Also indexed as: Hyperemesis Gravidarum, Nausea (Pregnancy)
Wake up to a new day with less nausea and a greater feeling of
well-being. According to research or other evidence, the following self-care steps may help
make your pregnancy more comfortable:
- Try vitamin B6
- Ease morning sickness by taking 10 to 25 mg three times a day
- Enjoy some ginger
- Reduce nausea and vomiting by taking 1 gram of encapsulated ginger
powder each day
- Fill up on fluids
- Prevent dehydration due to morning sickness by refueling with
fluids
These recommendations are not comprehensive and are not intended to replace
the advice of your doctor or pharmacist. Continue reading the full morning sickness article
for more in-depth, fully-referenced information on medicines, vitamins, herbs, and dietary and
lifestyle changes that may be helpful.
About morning sickness
Morning sickness is the common but poorly understood nausea that frequently accompanies
early pregnancy.
It is generally not serious, although it can be quite unpleasant. Hyperemesis gravidarum is
uncontrollable nausea and vomiting during pregnancy that results in severe dehydration and pH
imbalances in the blood. It is distinct from morning sickness with nausea and vomiting. The
former condition requires treatment by a healthcare professional and, sometimes,
hospitalization. Hyperemesis gravidarum can sometimes result from hyperthyroidism,1
liver disease, kidney infection, pancreatitis, intestinal obstruction, or other
causes—conditions that will not respond to any of the natural substances discussed in
this article.
Product ratings for morning
sickness
What are the symptoms?
Symptoms include nausea, vomiting, fatigue, lightheadedness, and dizziness during the early
stages of pregnancy. Women with morning sickness may be particularly sensitive to certain
odors and foods. However, eating small amounts of a particular food may relieve their
symptoms.
Medical options
No over-the-counter drugs are FDA-approved for treating morning sickness. However, drugs
such as dimenhydrinate (Dramamine), diphenhydramine (Benadryl), and meclizine (Dramamine Less Drowsy Formula) have been
used. Sea-Band, a medical device that applies pressure to the acupuncture point Pericardium 6
(P6), may also benefit people with morning sickness.
Prescription medications used include
prochlorperazine (Compazine), ondansetron (Zofran), meclizine (Antivert), promethazine (Phenergan), and metoclopramide (Reglan).
Healthcare practitioners typically recommend that women with morning sickness drink plenty
of fluids and try to eat whatever they can, regardless of its nutritional value.
Dietary changes that may be helpful
Some doctors recommend that women with morning sickness eat dry crackers upon waking.
Drinking liquids and eating solid foods at separate times may be helpful as well.
In a Harvard University study, women with a high intake of saturated fat (found mainly in meat and
dairy) during the year prior to pregnancy had a much higher risk of severe morning
sickness than did women eating less saturated fat. An increase in saturated fat intake of 15
grams per day (the equivalent of a four-ounce cheeseburger or three cups of whole milk) was associated with a greater than threefold
increase in the risk of developing morning sickness.2
Vitamins that may be helpful
In two double-blind trials, supplementation with vitamin B6 (10 or 25 mg three times per day)
significantly reduced the severity of morning sickness.3 4
Vitamin K and vitamin C, taken together, may provide relief of
symptoms for some women. In one study, 91% of women who took 5 mg of vitamin K and 25 mg of
vitamin C per day reported the complete disappearance of morning sickness within three
days.5 Menadione was removed from the market a number of years ago because of
concerns about potential toxicity. Although some doctors still use a combination of vitamin K1
(the most prevalent form of vitamin K in food) and vitamin C for morning sickness, no studies
on this treatment have been done.
In a preliminary study done in the 1930s, eight women suffering from nausea and vomiting
during the first trimester (13 weeks) of
pregnancy received large amounts of oral
adrenal cortex extract. In most cases, vomiting stopped after three to four
days.6 In a follow-up study, women with nausea and vomiting of pregnancy received
adrenal cortex extract, usually by injection at first, followed by oral administration. More
than 85% of the women were completely relieved of the problem or showed definite
improvement.7 Since no safety data exist for use during pregnancy, adrenal extract
should not be used in these situations unless supervised by a doctor.
