Patient education: Morning sickness (The Basics)

What is morning sickness? — Morning sickness is the nausea and vomiting (throwing up) that many people have during pregnancy. Symptoms can be mild or severe. Even though it is called "morning" sickness, symptoms can happen any time of day. In fact, most people who have the condition feel sick all day long. Morning sickness usually gets better after the first few months of pregnancy.

Does everyone get morning sickness during pregnancy? — No. But it's very common. As many as 9 out of 10 people feel nauseous early in pregnancy. A smaller number actually throw up.

A very small number of people get very severe nausea and vomiting and lose weight during pregnancy. This is called "hyperemesis gravidarum."

When does morning sickness happen? — That depends on the person and the pregnancy. Symptoms usually start during the first 2 months of pregnancy. They are often worst around the second and third months. Most people feel better by 4 or 5 months, or around the middle of pregnancy. But some people feel bad for much longer.

What causes morning sickness? — Doctors aren't sure why pregnancy sometimes causes nausea and vomiting, or why some people have more nausea and vomiting than others.

Should I see a doctor or nurse? — See your doctor or nurse right away if you:

●Throw up every day or throw up over and over during the day. This is even more of a concern if there is blood in your vomit.

●Are losing weight

●Have pain or cramps in your belly

●Think you have lost too many fluids. This is called "dehydration." Signs include not urinating very much, having dark yellow urine, or feeling dizzy when you stand up.

If you can't keep anything down, you might need to be given fluids through a thin tube that goes into a vein, called an "IV." Plus, you might need to get a medicine to prevent nausea and vomiting.

Is there anything I can do on my own to feel better? — Yes. If your symptoms aren't too serious, here are some things you can try:

●Eat as soon as you feel hungry, or even before you feel hungry

●Snack often and eat small meals – The best foods to eat have lots of protein or carbohydrates, but not a lot of fat. Good choices are crackers, bread, and low-fat yogurt. You should also avoid spicy foods.

●Drink cold, clear beverages that are either fizzy or sour – Good choices are lemonade and ginger ale.

●Suck on ginger-flavored lollipops

●Smell fresh lemon, mint, or orange

●Brush your teeth right after you eat

●Do not lie down right after you eat

●Take your vitamins at bedtime with a snack, not in the morning

●Avoid things that make you feel nauseous – That might include stuffy rooms, strong smells, hot places, loud noises, or not sleeping enough. Try to figure out if some foods and drinks stay down better than others. Avoid foods and drinks that seem to make you feel sick. This is different for different people.

Are there medicines I can take? — Yes. There are medicines that can help with nausea and vomiting. Some are safe to take while pregnant. Talk with your doctor before taking anything.

Medicines that might help include:

●Doxylamine-pyridoxine (brand names: Diclegis, Bonjesta) – This is a prescription medicine that combines 2 ingredients, doxylamine and pyridoxine (vitamin B6).

In some cases, doctors might suggest taking vitamin B6 alone, or with doxylamine. Doxylamine is sold over-the-counter under different brand names.

●Diphenhydramine (sample brand name: Benadryl) – This medicine is similar to doxylamine, and is sold over-the-counter under different brand names. Your doctor might suggest trying it. They can make you sleepy.

●Other medicines – There are other medicines that can sometimes be used if the above don't work. Your doctor can help you figure out what treatments are best for you.

There are also bands that you can wear on your wrists called "acupressure" bands. These bands are supposed to reduce morning or motion sickness. Some people feel better if they wear them.

Can morning sickness be prevented? — Doctors urge anyone who might get pregnant or who is pregnant to take multivitamins. The multivitamin should contain at least 400 micrograms of folic acid. Taking multivitamins before pregnancy and in early pregnancy might decrease nausea and vomiting. The multivitamins also help to prevent certain problems in the developing baby.

Will morning sickness hurt my baby? — Probably not. It is OK to gain weight slowly in the beginning of your pregnancy. Most people should gain between 25 and 35 pounds by the end. Even people with the worst symptoms usually have healthy babies.

More on this topic

Patient education: Pregnancy symptoms (The Basics)
Patient education: Hyperemesis gravidarum (The Basics)
Patient education: Nutrition before and during pregnancy (The Basics)

Patient education: Nausea and vomiting of pregnancy (Beyond the Basics)