Morning Sickness Misery

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Whether it's in the morning or all day long, pregnancy-related nausea and vomiting can be debilitating. Here are some ways to muddle through the misery.

By Carol Sorgen
WebMD Feature

Reviewed By Cynthia Haines

Jennifer Dansicker says the term morning sickness is a misnomer. "It's really 'all day' sickness," she says. "Six weeks of constant, undeniable, miserable nausea and vomiting."

During Dansicker's first pregnancy, she followed all the advice that well-meaning friends and family members doled out. Crackers, bland foods, apple cider vinegar, lots of water -- but nothing curbed the nausea or stopped the vomiting. "I stopped eating altogether and lost 15 pounds," Dansicker recalls. "I was a mess."

The next time around, Dansicker made a concerted effort to learn more about what was going on in her own body. "I took a more scientific approach to the problem," she says. "I knew that my body was producing extra hormones and that my chemical balance was out of whack because of that. So I decided to just keep eating through the nausea and the vomiting."

Dansicker ate her way through her morning sickness with fruit, proteins -- such as peanut butter, turkey sandwiches, and meat sauce served over pasta -- and bread. "I noticed that I vomited less and the nausea subsided when I continued to eat all day long even after and during the vomiting and nausea," she says.

She says she had more energy the second around, and the nausea didn't seem quite as bad as the last time, in part, she believes, because she was keeping her body, and in turn, her mind, strong with all the nutrients.

By the end of week 13, the nausea subsided and the vomiting stopped, says Dansicker. "I think the real key to fighting morning sickness is to eat through it with a variety of foods. It won't stop the nausea or vomiting but it will considerably help you manage it."

Dansicker is certainly not unique in suffering from morning sickness. According to Peter Degnan, MD, director of integrated medicine at Equinox Health and Healing, in Portsmouth, New Hampshire, morning sickness affects 50%-80% of pregnant women, and a third of those experience vomiting as well.

Some women report that the intensity of morning sickness-related vomiting is worse than that of chemotherapy, says Degnan. And like Dansicker herself found out, for a large majority of women with morning sickness, nausea lasts throughout the day.

Doctors don't know for sure exactly what causes morning sickness, but most likely, multiple factors are responsible, such as an increase in hormones and the physiological changes associated with pregnancy, says Cathryn Tobin, MD, author of The Parent's Problem Solver.

When working with pregnant women, Degnan likes to take as natural an approach as possible. Among his suggestions:

• Keep crackers, dry toast, or cereal at the bedside, and eat something before getting out of bed in the morning. These bland, carbohydrate-based foods help lessen nausea.
• Eat small amounts throughout the day to avoid becoming too full, or alternately, too hungry.
• Consider changing to an iron-free prenatal vitamin if you are not anemic, but check with your doctor first.
• Ginger -- in tea, candied, or in capsules -- can be effective in fighting nausea. Don't exceed more than 1,000 mg of ginger a day.
• Raspberry tea has been used by many pregnant women to ease morning sickness; there is currently some debate about its safety, however, so don't drink this without speaking to your physician first.
• Vitamin B-6 also provides relief for many pregnant women; don't take more than 25 mg a day, and again, consult your doctor first.

If all else fails, before resorting to prescription medications, Degnan will suggest Emetrol, an over-the-counter product containing glucose, fructose, and phosphoric acid. It seems to reduce nausea by easing intestinal hyperactivity, and appears to have no significant side effects (although it can raise blood sugar in patients with diabetes, including gestational diabetes, so if you are in that category, check with your doctor before taking).

Another remedy, suggests Degnan, are acupressure bands (marketed as Sea-Bands), which lay over the Pericardium 6 (P6) acupuncture point, long known to relieve feelings of nausea. This suggestion is echoed by William Grant, EdD, associate dean of graduate medical education and research professor of family medicine at the State University of New York Upstate Medical University in Syracuse, New York. Grant has coordinated a number of clinical trials on the effectiveness of Sea-Bands as a solution for nausea associated with morning sickness.

The bands are a noninvasive, drug-free alternative, he says. Between 67%-75% of patients using acupressure have high levels of relief from morning sickness nausea. A bonus, says Grant, is that the relief is almost immediate and does not have any unwanted side effects.

To obtain the greatest benefit from the bands, says Degnan, frequently massage the plastic button overlying the acupuncture point. Sea-Bands are relatively inexpensive -- approximately $8 a pair; a new product, called ReliefBand, is pricier -- at about $110 -- and releases low-level electrical pulses that stimulate the same acupuncture point.

Ann Douglas, author of The Mother of All Pregnancy Books, says that some women cope with morning sickness -- or the more medically accurate term, "nausea and vomiting of pregnancy" -- for their entire pregnancy. She offers additional tips for coping with the situation:

• Don't have fluids at mealtimes. Some women find that eating and drinking at the same time can trigger nausea. Just make sure, says Douglas, that you make up for the lost fluids at other times of the day, since dehydration can also cause nausea.
• Identify your triggers and avoid them. You may find that you feel fine unless you encounter a food (usually something high-fat and greasy) or odor (such as perfume, cigarette smoke, coffee, and strong cooking smells) that you find particularly offensive. Some experts, Douglas says, suggest eating your meals next to an open window in order to minimize the number of odors you're exposed to while you're eating.
• Try taking your prenatal vitamin in the middle of a meal instead of on an empty stomach.
• Choose "stomach-friendly" foods such as yogurt, and low-fat, high-carbohydrate foods.
• Avoid hard-to-digest foods such as sausages, onion rings, and other fatty fried foods.
• Experiment until you find one or more foods that appeal to you.
• Don't force yourself to eat foods that make you feel worse just because they're good for you. If you're going to throw up all the nutritious foods you're eating, you're better off just eating what you can keep down, and making up for it when you feel better.
• Avoid pants with belts and other tight-fitting clothing.
• Carry around a slice of lemon inside a small plastic bag. Some women find that sniffing lemon helps to settle their stomach. Others find similar relief from mint or grated ginger root.

New York nutritionist Keri Glassman, MS, RD, CDN, who recently experienced her own bout with morning sickness, recommends keeping healthy foods on hand, "just in case." "You may have a moment when you feel like you could eat something," she says. "If there's something nutritious already in the house -- like fruit or veggies that have been cut up into bite-size pieces -- you're much more likely to eat them than you would be if you first have to go to the store to get them."

There are also nutrients in fluids, Glassman adds, so if you don't feel like you can eat, you may be able to get down a fruit shake.

Finally, says Miriam Erick, a registered dietician at Brigham and Women's Hospital in Boston, and author of No More Morning Sickness: A Survival Guide for Pregnant Women and Take Two Crackers and Call Me in the Morning, find out what works for you, which may not be what worked for your mother or your best friend.

"There is no one-size-fits all remedy," she says.

Originally published Nov. 18, 2002.

Medically updated February 2005.

SOURCES: Jennifer Dansicker • Peter Degnan, MD, director of integrated medicine, Equinox Health and Healing, Portsmouth, New Hampshire • Cathryn Tobin, MD, author • Ann Douglas, author • William Grant, EdD, associate dean of graduate medical education and research professor of family medicine, State University of New York Upstate Medical University • Miriam Erick, registered dietician, Brigham and Women's Hospital

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Last Editorial Review: 2/28/2005 4:36:39 PM