Morning Sickness - Treatments

Treatments

There is no evidence to demonstrate the effectiveness of home treatments for morning sickness. Suggested treatments typically aim to lessen the symptoms of nausea, rather than attacking the root cause(s) of the nausea. Frequently suggested treatments include:

• If the vomiting/nausea is due to acid reflux, taking an antacid or two before bed may help reduce the stomach acid and prevent morning vomiting.
• If the vomiting/nausea is due to reduced stomach motility then reducing fibre and fat intake may help. (For example, white bread instead of brown bread, well cooked fruits and vegetables instead of raw, avoiding high-fiber foods, removing skins from fruit or vegetables, avoiding fatty meats and high-fat foods.) Also, walking after meals may help to increase stomach motility.
• If the vomiting/nausea is due to acid reflux or reduced stomach motility, eating more small meals during the day (instead of several larger ones) may help. This will also help to keep blood sugar levels more consistent.
• If the vomiting/nausea is due to iron pills (or multivitamins containing iron) a slower-release form or several lower-dose iron pills may help.
• If the vomiting/nausea is due to low blood sugar, avoiding an empty stomach may help (e.g. snacking throughout the day with several smaller meals instead of a few large ones.)
• Folk remedy: Lemons, in particular the smelling of freshly cut lemons.
• Accommodating food cravings and aversions.
• Eating cabbage.
• Ginger, in capsules, tea, ginger ale, or ginger snaps. Safety concerns have been raised in the medical community due to the powerful pharmacological activity of ginger, especially its anticoagulant action.
• Eating dry crackers in the morning. Some women benefit from eating crackers before rising out of bed in the morning. This may be because it helps to absorb the stomach acid.
• Drinking liquids 30 to 45 minutes after eating solid food.
• If liquids are vomited, sucking ice cubes made from water or fruit juice or trying lollipops.
• Sucking on a hard candy seems to help with nausea due to morning sickness.

A doctor may prescribe anti-nausea medications if the expectant mother suffers from dehydration or malnutrition as a result of her morning sickness, a condition known as hyperemesis gravidarum. The type of drug prescribed varies by country.

In the US, Zofran (ondansetron) is the usual drug of choice, though the high cost is prohibitive for some women. As such, popular pregnancy advice books recommend pregnant women suffering from hyperemesis gravidarum ask their doctors about recreating a drug sold in other countries as Diclectin or Debendox by combining vitamin B6 with doxylamine, an anti-histamine found in the sleep aid Unisom Tabs. When all other treatments fail, doctors may consider trying a corticosteroid medication such as methylprednisolone. This medication can be given orally or intravenously. It should not be used before 10 weeks gestation because of a small risk that it could cause a cleft lip or palate in the fetus. Because of possible maternal complications, the medicine should not be used for longer than six weeks.

In the UK, older drugs with which there is a greater experience of use in pregnancy are preferred, with first choice being promethazine otherwise as second choice metoclopramide, or prochlorperazine.

In Canada, Diclectin (a combination of vitamin B6 and doxylamine), has been prescribed for over 30 years. Diclectin is currently being evaluated by the FDA for sale in the US.