Morning Sickness

What is morning sickness?

Morning sickness is nausea or vomiting that usually occurs during the first 20 weeks of pregnancy. More than half of pregnant women have morning sickness during the first trimester. It usually goes away by the second trimester, when the level of pregnancy hormones in your body falls.

When morning sickness is severe it is called hyperemesis gravidarum. If you have severe morning sickness, you will need to go to the hospital to get IV (intravenous) fluids and to have some tests.

How does it occur?

It is not understood why some women develop morning sickness and others do not. Women with high levels of pregnancy hormones tend to have morning sickness and have it in future pregnancies. It is also more common among women who are pregnant with more than one baby (such as twins or triplets).

What are the symptoms?

Mild symptoms include nausea, queasy stomach, and vomiting 1 to 2 times a day.

The symptoms of severe morning sickness include:

• persistent vomiting shortly after eating or drinking anything, including water
• weight loss
• dehydration
• concentrated, dark-colored urine.

How is it diagnosed?

Your health care provider will review your symptoms and may do lab tests of your blood and urine. Your blood may be tested for chemical imbalance. The urine may be examined for concentration and the presence of ketones (a substance that comes from the breakdown of body fat). Your provider may examine you and use more blood tests to rule out other conditions that might cause vomiting.

How is it treated?

Your treatment may include changes in diet and medicines prescribed by your health care provider. If your morning sickness is severe, you may need to go to the hospital for treatment that will stop you from becoming dehydrated.

Mild morning sickness can be relieved by:

• eating foods with no fiber that are high in protein, such as cheese
• eating foods that are bland and dry
• having frequent small meals (4 to 6 times a day) instead of full meals
• eating foods that taste good to you
• eating dry toast or crackers before you get out of bed (movement often makes morning sickness worse)
• eating more foods with vitamin B, such as green, leafy vegetables
• avoiding strong odors and greasy or spicy foods
• drinking salty fluids, such as broth, cola, and Gatorade
• not drinking liquids with meals.

Because you are losing fluids when you throw up, it is important to stay hydrated. Even if liquids stay down just an hour, your body still absorbs a lot. Try sucking on ice chips or Popsicles. Take small sips often rather than drinking a whole glass of fluid all at once. Some women find that drinking small sips of peppermint tea relieves their symptoms.

Check with your health care provider before you use any natural remedies.

Moderate morning sickness may require:

• medicine to reduce nausea and vomiting
• intravenous (IV) fluid treatment to relieve dehydration.

Your health care provider will explain the side effects and risks of any medicine prescribed.

Severe morning sickness may require:

• staying at the hospital
• not eating or drinking anything, then slowly introducing food into your diet
• intravenous fluids to balance the electrolytes in your blood
• an ultrasound exam.

A dietitian can help you plan a way to eat balanced diet. You may also want to talk to a social worker about what kind of help you may need at home.