
For many women who've experienced morning sickness or food aversions in the first trimester of pregnancy, the second trimester is a welcome relief. You may start to have more energy as the tiredness common in the first trimester starts to fade. This is often when the pregnancy begins to seem more real. Your bump may be noticeable, and you'll soon start to feel your baby move.
However, nausea, vomiting, loss of appetite, and food aversions continue well into the second trimester for some women. Losing your appetite in the second trimester can have a number of different causes. While it's perfectly normal, you need to ensure you and your baby get enough nutrition.
What causes loss of appetite in the 2nd trimester?
Many different issues can cause a loss of appetite in the second trimester of pregnancy. Some of these, such as morning sickness, may carry over from the first trimester. Others, like your baby growing, may start for the first time. Some of the most common causes include:
Morning Sickness
Although it's usually thought of as a first-trimester problem, 15% to 20% of women experience nausea and vomiting into the third trimester. Nausea can occur at any time of the day or night. On the bright side, women who have nausea and vomiting during pregnancy are less likely to have a miscarriage or stillbirth than those who don't.
Most women experience some degree of nausea and vomiting during pregnancy, although people who experience these symptoms more severely may need to be hospitalized. This is called hyperemesis gravidarum and it can cause dehydration as well as vitamin and nutrient deficiencies if left untreated.
Like many pregnancy symptoms, constipation is related to your hormones and may serve a purpose. During the second and third months of pregnancy, your progesterone levels start increasing. This relaxes the muscles in your digestive tract and slows your bowel movements. Because your food stays in your digestive tract longer, your body is able to absorb more nutrients from it. The iron in your prenatal supplement may also contribute to your constipation.
Gastroesophageal reflux disease (GERD), or heartburn, in pregnancy can also be related to increased progesterone levels. Progesterone relaxes the muscles at the top of your stomach, causing stomach acid to flow back into your esophagus. Your growing uterus can also put pressure on your stomach, making heartburn worse.
Tips for getting enough to eat during pregnancy
Regardless of what's causing you to lose your appetite, it's important that you and your baby get enough to eat during your pregnancy. You don't have to worry if you're not that hungry for a week or two. As long as you're keeping fluids down, taking your prenatal vitamins, and getting something to eat, you should be fine. If you're so sick that you can't eat at all, or you're losing weight quickly, call your doctor.
Here are some tips to help you stay healthy and nourished during your pregnancy:
- Drink plenty of fluids, although you may need to separate eating and drinking so you don't overfill your stomach.
- Eat high-fiber foods to help with constipation.
- Stay active to help relieve constipation.
- Eat small, frequent meals.
- Keep crackers near your bed and eat a few before you get out of bed.
- Eat high-protein meals and snacks.
- If you can't take your prenatal supplement, make sure you take at least 0.4 to 1 milligram of folic acid daily.
- Drink smoothies made with high-protein, healthy ingredients such as yogurt, peanut butter, and frozen fruit.
- Try ginger tea or ginger ale to help with nausea.
- Avoid spicy, acidic, and fried foods if you're having heartburn.
- Avoid lying down for at least 45 minutes after eating to help reduce heartburn.
- Avoid eating for 2 to 3 hours before bed to avoid heartburn.
When to call your doctor
You should talk to your doctor about your symptoms, although you may not need medical treatment. Your doctor can offer suggestions to help you decide if medicine is appropriate. If you're having any of the following symptoms, call your doctor right away:
- Vomiting repeatedly throughout the day
- Blood in your vomit
- Inability to keep down food or fluids for 12 hours or more
- Abdominal pain or cramping
- Pelvic pain or cramping
- Losing more than five pounds
- Fever or diarrhea
- Infrequent or dark-colored urination
- Dizziness when standing
- Feelings of hopelessness, wanting to end the pregnancy, or suicidal thoughts

SLIDESHOW
Conception: The Amazing Journey from Egg to Embryo See SlideshowDieticians of Canada: "Tips to Help You Feel Better During Pregnancy."
Stanford Children's: "Pregnancy and Heartburn."
Tommy's: "Everything you need to know about the second trimester: weeks 13 to 28."
UpToDate: "Patient education: Nausea and vomiting of pregnancy (Beyond the Basics)."
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