Pregnancy | March 14, 2018 | Author: Naturopath
Nausea and vomiting in pregnancy is a common complication which can affect up to two thirds of women. While commonly referred to as ‘morning sickness’—these symptoms don’t just occur in the morning but can happen at any time of the day. The first trimester is usually when morning sickness is experienced—with symptoms typically peaking in week 9 and disappearing by week 20. Around 13% of women can be affected for longer.
Hyperemesis gravidarum is a rare, but more serious form of morning sickness which may require hospitalisation. The common naturopathic strategies to help relieve morning sickness include vitamin B6, ginger and peppermint, as well as simple dietary recommendations.
For many women unrelenting morning sickness can have a profound impact on their mood and quality of life. It can prevent them from socialising, looking after other children and working. This can lead to higher levels of psychological stress, including anxiety and depression.
While definitely unpleasant, there may be a positive side to morning sickness. Women who experience these symptoms have a significantly lower risk of miscarriage and congenital abnormalities compared to those who don’t experience nausea and vomiting. Interestingly, morning sickness is more common in women who go on to have a baby girl, possibly due to higher levels of a hormone called hCG.
If the morning sickness is persistent and severe it may be diagnosed as hyperemesis gravidarum. This condition roughly affects .3 to 1.5% of all live births and is more common in multiple pregnancies. Sometimes the vomiting can be so severe that it can lead to weight loss, dehydration and hospitalisation.
Making changes to what and how you eat can make a big difference to how you feel. Common trigger foods or aversions during pregnancy include strong tasting vegetables, caffeinated beverages, alcohol and animal products such as meats, fish, poultry and eggs. Even though some of these foods are considered healthy, it is best to avoid these if they are a trigger for you. Once the morning sickness has subsided you should be able to introduce them back into the diet.
Eating small, frequent meals every 2-3 hours can help to balance blood sugars and take the pressure off the digestive system.
Avoid getting hungry—as this tends to increase nausea.
Even before you get out of bed in the morning try eating some dry crackers or a small snack.
Some women have found eating a high protein snack before bed (such as a hardboiled egg) can help offset nausea in the morning. In fact, it is important to eat a source of protein with each meal as this has been found to reduce nausea, when compared to carbohydrate-rich and fatty foods. Healthy sources of protein include dairy, nuts, seeds, tofu, meat and lentils.
A small amount of fruit juice might help to relieve symptoms quickly but excess amounts of quickly absorbed carbohydrates (such as high glycaemic index foods) may exacerbate the occurrence of nausea and vomiting. Make sure if you eat grains they are wholegrain and avoid sugar and processed foods.
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If you are vomiting during pregnancy it is vital that you maintain adequate fluid intake.You may find liquid-based meals such as smoothies, soups and juices easier to consume.
Stimulants such as tea, coffee and cola should be avoided as well as alcohol.
If you are taking any supplements such as fish oil, iron or a multivitamin, it might be easier to take them later in the day or at a time where you are less likely to experience morning sickness. Certain nutrients can have nausea as a side-effect and fish oil can contribute to this if it induces reflux. Always take supplements after a meal unless you have been advised not to.
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While there are pharmaceutical options to reduce morning sickness, complementary medicines are a safe option to try.
Numerous studies have found vitamin B6 effective in reducing the severity of nausea during pregnancy. The dose usually ranges from 30mg to 100mg daily and a good quality pregnancy multivitamin should have this nutrient in the formulation. It is also possible to take a separate B6 supplement in addition to a pregnancy multivitamin at a separate time. High dose supplementation in the first trimester appears to be safe with no associated side-effects.
Ginger has a long history of use in pregnancy to reduce nausea. Its benefit has been demonstrated more recently in trials where it has been found to be more effective than placebo. One 2014 study discovered that the use of ginger (1g daily for at least 4 days) was associated with an impressive 5-fold likelihood of improvement in nausea and vomiting in early pregnancy.
Ginger can be taken in a variety of different ways— grated fresh and used to make an herbal tea, added to meals or drunk as a syrup or liquid extract. Capsules and tablets can be purchased for ease of use and some formulas can also be found with vitamin B6.
An alternative to ginger is peppermint which also has anti-nausea properties. Although no studies have been conducted on the efficacy and safety of peppermint in nausea and vomiting in pregnancy —peppermint does have a long history of traditional use in this area.
Caution: the essential oil is not recommended for internal use during pregnancy.
Hechtman L (2014). Clinical Naturopathic Medicine. Churchill Livingstone, Australia
Sharifzadeh F, et al. A comparison between the effects of ginger, pyridoxine (vitamin B6) and placebo for the treatment of the first trimester nausea and vomiting of pregnancy (NVP). J Matern Fetal Neonatal Med. 2017 Jul 7:1-6