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IntroductionIntroductionMore than half of all pregnant women suffer from nauseaand vomiting during their pregnancy. Since each womanis different and each pregnancy is different, the severityof nausea and vomiting of pregnancy (NVP) will vary fromwoman to woman.

What causes NVP?What causes NVP?No one knows exactly what causes the nausea ofpregnancy. Most researchers believe its a combinationof the many physical changes taking place in your bodysuch as the higher levels of hormones during earlypregnancy.

How long willHow long willmorning sickness last?morning sickness last?Nausea and vomiting usually begin around the 6th weekof pregnancy. Although common in the morning, morningsickness can actually happen at any time of the day. For

80% of sufferers, this condition stops around the 12thweek of pregnancy although queasiness can come andgo throughout pregnancy. The other 20% will suffer fromnausea and vomiting for a longer period of time. Somewomen may even have the condition until the end of theirpregnancy.

Most women who suffer from NVP will see their conditioninterfere with usual daily activities. Many will have tochange their daily schedule in some way in order to copewith their condition.

The health effects of nausea andThe health effects of nausea andvomiting of pregnancyvomiting of pregnancyMost cases of nausea and vomiting

in early pregnancy arent harmfulto the mother and her unborn

child. While short-term dietarydeficiencies do not appearto have any harmful effectson pregnancy outcome,severe and persistent NVP

symptoms can affect your

health.

Nausea andNausea andVomiting of PregnancyVomiting of PregnancyFor most women, the feelings of nausea and theepisodes of vomiting decrease at some point during theday so that they feel hungry again and can keep fooddown. However, if you are so sick that you are missingmeals day after day, your baby may not be getting all thedaily nutrients to grow as healthy as he or she can.

What if I justWhat if I justcant keep anything down?cant keep anything down?About 1% of pregnant women in Canada (some 4,000

women per year) will suffer from excessive vomitingin pregnancy called hyperemesis gravidarum. Insuch cases, the lack of food, fluids and nutrients maybe harmful to their health and the well-being of theirbaby. If left untreated, severe cases of NVP can lead todehydration.

Dehydration happens when the body does not haveas many fluids as it should. This may be caused bylosing too many fluids or not drinking enough. Severecases of dehydration may require intravenous fluids andvitamin supplementation from the hospital. Seek medicalattention if you suffer from signs of dehydration such as

infrequent urination or dark yellow urine. NVP can bedifficult to control; the sooner you are diagnosed andbegin treatment, the more likely you will be able to avoidsevere symptoms.

Helpful tips toHelpful tips tocontrol nausea and vomiting:control nausea and vomiting:DIET Food

When you first wake up, eat a few crackers and thenrest for 15 minutes before getting out of bed.

Get up slowly and do not lie down right after eating. Eat small meals or snacks often so your stomach

does not become empty (for example, every 2hours). Try not to skip meals.

Do not hesitate to eat whatever you feel like eatingand eat whenever you want to. However, it is best toavoid cooking or eating spicy, fatty and fried foods.

If cooking odours bother you, open the windows andturn on the stove fan. If possible, ask someone elseto cook the meals.

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Nausea andVomiting ofPregnancyPregnancy

Try eating cold food instead of hot (cold food maynot smell as strong as hot food).

Sniffing lemons or ginger can sometimes relieve anupset stomach.

Eating salty potato chips can help settle the stomachenough to eat a meal.

DIET Drinks

Drink small amounts offluids frequently during theday.

Avoid drinking fluids during meals and immediatelybefore or after a meal.

Food Ideas to Help Relieve Nausea

Salty: Chips, pretzelsTart/Sweet: Pickles, lemonadeEarthy: Brown rice, mushroom soup, peanut butter

Crunchy: Celery sticks, apple slices, nutsBland: Mashed potatoes, gelatin, brothSoft: Bread, noodlesSweet: Cake, sugary cerealsFruity: Fruity popsicles, watermelonLiquid: Juice, seltzer, sparkling water, ginger aleDry: Crackers

LIFESTYLE Rest

Get plenty of rest since nausea tends to worsenwhen a woman is tired. Try napping during the day.Typically, a pregnant woman needs more sleep inthe first three months of pregnancy.

You may need to take some time off work or makeother arrangements for household chores andchildcare.

Enlist the support of friends and family.

LIFESTYLE Other

Get plenty of fresh air and avoid warm places asfeeling hot can add to nausea.

Acupressure wrist bands or acupuncture can bebeneficial for some women. If you are consideringacupuncture, consult your healthcare professionaland look for an experienced and licensedacupuncturist.

Try ginger, an alternative remedy thought to settlethe stomach. Dosages of up to 250 mg four times aday appear to be safe.

Try taking your prenatal vitamins (one with a loweramount of iron if that mineral makes your nauseaworse) with food or just before bed. If multivitaminsmake your nausea worse, take folic acid alone on a

daily basis.

Note: So called natural products are often used underthe assumption that they are safe. However, the safetyand effectiveness of these treatments have not yet been

proven and it is important to note that very few of theseproducts have been properly studied in pregnancy. Askyour healthcare provider before taking herbal remedies.

MedicationsMedicationsAlthough it is generally wise to stay away from over-the-counter medications during pregnancy, there is asafe and effective prescription medication that can helpwomen when nausea and vomiting affect their well-beingand daily activities.

Doxylamine succinate/pyridoxine HCI (Diclectin), acombination of vitamin B6 and an antihistamine calleddoxylamine, is the only medication approved in Canadafor the treatment of nausea and vomiting in pregnancy.Its safety and effectiveness for the treatment of NVP

is recognized by Health Canada. Its safety throughoutpregnancy has been long established and studies haveshown no evidence that harmful effects are experiencedby babies.

If Diclectin does not cure your symptoms, othermedications may be prescribed by your health careprovider.

Who can help you with your NVP?Who can help you with your NVP?If you have NVP and are looking for support andcounselling, you should talk to your healthcare provider.

You may also contact the Motherisk NVP Helpline tollfree at 1-800-436-8477 for ways to deal with morningsickness. For information on the safety and risks ofmedications during pregnancy and breastfeeding,call the Motherisk Program at (416) 813-6780 or visitwww.motherisk.org.

Final thoughtsFinal thoughtsThere are many ways of lessening or eliminating nauseaand there is no reason for women to feel guilty abouttreating these symptoms. Your healthcare provider canhelp you control the nausea and vomiting so that you canhave a pleasant and healthy pregnancy.

Copyright SOGC 2000-2004 - The Society of Obstetricians andGynaecologists of Canada web site provides information on a wide range ofhealth and medical topics. The information contained herein is not intendedto substitute for the advice of a physician, and you are advised always toconsult your doctor for specific information on personal health matters. Unlessotherwise specifically indicated, the naming of any organization, product ortherapy on this site does not imply SOGC endorsement.