost more than 5 % of your pre-pregnancy weight, have ketones in your urine (indicating severe dehydration) , indicating dehydration or your blood results show that your body functions are being affected.
What else can cause severe symptoms?
If you are having excessive nausea and vomiting you doctor will offer some tests to first confirm if it is hyperemesis and also to rule out other possible causes.
These causes can be –
Urinary tract infection
Liver or kidney disease
Gastritis or ulcer in stomach
What is the treatment?
We usually like to go step by step in the treatment starting with the mildest and safest medicines first unless you have confirmed hyperemesis.
- Vitamin B6 – vitamin B6 is a safe water soluble vitamin which helps relieve the morning sickness to some extent.
- Ginger- ginger in form of crackers or with lemon can help relieve mild nausea. It now comes in tablet forms in combination with B6 and leps in mild cases.
- Doxylamine – this is a component of some sleep medicines. When combined with B6 it is found to be very effective for morning sickness. However it may cause sleepiness, so it may help to take 2 tablets at night, just before sleeping.
- Antacids – Medicines like ranitidine and omeprazole can be used in more severe cases of nausea to relieve the heartburn and acidity in the stomach.
- Anti vomiting medicines- if you are vomiting very frequently, you doctor may offer anti vomiting medicines like metoclopramide or even ondanstron. They are safe in pregnancy. Nevertheless, try and use them at the minimum dose and only for the duration that they are essential.
- If you are dehydrated and confirmed to be suffering form hyperemsis, you doctor may offer admission in the hospital to give you these medicines as injections and fluids in a drip to rehydrate you.
And ofcourse, communicate with your obsterician early in the symptoms so that they can guide you to avoid reaching the more complicated stage.
If you have any questions, please email me at drnehagami(at)gmail.com