If you are suffering from nausea and vomiting in pregnancy, you are not alone. It has been estimated the as many as 80% of women deal with nausea in their pregnancy. So what really works?
From both my personal, professional and anecdotal experience with patients, I have found this graduated approach to work most effectively.
Prevention
(you may already be beyond this part, then move ahead)
The best way to prevent nausea and vomiting in pregnancy is to:
1) Avoid Triggers such as: processed & packaged foods, greasy or spicy foods, & personal triggers
2) Skip on the high saturated fat diet like excessive beef, chicken, pork, and excessive dairy
3) One serving a day of non-fat greek yogurt may be helpful and is great source of protein.
4) Change from eating three large meals a day to six small ones
5) Try to maintain a stable blood sugar throughout the day (avoid high sugar snacks)
6) Take your prenatal vitamin(s) in the evening with food
5) Nosh on fruit, vegetables, seeds, popcorn, brown rice, or almonds throughout the day
6) Walk at least 30 min everyday.
Mild Nausea
If you feel nausea only sometimes throughout the day and not everyday, I recommend:
1) See the suggestions from prevention above
2) In addition to your prenatal, take vitamin B6 (25 mg) three times a day an vitamin C (200-500mg) three times a day. Usually three days is enough to see a change. If there isn't a reduction in nausea these vitamins may not help, and can be discontinued. Both are water soluble and are harmless to a mom-to-be. There are several over the counter (OTC) prenatal lozenges and lollipops like B-natal that patients find work well.
3) Ginger - raw ginger root (a small slice the size of a pumpkin seed) may be eaten anytime you feel nauseous. Simply peel, cut and eat. Ginger ale, ginger candies, and commercial ginger teas do not have the same effect.4) One tbs of apple cider vinegar, usually in the morning
5) Anise or Fennel seed tea.
6) At this stage fluids are usually best if drank cold and in small amounts.
7) It remains important to not let the stomach get empty and continue with small frequent meals.
Moderate Nausea
If you are experiencing mild nausea almost every day for a large part of the day, I recommend:
1) The over the counter (OTC) antihistamine Doxylamine combined with vitamin B6 can be effective.
2) Sea-bands are also found in most drugstores.
3) Acupuncture may also be equally effective.
4) Reglan or Zofran may be considered (see below).
Severe Nausea or Hyperemesis Gravidarium
If you are experiencing extreme nausea every day all the time you should consult with your provider. Many providers will prescribe pharmaceuticals: usually reglan or zofran.
Reglan (metoclopramide) is an antiemetic and a pregnancy category B (safe) medication. Reglan is commonly used in the pediatric population. Zofran (ondansetron), another antiemetic is a category B medication. While may women start and can have relief with reglan, zofran (antidotally) is must more effective and brings on much more relief. In cases of hyperemesis gravidarium hospitalization and IV treatments may be necessary. Talk to your provider about these symptoms immediately.
