Whilst nausea and vomiting is an almost normal part of pregnancy, it is unpleasant and in rare cases can lead to serious complications such as dehydration. Sometimes all that is required to improve your symptoms is to make some changes to the way you eat and drink. Sometimes medications are required, and it is important to know which ones you can safely take during pregnancy.
The most important thing is to ensure adequate fluid intake. You should drink at least 2000ml of fluid a day in addition to replacing fluid lost from vomiting. Fluid tends to be best tolerated when it is cold and drunk in frequent small amounts (sips) between meals (this avoids over filling your stomach). If you are drinking enough fluid, you will urinate normal volumes and it should be clear or yellow.
If you aren’t passing much urine or if it is becoming concentrated, this is a sign you are dehydrated. Try to increase the amount you are drinking, or use a sports drink like Powerade (it is easier for your stomach to absorb). If this doesn’t help, or you are unable to keep fluid down, contact either the Mercy Hospital for Women Emergency Department (8458 4000) or page Dr Lenore Ellett on 9387 1000 for advice.
Meals should be eaten slowly and in small amounts every one to two hours. An empty stomach should be avoided, as should an over full stomach. A snack upon waking and before getting up may help.
It’s difficult to be sure what foods are best, however historically simple foods like toast and crackers are most tolerable when nausea is at its worst. Everyone is different, so you might have to experiment. Try avoiding spicy, odorous, high fat, acidic and very sweet foods first and replace with higher protein and salty foods like nuts.
- Blackmore’s Morning Sickness
This contains ginger and vit B6 and should be taken regularly (4 times a day) to suppress your nausea. If you only take it when you have severe nausea, it probably won’t work. If you don’t like the ginger, you could instead take vitamin B6 50mg tablets 4 times a day.
If this doesn’t work by itself, take it with;
- Doxylamine (Restavit)
This is an antihistamine that is sold over the counter at most pharmacies. The dose is one tablet at night and ½-1 tablet in the morning and afternoon. It is a very safe medication in pregnancy. It is mildly sedating in some women, thus you may only be able to take ½ during the day.
If these tablets together don’t work, continue to take them, and add one the following medications that require a prescription
- Metoclopramide (Maxolon) – Category A
- Ondansetron (Zofran) – Category B1
- Promethazine (Phenergan) – Category C
Prochlorperazine (Stemetil) – Category C
When to seek further help
If the above measures are not working and you are still troubled by significant symptoms, you should make an appointment with Lenore in her rooms, call on 8458 4022. You should go to hospital if you are unable to tolerate any fluids or if you are not passing enough urine due to dehydration.
Nausea and vomiting late in the pregnancy can be abnormal, and you should contact your doctor if this occurs.
The vast majority of women’s symptoms resolve by about 13-15 weeks, and at the very least, you can expect symptoms to begin to subside by this stage.