Morning Sickness

Nausea and vomiting during pregnancy generally referred as “morning sickness” is a common pregnancy discomfort, some degree of nausea with or without vomiting occurs in 50% to 90% of all pregnancies. It starts around 5-6 weeks after gestation and ends around 16-18 weeks after gestation.

Symptoms include:

• Mild to severe nausea
• Vomiting, gagging
• Food/smell aversion

Severe form of morning sickness is a medical condition called hyperemesis gravidarum affecting 0.3% to 2 % of pregnancies, it can persist well into second trimester and less frequently until birth.

The symptoms include:

• Persistent vomiting, dry heaving
• Weight loss (more than 5% of pregnancy body weight)
• Ketonuria

Etiology: Hormonal changes during pregnancy and increased level of HCG, estrogen and progesterone have been suggested to cause morning sickness.

Risk Factors:
Women with hyperthyroid disorder, psychiatric illness, previous molar pregnancy, pre-existing diabetes, gastrointestinal disorder and Asthma have a higher chance of developing morning sickness during pregnancy.

Treatment of Morning sickness

• Avoid food triggers: women with hyperolfaction (heighten sensitivity to smell), should avoid offending smells (perfume, chemicals, smoke, meat) and tastes.
• For some women brushing teeth can cause gag reflex, in such cases, use low foaming mild minty flavored toothpaste, use child brush.
• Avoid stuffy rooms, heat, humidity, noise, visual and physical motion (flickering lights, driving)
• Avoid hypoglycemia by eating small, regular healthy meals and snacks through out the day (especially when waking up and before going to bed)
• Eat dry and slightly salty food such as crackers toast, pretzels, baked potato (in moderation) and plain pasta (in moderation).
• Avoid sugary foods that will quickly elevate your blood sugar levels; chocolate, cakes, pastries and orange juice, for example and instead consuming the slower releasing carbohydrates such as bread, pasta, rice and potatoes.
• Eat high quality protein such as slighting fruit sweetened yogurt. Snack on dried fruits (moderately), nuts.
• Avoid drinking large amount of plain water since it can cause nausea. It is recommended to sip on lemon/lime water, real ginger ale throughout the day to keep hydrated
• Clear broth, bouillon and miso are other nutritive fluid which can be taken
• Vitamin B6, 10-25 mg three times a day can help with nausea
• Acupuncture: Several studies have shown Acupuncture to be effective for morning sickness, some acupressure points such as P6 can be applied at home to ease nausea between treatments. Treatment focused on harmonizing the Chong mai and descending the stomach qi. Treatments should be at least 1-2 twice a week until symptoms disappear. Common points used are P6, KID21, KID6, KID 27, ST36, REN 12, BL20, LIV3, ST44, ST 40
• Essential oil such as lemon can help ease morning sickness symptoms

Herbs for Morning sickness:

• Ginger is a safe and effective herb to treat morning sickness, dosage of up to 1gr/day is safe and effective in treating both nausea and vomiting
• Peppermint improves digestion after eating, it is also used for esophageal dysmotility and nausea. The smell of essential oil can ease nausea symptoms. Since the volatile oil of peppermint can cross placenta, it is recommended only small account in the form of tea to be consumed.
• Dandelion root: gentle digestive bitter which improves bile flow, relieves nausea and vomiting and improves appetite. If needed it can be taken in tincture form (1-5 drops/day) in water or
  ginger ale.