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Help for Nausea and Vomiting of Pregnancy
Nausea and vomiting affect up to 85% of women at some point during pregnancy. It’s a good news, bad news kind of thing.
The bad news is, of course, that you’re more or less miserable for a few weeks to a few months. You may lose your appetite entirely, need to severely restrict what you eat in order to keep it down, and even lose a significant amount of weight.
The good news is that once you are out of the 1st trimester the nausea and vomiting usually fade away. It’s also true that pregnancies accompanied by nausea and vomiting usually result in good outcomes, even when the symptoms are severe.
What to do? First, try some simple non-drug remedies:
---Graze rather than eating. Eat small amounts of food very frequently. Try not to allow your stomach to empty completely. Keep some dry crackers next to your bed and eat several before you even lift your head off the pillow. If you wake up at night to urinate, have a quick bite while you’re up. High protein foods that are bland and dry often work best.
---Fluids and solids are sometimes better consumed separately rather than at the same time. This is the only time we recommend drinking colas or ginger ale! For some people, lemonade, diluted fruit juices, seltzer, or sports drinks are helpful.
---If it smells good to you, eat it. If not, avoid it for the time being. Don’t worry too much about the balanced pregnancy diet until you feel better.
---Acupressure bands (“Sea-Bands”), sold in drug or marine supply stores, are inexpensive elastic bracelets with a button that you place over the inside of each wrist with the button positioned over the nausea relief point P6. The bands come with diagrams to show you how to apply them.
---Powdered ginger in capsules (250 mg 4 times a day), ginger tea, even ginger ice cream have helped some people.
If necessary, there are medications that you can use---ask your midwife:
---doxylamine and vitamin B6
---anti-nausea drugs such as promethazine (Phenergan), which is available as a tablet or rectal suppository (these may cause drowsiness so use with caution if you must drive, care for children, etc)
---metoclopramide (Reglan) or ondansetron (Zofran) sometimes help a severe case when nothing else has worked.
When the symptoms are not relieved by these measures, intravenous fluids and medication are the next step. A hospital stay is sometimes advisable for these severe cases. Very rarely, the nausea and vomiting persist well beyond the 1st trimester. A pregnant woman in this situation requires a lot of support and understanding from family, caregivers, and sometimes her employer, but it can be managed successfully.
Wilcox SR, Edelman A, Logan JR. Hyperemesis Gravidarum. http://www.emedicine.com/emerg/topic479.htm
Brody, Jane. “Nausea? There’s No Need to Suffer in Silence.” New York Times, 10-24-06.