Morning Sickness

When to Call for Morning Sickness

Home Care Advice

Treating Morning Sickness (Nausea and Vomiting of Pregnancy)

1. What You Should Know:
   • Nausea and vomiting are common during the first 20 weeks of pregnancy. About 4 out of 5 of pregnant women have nausea. About half of pregnant women have vomiting.
   • These symptoms are called morning sickness. For some women the symptoms are worse in the mornings. But for many women these symptoms can occur any time during the day. Thus, a better term for these symptoms is Nausea and Vomiting of Pregnancy (NVP).
   • Pregnant women with vomiting need to stay hydrated. Women who become dehydrated should call or see their doctor.
   • Most women with morning sickness can treat it at home.
   • Here is some care advice that should help. Follow this step-by-step approach.
2. Step 1 - Clear Liquids:
   • Sip small amounts of water, soup broth, or sports-rehydration liquid (Gatorade or Powerade).
   • Other choices: ½ strength flat lemon-lime soda or ginger ale; Pedialyte popsicles
   • Goal: The goal is to drink 6-10 cups (1,000-1,500 mL) per day. You can do this by drinking ½ cup (4 oz, 120 mL) per hour for 12 hours.
3. Step 2 - Diet - Crackers:
   • Starchy foods are most easily handled by the stomach
   • Eat small frequent meals ("grazing throughout the day")
   • Try eating dry crackers or bread before getting out of bed in the morning
   • Try crackers, ginger snap cookies, white bread, white rice, noodles, mashed potatoes, cereal, or apple sauce.
   • Other choices: clear soup with rice or noodles.
4. Step 3 - DIET - Starches, Chicken, Fish:
   • Advance diet as tolerated.
   • Eat small frequent meals. Divide your food into 6 smaller meals per day.
   • Try soups, pasta dishes, mashed or baked potatoes, or rice.
   • Try baked chicken or baked fish.
   • Eat foods that taste good to you
   • Avoid fatty and spicy foods, and foods with strong aromas.
5. Take your Prenatal Multivitamin with Food:
   • Take your prenatal vitamin with food. This may help decrease stomach upset.
   • Some women find taking it at bedtime causes less nausea.
6. Vitamin B6 (Pyridoxine):
   • Has been shown to help reduce symptoms of morning sickness for some women.
   • It is available over-the-counter.
   • Dose: 10-25 mg by mouth two or three times a day. Do not take more than 50 mg a day. Take it with food.
7. Additional Diet Suggestions:
   • Try eating dry crackers or bread before getting out of bed in the morning.
   • Eat small frequent meals ("grazing throughout the day").
   • Eat foods that taste good to you.
   • Avoid fatty and spicy foods, and foods with strong aromas.
8. What to Expect:
   • The symptoms typically start around the 4th-8th week of pregnancy. They get worse until the 11th week.
   • The symptoms then start to get better and usually go away by the 20th week of pregnancy.
   • Morning sickness does not harm the baby and does not cause birth defects. However, it is important to stay hydrated.
9. Call Your Doctor If:
   • Severe vomiting (6 or more times)
   • No urine for more than 12 hours
   • Fever, stomach pain, diarrhea, or vaginal bleeding occur
   • You think you are dehydrated
   • You think you need to be seen
   • You get worse

What to do When Morning Sickness Gets Worse

1. What You Should Know:
   • There is no risk to the baby from morning sickness.
   • However, it is important to stay hydrated.
   • Here is some care advice that should help.
2. Clear Fluids:
   • Drink clear fluids in small amounts for 8 hours.
   • Water or ice chips are often the best source of fluids.
   • Sports-rehydration liquids (Gatorade or Powerade) are also good. Other options include ½ strength flat lemon-lime soda or ginger ale.
   • Sip small amounts often (1 tablespoon every 5 minutes).
   • After 4 hours without vomiting, increase the amount.
3. Solid Foods (After 8 hours without vomiting):
   • Begin eating bland foods after 8 hours without vomiting. Start with foods like saltine crackers, ginger snap cookies, white bread, rice, mashed potatoes, cereal, and apple sauce.
   • As you improve, slowly return to your normal diet in the next 24-48 hours.
4. Avoid Meds:
   • Stop using any over-the-counter medicine for 8 hours. Reason: Some of these can make vomiting worse.
   • Do not take ibuprofen (Motrin, Advil) or aspirin. These medicines (NSAIDs) should not be used when pregnant and can irritate the stomach.
   • Call your doctor if you vomit a needed prescription medicine.
5. Stop Iron Pills:
   • Iron pills are prescribed to prevent and treat anemia.
   • Iron can irritate your stomach. Stop taking iron if you have morning sickness and are vomiting.
   • Your doctor can tell you if and when you should re-start the iron.
6. Sleep: Try to go to sleep (Reason: sleep often empties the stomach and relieves the need to vomit).
7. Call Back If:
   • Unable to keep ANY liquids down (without vomiting) for more than 24 hours
   • No urine for more than 12 hours
   • Fever, stomach pain, diarrhea, or vaginal bleeding occur
   • You think you are dehydrated
   • You think you need to be seen
   • You get worse

Ginger and Acupressure Wrist Bands

1. Ginger:
   • The spice ginger may help lessen nausea and vomiting during pregnancy.
   • Available over the counter as a capsule. The dose is 250 mg by mouth four times a day.
   • Another option is to drink a glass of ginger ale (or ginger tea) as needed.
   • Studies suggest that ginger is probably safe in pregnancy. Talk to your doctor first before using ginger supplements.
2. Acupressure Wrist Bands(e.g., SeaBands or AcuBands):
   • Some people think that acupressure bands decrease nausea and vomiting during pregnancy. However, so far studies have not shown for sure if they help.
   • A button in this elastic wrist band puts pressure over the "Neiguan point". This point is located about 3 fingers above the wrist joint, on the palm side of the wrist.
   • Wrist bands may be worth trying. They cost about $10 and have no known bad side effects.
3. Call Your Doctor If:
   • Severe vomiting (6 or more times)
   • No urine for more than 12 hours
   • Fever, stomach pain, diarrhea, or vaginal bleeding occur
   • You think you are dehydrated
   • You think you need to be seen
   • You get worse

And remember, contact your doctor if you develop any of the 'Call Your Doctor' symptoms.

Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.