What advice would you give a patient who is experiencing nausea during pregnancy?

Morning sickness can happen any time

The name is a lie. The term “morning sickness” really is misleading. It’s one of the first pregnancy truths experienced by new moms as they learn what to expect while expecting.

In reality, that nauseous, queasy feeling which sometimes leads to vomiting can happen any time of day. It’s just one of the many changes nearly 90 percent of women – including many of my patients – experience during pregnancy, and there’s not much that health care providers can do to predict or prevent it.

Who is likely to develop nausea?

The women most likely to experience nausea during pregnancy are younger and having their first babies. Their mothers also likely had a rough time with morning sickness. It generally starts when women are five to six weeks pregnant and lasts about six weeks, although some lucky women feel nauseous through their entire pregnancy. 

As for what causes the nausea, no one really knows for sure. It could be the body’s response to stress or hormone fluctuations due to pregnancy, the stretching of abdominal walls or the increase in progesterone which slows down gastric motility. There’s a heightened sense of smell which adds to the equation, and it’s also safe to say that women who already suffer from acid reflux are more likely to have severe nausea, vomiting and heartburn.

So what can you do about it? 

While there is no tell-tale cure, I do have a list of recommendations:

1. Eat small, frequent meals throughout the day. Many of us are used to three big meals and some snacks in between, but that is not the game when you are pregnant. Instead, eat tiny meals all day long. I often tell my patients with morning sickness to eat some crackers or raisins before they even get out of bed or into the shower. 
2. Avoid food or smell triggers. If you can’t tolerate a certain taste or smell, get rid of it, and avoid strong smells or spices for a little while. Bland foods – crackers, toast, etc. – are generally best. If you feel like all you can eat is popcorn and string cheese, then eat popcorn and string cheese. Being on a specific diet for a few weeks will not harm your baby.  
3. Separate drinking from eating. Drink something either 30 minutes before or after eating to avoid that really full feeling. When it comes to beverages, clear and carbonated liquids tend to be best.  
4. Try an acupressure band. Worn approximately 3 finger-widths above the wrist, acupressure bands have been known to alleviate nausea. These small bands can be purchased over the counter at many local pharmacies.
5. Eat foods rich in ginger. Many scientific studies have shown that eating ginger can reduce nausea and vomiting in pregnancy. Try things such as ginger ale, ginger tea, ginger snaps or other foods made with ginger.
6. Take prenatal vitamins at night and add B6. Prenatal vitamins can upset your stomach, so take them in the evenings until you feel better. Consider a brand that is coated or chewable and take them with a meal. Some studies link Vitamin B6 to stress reduction and nausea relief, so it won’t hurt to add a little to your vitamin routine. A tip for those who are still trying to become pregnant: Starting a prenatal vitamin before conceiving may make you less likely to have nausea from the vitamin once you are pregnant.

If you can’t tolerate food or water for 24 to 48 hours, or if you lose the ability to urinate, you need to immediately contact your OB/GYN or one of the health care professionals at Methodist Physicians Clinic. 
 

FAQ126

Published: May 2020

Last reviewed: December 2021

Copyright 2022 by the American College of Obstetricians and Gynecologists. All rights reserved. Read copyright and permissions information.

This information is designed as an educational aid for the public. It offers current information and opinions related to women's health. It is not intended as a statement of the standard of care. It does not explain all of the proper treatments or methods of care. It is not a substitute for the advice of a physician. Read ACOG’s complete disclaimer.

Ways to manage morning sickness.

Nausea and vomiting in pregnancy can happen for many reasons. About 65 per cent of pregnant people have nausea and vomiting while pregnant. It often starts at about 4 to 8 weeks of pregnancy and continues to 12 to 16 weeks or more for some.

Although it’s often called “morning sickness”, nausea and vomiting can happen any time of the day or night.

Tips to manage nausea and vomiting

• Get as much rest as you can; being tired can make nausea worse.
• Rinsing your mouth with water or mouthwash can help control unpleasant mouth taste that can make nausea worse.
• Ice chips and popsicles can help reduce the metallic taste in your mouth.
• Grated fresh ginger, ginger syrup or crystallized ginger added into hot water may help reduce your nausea.
• Talk to your doctor about taking just folic acid instead of your prenatal vitamin while you are feeling nauseated. Once you are feeling better, you can go back to taking your prenatal multivitamin.

Foods that may make your nausea worse

• Very sweet foods
• Spicy foods
• Fatty or fried foods
• Hot foods

Avoid strong smelling foods that bother you

• Try eating outside in the fresh air if possible.
• Ask someone else to cook, especially “trigger” foods, hot foods and high smell foods.
• If you have to prepare meals for yourself or others – make food you are able to eat and try to make cold foods that are easy to make.
• A breathable mask can be helpful when you have to be in a place where smells are too strong for you. These masks help to block some of the food smell.
• Smelling lemons or lemon essential oils might help settle the stomach.

Meals and snacks

• Try not to drink fluids with your food. The fluid plus foods adds too much to your stomach and can cause you to vomit.
• Eat when you feel hungry and eat foods that are appealing to you.
• Eat every 2-3 hours (small meal or snack) to keep food in your stomach. An empty stomach can make your nausea worse.
• Eat slowly. Eating too quickly can cause you to eat more than your stomach can handle, which can cause you to vomit.
• After eating, avoid lying down. Keep your body at least semi-upright (greater than 45 degrees) for at least 30 minutes after a meal. This helps the food stay down.

Keep hydrated

Try to get about 8 cups or 2 litres of fluid per day. Sip small amounts of fluid throughout the day. If plain water does not sit well in your stomach try some of these other suggestions:

• Water (add sugar and salt)
• Diluted juice
• Gelatin (Jell-OTM)
• Clear soda (no fizz)
• Popsicles
• Weak tea
• Oral rehydration solutions
• Ice chips
• Broth

Signs you may not be drinking enough fluid

• More thirsty than usual
• Darker urine than usual
• Passing little or no urine in 8 hours
• Dizziness when standing or sitting
• Dry eyes and dry mouth

Foods to eat

Once you have stopped vomiting, eat small amounts of plain, cold or room temperature foods with very little smell, for example:

• Toasted white bread
• Mashed potatoes
• Crackers
• Fruit
• Graham crackers
• White rice
• Plain hot cereal
• Plain white pasta
• Pretzels

Speak to your health care provider

• If you experience vomiting 2-3 times per day.
• If you are vomiting and have a fever.
• If you have pain, bloating or a swollen stomach, and don’t feel better after vomiting.
• If these tips do not relieve any symptoms.
• If you are considering medications to manage your nausea and vomiting.

Nausea and vomiting in pregnancy clinics

We offer clinics that provide care, counselling and education for those experiencing severe nausea and vomiting during their pregnancy.

Speak to your doctor or call the clinic directly to see if these services may be appropriate for you.

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