Saturday, April 25, 2009

Nausea & Vomiting

One of the most common symptoms of pregnancy, nausea and vomiting plagues 80% of all pregnant women. At least you know you're not alone! The good news is that 90% of these women are feeling much better by the midway point in pregnancy; often much sooner with the first trimester being the most affected.

The AAFP (American Academy of Family Practice Physicians) website has a very thorough explanation of this condition.

Some tips to help you get through this:
  • You tend to become most nauseous when your stomach is empty. This is one reason it has been dubbed "morning sickness." You may have heard that it will help to keep some crackers at the bedside to eat before even rising out of bed. This is a tried and true technique. It can be hard to eat regularly when nothing sounds good to you. Try to find a few foods you tolerate and make sure you keep plenty on hand with "on the go" emergency snacks with you too.
  • Especially if you are vomiting, you may become dehydrated so keep some ice chips and/or water handy for sipping. If you are not keeping anything down, you may need extra help with hydration so talk to your doctor in this case. A condition called hyperemesis means "too much vomiting." There are available treatments and we don't want you to get into distress here. Your doctor may prescribe medications and sometimes IV therapy is needed, either on a one-time or ongoing basis.
  • Sea bands or nausea wrist bands are available with boating supplies because they are sometimes helpful when people get sea sickness. Some pharmacies also carry this with their antinausea treatments for motion sickness. This uses accupressure to help decrease nausea and some women find this helpful. It is totally safe, non-pharmacological and uninvasive. What do you have to lose?
  • It is always wise to discuss medication and supplements with your doctor but for years people have used ginger, either in capsule form or herbal teas to reduce nausea.
  • Many doctors are recommending a combination of Pyridoxine (Vitamin B6) and Doxylamine (Unisom). The AAFP says that 25 mg B6 taken orally every eight hours (75 mg per day) is often effective for controlling nausea and vomiting. In these doses, vitamin B6 has not been found to increase the risk of birth defects. A single 25-mg doxylamine tablet taken at night can be used alone or in combination with the B6.
  • If your nausea interferes with your life and is making you miserable your provider may recommend a prescription strength medication. There are several options available such as phenergan or Zofran (now available as a generic and very effective without making you drowsy). These also have not shown increased risk of birth defects. There are several other options also available so talk to your doctor or midwife.
  • If you seem to be spending extra time in looking into the toilet, keeping your bathroom super-clean will help you get through it. If this is tough for you and you don't have someone willing to do it for you, it might be worth it to pay someone to come in for an hour or so each week to make your environment more pleasant as opposed to something that might aggravate the condition!
I have to agree with suggestions from the March of Dimes Blog for how hubby or significant other can be a hero to the mom-to-be: Click here.'s Robin Elise Weiss suggests:

Over the counter medications can be helpful for some women. None of these are approved for use with morning sickness, but with guidance from your doctor or midwife, they may be helpful:

  • Vitamin B6
  • Reflux medications (Pepcid, Zantac)
  • Emetrol
  • Unisom Nighttime Sleep Aid (not the SleepGels) combined with vitamin B6
  • Some herbal substances with the help of your practitioner

There are also prescription drugs that can be useful in helping control nausea and vomiting. These can include:

  • Zofran (expensive, not always covered by insurance)
  • Phenergan (pill and suppository form)
  • Compazine
Medications are not used for the entire pregnancy unless symptoms persist that long. You and your practitioner can talk about what the best plan is for your pregnancy.
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  1. I have terrible all-day sickness, but with the last pregnancy I found something that helped was really dark chocolate. I couldn't stand sweets, which was helpful when I got gestational diabetes, but having the really dark chocolate in my mouth helped with the bad taste in my mouth. I would just take tiny bites and let it slowly melt in my mouth. Try Hershey's special dark or any of the Ghirardelli or Lindt really dark chocolate. I hope that helps.

  2. One of our clients finds it helpful to suck on ice chips continually. Worth a try and might help keep you from getting dehydrated too.

  3. There really are number of ways to achieve morning sickness relief. It's just a matter of finding the right one that your body would respond best.

  4. Acupressure! Every pregnant women should probably try this treatment for morning sickness. All you have to do is press on a certain pressure point on your wrist, or wear a sea sickness band.


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