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Full Article:

Morning Sickness/
Nausea & Vomiting in Pregnancy(NVP)/
Pregnancy Sickness/
Hyperemesis Gravidarum

Morning Sickness Prevention:

1. Eat frequent small meals, every 2 or 3 hours, rather than 3 large meals daily.
2. Avoid strong odors (carry a handkerchief with a few drops of lemon oil to breathe into if a certain smell bothers you.).
3. Get up slowly and do not lie down immediately after eating.
4. Eat dry crackers 15 minutes before getting up in the morning.
5. Eat more fruits and complex carbohydrates such as potatoes, crackers and pasta. Sensitive stomachs find those foods easier to tolerate.
6. Eat high protein foods as they help fight nausea.
7. Do not skip meals, allowing your stomach to become "empty".
8. Drink fluids ½ hour before a meal or ½ hour after a meal. Do not drink during your meal.
9. Try eating cold food instead of hot (cold food does not smell as much).
10. Try bland foods, as opposed to spicy foods.
11. Try to avoid fatty foods, which take longer to digest, particularly during pregnancy, when your stomach takes longer to empty.
12. If odors bother you while cooking, try to have good ventilation in the kitchen or ask for help in food preparation.
13. NVP may worsen when you get tired. Try to get more rest. Take naps during the day if possible.
14. Try taking your prenatal vitamins later in the day or discuss possible alternatives, such as children's chewables.
15. Try not to get overheated as it seems to agitate morning sickness.
16. Talk to your doctor about forgoing the iron supplements as they can be hard for your stomach to deal with.
    
17. Finally, if your symptoms persist, consult your healthcare provider. Talk to your healthcare provider about your symptoms and how they affect you. He or she can prescribe a safe and effective medication to treat your nausea and/or vomiting and to prevent further complications.
    
    

Morning Sickness FAQ

Does one get NVP only in the mornings? Although one study did find a slight increase in nausea from 6 a.m. until 9 a.m., the rest of the daytime hours averaged about the same. So, unlike the name suggests, morning sickness can come during any time of the day, or even last all day long and ranges from barely noticeable to extreme enough to warrant hospitalization. Severe morning sickness is known as Hyperemesis Gravidarum and affects 1-3% of those women who suffer from some form of nausea and vomiting during pregnancy.

How common is morning sickness? It is estimated that between 50%-80% of pregnant women suffer from some form of NVP. It is estimated that about 10-20% of women have no nausea or vomiting, while 28-30% have nausea only, and 52-56% experience some vomiting. Some researches say morning sickness can be a sign of a healthy pregnancy.

What causes NVP? The simple, safe answer is, "hormones of pregnancy." Strong correlations have been noted between nausea/vomiting of pregnancy and nausea brought on by birth control pills, suggesting a common hormonal basis for both phenomena. Some researchers found higher levels of hCG in patients with nausea and vomiting than those who were asymptomatic. Beyond that, nobody really knows.

What can put me at higher risk for morning sickness? You may be at a higher risk for NVP if:

• You're pregnant with twins or higher multiples. This may be due to the higher levels of hCG or other hormones in your system. You're also more likely to have a worse case than average. On the other hand, it's not a definite thing — some women with twins have no nausea at all.

• You have a history of nausea or vomiting as a side effect of taking birth control pills. This may have something to do with your body's response to increased levels of estrogen.

• You have a history of being susceptible to motion sickness.

• You have a genetic predisposition to nausea during pregnancy. If your mother or sisters had morning sickness, there's a higher chance you will, too.

• You have a history of migraine headaches.

When does morning sickness start? Some women experience symptoms within days of conception, but the average time from the last menstrual period to the onset of nausea is about 5-1/2 weeks, ranging from 1-8 weeks. For many women, a few weeks of nausea will precede the onset of vomiting. Click here to read our Pregnancy Signs & Symptoms Chart to find out more about when other pregnancy symptoms usually begin.

When does NVP end? About 60% of women will be over their nausea by the 12th week from their last menstrual period, and more than 90% are feeling better by the 16th week. Up to 20% of pregnant women will see their quality of life affected for more than 3 months. A few unlucky women do have nausea throughout the pregnancy, and a few have nausea return in the final weeks of the pregnancy.