Are there any side effects or interactions?
Refer to the individual supplement for information about any side effects or interactions.
Herbs that may be helpful
Ginger is well-known for alleviating nausea
and improving digestion. One gram of encapsulated ginger powder was used in one study to
reduce the severe nausea and vomiting associated with hyperemesis gravidarum.8 This
condition is potentially life-threatening and should only be treated by a qualified healthcare
professional. A review of six double-blind trials concluded that ginger is probably an
effective treatment for nausea and vomiting in pregnancy.9
Because ginger contains some compounds that cause chromosomal mutation in the test tube,
some doctors are concerned about the safety of using ginger during pregnancy. However, the available clinical research,
combined with the fact that ginger is widely used in the diets of many cultures, suggests that
prudent use of ginger for morning sickness is probably safe in amounts up to 1 gram per
day.10
Are there any side effects or interactions?
Refer to the individual herb for information about any side effects or interactions.
Holistic approaches that may be helpful
A controlled trial found that acupuncture
significantly reduced symptoms in women with hyperemesis gravidarum, a severe form of nausea
and vomiting of pregnancy that usually requires hospitalization.11 Treatment
consisted of acupuncture at a single point on the forearm three times daily for two
consecutive days. Acupressure (in which pressure, rather than needles, is used to stimulate
acupuncture points) has also been found in several preliminary trials to be mildly effective
in the treatment of nausea and vomiting of pregnancy.12 13
14
References:1. Chan NN. Thyroid function in hyperemesis gravidarum. Lancet
1999;353:2243 [letter].
2. Signorello LB, Harlow BL, Wang SP, Erick MA. Saturated fat intake and
the risk of severe hyperemesis gravidarum. Am J Epidemiol 1996;143 (11 Suppl):S25
[abstract # 97].
3. Sahakian V, Rouse D, Sipes S, et al. Vitamin B6 is effective therapy
for nausea and vomiting of pregnancy: a randomized, double-blind placebo-controlled study.
Obstet Gynecol 1991;78:33–6.
4. Vutyavanich T, Wongtra-ngan S, Ruangsri R. Pyridoxine for nausea and
vomiting of pregnancy: a randomized, double blind, placebo-controlled trial. Am J Obstet
Gynecol 1995;173:881–4.
5. Merkel RL. The use of menadione bisulfite and ascorbic acid in the
treatment of nausea and vomiting of pregnancy. Am J Obstet Gynecol
1952;64:416–8.
6. Kemp WN. Hyperemesis gravidarum treated as a temporary adrenal cortex
deficiency. Can Med Assoc J 1933;28:389–91.
7. Kemp WN. The vomiting of pregnancy treated as a temporary relative
insufficiency of maternal corticoadrenal function. Med Rec 1934;140:239–41.
8. Fischer-Rasmussen W, Kjaer SK, Dahl C, Asping U. Ginger treatment of
hyperemesis gravidarum. Eur J Obstet Gynecol Reprod Biol 1991;38:19–24.
9. Borrelli F, Capasso R, Aviello G, et al. Effectiveness and safety of
ginger in the treatment of pregnancy-induced nausea and vomiting. Obstet Gynecol
2005;105:849–56.
10. Fulder S, Tenne M. Ginger as an anti-nausea remedy in pregnancy and
the issue of safety. HerbalGram 1996;38:47–50.
11. Carlsson CPO, Axemo P, Bodin A, et al. Manual acupuncture reduces
hyperemesis gravidarum: a placebo-controlled, randomized, single-blind, crossover study. J
Pain Symptom Manage 2000;20:273–9.
12. Stainton MC, Neff EJ. The efficacy of SeaBands for the control of
nausea and vomiting in pregnancy. Health Care Women Int 1994;15:563–75.
13. Belluomini J, Litt RC, Lee KA, Katz M. Acupressure for nausea and
vomiting of pregnancy: a randomized, blinded study. Obstet Gynecol
1994;84:245–8.
14. Hyde E. Acupressure therapy for morning sickness. A controlled
clinical trial. J Nurse Midwifery 1989;34:171–8.