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DEAR MAYO CLINIC: I’m 15 weeks pregnant and have had horrible morning sickness from the beginning of the pregnancy. I’ve lost weight and worry that will affect the baby's health. I didn't experience any morning sickness with my first pregnancy. Is this normal? What can I do to get back to eating while feeling nauseated all the time?
ANSWER: Nausea and vomiting during pregnancy — whether it happens only in the morning or lasts all day — can make you feel bad. It also can be worrisome, especially when it causes weight loss. For most pregnant women, though, morning sickness doesn’t pose a health threat. And it usually goes away as a pregnancy progresses. In the meantime, there are steps you can take to ease morning sickness.
Morning sickness is most common during the first trimester, but it can linger throughout pregnancy. Exactly what causes morning sickness is unknown. It’s likely related to the hormones hCG and estrogen, which are high during pregnancy. As in your situation, it’s not unusual to have different levels of nausea with each pregnancy.
Women who have significant morning sickness often lose weight early in pregnancy. Only in rare circumstances does this cause problems. The nausea usually subsides over time. As that happens, most women are able to catch up and gain a healthy amount of weight by the end of the pregnancy.
Although morning sickness is hard to prevent, you may be able to make it less bothersome. Nausea tends to be worse when your stomach is completely full or empty. So rather than eating three large meals a day, eat smaller amounts more often. You can eat whatever foods appeal to you and don’t cause nausea. Some women find snacking on soda crackers or dry toast can quell feelings of queasiness. Ginger also can help. Try ginger ale, ginger tea or ginger lollipops.
Drink plenty of fluids throughout the day, but don't drink too much at one time. Some women find drinking beverages with a meal makes nausea worse. If so, take in solid foods and liquids separately to see if that helps.
The smell of certain foods, especially during cooking, can be a problem. Avoid those foods if you are preparing meals, and ask someone to help make meals if cooking triggers nausea.
Pay attention to when and how you take your prenatal vitamins. Taking them in the morning can sometimes makes nausea worse. If that's the case for you, try taking them in the evening instead. Taking your vitamins with food also may help. If those changes don’t make a difference, try a vitamin that has low iron or is iron-free until you feel better.
Acupressure and acupuncture seem to reduce morning sickness for some women. Acupuncture involves inserting very fine needles into the skin at strategic points on the body. Acupressure wristbands are available without a prescription in most pharmacies.
If nausea continues, your doctor may suggest over-the-counter medications. Anti-nausea medications and medications to reduce acid production can be useful. A combination of doxylamine succinate, a sleep aid, and vitamin B6 may be recommended to decrease symptoms. If that doesn't work, a prescription medication may help.
A small percentage of women develop serious nausea and vomiting during pregnancy called hyperemesis gravidarum. Women with this disorder often become dehydrated and lose weight. If it isn't treated quickly, hyperemesis gravidarum may require hospitalization. Rarely, it can lead to premature birth or low birth weight.
If you notice symptoms in addition to nausea, such as lightheadedness, dizziness, faintness, a fast heartbeat, or inability to keep food or fluids down for more than 12 hours, contact your health care provider. You may need additional evaluation or treatment.
Keep in mind that, although it’s certainly not a pleasant part of pregnancy, for most women, morning sickness resolves with a combination of self-care and time, and without any lasting problems. — Julie Lamppa, APRN, CNM, OB-GYN, Mayo Clinic, Rochester, Minnesota
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