Nausea in Pregnancy
Nausea is a normal occurrence in pregnancy.
85% of pregnant clients suffer from nausea at some point in their pregnancy.
How long does it last?
Nausea usually starts between 5 and 6 weeks of pregnancy. Nausea usually peaks by 7 weeks. Although common in the morning, “morning sickness” can actually last all day, or be worse in the evening. For 80% of sufferers, nausea gradually lessens until it ceases completely sometime after 12 weeks. The other 20% of sufferers will have nausea for a longer period of time, some even until the end of pregnancy.
Is it dangerous to my baby or me?
Nausea, especially if severe, can be emotionally draining. Many people find that it interferes with usual daily activities, making it necessary to find ways to cope. But the large majority of the time nausea isn’t physically harmful to mom or baby. If you are healthy before you pre-pregnancy, your body and your baby will draw on your nutritional reserves.
What if I can’t keep anything down?
About 1% of clients suffer from incredibly overwhelming nausea and/or excessive vomiting in pregnancy, a condition called “hyperemesis gravidarum.” In such cases, the lack of food, fluids and nutrients may be quite harmful to your health, and eventually the well-being of their baby. This nausea/vomiting needs treatment. Initial treatment usually includes IV fluids to treat the ensuing dehydration which worsens nausea, vomiting and fluid loss. Longer term treatment usually involves various drug prescription.
Nausea Survival Strategies
Low blood sugar
Having low blood sugar can cause or worsen nausea, so eat small, frequent meals.
Carry snacks such as raw almonds (which also minimize heartburn).
When you first wake up, eat a snack, and then rest for 15 minutes before getting out of bed.
Keep a few crackers or bowl of nuts by your bed, so you can keep your blood sugar up by snacking during night when you wake up to go to the bathroom.
Until your nausea decreases, eat according to your cravings – better to eat something than nothing at all
Carbs & Proteins
Eat protein for sustained energy. Try some just before bed to avoid morning nausea.
Go for complex carbs, as refined carbs can quickly cause a blood sugar low.
Some clients find carbs (crackers, dry toast, popcorn, granola bars) more relieving, other prefer proteins (nuts, cheese, peanut butter)
Flavours, Smells, Textures
People may crave certain flavors: salty, sweet, sour. Find what works for you.
Smelling citrus fruit – oranges and lemons – can help. Eating citrus also helps your body to efficiently absorb iron.
Keeping the saliva flowing by sucking on something sour can help
Avoid spicy, fatty and fried foods
Try eating food cold, as it may not smell as strong as when hot. Try popsicles.
Minimize cooking smells.
The smells of coffee and red meat are often triggers.
Fluids
Don’t let dehydration make your nausea worse: try to drink 2 litres of water a day.
Avoid mixing liquid and solid food
Add a dash of sea salt plus a dash of lemon or cranberry juice – all of these help speed digestion
Drinks that lessen nausea count towards your 2 litres: ginger tea, ginger ale, anything bubbly like sparkling water or seltzer
Caffeine counts against your 2 litres, as it causes more dehydration – drink an extra cup of water for every cup of caffeine or ounce of chocolate
Avoid sodas, as the high sugar content will likely make your nausea worse ultimately
Note – commercial sports drinks are full of sugar, often as much as soda
Indigestion
Avoid letting your stomach get fully empty
Don’t take supplements on an empty stomach.
Try digestive teas if indigestion, constipation or diarrhea is associated with your nausea: fennel, mint, chamomile, etc.
Eat foods with natural enzymes and probiotics, like yogurt with live cultures. A probiotic supplement is great for your gastrointestinal health.
Take digestive enzymes at mealtime, such as papain and bromelain.
Try activated charcoal for a “sour” stomach, 2 capsules when nauseous, up to twice a day.
Stress
Physical stress can make nausea worse
Avoid warm places as feeling hot can add to nausea
Increase sleep and rest
Being tired makes nausea worse. Focus on getting more sleep, including napping.
Emotional stress can make nausea worse. And nausea can definitely cause emotional distress!
If your work is stressful, consider taking some time from work, or adjust your work hours, if you can.
Consider seeing a counselor, especially someone who is familiar with helping women navigate the psychological and emotional challenges of serious nausea
Exercise
CO2 buildup in the blood contributes to nausea, but can be reduced with cardiovascular activity like walking and swimming.
Exercise in fresh air seems to be especially helpful.
Vitamins
To help with nausea: 25 mg Vitamin B6 in the morning, 25 mg Vit B6 at lunch, 50 mg Vit B6 in the evening. You can take up to 6 tablets (25mg each) per day.
You can also try Vitamin B6 lollipops.
The iron in daily vitamins can make nausea worse. Take vitamins with food or just before bed. If this doesn’t help, then decrease or stop taking daily vitamins until your nausea is gone. Vitamins are supposed to fill the nutrient gaps in your diet – if you eat worse because of increased nausea, then they are not helping. Continue to take folate alone on a daily basis.
Ginger
Take 250 mg capsules up to four times a day, or 5-6 cups of fluid per day (maximum 1000 mg per day). Try ginger ale, ginger beer, ginger tea, candied ginger or ginger-lemonade.
Aromatherapy
Many essential oils are off-limits in pregnancy. However, smelling lavender and/or citrus essential oils may help. Try putting some in a bath.
Professional Help
Acupuncture
Research has been shown acupuncture to be effective. Look for a practitioner with experience in treating pregnant people.
Counselling
Serious nausea can be a trigger for pregnancy anxiety/depression. Seek Counselling.
Medications
Diclectin is a medication considered safe for treating nausea in pregnancy. It is a combination of Vitamin B6 and an antihistamine. It can have uncomfortable side effects such as dry mouth or sleepiness, so it’s usually only for serious nausea. Ask your midwife for more info and/or a prescription.
There are further medications that may be suitable if Diclectin doesn’t work well enough to control your nausea. Speak to your midwife about these options.
HOME MEDICATIONS & TREATMENT for SEVERE NAUSEA
Please contact your midwife before starting this protocol!
Discontinue all multivitamins/prenatal vitamins and other supplements that contain IRON
Continue with folate (folic acid) only
For five days:
Take DICLECTIN 4x/day
Take GRAVOL 50mg orally or rectally, 30-45 minutes prior to Diclectin, up to 4x/day
RANITIDINE [Zantac] 75mg 2x/day
If constipated – take POLYETHYLENE GLYCOL 30mL powder once daily; alternative is Magnesium
If nausea not controlled after five days:
Increase Diclectin to 6/day
Can go up to 8/day if necessary
If Diclectin not effective after four days at larger doses:
Start also taking METACLOPRAMIDE [Maxeran] 5mg every 8 hrs
Once nausea better controlled, enough to keep food & water down:
Increase fluid intake … usually room temperature water or warm tea is best (digestive teas like mint are helpful)
Take digestive enzymes 10mins before meals
Increase protein intake; eat small regular amounts of food & avoid letting your stomach get empty
Consider taking Vitamin B6 25mg 3x/day
Consider taking GINGER ROOT powder, capsules or extract 250mg 4x/day
Go for Acupuncture
Go for a daily walk - to decrease CO2 buildup in the blood & help liver flush nausea hormones
IF AT ANY POINT YOU CANNOT KEEP FOOD AND FLUID DOWN FOR MORE THAN 12-24HRS, PAGE YOUR MIDWIFE. You will likely need to have rehydration at the hospital.