Will morning sickness affect me at work? Many women can still pursue their daily schedules, but 12%
find ordinary work during pregnancy impossible, and another study found that about half of women with symptoms felt their job efficiency was reduced.

Will all my pregnancies be like this? Not necessarily. In one study, only 63% the women who had been pregnant before and had more than 100 hours of nausea said that they had similar symptoms. Every pregnancy is different.

Is it really a "good sign"? Several studies have demonstrated that women with no symptoms of nausea or vomiting do experience a significantly greater proportion of miscarriage. But most women have live births, so lack of symptoms should not be cause for alarm. You can easily go through your pregnancy with no symptoms of morning sickness, and still have a healthy baby.

Will my nausea affect my baby? Not unless your morning sickness is extreme and you cannot hold down food and water. If this becomes the case, then your NVP has graduated into the category of "Hyperemesis Gravidarum" or severe morning sickness and your doctor will monitor you accordingly.

How do I know if I've graduated into the Hyperemesis Gravidarum category?
Call your practitioner if:

• You haven't been able to keep anything (including fluids) down for 24 hours.
• You have persistent vomiting shortly after eating or drinking anything, including water.
• You have weight loss.
• You suffer from dehydration.
• If you have concentrated, dark-colored urine.

If I don't have morning sickness, does that mean I'm more likely to have a miscarriage? Not at all. Although it's true that a number of studies have shown that women who have miscarriages are less likely to have had nauseayou should not concern yourself as there are also plenty of women with perfectly normal pregnancies who manage to escape nausea during their first trimester. Most of us call these women "lucky"! *wink*

Collected Morning Sickness Remedies*:

Acupressure or Acupuncture: General acupuncture or acupressure wristbands. Refer to our Make-At-Home Acupressure Wristbands or look into SeaBands, etc.

Apple Cider Vinegar: Mix 1 pint of hot water, 6 teaspoons of apple cider vinegar and 2 teaspoons of honey. Drink cold or warm.

Asarum: This remedy is indicated when a woman feels very ill, with constant nausea and retching. She is extremely sensitive to everything—especially noise, which can aggravate the nauseous feelings. She feels best when lying down and resting. Cool drinks or food may help, but it is hard for her to even think of eating.

B6 Supplement: Taking a B6 vitamin does seem to help some women. See Diclectin below.

Calabash Chalk: Calabash chalk is not a conventional food and must be purchased at ethnic shops, but it is eaten by some pregnant women, traditionally those from the Nigerian and wider West African community, as a remedy for morning sickness. On 15 October 2002, the Food Standards Agency began advising people not to eat a product because of high levels of lead contamination. Exposure to high levels of lead by pregnant and breastfeeding women poses a risk to the mental development of their unborn baby and breastfed infant. For more information, visit the Food Standards Agency: Warning issued over traditional morning sickness remedy.

Colchicum: Horrible nausea that is worse from the sight and smell of food (especially eggs or fish) often indicates this remedy. The woman retches and vomits, and has a sore and bloated feeling in the abdomen. She has trouble eating anything — although she often craves things, when she tries to eat them they make her sick. She is likely to feel ill from many smells that others don’t even notice.

Diclectin (Doxylamine Succinate and Pyridoxine Hydrochloride (Vitamin B6): If you decide to take medication for your NVP, there is a safe and effective one available in Canada, Diclectin® (a combination of vitamin B6 and an antihistamine, doxylamine), that can be prescribed especially for your NVP by your healthcare provider. For more info, visit the Diclectin® website.

