Morning Sickness

It’s what you don’t want to expect when you’re expecting, but there is help.

While it may be called morning sickness, anyone who’s had the misfortune of suffering through it knows it can strike at any time—morning, noon, or night—and last all day long.

After a bout of it while pregnant with my second child, I was curious about some of the whys and what-to-dos about this condition that can range from a slight annoyance to a downright danger.

First, a little background: It’s estimated that from 50% to 85% of pregnant woman experience morning sickness. Some feel just a little queasy when they wake up, but others are miserable for as long as six to 12 weeks with endless nausea, food and smell aversions, and sometimes vomiting.

A very small number of pregnant women develop hyperemesis gravidarum, a severe form of the condition that requires hospitalization. But for other women, there are some steps that can reduce the misery and ensure adequate nutrition intake.

Understanding a bit about what might cause morning sickness is the key to helping prevent or diminish it. While no one knows for sure why this happens during pregnancy, there are several theories. Among the suspected culprits are an extremely heightened sense of smell, the surge in hormone levels, and an excess of stomach acid. No matter the cause, what can you do to make it better?

• Avoid an empty or overly full stomach: Both an empty stomach and a too full belly can bring on feelings of nausea. The best thing you can do is eat small amounts very frequently—at least six small meals a day.

Start with the old crackers in bed approach. It really can help. Set your alarm to go off a bit earlier than usual so you have time to sit in bed for 20 to 30 minutes after you eat a few saltines, melba toasts, or some other plain, dry crackers. Then, throughout the day, try not to go for more than about two hours without eating, even if you don’t feel hungry. Getting a little something in your stomach may help keep the nausea at bay or at least tame it.

And, on the opposite end of the spectrum, if you’re famished, resist the urge to eat a lot of food at once. Pace yourself, and you’ll be much happier.

• Liquids: With the increasing blood volume that comes with pregnancy, as well as the extra burden on your body, you need fluids, especially if you’ve been vomiting. But don’t overdo it at one time. Your best bet is sipping fluids throughout the day to meet your needs. Guzzling a big drink can have the same effect as stuffing down a big meal—it may be too much for your stomach to handle at once, as can drinking a lot of fluid with your meals. Whether you’re at work, at home, in the car, or somewhere else, keep your beverage of choice close by to remind you to sip it regularly.

• Avoid offending smells: With your nose working overtime, common everyday smells can be enough to send you running to the bathroom. Anything—the coffee brewing in the morning, the guy on the elevator who just worked out, or your favorite roasted garlic chicken—can be a trigger. While some odors are harder to avoid than others, there are a few things you can do. Try preparing more cold than cooked foods, and if you do cook, stick with mild-smelling foods, such as scrambled eggs or plain soups. If you can, enlist someone else in the house to take over kitchen duties for a few weeks and just stay away from the kitchen if possible. Ask your husband and other family members to buy their java on the way to work. Remember, this won’t last forever.

• Other strategies: Be sure to take prenatal vitamins as prescribed by your doctor. If you find that they increase your nausea, ask for a different brand or try taking them at a different time of day. They’re like insurance because they can help regulate an inconsistent nutrient intake caused by the erratic eating habits of morning sickness. You might want to ask your healthcare provider about taking an additional vitamin B12 supplement that could help relieve nausea.

• Dietary tactics: And, finally, the most important part—what to eat. Some foods act as triggers while others may help you feel better. First and foremost, says Kate Geagan, MS, RD, a Utah-based nutrition consultant, “Be prepared to find that your normal eating habits and food cravings may be completely turned upside down. If you’re a sweet-a-holic, for instance, you may suddenly find yourself reaching for the saltiest thing you can find.” Typically carbs such as breads, cereals, and potatoes are favorites of women suffering through morning sickness, and it makes sense. They’re often very mild tasting and smelling, many don’t need cooking, and they’re not acidic.

Fats, especially from greasy or fried foods, can upset your stomach, so go easy on them. Proteins can both help and hurt. Women agree that meat of all kinds—beef, chicken, fish—are nauseating, sometimes even just the sight of it. However, because protein helps give our meals staying power—meaning that it’s digested slowly, helping to keep us full longer—it can help prevent that empty stomach feeling. Other troublemakers may be acidic foods like tomato sauces or orange juice.

And be prepared. Whenever you leave the house, pack helpful foods to bring with you. You’ll be happy to have a bag of peanut butter crackers in your purse when you find yourself stuck in traffic or waiting in a bank line.

You may feel as if there’s nothing you can eat, and it’s probably true that there are many foods that you need to avoid to keep from feeling horrible. But you might be able to maintain a more balanced diet than you think. Since carbs are usually pretty easy to tolerate, Try to focus on getting enough protein, vitamins, and minerals.

Below are a few different food lists. If you can choose at least one that you can tolerate from each column, even if it means eating the same thing for a week straight, then you’re probably not doing too badly. If you find several in each column that you can still enjoy, all the better. These lists are not meant to be all-inclusive. There may be foods listed that you can’t tolerate and foods you can eat that aren’t listed. Everyone is different.

Bottom line—try some new foods, even those you weren’t fond of before, and you may be surprised. And don’t force it. Eating what you used to think of as a balanced meal isn’t going to do you any good if it comes back up a few minutes later. Eat as much variety as possible from the key food lists below and keep in mind that in a few weeks, you’ll be back to your old self. Well, at least your stomach will be.

— Heidi Reichenberger McIndoo, MS, RD, LDN

Protein
Ground beef, in a mild sauce or plain
Tuna
Eggs, scrambled, poached, in egg salad
Peanut butter
Nuts
Cheese
Milk
Yogurt
Beans

Fruits & Veggies (for vitamins, minerals, and fiber)
Raw veggies like carrot or celery sticks, salad, etc.
Apples
Avocado
Watermelon
Raisins
Canned fruits like peaches and pears
Grapes

Carbs
Bread
Cold cereal
Plain rice
Pasta
Baked potato
English muffin
Bagel
Popcorn
Crackers — saltines, graham, etc.

Fluid
Water — cold or room temperature
Ginger ale — helpful both as a fluid, and the ginger may quell nausea
Ice pops
Gelatin