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Making Sense of Morning Sickness

The nausea and vomiting that often accompanies the first trimester of pregnancy may be called “morning sickness,” but the name is misleading; while it’s often worse in the morning, it can arrive at any time of the day and last all day and into the night. Three out of four expectant moms experience some level of morning sickness. It can begin as early as 4 weeks, although six weeks is most common. It typically lasts for eight to ten weeks, and is usually worst in the middle of that period. However, for a small percentage of women, morning sickness can lasts into the second or even third, trimester. If this happens to you, be sure to talk to your provider; prolonged morning sickness can leave you dehydrated and weak, and even keep you from gaining enough weight.

What Causes Morning Sickness?
No one really knows. But it’s probably a combination of factors. For example, both human chorionic gonadotropin (hCG) and estrogen levels rise rapidly early in your pregnancy, usually coinciding with the onset of morning sickness. If you’re expecting twins or higher multiples, your hCG levels will be higher, so your experience could be more severe. As if that weren’t enough, both your sense of smell and your stomach become more sensitive in the first trimester, which can add to your overall queasiness. You may be more predisposed to morning sickness if you experienced it during a previous pregnancy or if it runs in the family, if you suffer from motion sickness or migraines — and if you’re expecting a girl!

Does Morning Sickness Affect My Baby?
Morning sickness can leave you feeling so poorly at times that you begin to wonder if it’s having an effect on your baby. Don’t worry — mild to moderate nausea and occasional vomiting from morning sickness are completely normal and won’t harm your little one. If you can stay hydrated and keep some food down, everything is probably fine, even if you’re not gaining weight right away. Most of the time, your appetite will come back and you’ll begin to gain weight. You should take a prenatal vitamin if you’re not able to eat balanced meals, so that you can be sure you’re getting the nutrients you and baby need. (While severe and prolonged vomiting during pregnancy may be linked to a higher incidence of preterm birth and low birth weight, even women who are hospitalized with severe vomiting but are able to gain at least 15 pounds during their pregnancy have outcomes that are no different from other women.)

Is There Relief From Morning Sickness?
The biggest question most women have when they’re experiencing morning sickness is how to get relief. Fortunately, there are some steps you can take to make it more tolerable. Rather than three big meals, try small meals and frequent snacks throughout the day. Choose high-protein foods and complex carbohydrates, and eat more slowly. Be sure to take your prenatal vitamin with food shortly before bedtime. Take your time getting up in the morning, and have a few crackers right away. Crackers can also help in the middle of the night, so keep some at your bedside. Stay away from foods whose aromas make you feel nauseous; hot foods are often the biggest offenders. Opt for bland choices rather than those that are spicy, fatty or acidic. Have something you can sip on all day long; carbonated beverages are often easiest, and sports drinks can help replace lost electrolytes. Avoid non-food stimuli that trigger your nausea, whether it’s strong perfume, a stuffy room, riding in a car and so on — it’s different for everybody. Fresh air helps, and a nap can work wonders. Anything that takes your mind off how you’re feeling is beneficial. Ginger (as in ginger ale, ginger tea or ginger candies) can help, and so can peppermint. If nothing works, talk with your provider about medication to relieve nausea.

Can Morning Sickness Be More Serious?
In rare cases, an expectant mother may find that she’s unable to keep anything down, including water, juice, food, prenatal vitamins, or medications. That can be a condition called hyperemesis gravidarum, which may need to be treated in the hospital with IV fluids and medications. You should talk to your doctor or midwife if you lose two pounds or more, first experience nausea and vomiting after week nine of your pregnancy, continue to have nausea and vomiting after week twenty, vomit blood, feel dizzy when you stand, have signs of dehydration, abdominal pain, fever, headache or swelling in the front of the neck. Again, this is rare, but always talk to your provider about whatever you’re experiencing.