Exercise: Pregnant women who participate in a regular exercise program decrease their risk of morning sickness, without endangering their fetus, according to a study of almost 400 women. Women who exercised had lower rates of bloating and nausea than did non- exercisers. (Medical Tribune 33(12) June 25, 1992)

Ginger: Ginger contains gingerol, a Ginger oleoresin (combination of volatile oils and resin) that accounts for the characteristic aroma of Ginger, and explain its therapeutic properties. Components of gingerol (zingiberone, bisabolene, camphene, geranial, linalool and borneol) have recently been studied and found to possess beneficial properties for the treatment of poor digestion, heartburn, vomiting and preventing motion sickness. Ginger also contains moderate amounts of protein, calcium, phosphorous, iron, sodium, potassium, and magnesium. Another study (25/09/02) suggests that Ginger Honey Tonic, a potency-assured formulation manufactured by New Chapter, is a safe and effective way to treat nausea and vomiting associated with morning sickness. Check out a delicious alternative in the form of lollipops at PreggiePops.

Ipecacuanha: This remedy is indicated for intense and constant nausea that is felt all day (not only in the morning) with retching, belching, and excessive salivation. The woman may feel worse from lying down, but also worse from motion. Even after the woman vomits, she remains nauseous.

Kreosotum: When this remedy is indicated, the woman may salivate so much that she constantly swallows it, becoming nauseous. She may also vomit up food that looks undigested, several hours after eating.

Lacticum acidum: This remedy is indicated for “classic morning sickness”: nausea worse immediately on waking in the morning and on opening the eyes. The woman may salivate a lot and have burning stomach pain. She usually has a decent appetite and feels better after eating.

Lemon: Tart drinks seem curb nausea so try ice water with a twist of lemon.

Licorice: gastrointestinal healing properties.

Music: Our ears provide us with the ability to hear and the inner ear (vestibular system) is also responsible for our balance (our gyroscope). It is an acknowledged contributor in the process of being sick as a result of travel or motion sickness. In recent years it has been confirmed that the vestibular system is regarded as a significant organ involved in the process of being sick. MorningWell
uses sound tones, patterns and frequencies sent to the ears, ease morning sickness symptoms (reported from dramatically reduced to easily tolerable levels or they stop completely).

Naval Acupressure: Place 2 fingers on her navel (bellybutton) and press gently. The nausea would disappear in about 1 to 2 minutes. It sounds strange, but I have heard a few women swear to this practice! I assume it is some form of acupressure.

Nux vomica: Nausea, especially in the morning and after eating, may respond to this remedy—especially if the woman is irritable, impatient, and chilly. She may retch a lot and have the urge to vomit, often without success. Her stomach feels sensitive and crampy, and she may be constipated.

Peppermint: PEPPERMINT leaf contains volatile oils and other constituents that absorb intestinal gas, calm upset stomach, inhibit diarrhea as well as constipation, aid digestion, eliminate heartburn, and prevent & remedy childhood colic. Peppermint is probably the best known remedy for stomach problems. It is used for both chronic and cute indigestion, gastritis and enteritis, acting in two distinct ways to remedy these problems. First, its essential oils enhance digestive activity by stimulating contractile activity in the gallbladder, and by encouraging the secretion of bile. Secondly, Peppermint leaf oils normalize gastrointestinal activity, removing flaccidity and reducing cramps.

Protein: Have frequent protein snacks. (Low fat meats and seafood, nuts, eggs and beans are high protein.)

Pulsatilla: This remedy can be helpful if nausea is worse in the afternoon and evening (often in the morning, as well). The woman is not very thirsty, although she may feel better from drinking something cool. She can crave many different foods, but feels sick from many things (including foods she craves). Creamy foods or desserts may be appealing, but can cause discomfort and burping or bring on vomiting. A woman who needs this remedy usually is affectionate, insecure, and weepy—wanting a lot of attention and comforting.

Sepia: Gnawing, intermittent nausea with an empty feeling in the stomach suggests a need for this remedy. It is especially indicated for a woman who is feeling irritable, sad, worn out, and indifferent to her family. She feels worst in the morning before she eats, but is not improved by eating and may vomit afterward. Nausea can be worse when she is lying on her side. Odors of any kind may aggravate the symptoms. Food often tastes too salty. She may lose her taste for many foods, but may still crave vinegar and sour things.

Rapberry Leaf Tea: 1-3 glasses daily. In high amounts causes uterine irritability; not recommended for high-risk pregnancies.

