Nausea and vomiting in pregnancy is one of the most common ‘discomforts of pregnancy’ in the first trimester, but this terminology does not address how disruptive it can be to everyday life! The term ‘morning sickness’ is also misleading, as it can often be all-day sickness.
It is very common – about 60-85% of people will experience nausea in pregnancy and around 40-50% of these will have vomiting to accompany it. It usually starts at around 6 weeks after the first day of your last period.
There are all sorts of theories as to what causes it, but no one really knows why it happens. It is likely to be a combination of endocrine, metabolic, allergic, and psychological/social factors.
Around 60% of people will find it disappears by 10-12 weeks pregnant. Less than 10% of people who experience it will still be consistently nauseous or vomiting by 20 weeks.
Dietary strategies to reduce the impact of nausea and vomiting include:
- small frequent meals and snacks to avoid hunger or blood sugar levels dropping
- avoid fatty or spicy food as these may exacerbate symptoms
- drink fluids between meals not with meals to decrease stomach volume at meal times
- sip drinks throughout the day to prevent dehydration
- sip meal replacements throughout the day
- try different fluids like flat lemonade or diluted fruit juice – these may be easier to keep down than water
- eat low-fat/high-carb foods as these leave the stomach quickly
- eat dry toast or crackers before getting up in the morning
- salty foods may help
- avoid smells/foods that trigger nausea
- try ginger tea, ale or supplements
- acupressure or acupuncture
Around 10% of people may experience persistent nausea and vomiting, and may need to trial medications to help. The first line treatment is not a medicine, but a vitamin supplement – pyridoxine or vitamin B6. If this does not help there are several medications that can be tried.
If the nausea and vomiting is persistent and difficult to deal with, and you struggle to keep any food or fluid down, you may have hyperemesis gravidarum.