NAUSEA AND VOMITING IN PREGNANCY
Department of Obstetrics and Gynecology,
Multicare Associates of the Twin Cities

Nausea and vomiting in early pregnancy, though annoying, are actually good signs that everything is going well with your pregnancy. Other good signs are breast tenderness, breast fullness, and easy fatigability. There are several theories concerning the etiology of nausea during early pregnancy, but none are proven. The most likely explanation is that the levels of hormones are changing in your body. Three of these hormones; estrogen, progesterone, and human chorionic gonadotropin (hCG); are the most likely cause. Estrogen and hCG likely stimulate areas in the brain that are responsible for nausea. Progesterone causes the stomach and intestines to relax, which can lead to your stomach being overly full and this can cause nausea. These hormones change rapidly during the first 14 weeks of pregnancy. Afterwards, the levels are more stable and nausea resolves. The most important goal during this period is to stay well hydrated, to keep enough fluid in your body. The following suggestions and recommended diet may provide you some relief during this period.

Suggestions

• Before you get out of bed in the morning eat a dry, starchy food (like crackers, dry unsweetened cereal, a piece of dry bread or toast). Place these food items by your bedside so you do not have to get out of bed with an empty stomach.
• Get up slowly in the morning. Set your alarm earlier to allow yourself extra time in the morning.
• Eat small frequent meals, every two to three hours. Try to eat your food at room temperature. Avoid long periods between meals because this will allow your stomach to become empty and may make nausea worse.
• Drink fluids between meals rather than with meals. This prevents your stomach from becoming to full.
• If nausea develops try a small amount of liquid, preferably one without to much added sugar or fat. Carbonation is fine.
• Avoid fatty foods, like margarine, butter, gravy, and salad dressings.
• Avoid strong spices, season foods lightly.
• Allow plenty of fresh air in the kitchen and house. Strong odors can cause nausea.
• The best foods for you are whatever will stay down. Try to eat dairy products, whole grains, fresh fruits and vegetables.

Recommended Diet

Dairy Foods, four servings

• Allowed: skim milk, low-fat yogurt, cheese, low-fat pudding, ice milk, low-fat ice cream, cottage cheese
• Avoid: one percent, two percent, and whole milk; regular yogurt, pudding, and ice cream


Meats/protein, two to three servings

• Allowed: lean meats, fish or poultry (remove skin), boiled eggs, beans, peas
• Avoid:fatty meat, fish or poultry, fried meat, fried eggs, nuts and peanut butter


Fruits, two to four servings

• Allowed: all fresh, canned, cooked, or frozen fruits without added sugar, include one citrus fruit daily
• Avoid: dried fruits, sugar sweetened fruits and juices
Vegetables, three to five servings

• Allowed: all fresh, canned, cooked, or frozen vegetables without added fats
• Avoid: french fries, potato chips, fried, creamed, or scalloped potatoes, avocados


Starch/breads, 6 to 11 servings

• Allowed: rice, spaghetti, noodles, macaroni, cereals, breads, low-fat crackers, plain popcorn, pretzels
• Avoid: high-fat granola, sugar coated cereals, waffles, pancakes, buttered popcorn


Beverages, 8 to 12 cups

• Allowed: water, skim milk, unsweetened juices, decaffeinated coffee and tea, carbonated water, clear broth, fat-free bouillon
• Avoid: alcohol, caffeine, carbonated pop, sweetened juices

Over the Counter Options

Vitamin B6

• 30 to 75 milligrams a day. This may be combined with doxylamine 10 milligrams (Unisom).
  
  Ginger
  
• Ginger tea 1 gram per day, taken 250 milligrams of ginger powder (250 milligrams is also the amount in a cup of ginger tea) in four divided doses, once after each meal and once at bedtime. You may buy ginger tea bags, or you may buy fresh ginger root and grate it into boiling water.
  
  Seasickness bands
  
• Acupressure using seasickness bands may help some women. The Neiguan pressure point is on the inside of the forearm about three centimeters from the wrist crease and in between the two central tendons of the forearm.

Conclusion

In general you want to avoid fatty foods because fat slows down your digestive system and can lead to delayed emptying of your stomach, causing nausea and vomiting. You should also avoid simple sugars because these are absorbed very rapidly leading to fluctuations in your blood glucose (sugar) level which can cause nausea. If your prenatal vitamin is making you nauseated, try taking it with food, prior to bedtime, or just do not take it until you are feeling better. If you cannot keep fluids down, are always dizzy, faint upon standing, or have not urinated in over 12 hours, please notify your physician.