Soda Pop (Carbonated): Try ginger ale or 7-up. Experts agree that carbonated sodas buffer the stomach and reduce nausea.

Tabacum: This remedy can be helpful to a woman who feels a ghastly nausea with a sinking feeling in the pit of her stomach. She looks extremely pale, feels very cold and faint, and needs to lie very still and keep her eyes closed. If she moves at all, she may vomit violently—or break out in cold sweat and feel terrible.

Yams: Wild Yam Root: Taking ½ to 1 tsp of Wild yam root every day will help you deal your morning sickness.

Additional Drugs deemed safe (Source: New England Journal of Medicine, April 16, 1998) during pregnancy for the treatment of nausea and vomiting: Chloropromazine, metoclopramide (in third trimester, diphenhydramine, dimenhydrinate, meclizine, cyclizine).

Additional Resources:

Polls:
What morning sickness treatment helped you the most? from Baby-Place.com. At last count: of 5,197 voters, the results were as follows: Acupuncture/Acupressure/C-bands: 4.4% (226), Dietary Changes: 15.7% (803), Exercise: 4.9% (248), Herbal Treatments (Ginger, wild yam, herbal teas): 9.6% (488), Vitamins or medications: 12.1% (618), None of the above helped: 53.3% (2721).
If you experienced morning sickness, when did it occur? from mommyguide.com. At last count: of 101 voters, the results were as follows:
When did you experience morning sickness? Mornings, predominantely: 17.8% (18), Afternoons: 4.0% (4), Evenings: 6.9% (7), Different times of the day 33.7% (34), I seemed to have it all day 37.6% (38).
Did you experience morning sickness during pregnancy? from mommyguide.com. At last count: of 131 voters, the results were as follows:
Yes, so bad I had to be hospitalized: 4.6% (6), Yes, I puked a lot: 23.7% (31), Yes, I felt nauseous most of the time: 37.4% (49), Yes, but I barely noticed: 11.5% (15), Nope, not really: 22.9% (30).

Support:

Forums:
BabyCenter's Morning Sickness Forum. Rating: ***** Seems well posted and on-topic.
Pregnancy-Place.com's Morning Sickness Message Board. Rating: ** Quite active, but often off-topic.
ParentsNest Morning Sickness Message Board. Rating: * Apparently new, with very few posts.

Telephone:
Motherisk exists as a helpline for women experiencing hyperemesis gravidarum on 1-800-436-8477. This toll free number allows you to talk to an expert about NVP in general or treatments or anything related to morning sickness.

* NOTE: Please speak with your provider regarding these listed "remedies" as they have not necessarily been proven neither safe nor reliable and were gathered from comments made from other mothers-to-be who suffered from morning sickness.

Selected References:

Roger Gadsby, Anthony M Barnie-Adshead and Carol Jagger, 'A
prospective study of nausea and vomiting during pregnancy'. Br. J.Gen.
Pract., 1993, 43: 245-8, p. 246.

Ann Jarnfelt-Samsoie, G Samsoie, G M Velinder, 'Nausea and Vomiting in
pregnancyoea contribution to its epidemiology. Gynecol Obstet Invest,
1983, 16:221-9.

Masoa Mori, Nobuyoki Amino, Haruo Tamaki, Kiyoshi Miyai and Osamu
Tanizawa, 'Morning sickness and thyroid function in normal pregnancy',
Obstet Gynecol, 1988, 72:355-9.

Beverly O'Brien, and Sarah Naber, 'Nausea and vomiting during
pregnancy: effects on the quality of women's lives', Birth, 1992,
19:138-43.

Michael R Soules, Claude L Hughes Jr., Jose A Garcia, C H.Livengood,
Michael R Prystowsky and Eben Alexander, 'Nausea and vomiting of
pregnancy: role of human chorionic gonadotropin and 17-
hydroxyprogesterone', Obstet Gynecol, 1980, 55:696-700.

Forrest D. Tierson, Caroln L. Olsen and Ernest B. Hook, 'Nausea and
vomiting of pregnancy and association with pregnancy outcome', Am J
Obstet Gynecol, 1986, 5:1017-1022.