Heather Hilkowitz, MD, OB/GYN: Morning Sickness
Morning Sickness Video Transcript
My name is Heather Hilkowitz. I’m a medical doctor and the type of medicine I practice is general obstetrics and gynecology.
Morning sickness is normal
Well over half of pregnancies deal with some morning sickness to some degree. It really runs a large spectrum. Some women are very lucky and just feel a little bit queasy here and there. Other women have the all-day sickness but most of the time it gets better shortly after that first trimester ends. There can actually be some validity to the old wives’ tale that morning sickness is a reassuring sign for a pregnancy. Typically part of what drives morning sickness are the chemicals associated with pregnancy and the hormone changes associated with pregnancy. If all is going well those pregnancy levels early on are driven higher and higher and lead to that sensation of morning sickness. So there really is some truth to that.
Simple Relief for Morning sickness
The good thing is there a lot of simple measures we can put in place to make this time a lot more comfortable for them. For instance, if they get morning sickness truly in the morning when they first get up, we tell patients to keep something right at your bedside so before you even sit up in the morning eat a couple of small crackers, take a few sips of water. Even something that simple can really help steady the sensation of the morning sickness and the hormones and make the morning go much smoother. Other measures are avoiding drinks that have really strong tastes or extremes of temperature. Keeping the sensory input . . .what you’re putting in your body . . . a little bit on the blander side can really help keep things steady and level as well.
Vitamins and Morning Sickness
When their nausea and vomiting are worse, sometimes they are not able to tolerate a regular pre-natal vitamin which can be distressing for new moms who are trying to best they can for their new baby. It adds to the worry when they can’t get that prenatal vitamin down. One of the options we’ve found as an alternative is finding a children’s vitamin, often a chewable one or a gummy vitamin, look at the back and make sure you are getting at least 800 mg of folic acid. Usually taking two children’s vitamins – either chewable or gummy -- is a good temporary substitute until we can get you through that time period when the nausea and vomiting are better and we can get you back to your prescription prenatal vitamin that has the optimal nutrients in it for your pregnancy.
Severe Morning Sickness
I suffered from morning sickness terribly. Only about 2 percent of the pregnant population will have it to the degree that I ended up with it and in that case there’s a medical term called hyperemesis gravidarum which describes that where as not only do you feel ill and have some morning sickness but it turns out to be an all day sickness that doesn’t go away not even later on in the pregnancy like it’s supposed to. So in these types of cases patients can drop large amounts of weight, their electrolytes can become unbalanced and you worry about not only the mom’s physical health but also the baby. Fortunately in my case it turned out well but it made me particularly cognizant to watch for this in my patients. For people who have really bad morning sickness, some of the foods that seem to be sought out more than others include cheeses; those seem to be tolerated relatively well, whereas a glass of milk or even a glass of water would be the last thing that would make someone comforted. Some string cheese or some strong citrus flavor . . . maybe a lime or a lemon . . . those kinds of thing that we typically would never think of taking a big bite out of a lime but if you’re pregnant and having a lot of trouble with morning sickness, that might be just the ticket to make you feel a little better. If you have really extreme nausea and vomiting, we want to know about that. So absolutely we want you to call us if it’s been even 12 hours of not being able to keep anything down. That’s an absolutely appropriate phone call to your doctor to help get some guidance of what to do next.
Weight Loss Due to Morning Sickness
One of the most common questions in early pregnancy taking care of patients suffering from nausea and vomiting . . . they’re really worried about the couple of pounds they may have lost because of not being able to get the dietary intake they are used to. We all want to reassure our patients that, yes we all think it’s important to follow that weight loss; if it becomes extreme we are going to go down that path and investigate it, however losing a couple of pounds here and there in the first trimester during this period of nausea and vomiting is usually very well tolerated and it’s okay. To impart that to mom, your body is going to do everything it can to support that pregnancy even if it’s at your cost. So, even if you’ve lost a couple of pounds, your baby is going to be okay. We’re going to get you through this and a little bit down the road things are going to feel so much better.