Articles

Key takeaways

• Morning sickness can happen at any time of day or night.
• Hormonal changes, like GDF-15, are thought to cause pregnancy sickness.
• Eating small, frequent meals and getting rest can help manage nausea.
• Seek medical help for severe symptoms like dehydration or significant weight loss.

What is morning sickness and what causes it?

Nausea and vomiting in pregnancy is often called morning sickness. It is very common in early pregnancy. This sickness can affect you at any time of the day or night. You might even feel sick all day long. It is also known as pregnancy sickness. It is thought that hormonal changes in the first 12 weeks of pregnancy are a likely cause. A hormone called GDF-15 is probably a cause of pregnancy sickness. Levels of GDF-15 rise during pregnancy. This hormone is produced by the placenta and can cause a loss of appetite and nausea. Some people are more sensitive to GDF-15 than others. Research suggests that genetic differences can lead to higher levels of this hormone.

Other hormones, like human chorionic gonadotropin (hCG) and oestrogen, also increase in early pregnancy. These hormones help support the pregnancy, but may also contribute to pregnancy sickness.

You may be more likely to experience morning sickness if:

• You are having twins or more babies.
• You had severe sickness in a previous pregnancy.
• You tend to get motion sickness, like car sickness.
• You have a history of migraine headaches.
• Morning sickness runs in your family.
• You used to feel sick when taking contraceptives containing oestrogen.
• It is your first pregnancy.
• Your body mass index (BMI) is 30 or more.

Strategies for preventing and managing nausea

There are several practical ways to help prevent and manage nausea during pregnancy. Getting plenty of rest is important, as tiredness can make nausea worse. Try to avoid foods or smells that make you feel sick.

Dietary adjustments

Eating small, frequent meals can be helpful. You could try eating six small meals a day instead of three large ones.

Focus on plain foods that are high in carbohydrate and low in fat. Examples include bread, rice, crackers, and pasta.

• Dry snack – Have something like dry toast or a plain biscuit in the morning before you get up.
• Cold foods – Eat cold foods rather than hot ones if the smell of hot meals makes you feel sick.
• Ginger – Foods or drinks containing ginger may help reduce nausea and vomiting, such as ginger biscuits or tea. Always check with your pharmacist before taking ginger supplements.
• Hydration – Drink plenty of fluids like water, sipping them little and often to help prevent vomiting. You can also try sucking peppermints or ice cubes.

Avoid foods with lots of sugar or saturated fats. This includes sweets, chocolate, and red meat.

Lifestyle and other remedies

Rest is crucial, so put your feet up when you can. Keep away from sickness triggers, as certain foods or smells can make you feel sick.

• Acupressure – There is some evidence that putting pressure on your wrist may help, using a special band or pressing with your fingers. Acupressure bands are available in most pharmacies.
• Vitamin B6 – If you are finding it hard to eat, your doctor or midwife may suggest a supplement called vitamin B6 (pyridoxine). However, always speak to them before taking new medicines or supplements.

When to seek medical help

Nausea and vomiting in pregnancy is common. It usually clears up by 16 to 20 weeks of pregnancy. It does not typically put your baby at any increased risk. However, there is a chance of developing a severe form of pregnancy sickness (hyperemesis gravidarum, or HG). Hyperemesis gravidarum is much worse than typical pregnancy nausea and vomiting. It can be serious. This means you might not get enough fluids in your body (dehydration), or enough nutrients from your diet (malnutrition). This condition can be so severe that you might find it impossible to keep any food or drink down.

Symptoms of hyperemesis gravidarum include:

• Prolonged and severe nausea and vomiting.
• Being sick many times a day.
• Being unable to keep food or drink down.
• Weight loss.
• Fatigue.

When to contact a doctor or midwife

You should contact your midwife, GP, or 111 if you are vomiting and have certain symptoms. Getting help early can help you avoid dehydration and weight loss.

Seek medical advice as soon as possible if you:

• Have very dark-coloured urine.
• Have not passed urine in more than 8 hours.
• Are unable to keep food or fluids down for 24 hours.
• Feel very weak, dizzy, or faint when standing up.
• Have pain in your tummy (abdominal pain).
• Have a high temperature.
• Vomit blood.
• Have lost weight.