“Morning sickness” : Nausea and Vomiting that can occur day or night

Nausea and Vomiting AKA “Morning Sickness

Around 70 – 85% of pregnant women experience nausea and/or vomiting. It frequently occurs in the morning, but it can occur throughout the day. Nausea and vomiting are common complaints during the first trimester of pregnancy, so common, in fact, that they are presumptive signs of pregnancy.

What causes morning sickness?

These are some of the most important theories to explain the cause of morning sickness:

Elevated estrogen, progesterone and hCG (Human Chorionic Gonadotropin) levels.
– hCG is know as the pregnancy hormone, this hormone is the one that is present in a pregnancy test, which doubles every two day in the first 12 weeks.
– Progesterone slows down digestion and gastric emptying by relaxing smooth muscles which may contribute to nausea and vomiting.

Although the hormones levels are increased, the blood volume at the beginning of pregnancy is not much different than a non-pregnant woman. This makes a concentrated amount of hormones in the blood stream, making some women be more nauseated than others. As pregnancy progresses, the blood volume expands and hormones levels get diluted even though they remain high, easing the stress to the liver and mother.

Empty stomach in the morning
– Possibly this is the reason why is called “morning sickness”
– Although worse in the morning both symptoms frequently continue throughout the day.
– Some women only experience nausea without vomiting.

Hypoglycemia (low blood sugar)
– Perhaps caused by not eating, believing that will give relief to the discomfort thereby creating a vicious cycle
– Check for blood sugar levels when headaches, dizziness and fainting are present.

Strong odors
– During pregnancy there is a normal heightened sense of smell, for some women this strong sense of smell makes them develop even an aversion for some odors.
– Individual preferences or dislikes may change in pregnancy.

Emotional factors and stress.
– Some studies support that psychological upsets may contribute to morning sickness.

When Does Morning Sickness Start During Pregnancy?

Nausea and Vomiting can start as early as 2 weeks (average time of onset between 5 to 6 weeks), with a peak at 11 weeks’ gestation and lasting from 14 to 22 weeks’ gestation. For women with a multiple gestation often have longer-lasting and more severe nausea and vomiting (hCG levels double every two days for 1 baby, it is much higher for 2 babies).

A small minority may NOT experience nausea and vomiting throughout pregnancy, lucky girl!

Recommendations That Will Make You Feel Better

Non-pharmacologic therapies are the first line of treatment for nausea and vomiting during pregnancy.

<< 1 >> You may have to discontinue prenatal vitamins with iron until nausea and vomiting ease; but remember always continue your folic acid.

<< 2 >> Eating small meals at more frequent intervals (no restriction on the kind of food nor how often, if they are high in protein the better) Keep snacks on hand at all times, remember low blood-sugar can cause nausea try to avoid fasting, you need to eat well to grow a healthy baby.

<< 3 >> Do not brush your teeth immediately after eating to avoid stimulating the gag reflex.

<< 4 >> Avoid spicy and highly acidic foods, and lie down immediately after eating for just a few minutes.

<< 5 >> Make a running list of offensive and/or strong odors which trigger nausea and avoid them.

<< 6 >> Acupressure, including sea bands for wrists (they may be worn at any time). This can work during labor as well, stimulating the acupressure point known as PC-6, found on the inner wrist until it helps ease nausea and vomiting, it may take several minutes but relief will come.

<< 7 >> Dry saltine Crackers or plain yogurt during the night or just before getting up early in the morning. Alternative for cracker can be potato chips, dry bagel, dry toast. They are a good source of potassium.

<< 8 >> Carbonated beverages like Ginger ale.
If ginger ale does not work try drinking lemonade (or smelling a lemon) may help settle your stomach.

<< 9 >> Inhaled Isopropyl Alcohol or sniffing alcohol swabs, helps controlling nausea and vomiting in a very simple way, according to several studies. Mechanism of action is currently unknown but it has been tested even in patients with cancer providing great relief.

<< 10 >> Pedialyte freezer pops or ingestion of ice cold water or crushed ice helps ease nausea, the pedialyte pops have a good taste if you don’t want just ice water and helps prevent dehydration when vomiting.

Receiving emotional support from husband and family is very important, loving treatment given with special attention to the little things that are important to you when you are pregnant it’s so valuable and incredibly reduce feelings of nausea and vomiting.

Herbal remedy

  • Ginger (1g per day in divided doses) is likely effective.
  • Ginger tea: pour 1 cup boiling water over three to five slices of fresh ginger root. Let steep five minutes and sip slowly.
  • Raspberry leaf tea or peppermint tea
  • Hard candy

Homeopathic remedies

Pulsitilla, sepia, nux vomica, and ipecacuanha.
Additional remedies to consider include antimonium tartrate, argentum nitricum, petroleum, sulfur, and tabacum.

Interesting reference book for Homeopathic remedies:

  • Homeopathic Medicine for Women, by Trevor Smith, MD
  • Homeopathic Medicines for Pregnancy and Childbirth, by Moskowitz.

Over the Counter medications

For mild symptoms:

  • Pyridoxine (Vitamin B6) either 25 mg QID or 50 mg BID (at bedtime and again at midday) or tid orally
  • Antihistamine Doxylamine 12.5 mg BID or QID with pyridoxine orally

Medication is usually reserved for those women who have significant vomiting or dehydration, they may require antiemetics agents like:

  • Metoclopramide
  • Promethazine
  • Phenothiazine

Call your health care provider if:

  • If in 24 hours there is inability to tolerate fluids or bland foods or hyperemesis gravidarum develops, which is persistent vomiting and so severe that dehydration, electrolyte and acid-base disturbances, and starvation ketosis become serious problem.

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